Unpicking midwives' perspectives on perineal suturing skill acquisition

Unpicking midwives' perspectives on perineal suturing skill acquisition

Perineal suturing, while an essential component of full scope midwifery practice, is not routinely practiced by Australian midwives (Lee et al., 2024). Suturing is a component of midwifery undergraduate education and hospital programs, however this does not translate to a retained skill for many. Evidence suggests that some of the barriers to this are midwives’ confidence in applying the skill, and busy work environments with a lack of available support or effective supervision (Lee et al., 2024). Suturing as a midwifery skill enhances woman-centred continuity of care, alleviates pressure from the medical team, and supports midwives to maintain currency in the prevention and assessment of perineal tears (Abela & Spiteri, 2021; Hammond et al., 2022).
Suturing training focuses largely on technical aspects of perineal repair, and while this is essential knowledge, research suggests that outcomes for women are improved with suturing training that fosters relational care including continuity and respectful, reassuring, and conversational approaches (Hammond et al., 2022). Blended learning packages for students studying suturing results in greater levels of confidence and readiness for practicing suturing in the clinical setting (Brereton et al., 2022). Anecdotally, midwives experienced in hand sewing have reported greater confidence with suturing materials and comfort with adopting the skill. Creative solutions to enhance midwifery confidence and willingness to adopt this key skill are essential. Education and re-education is costly in both time and resources, and systems change facilitating greater support for midwifery suturing skill development are reportedly slow in many facilities.
This facilitated workshop is intended to explore midwives’ perspectives of barriers and enablers to suturing through a hands-on experiential sewing circle. Participants will be provided with fabric, an embroidery hoop, needle and thread. The intention is not to replicate or practice specific suturing techniques, but to use the craft of sewing as a tactile tool for kinaesthetic learning, and through this to share thoughts and insights as they emerge. Conversation prompts will be utilised by providing small groups of four to six midwives with cards asking some basic questions to explore within their group. At the close of the workshop midwives will be welcome to keep their sewing. If the workshop is able to be held close to the start of the festival midwives could continue with this throughout the remainder of the conference. Additional materials will be available for those who require this.
This workshop can be offered as a standalone session, or could be offered as a research workshop within the conference; the difference between these two approaches would be in seeking approval from midwives to participate in the workshop study, the gathering of some basic demographic details from participants, and audio recordings. Specific details relating to study design and ethical considerations will need to be provided separately to this abstract submission if ACM deems that this would be appropriate to consider within the conference.

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