Home birth in Ireland 1993-1997: a review of community midwifery practice

To date little is known about the practices of domiciliary midwives and the outcomes of home birth in Ireland. The purpose of this review is to provide some background information on the situation for women seeking a home birth and to document the outcomes of home births in Ireland between 1993 -1997. Design: Descriptive analysis of prospective data collected from domiciliary midwives regarding women who requested a home birth between 1993 and 1997. Participants: The questionnaire was distributed to 15 domiciliary midwives; this included all the domiciliary midwives known to the authors to be practising in Ireland at that time. Findings: During this period, 585 women planned to give birth in their home with the assistance of midwives, 500 women achieved this. The spontaneous vaginal delivery rate for women who commenced their labour at home was 96.9% (n = 554). These women gave birth without medications or other interventions. 544 (93%) of the women breastfed their babies and 538 (92%) were still breastfeeding at 6 weeks. This is the first review of domiciliary midwifery practice in Ireland in recent years. They obtained data from 11 independent midwives on 585 women who planned home births. Findings showed high rates of spontaneous vaginal delivery and breastfeeding. There were 500 babies born at home with three perinatal deaths, including one undiagnosed breech delivery, one infant with abnormal lungs on post-mortem and one infant with Potter's Syndrome who was stillborn.

Leadership in the community sector: promoting collaboration and social change in Belfast

Community development is centrally concerned with people in communities working together to achieve a common goal, that is, to collaborate, whether within local geographical communities, in communities of shared interests or among groups sharing a common identity. Its overarching goal is one of progressive transformational social change. As Belfast transitions from a conflict to a post-conflict society, there is a need for greater, more effective work at local community level in order to address a range of ongoing social and economic issues facing communities, including high levels of disadvantage and division. Given the significance of leadership in building effective collaboration and the centrality of collaboration for community development, it is important to understand how leadership is currently enacted and what kinds of leadership are required to support communities to collaborate effectively to bring about social change. This thesis thus centers on the kind of leadership practised and required to support collaboration for social change within the community sector in Belfast, a city that contains an estimated 28% of the total number of community and voluntary sector (CVS) organisations in Northern Ireland (Northern Ireland Council for Voluntary Action, 2012). Through a series of qualitative, in-depth interviews with people playing leadership roles in local communities, the study critically explores and analyses their experiences and perceptions in relation to leadership and collaboration. Community development in Belfast today is practised within a wider context of neoliberal policies, characterised by austerity and public spending cuts. Whilst not the only influencing factor, this context has had a particular and profound impact on the nature and role of community development practised, and on the kind of leadership enacted within it. The space for reflection and transformative action appears to be shrinking as the contraction of resources to support community development in local communities continues unabated. Those playing leadership roles increasingly find themselves compelled to spend time seeking resources and managing complex funding arrangements rather than focusing on the social change dimensions of their work. Collaboration as promoted by the state seems to have become an instrumental tactic used to implement its austerity measures and curtail the potential of the community sector. Despite this, local leaders are driving initiatives that attempt to push back, helping the sector refocus on its transformational goals of social change. To do this requires support. Those playing leadership roles require resources, including time, to encourage and enable communities to reconnect with the purpose and underpinning values of community development. Leaders also need support to develop and promote new, progressive narratives and visions and pursue these through building collaboration and solidarity.

From project ontologies to communities of virtue

Projects, as an organizing principle, can provide exciting contexts for innovative work. Thus far, project management discourse has tended to privilege the vital need to deliver projects ‘on time, on budget, and to specification’. In common with the call for papers for this workshop we suggest that perhaps the “instrumental rationality” underpinning this language of characterising project activity may create more problems than it solves. In this paper we suggest that such questions (and language) frame project contexts in a partial way. We argue that such concerns stem from a particular worldview or ontology, which we identify as a ‘being’ ontology. Here we contrast being and becoming project ontologies, to explore the questions, methods and interventions that each foregrounds. In an attempt to move this dialogue further than simply another contrast of modern and postmodernist accounts of project organising, we go on to consider some possible ethical concomitants of valuing being and becoming ontologies in project contexts.