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

Biography

Margaret Dunlea PhD, M.Sc. Midwifery Education, B.Sc. Anthropology, RM, RGN,RNMH is an Assistant Professor in Midwifery in the School of Nursing and Midwifery, Trinity College Dublin (TCD) (2006-present). She is an experienced midwife with expertise in both hospital and community settings in the UK and Middle East and more recently in Ireland. This has proved invaluable in her current role in Midwifery student education. On returning to Ireland in 1998, she undertook a Masters in Midwifery Education at University College Dublin (2001-2003). She has also completed a B.Sc. in Anthropology in University College London in 1997. Her research activities include undergraduate and postgraduate student research supervision, with a particular interest in all matters concerning maternity care, using qualitative methodologies and informed by critical sociological theories. Her doctoral thesis was an institutional ethnography of change and entrenchment in the Irish maternity services with a particular focus on women's and healthcare provider's lived experience of antenatal care. She believes that all midwife's need to be political and is now actively involved in campaigning for improvements in the Irish maternity services.

Publications and Further Research Outputs

Peer-Reviewed Publications

From "Mastership" to Active Management of Labor: The Culture of Irish Obstetrics and Obstetricians. in, editor(s)Robbie Davis-Floyd and Ashish Premkumar , The Anthropology of Obstetrics and Obstetricians: The Practice, Maintenance, and Reproduction of a Biomedical Profession, Volume II Cognition, Risk, and Responsibility in Obstetrics: Anthropological Analyses and Critiques of Obstetricians' Practices., New York, Berghahn Books., 2022, [Margaret Dunlea] Book Chapter, 2022

Ohaja M., Murphy-Lawless J. Dunlea M., Midwives' views of traditional birth attendants within formal healthcare in Nigeria., Women and Birth , Vol 33, (No. 2), 2020 Journal Article, 2020 URL

Ohaja M., Murphy-Lawless J. Dunlea M., Spiritual and Religious Aspects of Pregnancy and Birth in Nigeria: Women's Perspectives. , Health and Social Care Chaplaincy, Vol. 7, (No. 2), 2019 Journal Article, 2019 DOI

Ohaja M, Murphy Lawless J and Dunlea M., Religion and Spirituality in Pregnancy and Birth: The Views of Birth Practitioners in Southeast Nigeria , Religion , 10, (82), 2019, p1 - 10 Journal Article, 2019 URL

Ohaja M, Murphy-Lawless J & Dunlea M., Birth Space in Nigeria: a site of conflict,, Old Tension, Emerging Paradoxes in Health: Rights, Knowledge and Trust, ISTE Lisbon, Portuga, 6-8 June 2018, 2018 Conference Paper, 2018

Ohaja M, Murphy-Lawless J, Dunlea M., Spiritual and Religious Aspects of Pregnancy and Birth in Nigeria , Spirituality at a Crossroads, Trinity College Dublin , 20-21 June , 2018 Conference Paper, 2018

Ohaja M, Murphy-Lawless J and Dunlea M, Cultural safety: Construction of risk in the context of safe motherhood in Nigeria, Risk in Childbirth In Historical Perspective (AHRC Funded Network), University of Brighton , 06072017, 2017 Conference Paper, 2017

Dunlea M, Murphy-Lawless J, Ohaja M. , The nature and impact of risk discourse in the provision of antenatal care: A literature review, Risks of Childbirth in Historical Perspective (AHRC funded network), University of Leeds , 29th March 2017, 2017 Conference Paper, 2017

Cowman T and Dunlea M, Perineal Repair by Midwives in Ireland: A National Survey of Skills Knowledge and Experience, Normal labour and Birth Conference, Grange over Sands in the English Lake District, 15th to 17th June, 2015 Conference Paper, 2015

Dunlea M, Cowman T, Kelly P., Poster: A national survey identifying the perceived competence and the process of education and training in perineal repair by midwives in Ireland , School of Nursing and Midwifery Trinity College Dublin, Trinity College Dublin , 07.11.2014, 2014 Conference Paper, 2014

Cowman T and Dunlea M., Perineal Repair by Midwives in Ireland: A National Survey of Skills Knowledge and Experience, Optimising Childbirth Across European: An Interdisciplinary Maternity Care Conference , Brussels Belgium, 9 to 10th April 2014, 2014 Conference Paper, 2014

Dunlea M, Brady V, Begley C, Murphy-Lawless J. , An exploration of the meaning of the first antenatal encounter from the perspective of service user and provider. , OPTIMISE2014 Conference: Optimising Childbirth across Europe: An interdisciplinary maternity care conference., Vrije Universiteit Brussel, Belgium, 9 &10 April 2014, 2014, pp53 - 54 Conference Paper, 2014 URL

Ohaja M, Dunlea M and Muldoon K., Group marking and peer assessment during a group poster presentation: The experiences and views of midwifery students, Nurse Education in Practice, 13, (5), 2013, p466 - 470 Journal Article, 2013 DOI

Dunlea M, Brady V, Begley C, Murphy-lawless J, Ethnography of antenatal encounters: research ethics challenges, Trinity College Dublin Research Colloquium, School of Nursing and Midwifery TCD, 05.11.2013, 2013 Meeting Abstract, 2013

Sweetman S, Dunlea M, Biesty L, Brady V, Lawlor D, Andrews L, and Sheaf G., Women's Experiences of Vaginal Examination in Labour: A Meta-Study., The School of Nursing and Midwifery Annual Interdisciplinary, Trinity College Dublin, 09/11/2011, 2011 Oral Presentation, 2011

Dunlea M, Muldoon K and Ohaja M, Midwifery student's experiences of group work when preparing and presenting a poster, AISHE International Conference: The Challenges for Graduates in a Changed World, School of Nursing, Dublin City University, Ireland, 25-26 Aug. , 2011 Meeting Abstract, 2011

Dunlea M, Muldoon K, Ohaja M., An exploratory study of midwifery students' experiences of the use of poster presentation for learning and assessment, 12th Annual Interdisciplinary Research Conference, Transforming Healthcare through Research and Education, School of Nursing and Midwifery Trinity college Dublin, 9 & 10 Nov. , 2011 Meeting Abstract, 2011

M. Dunlea, An Examination of the Relation of Work Empowerment and Level of Reported Autonomy in Midwifery, (RCSI) Annual International Nursing and Midwifery Conference, Royal College of Surgeons in Ireland , February, 2005 Meeting Abstract, 2005

Dunlea M, Do Irish midwives want autonomous midwifery practice. , Coombe Conference International Day of the Midwife, Coombe Women & Infant university hospital Dublin , May , 2005 Meeting Abstract, 2005

Non-Peer-Reviewed Publications

Vivienne Brady, Ashamole Clive, Deirdre Daly, Margaret Dunlea, Louise Gallagher, Patricia Hughes, Felicity Kalu, Elizabeth Newnham, Colm O'Boyle, Magdalena Ohaja, and Jeannine Webster, 'We need maternity care providers who respect women and who listen to women', The Irish Times, (Jun 2nd ), 2018 Journal Article, 2018

Vivienne Brady, Ashamole Clive, Deirdre Daly, Margaret Dunlea, Louise Gallagher, Patricia Hughes, Felicity Kalu, Elizabeth Newnham, Colm O'Boyle, Magdalena Ohaja, and Jeannine Webster, Readers' blog: Natural birth is not an 'elitist' philosophy, The Irish examiner, (June 8th ), 2018 Journal Article, 2018

Research Expertise

Description

My research interests are 1. The history of and continued development of the midwifery profession 2. Student learning and assessment 3. The provision of evidenced-based, community midwife-led maternity care in the Irish setting. My PhD was an institutional ethnography that focus on change and entrenchment in the Irish maternity services. 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. 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. 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. Crucial to campaigning for change is forging alliances with childbearing women, maternity care activists, politicians, leaders in healthcare, the Department of Health and the HSE, lawyers, and other stakeholders to drive the message of reform and influence maternity policy decision making. This is already happening. So, while I will disseminate my finding in national and international conferences and peer reviewed journals, I will also send a user-friendly and accessible summary of my key findings to our public representatives in the Dail, to childbearing women using maternity care activist groups, antenatal education leaflets and social media platforms, to midwives and doctors using their professional associations, professional journals and conferences. Future research projects will focus on the politics of birth and the implementation of evidence based change with a particular focus on the campaign to develop Birthing Centres/Midwife-Led Units in our 19 maternity hospitals, as recommended in the National Maternity Strategy (HSE 2016). Research into barriers and facilitators for implementing women-centred community midwifery models of care and how best these can be tackled is also required. Research is also needed on how healthcare providers can best protect physiological birth. To this end, with the help of a TCD Stipend and/or HRB funding, I hope to supervise students at Masters and/or PhD level, who want to pursue research in this area. I am to present an oral paper at the RCM/INMO All Ireland Midwifery Conference in November 2022. I have also submitted an abstract to The International Normal Labour and Birth Research Conference due to take place in Denmark in September 2022. I also intend to submit an abstract to the SNM TCD Conference (March 2023) and RCSI (March 2023). A book chapter entitled From "Mastership" to Active Management of Labor: The Culture of Irish Obstetrics and Obstetricians is currently with the printers. I am also currently involved in 3 research undertakings. 1. Midwifery students' experiences of learning during the pandemic. 2. TCD Staff and students' experiences of using the breast feeding rooms on Campus (Athena Swan initiative). 3. Birth partners experiences of using the maternity services during the pandemic: A qualitative evidence synthesis.

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

Keywords

MIDWIFERY; MIDWIFERY EDUCATION; MIDWIVES

Recognition

Representations

Founding member of The Elephant Collective: A national campaign for legislative changes that culminated with the passing into law of the Coroners (Amendment) Act 2019 making all maternal deaths subject to a mandatory public inquest. 2013

Midwifery Associate of Ireland Committee Member 2019

Education Officer of Midwives Section of Irish Nursing and Midwifery Association (INMO) 2022

Membership of the All Ireland Society for Higher Education (AISHE). 2011- 2022

Working Party Member for the National Review of Undergraduate Nursing and Midwifery Degree Programmes (DHC) 2012

Member of Health Forum on Female Genital Mutilation (FGM). 2007-2008

Involvement in Consultancy process: 2007-Review of Maternity and Gynaecology Care Services (KPMG on behalf of NHS) 2007

Awards and Honours

Research Stipend. School of Nursing and Midwifery, Trinity College Dublin 2012

TCD Centre for Academic Practice and eLearning (CAPSL) €500.00 for publication 2011

RCSI 24th Annual International Nursing and Midwifery Conference Greatest Potential Contribution for Nursing/Midwifery/Midwifery Practice 2005

Memberships

Midwifery Association of Ireland (MAI) 2018 – 2022

Nursing and Midwifery Board of Ireland (NMBI) 1998 – present

Irish Nursing and Midwifery Organisation (INMO) 1998 – 2022

All-Ireland Midwifery-led Unit (MLU)/Care Network 2022 – 2022

Trinity Centre for Maternity Care Research 2021 – 2022

INMO representative of the International Conference of Midwives (ICM) - Regional Professional Committees 2022 – 2022