Ms. Margaret Dunlea
Assistant Professor, School of Nursing & Midwifery

Projects

• Title
  • Change and entrenchment in Irish maternity care policies and antenatal practices: An Institutional Ethnography
• Summary
  • I used a critical institutional ethnography with a feminist perspective, framed by Dorothy Smith, drawing on Foucault's critique of power/knowledge. This reflects a critical interpretive ontology and epistemology which assumes that realities are socially constructed, context-specific and relational. How the biomedical model is perpetuated, the broader organizational and institutional processes embedded in power relations that impact its perpetuation, and how this in turn impacts childbearing women's experiences were explored. A central finding was a strong resistance to change from what is currently a dominant, highly interventionist, biomedical model of care, despite mounting evidence supporting alternative models of care. My research findings, therefore, are crucial to a better understanding of why the maternity service are so resistant to change. It is hoped that by raising awareness of my research findings and making these institutional processes, that often remain unknown visible among policy makers, healthcare providers, childbearing women and midwifery students, it may offer a means to successfully bring about whole systems change in the provision of the maternity services in Ireland, at both national policy and legislation level and local practitioner level. Revisions are just completed and dissemination of findings has begun.
• Funding Agency
  • Stipent TCD
• Date From
  • 2012
• Date To
  • 2021

• Title
  • From "Mastership" to Active Management of Labor: The Culture of Irish Obstetrics and Obstetricians
• Summary
  • The book chapter explores why male-oriented authority, widely accepted in 1950s Ireland, continues to dominate the organisation and provision of maternity services today. The authors argue that medical entrenchment of maternity care is linked to the shift from home to hospital birth, and this in turn is linked to the introduction of state-run maternity services with The Maternity and Child Health Services Regulations (1953). Following the legacy of male-orientated authoritative knowledge embedded in 1950s Ireland, the Irish state has continued to fully accepts obstetric authority, as the sole authority on maternity care, despite major changes in the status of women In Ireland. The 1953 Act was operationalised as the Combined Care Scheme (Health Act 1970), and prioritised hospital obstetric care over community midwife/GP based home birth. Publicly funded maternity services continue to limit midwifery autonomy while allowing private obstetric care to flourish within the same complexes of the 19 publicly funded maternity units across the country. The recent call from elite obstetricians in the voluntary hospitals to expand the Mastership governance structures to all maternity hospitals across the country, exemplifies their motivation to protect their vested interests, in the face of alternative models of maternity care emerging, that might challenge their hierarchal position within these state-run institutional structures.
• Date From
  • 2021
• Date To
  • 2022

• Title
  • Survey of staff and students' experiences of breastfeeding facilities in Trinity College University (TCD) Campus
• Summary
  • The Government of Ireland passed a Health and Wellbeing (Workplace Wellbeing) Bill in 2015. Subsequently the Healthy Trinity initiative was commenced, and it was decided to embed health into all aspects of campus culture, across the administration, operations, student and staff services. Trinity is a Breastfeeding Friendly Campus and supports breastfeeding as a normal way to feed babies. Breastfeeding rooms were established across college in 2017. It is now time t evaluate these services. what is proposed is an online survey where participants will receive an email from the Secretary to college (Staff) and the TCDSU (students) with a link to the survey. The research aim is to survey the experiences of staff and students in using breastfeeding facilities on TCD Campus
• Funding Agency
  • no
• Date From
  • 2022
• Date To
  • 2023

• Title
  • VISITING PROFESSORS FUND
• Summary
  • I support the successful application to assist in financing the cost of a visit from Lactation consultant, speaker and creator of innovative breastfeeding education, Nancy Mohrbacher. Her mission is to simplify life for new families, many of whom--without realizing it--make breastfeeding more complicated than it needs to be. Prof Mohrbacher is a leading lactation consultant in the greater Chicago area (USA) with expertise in lactation. In 2008 the International Lactation Consultant Association officially recognized Nancy's contributions to the field of lactation by awarding her the designation FILCA (Fellow of the International Lactation Consultant Association). Nancy Mohrbacher was one of the first group of 16 to be recognized for their lifetime achievements in breastfeeding. She co-authored all three editions of The Breastfeeding Answer Book, a research-based counselling guide that sold more than 130,000 copies internationally. Her 'Natural Breastfeeding Professional Package' provides digital resources for professionals for staff training and one-on-one work with families. What is proposed is a two-day conference Including Public lecture, master class and workshop on laid back breastfeeding and biological nurturing, art exhibition in the long room hub, visit to the Book of Kells. The conference dates will coincide with National Breast feeding week.
• Funding Agency
  • TCD Visiting Professor Fund
• Date From
  • 4/10/2022
• Date To
  • 5/10/2022

• Title
  • Pregnant people's partners or support persons views and experienced of maternity care during COVID-19: a qualitative evidence synthesis
• Summary
  • we are currently in the process of registering our proposed qualitative evidence synthesis. A search strategy will be conducted using PICO and PRISMA research tools. This will be followed with thematic analysis and findings.
• Date From
  • 2022
• Date To
  • 2023

• Title
  • An examination of the relation of work empowerment and level of reported in midwifery practice.
• Summary
  • Findings: Work Empowerment Moderate empowerment levels reported in both groups (mean 11.25, SD=2.38, range 4-20) Midwifery led group consistently scored higher-Consultant led group consistently scored lower. Findings: Formal & Informal power -Informal power rated higher than formal power (mean 3.33 and 2.7, range 1-5) -Collaboration with midwifery managers(mean 2.5) rated significantly lower than doctors (mean .6) and peers (mean 3.6)Findings: Perceived Autonomy Moderate autonomy levels reported in both groups (average mean 3 range 1-5)-Midwifery led group consistently scored higher-Consultant led group consistently scored lower -Years of experience no influence on perceived autonomy.Findings: Desired Autonomy -High desire autonomy levels reported in both groups (mean 25 range 6-30).Findings: Desired Autonomy.-Level of desired responsibility (mean 4.2)= level reported in practice (mean 4.48)-Midwives appeared to want more decision making powers (Mean 4) in comparison to level reported in practice (mean 3.42)Findings: Statistical Significance -Using independent sample t- test-Midwives in the midwifery led service reported statistically significantly higher levels of work empowerment and autonomy in practice compared to midwives in the consultant led group.Findings: Kanter's Hypothesis -Using Pearson correlation coefficient - A strong positive correlation was found between perceived work empowerment and perceived autonomy in practice in both groups
• Funding Agency
  • self funding
• Date From
  • Sept 2001
• Date To
  • June 2003

• Title
  • Member of Health Forum on Female Genital Mutilation (FGM)
• Summary
  • This project was funded by The Office of the Minister for Integration and was carried out in collaboration with The African and Migrant Women's network in Ireland (AKiDwA.) The forum was established in response to the difficulties encountered by a growing number of women with FGM when attending The Irish Maternity Services. I played a key role in the design and publication of an information booklet for health care professionals entitled Female Genital Mutilation. This is now available on CD and has been widely distributed and well received by health care professionals. Also a representation on behalf of this group was made to the Oireactas Committee in an attempt to bring Irish legislation in line with other European countries, where FGM is illegal.
• Funding Agency
  • The Office of the Minister for Integration
• Date From
  • 2007
• Date To
  • 2008

• Title
  • "Women's Experiences of Vaginal Examinations in Labour: A methasynthesis"
• Summary
  • 2010 - Present: The Midwifery Metasynthesis Group (MSMG) In 2010, I attended along with four midwifery colleagues a three day seminar and workshop on Metasynthesis, which was facilitated by Professor Terese Bondas from University of Nordland (Norway). Methasynthesis emerged as a response to the proliferation but relatively underutilisation of the findings of qualitative research (Sandelowski & Barossa 2007). After this seminar, we established a Midwifery Metasynthesis Group in TCD. Working in collaboration with other academic colleagues including a librarian and service user has proved invaluable. This work involved moves beyond synthesis to interpretation and the development of one explanatory theory, model or description (Paterson 2001). "Women's Experiences of Vaginal Examinations in Labour: A methasynthesis", was presented by myself and a service user at a Conference in November 2011. A paper focusing on the process and outcome of this work is currently being prepared for a peer review journal. The work of the MSMG is ongoing.
• Funding Agency
  • self-funded
• Date From
  • 2010
• Date To
  • 2012

• Title
  • 2011-2012 Perineal Repair by Midwives in Ireland: A National Survey:
• Summary
  • My direct involvement in running Perineal Suture Workshops in the Centre of Midwifery Education in the CWIUH has been the impetus for the current proposed study entitled: Perineal Repair by Midwives in Ireland: A National Survey of Skills, Knowledge, Attitude and Experience. We have been struck by the apparent success at implementing perineal repair by midwives in some hospitals as opposed to others, where there continues to be massive resistance to the practice. Ethical approval is being sought in February and the questionnaire will be distributed to all seven maternity units in Ireland by May 2012. I hope to engage an undergraduate student to act as research assistant on this project pending successful application for Health Research Board (HRB) Scholarship.
• Funding Agency
  • self
• Date From
  • 2011
• Date To
  • 2012

• Title
  • 2011-2012 Group Poster Presentation Research
• Summary
  • I led a research team who conducted a study entitled An Exploratory Study of Midwifery Students' Experience of the use of Poster Presentation for Learning and Assessment. Ethic approval was obtained and twelve individual semi-structured interviews were carried out on consenting participants. The overall finding was that poster presentation, as an alternative method of learning and assessment, although highly valued by the majority of students, was not without its difficulties. Some of the positive findings included: acquisition of skills such as communication, delegation and team working. On the other hand group marking proved problematic as it did not always reflect individual contribution and is open to misuse by 'free-riders'. Also students' experiences' of peer marking were fraught with notions of favoritism. It is intended that this study will inform future preparation of students for group work in general and poster presentation in particular. The findings have been presented at two national conferences. We are currently preparing two papers for publication in peer review journals.
• Funding Agency
  • self
• Date From
  • 2011
• Date To
  • 2012

• Title
  • Visiting Professor Fund
• Summary
  • Dr. Barbara Paterson, Thompson Rivers University, School of Nursing, Kamloops, British Columbia, Canada. She has widely acknowledged expertise in Qualitative Research Synthesis. She wrote the book Meta-study of Qualitative Health Research, Sage Publications. She was invited to do a key note address at the TCD School of Nursing and Midwifery Conference in 2008. She also did a workshop on Qualitative Synthesis.
• Funding Agency
  • TCD VPF
• Date From
  • Nov 2008
• Date To
  • 2008