Connecting Status and Professional Learning: An Analysis of Midwives Career Using the Place© Model

Does the introduction provide sufficient background and include all   relevant references?

Must be improved

The title and abstract have been revised and the introduction has   been further developed. All   changes to the paper in response to both reviewers’ comments are highlighted   in yellow.

Is the research design appropriate?

Must be improved

It is now stated in the abstract that this is an analytical rather   than empirical paper. Also further detail about the Place Model has now been   included under the Origin and Components heading.

Are the methods adequately described?

Not applicable

Not applicable

Are the results clearly presented?

Must be improved

The application of the PLACE model within the context of midwifery   has been further developed and explained.

Are the conclusions supported by the results

Not applicable

Not applicable

Comments and Suggestions for   authors

The PLACE model does not answer the questions posed by the researchers

The title of the paper has been amended.

In the section Origins and Components of the PLACE model should   explain better in what this methodology exists

Further explanation about the PLACE model is now included in this   section.

The bibliographical references are in different citation models

These have been corrected to ensure that all references now conform   to Education Sciences format.

Does the introduction provide sufficient background and include all   relevant references?

Must be improved

The title and abstract have been revised. All changes to the paper in response to both   reviewers’ comments are highlighted in yellow.

Is the research design appropriate?

Must be improved

Further detail about the Place Model has now been included under the   Origin and Components heading.

Are the methods adequately described?

Must be improved

It is now stated in the abstract that this is an analytical rather   than empirical paper and further detail included about the PLACE model as   above.

Are the results clearly presented?

Must be improved

The application of the PLACE model within the context of midwifery   has been further developed and explained.

Are the conclusions supported by the results

Must be improved

The conclusion has been revised.

Comments and Suggestions for authors

The paper has a number of concerning claims and omissions and at   times a patronising tone

I have read the feedback carefully and believe that I have addressed   the ‘concerning claims and omissions’ as pointed out by the reviewer.  The author is a midwife since 1987 and   currently working in academia and in the practice setting undertaking   research and development activity with midwives and service users.

Who is the audience for this work? It would not likely be midwives,   their health professional colleagues or employers who would know the   qualification and scope of midwives. Please comment

The author believes that this paper would be of interest to midwives   working in practice, research and education.

The paper refers to the contested place of midwives, contested by   whom?

Contested has been removed in the editing of the abstract.

The focus of the paper drifts from perspectives of expertise and   professional learning to place within public esteem, to midwifery as a   protected legal function, to no midwife. What is the purpose of the place   model?  Who will use the model and how?

Further explanation is provided about the model generally and each   quadrant specifically.

The full scope of practice of the midwife does not seem to be   understood by the authors, limited only to childbirth and pregnancy in this   paper. This needs to be expanded to antenatal, postnatal care, care of the   neonate, sexual health, fertility and supported by the literature

First paragraph in paper revised to reflect the broader remit of the   midwife, supported by the literature.

The understanding of a normal state of a woman’s body is also not   understood by the authors- on page 3 there is a reference to ‘ a pregnant   woman’s return to normal state after birth’ are the authors suggesting that   being pregnant is not normal?

P3. This has been rephrased to make it clearer that terms such as ‘ a   pregnant woman’s return to normal state after birth’ have been used by   medical colleagues  and midwives have challenged   the use of this terminology for many years (Rothman 1982).

Equally, what is meant by a midwife’ being competent and of good   health and character? P.4.

This has now been clarified under Proto-professionals on page 5.

What is meant by ‘it can be difficult to undertake development   activities’? are the authors suggesting midwives would find it more difficult   than other health professionals? Are the authors suggesting that only   midwives attend these activities in their own time and at their own expense?   These statements need to be supported by evidence from the literature.

This has been further clarified to recognise that this is a challenge   faced by most healthcare professionals.

How has the section of nearly a full page on ‘No Midwife’ including   freebirthing contributed to this paper

The No Midwife relates to the second quadrant of the Place© model.   There is strong evidence that midwives positively impact on the health and   well-being of women and babies (the Lancet Series 2014). However, the   phenomenon of free birthing is growing in high income countries and is   indicative of a lack of women’s trust in maternity care services and fear of   unnecessary interventions  including   care provided by midwives.

P6. There is a paragraph referencing abuse of women in pregnancy and   childbirth without any clear link to how this relates to midwives   professional learning. This needs to be removed or a link needs to be made.

This has been revised to make the link with professional learning.

P7. What is the link with status and ‘ideal type’?

Status has been addressed throughout paper and ‘ideal’ removed

P8 What is meant by an ideal midwife (high status, learned   professional) and also less ideal versions?

Ideal has been removed, see page 10 under ‘the professionals’-with   links to regulation, education and practice.

Why would authors think any health professional would think being a   midwife is ‘based on reality TV or dramatization which tend to have a rose tinted   hue?

In the UK, there is some evidence that applications to the midwifery   profession have increased as a result of TV dramas such as ‘Call the Midwife’   (Tiran 2012). However, sentence relating to this on page 8 removed.

P9 What is meant by ‘minimise the fear factor? Who is fearful?

There is evidence that midwives are feeling vulnerable and fearful in   practice particularly when caring and supporting women who have made   unconventional birth choices (Feeley et al, 2019;Scammell, 2016,; Dahlen 2010).

Question

Comment

Response

Does the introduction provide sufficient background and include all relevant references?

Can be improved

 This section has been revised

Is the research design appropriate?

Can be improved

This section has been revised

Are the methods adequately described?

Can be improved

This section has been revised

Are the results clearly presented?

Can be improved

This section has been revised

Are the conclusions supported by the results

Can be improved

This section has been revised

Comments and Suggestions for authors

This paper could be an interesting contribution to the field but it has numerous problems with sentence flow, punctuation and most significantly, clarity.  

Thanks to the reviewer 3 for their feedback.

All changes to the paper in response to the reviewer’s comments are in tracked changes.

Revisions made throughout the paper to address sentence flow, punctuation and most significantly, clarity.  

It appears to be a survey of the literature, primarily in the UK, using a descriptive analysis model taken from education.  There is an assumption made by the authors, but not convincingly argued in the paper, that midwives can be viewed in terms of status and competency like "teachers".  

Argument has been strengthened throughout paper ( see tracked changes in paper).

I found the paper difficult to follow, not because the analytical model isn't described clearly, but because the arguments made by the authors regarding the profession of midwifery were presented as widely agreed upon conclusions and/or never fully explained to the reader.  While the paper is well cited, the discussion is not well articulated.  

The conclusions about the midwifery profession are drawn from empirical research and regulatory and professional organisations. In the paper, I have strengthened the arguments within the confines of the word count.

More importantly, there is little critical analysis or discussion of how this analysis contributes to the field.  While looking through a new lens is interesting, there is little documentation of how/in what ways the analysis improves our general understanding of the status of midwives or how the analysis could/should be used to improve education/training, research, practice or policy.  

There is further discussion about how this analysis contributes to the field.

I am not sure what the point of the paper is and was confused by the inadequate explanation of the purpose for practice of this paper.  While the model is useful for 'organizing' the literature and what is known about the theory and practice of midwifery, I didn't learn anything new from the paper.

The point of the paper has been further explicated

A revision/rewrite is necessary for the authors to clarify their point of the paper for readers and to refine their presentation so as to be a more comprehensible representation of their argument.  Finally, the authors make conclusions about the literature they cite but do not really explain the points they base their conclusions on nor do they clearly present the reasoning for the conclusions they come to in their own paper.

 There has been a considerable revision of the paper to address the reviewers comments