Looking through the research lens at the challenges facingmidwives delivering evidence informed antenatal education
Year: 2013

The 'Z' generation of new mothers and fathers are hungryfor instant access to data that can be linked and mapped inseconds and arrive on their hand held mobile, with multimediaresources including video, blogs, YouTube links,Google alerts and online publications. The appetite fortraditional, face to face antenatal education classes may belost if we do not take action now and begin to prepare ourstudent midwives and our midwife educators for this rapidlychanging technological field.Technology based learning may have many advantagesover a traditional educational setting, however, developmentof face to face education has a unique role to play. An expertteacher does not rely on transferring information to novicepupils, instead, as a highly skilled communicator, they havethe ability to facilitate the learners in using the informationto generate their own knowledge.A teacher who can achieve this face to face has the powerto emulate the learning that occurs online where the studentis in control of learning. This teacher will always teach withimpact and will undoubtedly remain in post; he or she maybecome exceptional and may even be highly desirable andsought after.I say this because I wholeheartedly believe we will alwaysvalue the human touch, the personal contact and theinteraction that guides us towards understanding knowledgefor ourselves. For example, we all remember excellentteachers who brought joy to the antenatal classes and keptus totally enthralled as we absorbed their every word andthought about how we could apply their ideas.Women and their partners today want that same expertteaching in their antenatal education sessions and not justonline; a midwife educator who, as an expert, facilitatestheir personal learning and helps them discover what theiroptions are and what is likely to work for them. I can stillremember the breastfeeding antenatal class I attended in1981 where the midwife advised us to toughen up ournipples in preparation for breastfeeding by wearing roughor coarse fabrics without a bra. You have to ask yourselfwhere did this type of information come from and wherewas the evidence to support it? Of course there was no RCTor feasibility or cohort study to support the advice. Themidwife was sharing her lived experience with us and we allbelieved what she had to say was valuable and highly relevantto our planning and preparation for our breastfeedingexperience. There were no online breastfeeding tutorials onYouTube to show you how to breastfeed, or apps to helpyou remind what side you fed on last time. However, thisteacher's approach was successful for many of us and youhave to ask yourself why? Was it the skill of the educatorand her ability to prepare us for a realistic breastfeedingexperience or was it that she cared for us and invested inour success? Maybe it was both.It is important for our new midwives to value bothevidence from the RCTs and what technology has to offerin the application of that evidence. However, midwives, asexperts, must remember that true learning is what happenswhen we support women in their discovery of their differentoptions, and facilitate them in exploring how those optionsmight work for them. It is only when midwives as educatorsachieve this that real evidence based practice can exist. Ourthinking must remain free and we need to view all evidencebasededucation with the women we care for in mind. If wedon't, we will stifle creativity, innovation and women willnot find what works for them and in what circumstances.This is where the internet has one up on face to faceeducation; the internet does not see you or I in a particularsocial class, or with a particular skill set, or as a somebodyor nobody. We are all simply 'users' of a service availableand we all can generate our own knowledge from thedifferent choices we are presented with. The internet is anamazing resource that connects, collects and stores our toptips and remains in the control of women, not midwives orresearchers, who look with the research lens and dismissthat which is not supported by best evidence.The challenge for midwives in the future, however, is tolearn how to harness the power of the internet by being'digitally ready' and 'face to face ready' in equal parts.Women need midwives who have achieved in both skillsets who have equally developed their ability to teachand communicate through both human and technologicalinterfaces. The midwife in the antenatal setting can be eithervirtual or real and the choice should be the woman's as towhich midwife she interacts with and at what point in time.In fact, midwifery education ought to prepare midwives tobe the conduit between the woman and the technology, sothat the information exchange, information analysis andsynthesis are, literally speaking, a natural streaming ofinformation in human or electronic format.I believe the norm for antenatal education of mothersand fathers in the future will be online and face to face,with mothers making the choice of connecting to educationforums, drawing data from repositories, becoming membersof communities of practice, using avatars and attending'good old fashioned face to face classes'.The choice does not have to be technological or face toface,nor should it be. Choice should be blended to meetwomen's needs needs that are met through an evidencebased,technological and midwife to women centred lens.