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A woman's hand and a lion's heart: skills and attributes for rural midwifery practice in New Zealand and Scotland.

Gilkison, Andrea; Rankin, Jean; Kensington, Mary; Daellenbach, Rea; Davies, Lorna; Deery, Ruth; Crowther, Susan


Andrea Gilkison

Jean Rankin

Mary Kensington

Rea Daellenbach

Lorna Davies

Ruth Deery

Susan Crowther


Objective:- The complex and challenging nature of rural midwifery is a global issue. New Zealand and Scotland both face similar ongoing challenges in sustaining a rural midwifery workforce, and understanding the best preparation for rural midwifery practice. This study aimed to explore the range of skills, qualities and professional expertise needed for remote and rural midwifery practice. Design:- Online mixed methods: An initial questionnaire via a confidential SurveyMonkey{reg} was circulated to all midwives working with rural women and families in New Zealand and Scotland. A follow-up online discussion forum offered midwives a secure environment to share their views about the specific skills, qualities and challenges and how rural midwifery can be sustained. Data presented were analysed using qualitative descriptive thematic analysis. Setting and participants:- 222 midwives participated in this online study with 145 from New Zealand and 77 from Scotland. Findings:- Underpinning rural midwifery practice is the essence of 'fortitude' which includes having the determination, resilience, and resourcefulness to deal with the many challenges faced in everyday practice and to safeguard midwifery care for women within their rural communities. Key conclusions:- Rural midwives in New Zealand and Scotland who work in rural practice specifically enhance skills such as preparedness, resourcefulness and developing meaningful relationships with women and other colleagues which enables them to safeguard rural birth. Implications for practice:- Findings will inform the preparation of midwives for rural midwifery practice.


GILKISON, A., RANKIN, J., KENSINGTON, M., DAELLENBACH, R., DAVIES, L., DEERY, R. and CROWTHER, S. 2017. A woman's hand and a lion's heart: skills and attributes for rural midwifery practice in New Zealand and Scotland. Midwifery [online], 58, pages 109-116. Available from:

Journal Article Type Article
Acceptance Date Dec 6, 2017
Online Publication Date Dec 19, 2017
Publication Date Mar 31, 2018
Deposit Date Dec 21, 2017
Publicly Available Date Dec 20, 2018
Journal Midwifery
Print ISSN 0266-6138
Electronic ISSN 1532-3099
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 58
Pages 109-116
Keywords Midwifery practice; Midwifery preparation for practice; Rural midwifery; Rural practice
Public URL


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