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《Women and birth : journal of the Australian College of Midwives》2020,33(5):490-495
BackgroundEarly labour care presents a challenge for maternity services and is a cause of dissatisfaction for women planning birth in an obstetric or midwifery unit who may feel unsupported or unwelcome at their planned place of birth. Little is known about the perspectives of men who support their partner during early labour.MethodsOpportunity sample offathers (n = 12) in the UK who had been present during their partner’s labour in the previous twelve months. Semi-structured interviews were audio-recorded and transcribed before thematic analysis.ResultsFathers learned about the stages of labour during antenatal education and felt well prepared for early labour but found their knowledge difficult to apply, and relied on their partners to decide when to travel to the planned place of birth. Early labour was described as the ‘calm before the storm’ during which they carried out practical tasks or rested to ensure they could fulfil their role when labour progressed. However, men frequently felt ‘like a spare part’ during the later stages of labour.DiscussionThe study has implications for antenatal educators, midwives and others supporting couples during pregnancy and labour. It supports reconsideration of how information about labour progress can be most usefully conveyed to couples. Professionals could acknowledge the value of supportive tasks carried out by fathers that might otherwise be experienced as doing ‘nothing’. Further research should recruit more diverse samples of men and same-sex couples. Dyadic data collection methods may be of value. 相似文献
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Ingegerd Hildingsson Christine Rubertsson Annika Karlström Helen Haines 《Women and birth : journal of the Australian College of Midwives》2018,31(5):407-413
Aim
The aim of this pilot study was to explore the Fear of Birth Scale in a mixed sample of women of childbearing age, by investigating the levels of childbirth fear and the content of women’s thoughts when completing the scale.Methods
A cross-sectional mixed method study of 179 women who completed a short questionnaire and a think aloud interview.Results
The mean score of the Fear of Birth Scale was 40.80 (SD 27.59) and 28.5% were classified as having fear of childbirth (≥60). The internal consistency showed a Cronbach’s α > 0.92, and a mean inter-item correlation of 0.85.The highest scores were found in women younger than 25 years (mean 60.10), foreign-born women (mean 54.30) and women who did not have any previous children (48.72). The lowest scores were found in women who had recently given birth (mean 34.82) and women older than 35 years (mean 34.85). The content analysis categorization matrix clearly accommodated all 436 statements into the five pre-existing categories. The largest categories were: the content of fear and worry with 138 statements and strategies to cope with fear or worry (122 statements).Conclusion
The Fear of Birth Scale seems to be a useful instrument for different subgroups of women. The construct of fear of childbirth may be universally understood and experienced by women of childbearing age irrespective of whether they are currently pregnant, have recently given birth or do not have children. Identifying fear of birth is important in clinical practice in order to support women’s reproductive needs. 相似文献4.
Hadi Khoshneviss 《Mobilities》2017,12(3):311-323
This paper studies the lived experience of Iranian students upon arrival at American airports. By using two concepts of liminality and accountability, I examine how Iranian students walk the gauntlet of US airports, and study the influences of the treatment they receive at airports on their perceptions of the US. Empirically, I draw on 15 in-depth qualitative interviews with eight Iranian students at a Southern university in the US. The paper posits that multiple layers of liminality surface and intensify in airports as a threshold where international travelers can see both ways, behind and before them, while belonging to neither one. The requirement to be an ‘accountable other’ adds up to the contingencies of the situation. Theoretically, this paper puts the politics of mobility in the colonial context and claims that legal recognition will not result in integration when negative discourses around the civilizational other regards their mobility as a threat and challenges their social recognition. 相似文献
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Li Thies-Lagergren Ingegerd Hildingsson Kyllike Christensson Linda J. Kvist 《Women and birth : journal of the Australian College of Midwives》2013,26(4):e99-e104
BackgroundPhysical benefits are suggested for women and their babies when women adopt an upright position of their choice at birth. Available care options during labour influence women's impressions of what intrapartum care is. This indicates that choice of birth positions may be determined more by midwives than by women's preferences.QuestionThe aims of this study were to investigate factors associated with adherence to allocated birth position and also to investigate factors associated with decision-making for birth position.MethodAn invitation to answer an on-line questionnaire was mailed.FindingsDespite being randomised, women who gave birth on the seat were statistically significantly more likely to report that they participated in decision-making and that they took the opportunity to choose their preferred birth position. They also reported statistically significantly more often than non-adherers that they felt powerful, protected and self-confident.ConclusionsMidwives should be conscious of the potential impact that birth positions have on women's birth experiences and on maternal outcomes. Midwives should encourage women's autonomy by giving unbiased information about the birth seat. An upright birth position may lead to greater childbirth satisfaction. Women's experience of and preferences for birth positions are consistent with current evidence for best practice. 相似文献
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Sarah Munro Patricia Janssen Kitty Corbett Elizabeth Wilcox Nick Bansback Jude Kornelsen 《Women and birth : journal of the Australian College of Midwives》2017,30(2):129-136
Problem
Clinical practice guidelines indicate that over 80% of women with a previous caesarean should be offered a planned vaginal birth after caesarean (VBAC), however only one third of eligible women choose to plan a VBAC. To support informed choices for birth after caesarean, it is necessary to understand the factors that influence women’s decision-making.Aim
The goal of this study was to explore attitudes towards and experiences with decision-making for mode of delivery after caesarean from the perspectives of Canadian women.Methods
In-depth, semi-structured interviews were conducted with 23 women eligible for VBAC in three rural and two urban communities in British Columbia, Canada, during summer 2015. Constructivist grounded theory informed iterative data collection and analysis.Findings
Women’s decision-making experiences were a process of “seeking control in the midst of uncertainty.” Women formed early preferences for mode of delivery after their primary caesareans and engaged in careful deliberation during their inter-pregnancy interval, consisting of: reflecting on their birth, clarifying their values, becoming informed, considering the feasibility of options, deliberating with the care team, and making an actual choice. Women struggled to make trade-offs between having a healthy baby and social attributes of delivery, such as uninterrupted bonding with their newborn.Conclusions
Women begin decision-making for birth after caesarean earlier than previously reported and their choices are influenced by personal experience and psychosocial concerns. Future interventions to support choice of mode of delivery should begin early after the primary caesarean, to reflect when women begin to form preferences. 相似文献7.
《Women and birth : journal of the Australian College of Midwives》2022,35(5):440-446
BackgroundThe COVID-19 pandemic has had a profound effect on the emotional well-being of expecting mothers. Sweden’s unique strategy for managing COVID-19 involved no national lockdown. Emphasis was instead placed on limiting crowding and asking citizens to practice social distancing measures.AimTo gain a deeper understanding of how women not infected by SARS-CoV-2 experienced pregnancy during the COVID-19 pandemic in Sweden.MethodsThis was a qualitative study with a reflective lifeworld approach. Fourteen women that had not contracted COVID-19 and who were pregnant during the first and second wave of the pandemic were interviewed. Data were analysed with a phenomenological reflective lifeworld approach.FindingsThe essence of the women’s experiences of being pregnant during the COVID-19 pandemic was best described as being in the shadow of the unknown, where the COVID-19 pandemic could at times totally overshadow the experience of being pregnant, while at other times, rays of sunlight pierced through the clouds. The experience was characterised by having to deal with the uncertainties caused by the pandemic and feelings of being in an information echo. Women felt socially isolated and had to face maternal check-ups without the support of their partners. There was, however, a strong trust in maternal health-care services despite the lack of information available.ConclusionBeing in the shadow of the unknown represents the uncertainties posed by the COVID-19 pandemic on the experience of pregnancy. Sufficient information, a companion of choice and screening for emotional well-being are important factors in maternity care during pandemics. 相似文献
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《Women and birth : journal of the Australian College of Midwives》2021,34(5):477-486
IntroductionGlobally, mistreatment during childbirth remains a powerful deterrent to skilled birth utilization.AimWe determined the perpetrated and witnessed experiences of mistreatment and Respectful Maternity Care (RMC) among maternal health providers in a tertiary hospital in Nigeria.MethodsA cross-sectional study was conducted among 156 maternal health providers in a tertiary hospital in Nigeria. Information was collected using semi-structured, self-administered questionnaires, and 3 focus group discussions. Quantitative and qualitative data analyses were performed using SPSS version 20 and thematic analysis respectively.FindingsMost respondents were males (64.1%) and doctors (74.4%) with mean age of 31.97 ± 6.82. Two-fifths (39.1%) and 73.1% of the respondents had ever meted out or witnessed disrespectful and abusive care to women during childbirth respectively. Verbal abuse and denial of companionship in labour were major mistreatments reported qualitatively and quantitatively. About a third of the respondents mistreated women 1–2 times in a week. Younger respondents had 64% lower odds of reporting mistreatment during childbirth (AOR = 0.36, 95% CI = 0.14−0.96). The most and least frequently practiced RMC element were provision of consented care (62.8%) and allowing birth position of choice respectively (3.8%). Poor hospital patronage and reputation were the perceived consequences of mistreatment during childbirth.ConclusionWitnessed rather than self-perpetrated mistreatment during childbirth was more reported in addition to poor RMC practices Self-perpetrated mistreatment during childbirth was less reported among younger providers. We recommend intensification of provider capacity building on RMC with special focus on older practitioners and the provision of supportive work environments that encourage respectful maternal care practices. 相似文献
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Hazel Keedle Virginia Schmied Elaine Burns Hannah Grace Dahlen 《Women and birth : journal of the Australian College of Midwives》2018,31(1):69-79
Background
Vaginal birth after caesarean can be a safe and satisfying option for many women who have had a previous caesarean, yet rates of vaginal birth after caesarean remain low in the majority of countries. Exploring women’s experiences of vaginal birth after caesarean can improve health practitioners’ understanding of the factors that facilitate or hinder women in the journey to have a vaginal birth after caesarean.Methods
This paper reports on a meta-ethnographic review of 20 research papers exploring women’s experience of vaginal birth after caesarean in a variety of birth locations. Meta-ethnography utilises a seven-stage process to synthesise qualitative research.Results
The overarching theme was ‘the journey from pain to power’. The theme ‘the hurt me’ describes the previous caesarean experience and resulting feelings. Women experience a journey of ‘peaks and troughs’ moving from their previous caesarean to their vaginal birth after caesarean. Achieving a vaginal birth after caesarean was seen in the theme ‘the powerful me,’ and the resultant benefits are described in the theme ‘the ongoing journey’.Conclusion
Women undergo a journey from their previous caesarean with different positive and negative experiences as they move towards their goal of achieving a vaginal birth after caesarean. This ‘journey from pain to power’ is strongly influenced by both negative and positive support provided by health care practitioners. Positive support from a health care professional is more common in confident practitioners and continuity of care with a midwife. 相似文献14.
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IntroductionThe ongoing closure of regional maternity services in Australia has significant consequences for women and communities. In South Australia, a regional midwifery model of care servicing five birthing sites was piloted with the aim of bringing sustainable birthing services to the area. An independent evaluation was undertaken. This paper reports on women’s experiences and birth outcomes.AimTo evaluate the effectiveness, acceptability, continuity of care and birth outcomes of women utilising the new midwifery model of care.MethodAn anonymous questionnaire incorporating validated surveys and key questions from the Quality Maternal and Newborn Care (QMNC) Framework was used to assess care across the antenatal, intrapartum and postnatal period. Selected key labour and birth outcome indicators as reported by the sites to government perinatal data collections were included.FindingsThe response rate was 52.6% (205/390). Women were overwhelmingly positive about the care they received during pregnancy, birth and the postnatal period. About half of women had caseload midwives as their main antenatal care provider; the other half experienced shared care with local general practitioners and caseload midwives. Most women (81.4%) had a known midwife at their birth. Women averaged 4 post-natal home visits with their midwife and 77.5% were breastfeeding at 6–8 weeks. Ninety-five percent of women would seek this model again and recommend it to a friend. Maternity indicators demonstrated a lower induction rate compared to state averages, a high primiparous normal birth rate (73.8%) and good clinical outcomes.ConclusionThis innovative model of care was embraced by women in regional SA and labour and birth outcomes were good as compared with state-wide indicators. 相似文献
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《Women and birth : journal of the Australian College of Midwives》2021,34(4):e396-e405
BackgroundThe process of developing a survey instrument to evaluate women’s experiences of their maternity care is complex given that maternity care encapsulates various contexts, services, professions and professionals across the antenatal, intranatal and postnatal periods.AimTo identify and prioritise items for inclusion in the National Maternity Experience Survey, a survey instrument to evaluate women’s experiences of their maternity care in the Republic of Ireland.MethodsThis study used an adapted two-phase exploratory sequential mixed methods design. Phase one identified items for possible inclusion and developed an exhaustive item pool through a systematic review, focus groups and one to one interviews, and a gap analysis. Phase two prioritised the items for inclusion in the final item bank through a Delphi study and consensus review.FindingsFollowing iterative consultation with key stakeholder groups, a bank of 95 items have been prioritised and grouped within eight distinct care sections; care during your pregnancy, care during your labour and birth, care in hospital after the birth of your baby, specialised care for your baby, feeding your baby, care at home after the birth of your baby, overall care and you and your household.ConclusionRobust and rigorous methods have been used to develop a bank of 95 suitable items for inclusion in the National Maternity Experience Survey. 相似文献
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《Women and birth : journal of the Australian College of Midwives》2020,33(6):e535-e542
BackgroundEach year thousands of pregnant women experiencing threatened premature labour are transferred considerable distances across Australia to access higher level facilities but only a small proportion of these women go on to actually give birth to a premature baby. Women from regional areas are required to move away from their home, children and support networks because of a perceived risk of birthing in a centre without neonatal intensive care facilities.AimThis study examines the experience of women undergoing antenatal transfer for threatened premature labour in New South Wales and the Australian Capital Territory who do not give birth during their transfer admission.MethodsThirteen semi-structured in-depth interviews were held with women across five tertiary referral sites across New South Wales and the Australian Capital Territory, and analysed until saturation for themes.FindingsSeven urban and six rural women were interviewed. Women and their families were all negatively affected by antenatal transfer. Factors that helped enable a positive experience were; enhanced sense of safety in the tertiary unit, and individual qualities of staff. Factors that contributed to negative experiences were; inadequate and conflicting information, and no involvement or choice in the clinical decision-making process to move to another facility.ConclusionsAntenatal transfer is an extremely stressful experience for women and their families. The provision of high quality written and verbal information, and the inclusion of women's perception of risk in the clinical decision making process will improve the experience for women and their families in NSW and the ACT. 相似文献
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《Women and birth : journal of the Australian College of Midwives》2022,35(1):e19-e27
AimTo investigate the experiences, perspectives and plans of students who had a six-month placement with the midwifery group practice.MethodsFocus groups were conducted with fifteen third – year Bachelor of Midwifery students who had undertaken an extended placement at a midwifery group practice in a large tertiary referral hospital in Queensland, Australia.ResultsFour main themes were identified in the data: Expectations of the Placement; Facilitating learning within a midwifery group practice model; Transitioning between models of care and Philosophy and culture of midwifery group practice.Discussion and conclusionThird-year midwifery students valued the experience of working one-on-one for an extended placement with a midwife providing continuity of care within a caseload model. The experience was the highlight of their degree and they learned ‘how to be a midwife’. Most students found reintegrating back into the hospital system of care challenging, reporting that their developed skills of supporting women holistically and facilitating normal birth were not fully utilised when returning to the task-orientated birth suite. Students valued thoughtful, kind and supportive midwifery preceptors who supported them to transition back into the hospital.Implications and recommendationsUndertaking an extended placement within a midwifery group practice provides students with a rich and holistic learning experience and helps them develop a sense of professional identity. Student placements situated within models of care which provide continuity of midwifery care should be proactively enabled by health services and universities. Research of the longer-term impacts of an extended midwifery group practice clinical placement on midwifery graduates’ capabilities and competencies 3–5 years post registration should be conducted. 相似文献
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《Women and birth : journal of the Australian College of Midwives》2022,35(5):e446-e455
BackgroundSome childbearing women/birthing people prioritize out of maternity care organizational guidelines’ approaches to childbirth as a way of optimizing their chances of a normal physiological birth. Currently, there is little known about the experiences of midwives who support their choices.AimTo explore the experiences of UK midwives employed by the NHS, who self-defined as supportive of women’s alternative physiological birthing choices.MethodsA narrative inquiry was used to collect and analyse professional stories of practice via self-written narratives and interviews. Forty-five midwives from across the UK were recruited.FindingsThree overarching storylines were developed with nine sub-themes. ‘Stories of distress’ highlights challenging experiences due to poor supportive working environments, ranging from small persistent challenges to extreme situations. Conversely, ‘Stories of fulfilment’ offers a positive counter-narrative where midwives worked in supportive working environments enabling woman-centred care unencumbered by organisational constraints. ‘Stories of transition’ abridge these two polarized themes.ConclusionThe midwives’ experiences were mediated by their socio-cultural working contexts. Negative experiences were characterised by a misalignment between the midwives’ philosophy and organisational cultures, with significant consequences for the midwives. Conversely, examples of good organisational culture and practice reveal that it is possible for organisations to fulfil their obligations for safe and positive maternity care for both childbearing women who make alternative birthing choices, and for attending staff. This highlights what is feasible and achievable within maternity organisations and offers transferable insights for organisational support of out-of-guideline care that can be adapted across the UK and beyond. 相似文献