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Predictors of women’s positive childbirth pain experience: Findings from an Icelandic national study
Sigfridur Inga Karlsdottir Herdis Sveinsdottir Hildur Kristjansdottir Thor Aspelund Olof Asta Olafsdottir 《Women and birth : journal of the Australian College of Midwives》2018,31(3):e178-e184
Background
Pain in childbirth has been identified as one of the major components in the childbirth experience and an important topic that needs to be addressed during pregnancy, birth and the after-birth period.Aim
The aim of the study was to describe women’s childbirth pain experience and to identify predictors of women’s positive childbirth pain experience.Method
A population-based cross-sectional cohort study design was implemented, with convenient consecutive sampling, stratified according to residency. Pregnant women were recruited through 26 health care centers. Participants were sent a questionnaire by mail during early pregnancy and another one five to six months after childbirth. A multiple regression analysis was done, with women’s childbirth pain experiences as the dependent variable.Findings
Altogether 726 women participated in the study, with a response rate of 68%. The strongest predictors for women’s positive childbirth pain experience were positive attitude to childbirth during pregnancy; support from midwife during childbirth; use of epidural analgesia and low intensity of pain in childbirth.Discussion
The majority of the women in the study experienced childbirth pain as a positive experience, which is in line with studies that have demonstrated that pain in childbirth is different from other kinds of pain. In addition to epidural use as a predictor for positive childbirth pain experience, many other strong predictors exist and must be acknowledged.Conclusion
When planning pregnancy and childbirth services, predictors of positive experience of childbirth pain should be considered and investigated further. 相似文献3.
Clemence Due Kate Obst Damien W. Riggs Catherine Collins 《Women and birth : journal of the Australian College of Midwives》2018,31(4):331-338
Background
Despite increased awareness of the psychological impact of pregnancy loss, a lack of recognition continues with regards to women’s experiences. Healthcare professionals have an important role to play in supporting women following a pregnancy loss, yet to date only a relatively small body of research has examined women’s experiences with healthcare providers.Aim
This paper seeks to contribute to the literature on women’s engagement with healthcare professionals by exploring the experiences of an Australian sample.Method
Fifteen heterosexual women living in South Australia were interviewed about their experiences of pregnancy loss. A thematic analysis was undertaken, focused on responses to one interview question that explored experiences with healthcare professionals.Findings
Three themes were identified. The first theme involved negative experiences with healthcare providers, and included four subthemes: (1) ‘confusing and inappropriate language and communication’, (2) ‘the hospital environment’, (3) ‘lack of emotional care’, and (4) ‘lack of follow-up care’. Under the second theme of positive experiences, the sub-themes of (1) ‘emotionally-engaged and present individual staff’, and (2) ‘the healthcare system as a whole’ were identified. Finally, a third theme was identified, which focused holistically on the importance of healthcare professionals.Conclusion
The paper concludes by discussing the importance of training for healthcare professionals in supporting women who experience a pregnancy loss, and the need for further research to explore the experiences of other groups of people affected by pregnancy loss. 相似文献4.
Ying Zhao Michelle L. Munro-Kramer Shenxun Shi Jing Wang Xinli Zhu 《Women and birth : journal of the Australian College of Midwives》2018,31(6):e395-e402
Background
Information is needed on the prevalence of depression in Chinese women with medically defined complications across the perinatal period, as well as key risk factors to develop appropriate perinatal mental health services and ensure the services target those most in need.Aim
The goal of this study was to examine whether women’s perinatal depression scores change across the perinatal period and evaluate risk factors associated with postnatal depression at 6-weeks after delivery.Methods
A sample of 167 Chinese pregnant women with medically defined complications and an Edinburgh Postnatal Depression Scale ≥ 9 and/or a Postpartum Depression Screening Scale ≥ 60 were followed throughout early pregnancy (<28 weeks), late pregnancy (>28 weeks), 3-days and 6-weeks after delivery.Findings
Repeated measures analysis of variance showed that there were significant differences on the Edinburgh Postnatal Depression Scale and Postpartum Depression Screening Scale scores at each time point between high-risk depressed and low-risk depressed groups. Binary logistic regression indicated a significant association between postnatal depression at 6-weeks after delivery and depression in late pregnancy and 3-days after delivery, postnatal stress events, postnatal complications, and concerns about the fetus.Conclusions
Postnatal depression is a common condition with limited research among Chinese pregnant women with medically defined complications. Additional research is warranted to develop strategies to identify high-risk depressed pregnant women as well as effective treatment options during the perinatal period. 相似文献5.
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Sara Molgora Valentina Fenaroli Laura Elvira Prino Luca Rollè Cristina Sechi Annamaria Trovato Laura Vismara Barbara Volpi Piera Brustia Loredana Lucarelli Renata Tambelli Emanuela Saita 《Women and birth : journal of the Australian College of Midwives》2018,31(2):117-123
Background
The prevalence of fear of childbirth in pregnant women is described to be about 20–25%, while 6–10% of expectant mothers report a severe fear that impairs their daily activities as well as their ability to cope with labour and childbirth. Research on fear of childbirth risk factors has produced heterogeneous results while being mostly done with expectant mothers from northern Europe, northern America, and Australia.Aims
The present research investigates whether fear of childbirth can be predicted by socio-demographic variables, distressing experiences before pregnancy, medical-obstetric factors and psychological variables with a sample of 426 Italian primiparous pregnant women.Methods
Subjects, recruited between the 34th and 36th week of pregnancy, completed a questionnaire packet that included the Wijma Delivery Expectancy Questionnaire, the Edinburgh Postnatal Depression Scale, the State-Trait Anxiety Inventory, the Dyadic Adjustment Scale, the Multidimensional Scale of Perceived Social Support, as well as demographic and anamnestic information. Fear of childbirth was treated as both a continuous and a dichotomous variable, in order to differentiate expectant mothers as with a severe fear of childbirth.Findings
Results demonstrate that anxiety as well as couple adjustment predicted fear of childbirth when treated as a continuous variable, while clinical depression predicted severe fear of childbirth.Conclusions
Findings support the key role of psychological variables in predicting fear of childbirth. Results suggest the importance of differentiating low levels of fear from intense levels of fear in order to promote adequate support interventions. 相似文献7.
Oluwakemi C. Amodu Bukola Salami Solina Richter 《Women and birth : journal of the Australian College of Midwives》2017,30(5):e258-e263
Background
Obstetric Fistula is a childbirth injury that disproportionately affects women in sub-Saharan Africa. Although poverty plays an important role in perpetuating obstetric fistula, sociocultural practices has a significant influence on susceptibility to the condition.Aim
This paper aims to explore narratives in the literature on obstetric fistula in the context of Hausa ethno-lingual community of Northern Nigeria and the potential role of nurses and midwives in addressing obstetric fistula.Discussion
Three major cultural practices predispose Hausa women to obstetric fistula: early marriages and early child bearing; unskilled birth attendance and female circumcision and sociocultural constraints to healthcare access for women during childbirth. There is a failure to implement the International rights of the girl child in Nigeria which makes early child marriage persist. The Hausa tradition constrains the decision making power of women for seeking health care during childbirth. In addition, there is a shortage of nurses and midwives to provide healthcare service to women during childbirth.Conclusion
To improve health access for women, there is a need to increase political commitment and budget for health human resource distribution to underserved areas in the Hausa community. There is also a need to advance power and voice of women to resist oppressive traditions and to provide them with empowerment opportunities to improve their social status. The practice of traditional birth attendants can be regulated and the primary health care services strengthened. 相似文献8.
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Yael Benyamini Maya Lila Molcho Uzi Dan Miri Gozlan Heidi Preis 《Women and birth : journal of the Australian College of Midwives》2017,30(5):424-430
Problem
Rates of medical interventions in childbirth have greatly increased in the Western world.Background
Women’s attitudes affect their birth choices.Aim
To assess women’s attitudes towards the medicalization of childbirth and their associations with women’s background as well as their fear of birth and planned and unplanned modes of birth.Methods
This longitudinal observational study included 836 parous woman recruited at women’s health centres and natural birth communities in Israel. All women filled in questionnaires about attitudes towards the medicalization of childbirth, fear of birth, and planned birth choices. Women at <28 weeks gestation when filling in the questionnaire were asked to fill in a second one at ～34 weeks. Phone follow-up was conducted ～6 weeks postpartum to assess actual mode of birth.Findings
Attitudes towards medicalization were more positive among younger and less educated women, those who emigrated from the former Soviet Union, and those with a more complicated obstetric background. Baseline attitudes did not differ by parity yet became less positive throughout pregnancy only for primiparae. More positive attitudes were related to greater fear of birth. The attitudes were significantly associated with planned birth choices and predicted emergency caesareans and instrumental births.Discussion
Women form attitudes towards the medicalization of childbirth which may still be open to change during the first pregnancy. More favourable attitudes are related to more medical modes of birth, planned and unplanned.Conclusion
Understanding women’s views of childbirth medicalization may be key to understanding their choices and how they affect labour and birth. 相似文献10.
Helén Wahlbeck Linda J. Kvist Kajsa Landgren 《Women and birth : journal of the Australian College of Midwives》2018,31(4):299-306
Background
Fear of childbirth is a serious problem that can have negative effects on both women and babies and to date treatment options are limited. The aim of this study was to elucidate the experience of undergoing art therapy in women with severe fear of childbirth.Method
Nineteen women residing in Sweden, who had undergone art therapy for severe fear of childbirth, were interviewed during 2011–2013 about their experiences of the treatment. All women had received both support from a specialist team of midwives and treatment by an art therapist who was also a midwife. The women were interviewed three months after giving birth. The transcribed interviews were analysed with a phenomenological hermeneutical method.Findings
A main theme and three themes emerged from the analysis. The main theme was Gaining hope and self confidence. The three themes were; Carrying heavy baggage, Creating images as a catalyst for healing and Gaining new insights and abilities. Through the use of images and colours the women gained access to difficult emotions and the act of painting helped them visualize these emotions and acted as a catalyst for the healing process.Discussion
Art therapy was well accepted by the women. Through sharing their burden of fear by creating visible images, they gained hope and self-confidence in the face of their impending childbirth.Conclusion
The results may contribute to knowledge about the feasibility of treating fear of childbirth by art therapy. 相似文献11.
Sarah E. Bledsoe Cynthia F. Rizo Traci L. Wike Candace Killian-Farrell Julia Wessel Anne-Marie O. Bellows Alison Doernberg 《Women and birth : journal of the Australian College of Midwives》2017,30(5):e248-e257
Problem
Adolescent mothers and their children are at high-risk for depression and the associated negative educational, social, health, and economic outcomes.Background
However, few pregnant adolescent women with depression receive psychiatric services, especially low-income or racial/ethnic minority adolescent women.Aim
This qualitative study explores perceptions of depression, psychiatric services, and barriers to accessing services in a sample of low-income, pregnant racial/ethnic minority adolescent women. Our goal was to better understand the experiences of depression during pregnancy for these vulnerable adolescent women, and thereby improve their engagement and retention in services for perinatal depression.Methods
We recruited 20 pregnant adolescent women who screened positive for depression from 2 public health prenatal clinics in the southeastern United States. Participants were low-income and primarily racial/ethnic minority women between 14 and 20 years old. Data were collected through individual in-depth, ethnographically informed interviews.Findings
Generally, participants lacked experience with psychiatric services and did not recognize their symptoms as depression. However, participants perceived a need for mood improvement and were interested in engaging in services that incorporated their perspective and openly addressed stigma.Discussion
Participants reported practical and psychological barriers to service engagement, but identified few cultural barriers. Family perceptions of psychiatric services served as both a barrier and support.Conclusion
Adolescent women are more likely to engage in psychiatric services if those services reduce practical and psychological barriers, promise relief from the symptoms perceived as most meaningful, and address underlying causes of depression. Culture may affect Latina adolescent women’s perceptions of depression and services. 相似文献12.
Melissa Buultjens Gregory Murphy Priscilla Robinson Jeannette Milgrom Melissa Monfries 《Women and birth : journal of the Australian College of Midwives》2017,30(5):406-414
Background
While the provision of maternity education across the perinatal period can increase the confidence and self-efficacy in childbearing women, there is still thought to be a lack of effective educational resources for parenthood. This study, conducted in Victoria, Australia, investigated women’s experiences of, and attitudes to education communicated in maternity service provision.Methods
189 women were recruited from a variety of settings to participate in a mixed-methods survey about their experiences of perinatal health service education.Findings
Of the sample of childbearing women, 153 (81%) reported attending antenatal classes. Women perceived their antenatal education as beneficial, though many women still felt unprepared beyond labour and birth. With respect to the hospital postnatal stay, findings suggested a variation among the content imparted to women across different Victorian maternity services, (e.g. rural women tended to be more dissatisfied with information received in relation to maternal emotional and physical health). Overall, women wished they had been more informed about breastfeeding and settling techniques, while a lack of information relating to social support initiatives for the postnatal period was also indicated. Women reported that they were missing educational and practical reinforcement of mothercraft skills.Conclusions
There is a need for a reorientation of perinatal health service education. A health promotion approach is suggested as it extends beyond the physical recovery from birth to encompass psychosocial factors; including perinatal morbidities that can disrupt the quality and experience of the transition to parenthood. 相似文献13.
Diana Jefferies Debbie Horsfall Virginia Schmied 《Women and birth : journal of the Australian College of Midwives》2017,30(1):e24-e31
Problem
Often, there is a sense of shock and disbelief when a mother murders her child.Background
Yet, literary texts (plays, poems and novels) contain depictions of women experiencing mental illness or feelings of desperation after childbirth who murder their children.Aim
To further understand why a woman may harm her child we examine seven literary texts ranging in time and place from fifth century BCE Greece to twenty-first century Australia.Methods
A textual analysis approach examined how the author positioned the woman in the text, how other characters in the text reacted to the woman before, during, and after the mental illness or infanticide, and how the literary or historical critical literature sees the woman.Findings
Three important points about the woman's experience were revealed: she is represented as morally ambiguous and becomes marginalised and isolated; she is depicted as murdering or abandoning her child because she is experiencing mental illness and/or she is living in desperate circumstances; and she believes there is no other option.Conclusion
Literary texts can shed light on socio-psychological struggles women experience and can be used to stimulate discussion by healthcare professionals about the development of preventative or early intervention strategies to identify women at risk. 相似文献14.
Sigridur Sia Jonsdottir Marga Thome Thora Steingrimsdottir Linda Bara Lydsdottir Jon Fridrik Sigurdsson Halldora Olafsdottir Katarina Swahnberg 《Women and birth : journal of the Australian College of Midwives》2017,30(1):e46-e55
Background
It is inferred that perinatal distress has adverse effects on the prospective mother and the health of the foetus/infant. More knowledge is needed to identify which symptoms of perinatal distress should be assessed during pregnancy and to shed light on the impact of women’s satisfaction with their partner relationship on perinatal distress.Aim
The current study aimed to generate knowledge about the association of the partner relationship and social support when women are dealing with perinatal distress expressed by symptoms of depression, anxiety and stress.Methods
A structured interview was conducted with 562 Icelandic women who were screened three times during pregnancy with the Edinburgh Depression Scale and the Depression, Anxiety, Stress Scale. Of these, 360 had symptoms of distress and 202 belonged to a non-distress group. The women answered the Multidimensional Scale of Perceived Social Support and the Dyadic Adjustment Scale. The study had a multicentre prospective design allowing for exploration of association with perinatal distress.Findings
Women who were dissatisfied in their partner relationship were four times more likely to experience perinatal distress. Women with perinatal distress scored highest on the DASS Stress Subscale and the second highest scores were found on the Anxiety Subscale.Conclusion
Satisfaction in partner relationship is related to perinatal distress and needs to be assessed when health care professionals take care of distressed pregnant women, her partner and her family. Assessment of stress and anxiety should be included in the evaluation of perinatal distress, along with symptoms of depression. 相似文献15.
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Ingegerd Hildingsson Helen Haines Annika Karlström Astrid Nystedt 《Women and birth : journal of the Australian College of Midwives》2017,30(5):e242-e247
Background
The prevalence of fear of birth has been estimated between 8–30%, but there is considerable heterogeneity in research design, definitions, measurement tools used and populations. There are some inconclusive findings about the stability of childbirth fear.Aim
to assess the prevalence and characteristics of women presenting with scores ≥60 on FOBS-The Fear of Birth Scale, in mid and late pregnancy, and to study change in fear of birth and associated factors.Methods
A prospective longitudinal cohort study of a one-year cohort of 1212 pregnant women from a northern part of Sweden, recruited in mid pregnancy and followed up in late pregnancy. Fear of birth was assessed using FOBS-The fear of birth scale, with the cut off at ≥60.Findings
The prevalence of fear of birth was 22% in mid pregnancy and 19% in late pregnancy, a statistically significant decrease. Different patterns were found where some women presented with increased fear and some with decreased fear. The women who experienced more fear or less fear later in pregnancy could not be differentiated by background factors.Conclusions
More research is needed to explore factors important to reduce fear of childbirth and the optimal time to measure it. 相似文献17.
Ikuyo Torigoe Allison Shorten 《Women and birth : journal of the Australian College of Midwives》2018,31(1):e9-e19
Background
Opportunities for women and providers to use decision aids and share decisions about birth after caesarean in practice are currently limited in Japan. This is despite known benefits of decision aids to support value-sensitive healthcare decisions.Aim
To explore Japanese women’s decision making experiences using a decision aid program for birth choices after caesarean.Methods
A mixed methods study was conducted among 33 consenting pregnant women with previous caesarean in five obstetrics institutions located in the western part of Japan. Outcome measures included change in level of decisional conflict, change in knowledge, and preference for birth method. Semi-structured interviews examined women’s decision making experiences, and qualitative data were analyzed using thematic analysis.Findings
The participants in the program experienced a statistically significant improvement in knowledge and reduction in decisional conflict about birth after caesarean. Four themes were identified in the qualitative data related to decision making: change in women’s knowledge about birth choices, clarifying women’s birth preference, feelings about shared decision making, and contrasting feelings after receiving information.Discussion
This study confirmed potential benefits of using the decision aid program. However, uncertainty about mode of birth continued for some women immediately prior to the birth. This finding emphasized the need to identify additional ways to support women emotionally throughout the process of decision making about birth after caesarean.Conclusions
It was feasible to adapt the decision aid for use in clinical practice. Future research is necessary to examine its effectiveness when implemented in Japanese clinical settings. 相似文献18.
Comprehensive maternity support and shared care in Switzerland: Comparison of levels of satisfaction
Lucia Floris Olivier Irion Jocelyne Bonnet Maria-Pia Politis Mercier Claire de Labrusse 《Women and birth : journal of the Australian College of Midwives》2018,31(2):124-133
Background
According to the woman-centred care model, continuous care by a midwife has a positive impact on satisfaction. Comprehensive support is a model of team midwifery care implemented in the large Geneva University Hospitals in Switzerland, which has organised shared care according to the biomedical model of practice. This model of care insures a follow up by a specific group of midwives, during perinatal period.Aim
The goal of this study was to evaluate the satisfaction and outcomes of the obstetric and neonatal care of women who received comprehensive support during pregnancy, childbirth and the postpartum period, and compare them to women who received shared care.Methods
This was a prospective comparative study between two models of care in low risk pregnant women. The satisfaction and outcomes of care were evaluated using the French version of the Women’s Experiences Maternity Care Scale, two months after giving birth.Findings
In total, 186 women in the comprehensive support group and 164 in the control group returned the questionnaire. After adjustment, the responses of those in the comprehensive support programme were strongly associated with optimal satisfaction, and they had a significantly lower epidural rate. No differences were observed between the two groups in the mode of delivery. The satisfaction relative to this support programme was associated with a birth plan for intrapartum and postnatal care.Conclusions
Team midwifery had a positive impact on satisfaction, with no adverse effects on the obstetric and neonatal outcomes, when compared to shared care. 相似文献19.
Hlengiwe Mohale Linda Sweet Kristen Graham 《Women and birth : journal of the Australian College of Midwives》2017,30(4):298-307
Background
Increasing global migration is resulting in a culturally diverse population in the receiving countries. In Australia, it is estimated that at least four thousand Sub-Saharan African women give birth each year. To respond appropriately to the needs of these women, it is important to understand their experiences of maternity care.Objective
The study aimed to examine the maternity experiences of Sub-Saharan African women who had given birth in both Sub-Saharan Africa and in Australia.Design
Using a qualitative approach, 14 semi-structured interviews with Sub-Saharan African women now living in Australia were conducted. Data was analysed using Braun and Clark’s approach to thematic analysis.Findings
Four themes were identified; access to services including health education; birth environment and support; pain management; and perceptions of care. The participants experienced issues with access to maternity care whether they were located in Sub-Saharan Africa or Australia. The study draws on an existing conceptual framework on access to care to discuss the findings on how these women experienced maternity care.Conclusion
The study provides an understanding of Sub-Saharan African women’s experiences of maternity care across countries. The findings indicate that these women have maternity health needs shaped by their sociocultural norms and beliefs related to pregnancy and childbirth. It is therefore arguable that enhancing maternity care can be achieved by improving women’s health literacy through health education, having an affordable health care system, providing respectful and high quality midwifery care, using effective communication, and showing cultural sensitivity including family support for labouring women. 相似文献20.
Madeleine Simpson Virginia Schmied Cathy Dickson Hannah G. Dahlen 《Women and birth : journal of the Australian College of Midwives》2018,31(5):367-379