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1.
Shigeki Koshida Tetsuo Ono Shunichiro Tsuji Takashi Murakami Hisatomi Arima Kentaro Takahashi 《Women and birth : journal of the Australian College of Midwives》2019,32(2):127-130
Background
Decreased fetal movements are associated with adverse perinatal outcomes, including stillbirth. Delayed maternal visits to a health care provider after perceiving decreased fetal movements are frequently observed in stillbirths. Informing pregnant women of the normal range of fetal movement frequency is essential in their earlier visits in order to prevent stillbirth.Aim
To investigate the fetal movement frequency in late pregnancy and the effects of associated perinatal factors.Methods
This prospective multicenter study was conducted in 20 obstetric facilities in our region of Japan. A total of 2337 pregnant women were asked to record the time it took to perceive 10 fetal movements by the modified ‘count to 10’ method every day from 34 weeks of gestation until delivery.Findings
The 90th percentile of the time for the maternal perception of 10 fetal movements was 18–29 min, with a gradually increasing trend toward the end of pregnancy. The numbers of both pregnant women giving birth after 39 weeks’ gestation and infants with a birth weight exceeding 3000 g were significantly higher in mothers who took ≥30 min to count 10 fetal movements than in those who took <30 min.Conclusion
The maternal perception time of fetal movements shows a gradually increasing trend within 30 min for 10 fetal movements by the modified ‘count to 10’ method. Informing pregnant women of the normal range of the fetal movement count time will help improve the maternal recognition of decreased fetal movements, which might prevent fetal death in late pregnancy. 相似文献2.
Atefeh Vaezi Fatemeh Soojoodi Arash Tehrani Banihashemi Marzieh Nojomi 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e238-e242
Background
Prevalence of postpartum depression is estimated to be about 10–15% worldwide. Many risk factors are supposed to play a role leading a new mother to maternal postpartum depression which can considerably affect the baby, mother, family and also the society.Objective
To investigate the prevalence of maternal postpartum depression and its association with social support.Methods
Using a cross-sectional study, 200 new mothers who attended three teaching hospitals in Tehran, Iran were selected with a convenience sampling. Postpartum depression was assessed using the Iranian version of Edinburgh Postpartum Depression Scale and women’s levels of social support were measured using the Iranian version of Social Support Questionnaire.Results
Prevalence of postpartum depression was 43.5% in new mothers. The mean (±Standard Deviation) score of social support network was 2.09 ± 0.99; which is lower in depressed mothers in comparison to non-depressed mothers (1.78 ± 0.87 vs. 2.33 ± 1.00 respectively, P < 0.001). A reverse significant association was found between social support and postpartum depression after adjusting for confounding variables such as past history of depression, illness of baby and medication consumption during pregnancy (Odds Ratio = 0.47, 95% Confidence Interval = 0.33–0.67).Conclusion
The bigger the social network of a mother, the less postpartum depression occurs. It is suggested to educate the family about the very important role of social support and improve it in every aspect of health care in order to prevent postpartum depression. 相似文献3.
Fatemeh Darsareh Teamur Aghamolaei Minoo Rajaei Abdoulhossain Madani Shahram Zare 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e166-e172
Problem
The steep increase and inappropriateness of caesarean birth represent a healthcare problem in Iran.Aim
The purpose of study was to evaluate the effect of a campaign based on social marketing to promote normal childbirth.Method
The study was designed as a prospective case control study. The social marketing campaign was implemented from March 2016 to January 2017. A demographic data questionnaire, obstetrical history questionnaire, maternal knowledge assessment questionnaire, and maternal health belief questionnaire comprised the instruments for this study. Only women planning a caesarean birth without any medical indications for the caesarean were enrolled in the study as a case. Those who met the same inclusion criteria and did not want to participate in the campaign were assigned to the control group.Findings
In total, 350 first-time pregnant women who composed the campaign group (n = 194) and control group (n = 156) completed the study. The mean baseline level of knowledge and Health Belief Model component score did not differ between the two groups at baseline. However, after the campaign, knowledge scores, perceived severity, perceived susceptibility, self-efficacy, and cues to action scores differed significantly between the campaign and control groups. The follow-up of all participants in both groups showed that 35.6% (n = 69) of participants in the campaign group chose natural birth as their birth method, whereas only 13.5% (n = 21) in the control group delivered their newborn vaginally.Conclusion
The B Butterfly social marketing campaign successfully targeted first-time pregnant women who chose to have unnecessary elective cesarean births. 相似文献4.
Shigeki Koshida Tetsuo Ono Shunichiro Tsuji Takashi Murakami Hisatomi Arima Kentaro Takahashi 《Women and birth : journal of the Australian College of Midwives》2017,30(6):468-471
Background
Fetal movement is the most common method to evaluate fetal well-being. Furthermore, maternal perception of decreased fetal movements is associated with perinatal demise. Previously, we showed that perception of decreased fetal movements was the most common reason for mothers visiting the outpatient department among those who had stillbirths in our region. Further investigation of stillbirths with decreased fetal movements is essential to find a possible way of preventing stillbirth.Aim
To investigate maternal reaction time after their perceiving decreased fetal movements among stillbirths in our region of Japan.Methods
This is a population-based study of stillbirths in Shiga Prefecture, Japan conducted from 2007 to 2011. We sent a questionnaire to each obstetrician who had submitted the stillbirth certificate. We reviewed and evaluated the questionnaires returned from the obstetricians.Findings
There were 66 cases (35%) with decreased fetal movements among 188 stillbirths in Shiga during the study period. The number of maternal visits to outpatient department after perception of decreased fetal movements within 24 h was only seven (11%) among 64 stillbirths diagnosed at outpatient department.Conclusion
We conclude that delayed maternal visit after perceiving decreased fetal movements is frequently observed in stillbirths. Promoting more thorough maternal education on fetal movements, including emphasizing earlier visitation after perceiving decreased fetal movements, may prevent stillbirths. 相似文献5.
Jane Warland Pauline Glover 《Women and birth : journal of the Australian College of Midwives》2017,30(1):23-28
Problem
Information that women receive about the importance of monitoring fetal movements and what to do if there are changes is inconsistent and may not be evidence based.Background
This paper reports a summary of the kind of messages a group of South Australian midwives (n = 72) currently give pregnant women.Methods
Comment data from two questions in a larger survey asking (1) what information midwives routinely provide to women about fetal movements and (2) their practice regarding advice they give to women reporting reduced fetal movements. Data were analysed using summative content analysis.Findings
Four main recurring words and phrases were identified. With respect to information midwives give all women about monitoring fetal movements, recurring words were “10”, “normal”, “kick charts” and “when to contact” their care-provider. Recurrent words and phrases arising from answers to the second question about advice midwives give to women reporting reduced fetal movement were “ask questions,” “suggest fluids,” “monitor at home and call back” or “come in for assessment”.Discussion
These findings suggest that a group of South Australian midwives are providing pregnant women with inconsistent information, often in conflict with best practice evidence.Conclusion
As giving correct, evidence based information about what to do in the event of an episode of reduced fetal movement may be a matter of life or death for the unborn baby it is important that midwives use existing guidelines in order to deliver consistent information which is based on current evidence to women in their care. 相似文献6.
Ahmed H. Al-Shahethi Rafdzah Ahmad Zaki Abdul Wahed A. Al-Serouri Awang Bulgiba 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e204-e215
Background
Perinatal mortality remains a major international problem responsible for nearly six million stillbirths and neonatal deaths.Objectives
To estimate the perinatal mortality rate in Sana’a, Yemen and to identify risk factors for perinatal deaths.Methods
A community-based prospective cohort study was carried out between 2015 and 2016. Nine-hundred and eighty pregnant women were identified and followed up to 7 days following birth. A multi-stage cluster sampling was used to select participants from community households’, residing in the five districts of the Sana’a City, Yemen.Results
Total of 952 pregnant women were tracked up to 7 days after giving birth. The perinatal mortality rate, the stillbirth rate and the early neonatal mortality rate, were 89.3 per 1000, 46.2 per 1000 and 45.2 per 1000, respectively. In multivariable analysis older age (35+ years) of mothers at birth (Relative Risk = 2.83), teenage mothers’ age at first pregnancy (<18 years) (Relative Risk = 1.57), primipara mothers (Relative Risk = 1.90), multi-nuclear family (Relative Risk = 1.74), mud house (Relative Risk = 2.02), mothers who underwent female genital mutilation (Relative Risk = 2.92) and mothers who chewed khat (Relative Risk = 1.60) were factors associated with increased risk of perinatal death, whereas a positive mother’s tetanus vaccination status (Relative Risk = 0.49) were significant protective factors against perinatal deaths.Conclusion
Rates of perinatal mortality were higher in Sana’a City compared to perinatal mortality at the national level estimated by World Health Organization. It is imperative there be sustainable interventions in order to improve the country’s maternal and newborn health. 相似文献7.
Annabel Sheehy Rachel M. Smith Joanne E. Gray Caroline S.E. Homer 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e182-e188
Background
Midwives in Australia are educated through a range of routes providing flexible ways to become a midwife. Little is known about whether the route to registration impacts on mid-career experiences, in particular, whether the pathway (post-nursing pathway compared with ‘direct-entry’) makes any difference.Aim
The aim of this study was to explore the midwifery workforce experiences and participation in graduates six to seven years after completing either a post-nursing Graduate Diploma in Midwifery (GradDip) or an undergraduate degree, the Bachelor of Midwifery (BMid), from one university in New South Wales, Australia.Methods
Data were collected from mid-career midwives having graduated from one NSW university from 2007–2008 using a survey. The survey included validated workforce participation instruments — the Maslach Burnout Inventory (MBI), the Practice Environment Scale-Nursing Work Index (PES-NWI) and the Perceptions of Empowerment in Midwifery Scale (PEMS).Results
There were 75 respondents: 40% (n = 30) Bachelor of Midwifery and 60% (n = 45) GradDip graduates. The age range was 27–56 years old (mean age = 36 years) Bachelor of Midwifery graduates being on average 7.6 years older than Graduate Diploma in Midwifery graduates (40 vs 33 years; p < 0.01). Almost 80% (59), were currently working in midwifery. Nine of the 12 not working in midwifery (75%) planned to return. There were no differences in workforce participation measures between the two educational pathways. Working in a continuity of care model was protective in regards to remaining in the profession.Conclusion
Most mid-career graduates were still working in midwifery. There were no differences between graduates from the two pathways in relation to burnout, practice experiences or perceptions of empowerment. 相似文献8.
April M. Miller Kristy Sanderson Raimondo B. Bruno Monique Breslin Amanda L. Neil 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e272-e278
Background
The increasing prevalence and adverse outcomes associated with opioid analgesia use in women of reproductive age have become a significant public health issue internationally, with use during pregnancy potentially affecting maternal and infant health outcomes.Objective
This study aims to provide national estimates of chronic pain, pain severity and analgesia use in Australian women of reproductive age by pregnancy status.Method
Data were obtained from the Australian Bureau of Statistics 2011–12 National Health Survey (n = 20,426). Weighting was applied to sample data to obtain population estimates. For this study data were analysed for pregnant (n = 166, N = 192,617) and non-pregnant women (n = 4710, N = 5,256,154) of reproductive age (15–49 years).Results
Chronic or reoccurring pain was reported in 5.1% of pregnant women and 9.7% of non-pregnant women, and 0.7% and 2.6% of pregnant and non-pregnant women reported recent opioid analgesia use respectively. Moderate-to-very severe pain was more common in pregnant than non-pregnant women taking opioid analgesics, and no pain and very mild-to-mild pain in non-pregnant women.Conclusion
Approximately 1 in 20 pregnant Australian women have chronic or reoccurring pain. Opioid analgesia was used by around 1% of Australian pregnant women during a two-week period, with use associated with moderate-to-very severe pain. Given that the safety of many analgesic medications in pregnancy remains unknown, pregnant women and health professionals require accurate, up-to-date information on the risks and benefits of analgesic use during pregnancy. Further evidence on the decision-making processes of pregnant women with pain should assist health professionals maximise outcomes for mothers and infants. 相似文献9.
Linda Sweet Janice Bass Mary Sidebotham Jennifer Fenwick Kristen Graham 《Women and birth : journal of the Australian College of Midwives》2019,32(2):119-126
Background
Practice-based or clinical placements are highly valued for linking theory to practice and enabling students to meet graduate outcomes and industry standards. Post-practicum, the period immediately following clinical experiences, is a time when students have an opportunity to share, compare and engage critically in considering how these experiences impact on their learning. Reflective practice has merit in facilitating this process.Aim
This project aimed to optimise the learning potential of practice-based experiences by enhancing midwifery students’ capacity for reflective practice through writing.Methods
Design-based research was used to implement an educational intervention aimed at developing reflective practice skills and enhance reflective writing. The Bass Model of Holistic Reflection was introduced to promote the development of reflective capacity in midwifery students. Academics and midwifery students were provided with guidance and resources on how to apply the model to guide reflective writing. Students’ written reflections completed before (n = 130) and after the introduction of the intervention (n = 96) were evaluated using a scoring framework designed to assess sequential development of reflective capacity.Findings
The pre-intervention scores ranked poorly as evidence of reflective capacity. All scores improved post-intervention.Conclusions
The introduction of a holistic structured model of reflection resulted in improved scores across all five components of reflective writing; self-awareness, sources of knowledge, reflection and critical reflection, evidence informed practice and critical thinking. While further work is required the results show that the implementation process and use of the Bass Model enables students to demonstrate their capacity to reflect-on-practice through their writing. 相似文献10.
Che Muzaini Che’ Muda Tengku Alina Tengku Ismail Rohana Ab Jalil Suhaily Mohd Hairon Zaharah Sulaiman Nazirah Johar 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e243-e251
Background
The first week after childbirth is a crucial period for exclusive breastfeeding initiation.Objective
This study aims to determine the association of postnatal breastfeeding education with knowledge, attitude, and exclusive breastfeeding practice at six months after childbirth among women who delivered at two district hospitals in the northeast part of Peninsular Malaysia.Methods
This is a quasi-experimental study design. A newly developed and validated questionnaire was used to determine scoring for baseline and six months after childbirth. The intervention consisted of individualized postnatal breastfeeding education delivered by researchers using flipchart one week after childbirth and breastfeeding diary in addition to usual care. The comparison group received the usual postnatal care by health clinics. Repeated measure analysis of variance and multiple logistic regression analysis were used.Results
A total of 116 participants were included in this study (59 in intervention group and 57 in comparison group). Six months after childbirth, the adjusted mean score of knowledge and attitude of the intervention group were significantly higher than that of the comparison group (p < 0.001 and p = 0.002, respectively). More participants in the intervention group (n = 26, 44.1%) exclusively breastfed their infants compared with 15 (26.3%) in the comparison group (p = 0.046). Postnatal breastfeeding education was significantly associated with exclusive breastfeeding practice six months after childbirth [adjusted odds ratio 2.31; 95% confidence interval: 1.02, 5.14; p = 0.040].Conclusions
Postnatal breastfeeding education was significantly associated with an improvement in women’s knowledge, attitude and exclusive breastfeeding practice six months after childbirth. 相似文献11.
Bethany L. Carr Beverley Copnell Meredith McIntyre 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e259-e263
Background
Meconium stained amniotic fluid commonly occurs postdates (?>40 weeks gestation) indicating fetal maturity. Previous literature indicates that different ethnicities mature at different rates.Aim
To compare the rate of meconium stained amniotic fluid of Australian-born and non-Australian born women.Methods
A retrospective correlation study design was implemented, using data collected in the birth outcomes system at one tertiary hospital. Data was collected from all women who gave birth to a term (>/=37 weeks gestation), singleton, liveborn baby between January 1st to December 31st, 2014. Maternal country of birth was used for comparison. Categorical data was analyzed using Chi-Square test for Independence. Continuous variables were assessed for normality, and differences were compared using an Independent t-test or a Mann–Whitney U test. All tests were two-tailed and p < 0.05 was considered statistically significant.Results
3,041 women were included; 1131 Australian-born and 1910 non-Australian born. Meconium stained amniotic fluid occurred more frequently in non-Australian born women compared to Australian-born women (23.5% vs. 19.8 p = 0.02). Their babies were significantly smaller (Mean = 3265 g, Standard Deviation 463.8 vs Mean = 3442 g, Standard Deviation 499.2, p < 0.001), with no difference in gestational length (Mean = 39.4, Standard Deviation 1.28 vs Mean = 39.5, Standard Deviation 1.18, p = 0.06). Increasing gestational age had the strongest association with meconium stained amniotic fluid;?>/=42 weeks gestation occurring 3.52 (95% Confidence Interval: 2.00, 6.22, p = <0.001) more than <40 weeks gestation.Conclusion
Maternity health services should record ethnicity and region of birth to provide individualised care as women born overseas often have poorer perinatal outcomes when compared to Australian-born women. 相似文献12.
Meta Weltens Jascha de Nooijer Marianne J. Nieuwenhuijze 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e197-e203
Background
Dutch maternity care is based on the principle that pregnancy and childbirth are physiological processes. However, the last decade an increase of intra-partum referrals to obstetric-led care has been observed. Most of these referrals are among nulliparous women, non-urgent and occur during the first stage of labour. The increase in referrals seems not associated with better perinatal outcomes.Objective
Gain understanding of underlying factors in the decision-making process prior to referral to obstetric-led care among midwives attending childbirth in midwifery-led care.Method
A qualitative study based on in-depth interviews with Dutch midwives (n = 10) working in midwifery-led care. We performed a thematic analysis based on the hypothetico-deductive and the intuitive-humanist theory.Results
Midwives mentioned knowledge as the basis of a reasoned decision. This included both theoretical knowledge, and knowledge from clinical experience. Influences of others, like the needs and wishes of labouring women were another factor influencing the decision-making, especially in non-urgent situations. Under subjective factors, the fear of being held responsible for professional choices emerged.Key conclusion
The decision-making process during childbirth is multi-factorial. The women’s needs and wishes are recognized as of great influence on the decision-making process during childbirth, which is not included as a factor in the hypothetico-deductive or the intuitive-humanist theory.Implication for practice
The influence of women’s needs and wishes should be part of models about the intra-partum decision-making process. Midwives should find strategies to support women to make well-informed choices that include adequate information on the consequences of medicalisation in obstetric-led care. 相似文献13.
Susanne Grylka-Baeschlin Thorsten Meyer Luise Lengler Edwin van Teijlingen Jessica Pehlke-Milde Mechthild M. Gross 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e229-e237
Background
The Mother-Generated Index (MGI) assesses postnatal quality of life (QoL) without providing a predefined checklist, thus offering mothers the opportunity to identify areas of life affected by having a baby.Aim
To identify: (a) details and particularities of areas of life affected after childbirth and thus specific domains defining postnatal quality of life; (b) changes in the importance of domains specifying QoL within the first weeks postpartum; and (c) the potential role of cultural differences with regard to the nature of QoL definitions.Methods
Prospective, cross-cultural, longitudinal survey. We applied a qualitative content analysis to Mother-Generated Index data collected in Switzerland and Germany using combined deductively and inductively category building.Results
Women participated at three days (n = 124) and six and a half weeks (n = 82) postpartum. Eleven domains were identified, each with several subdomains: ‘physical well-being’ (e.g. fatigue), ‘psychological well-being’ (e.g. happiness, emotional confusion), ‘general well-being’, ‘motherhood’ (e.g. bonding with the baby), ‘family and partnership’ (e.g. time for partner and children), ‘social life’ (e.g. friends, being isolated), ‘everyday life’ (e.g. organisation daily routine), ‘leisure’ (e.g. less time), ‘work life’ (e.g. worries about job), ‘financial issues’ (e.g. less money), and further aspects. The most frequently indicated domains were ‘motherhood’ and ‘family and partnership’. Differences between the stages of assessment and countries were identified.Discussion
Mothers faced challenges in defining their new role but welcomed the slowdown in the rhythm of life and experienced overwhelming maternal feelings.Conclusion
Our findings suggest that postnatal quality of life is a concept that changes over time and differs between countries. 相似文献14.
Anna Dencker Christina Nilsson Cecily Begley Elisabeth Jangsten Margareta Mollberg Harshida Patel Helena Wigert Eva Hessman Helen Sjöblom Carina Sparud-Lundin 《Women and birth : journal of the Australian College of Midwives》2019,32(2):99-111
Problem
Fear of childbirth negatively affects women during pregnancy and after birth.Aim
To summarise the findings of published studies regarding possible causes/predisposing factors and outcomes of fear of childbirth for childbearing women.Design
A systematic review, searching five databases in March 2015 for studies on causes/predisposing factors and outcomes of fear of childbirth, as measured during pregnancy and postpartum. Quality of included studies was assessed independently by pairs of authors. Data were extracted independently by reviewer pairs and described in a narrative analysis.Findings
Cross-sectional, register-based and case-control studies were included (n = 21). Causes were grouped into population characteristics, mood-related aspects, and pregnancy and birth-related aspects. Outcomes were defined as mood-related or pregnancy and birth-related aspects. Differing definitions of fear of childbirth were found and meta-analysis could only be performed on parity, in a few studies.Conclusions
Stress, anxiety, depression and lack of social support are associated with fear during pregnancy. Need for psychiatric care and presence of traumatic stress symptoms are reported outcomes together with prolonged labour, longer labours, use of epidural and obstetric complications. Nulliparous and parous women have similar levels of fear but for different reasons. Since the strongest predictor for fear in parous women is a previous negative birth experience or operative birth, we suggest it is important to distinguish between fear of childbirth and fear after birth. Findings demonstrate the need for creating woman-centred birthing environments where women can feel free and secure with low risk of negative or traumatic birth experiences and consequent fear. 相似文献15.
Anders Linde Ingela Rådestad Karin Pettersson Linn Hagelberg Susanne Georgsson 《Women and birth : journal of the Australian College of Midwives》2017,30(5):376-381
Background
Experience of reduced fetal movements is a common reason for consulting health care in late pregnancy. There is an association between reduced fetal movements and stillbirth.Aim
To explore why women decide to consult health care due to reduced fetal movements at a specific point in time and investigate reasons for delaying a consultation.Methods
A questionnaire was distributed at all birth clinics in Stockholm during 2014, to women seeking care due to reduced fetal movements. In total, 3555 questionnaires were collected, 960 were included in this study. The open-ended question; “Why, specifically, do you come to the clinic today?” was analyzed using content analysis as well as the complementary question “Are there any reasons why you did not come to the clinic earlier?”Results
Five categories were revealed: Reaching dead line, Receiving advice from health care professionals, Undergoing unmanageable worry, Contributing external factors and Not wanting to jeopardize the health of the baby. Many women stated that they decided to consult care when some time with reduced fetal movements had passed. The most common reason for not consulting care earlier was that it was a new experience. Some women stated that they did not want to feel that they were annoying, or be perceived as excessively worried. Not wanting to burden health care unnecessarily was a reason for prehospital delay.Conclusion
Worry about the baby is the crucial reason for consulting care as well as the time which has passed since the women first experienced decreased fetal movements. 相似文献16.
Karen Matvienko-Sikar Samantha Dockray 《Women and birth : journal of the Australian College of Midwives》2017,30(2):e111-e118
Problem
Low prenatal well-being has adverse outcomes for mother and infant but few interventions currently exist to promote and maintain prenatal well-being.Background
Mindfulness and gratitude based interventions consistently demonstrate benefits in diverse populations. Interventions integrating these constructs have potential to improve psychological and physiological health during pregnancy.Aim
The aim of this pilot study is to examine the effect of a novel gratitude and mindfulness based intervention on prenatal stress, cortisol levels, and well-being.Methods
A pilot randomised controlled trial was conducted with 46 pregnant women. Participants used an online mindfulness and gratitude intervention 4 times a week for 3 weeks. Measures of prenatal stress, salivary cortisol, gratitude, mindfulness, and satisfaction with life were completed at baseline, 1.5 weeks later, and 3 weeks later.Findings
Intervention participants demonstrated significant reductions in prenatal stress in comparison to the control condition (p = .04). Within subjects reductions in waking (p = .004) and evening cortisol (p > .001) measures were observed for intervention participants. Significant effects were not observed for other well-being outcomes.Discussion
Reducing self-report and physiological stress in pregnancy can improve maternal and infant outcomes. The findings of this pilot study indicate potential direct effects of the intervention on self-reported stress in comparison to a treatment-as-usual control. Effects on a biomarker of stress, cortisol, were also observed within the intervention group.Conclusion
A brief mindfulness and gratitude based intervention has the potential to reduce stress in pregnancy. Future research is needed to further explore mechanisms and potential benefits of such interventions. 相似文献17.
Rima Kaddoura Jocelyn DeJong Huda Zurayk Tamar Kabakian Christine Abbyad Fadi G. Mirza 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e223-e228
Problem
There is lack of data on the rate of episiotomy in Lebanon and the study’s hospital.Background
Only a few studies have addressed episiotomy practice in Lebanon and the Middle East and they show varying rates.Aim
To identify the rate, and change in rate, of episiotomy practice over the years at a teaching hospital in Lebanon and to assess whether maternal age, parity, fetal weight, woman’s hospital admission class, and physician’s gender were associated with episiotomy. We also tested the association between episiotomy and postpartum hemorrhage and/or high degree perineal tears.Methods
A retrospective observational study was conducted on 1756 records for women having a normal vaginal birth at a single centre from January 2009 to January 2014.Findings
The rate of episiotomy at the hospital was very high, with 97.4% of women receiving an episiotomy in 2009. A major decrease in the rate was identified with a decline from 97.4% in 2009 to 73.3% in January 2014. Episiotomy was found to be associated with parity, maternal age, and with high degree perineal tears.Discussion
The episiotomy rate at this centre remains higher than the 10% rate recommended by the World Health Organization, although there has been a significant reduction after a call for restrictive rather than liberal use.Conclusion
Raising awareness among providers appeared to play a significant role in reducing this rate, although more efforts remain warranted. Other strategies – such as raising awareness of women about potential risks of episiotomy – are also worth exploring. 相似文献18.
Roianne West Somer Wrigley Kyly Mills Kate Taylor Dale Rowland Debra K. Creedy 《Women and birth : journal of the Australian College of Midwives》2017,30(3):236-244
Background
Midwives have a central role in closing the gap in health inequalities between Australias’ First Peoples and other childbearing women. The Aboriginal and Torres Strait Islander Health Curriculum Framework (The Framework) identifies five core cultural capabilities (respect, communication, safety and quality, reflection and advocacy) to foster culturally safe health care.Aim
To use a decolonising, First Peoples-led approach to develop and validate a tool to measure the development students’ cultural capabilities.Method
A pre- post intervention design was used. Development of the Cultural Capability Measurement Tool followed a staged process which centred on First Peoples’ knowledges. This process included: item generation, expert review; a pilot, test-retest; and psychometric testing (reliability, factor analysis and construct validity). All third year midwifery students (n = 49) enrolled in a discrete First Peoples health course were invited to complete the survey pre and post course.Findings
A response rate of 77.5% (n = 38/49) pre-course and 30.6% (15/49) at post-course was achieved. The tool demonstrated good internal reliability (Cronbach alpha = .89–.91). Principal component analysis with varimax rotation produced a five-factor solution. A paired samples t-test revealed a significant increase from pre-course (mean 93.13, SD 11.84) to post-course scores (mean = 100.53, SD 7.54) (t (14) = ?2.79, p = .014).Conclusion
A First Peoples approach was critical to tool development and conceptual validity. The 22 item Cultural Capability measurement Tool reflected the core cultural capabilities of The Framework. The draft tool appears suitable for use with midwifery students. 相似文献19.
S.A.S. Moimaz N.B. Rocha C.A.S. Garbin T.A. Rovida N.A. Saliba 《Women and birth : journal of the Australian College of Midwives》2017,30(2):e119-e124
Background
Knowing the intention of mothers is important to plan actions to improve exclusive breastfeeding rates.Aim
The objective of this retrospective study was to verify the intention to breastfeed and the intended breastfeeding duration of a group of women participating in a public prenatal dental care program in the city of Araçatuba, Brazil.Methods
The records of 933 childbearing women were analyzed and their intention to breastfeed and intended breastfeeding duration were associated to women’s age, ethnicity, marital status, education, employment, number of gestations, previous breastfeeding experience, previous breastfeeding guidance, presence of complications during pregnancy, and systemic diseases. Data were inserted into Epi Info 2000 and analyzed with Biostat, at a 5% level of significance, and confidence interval of 95%.Findings
Participants mean age was 26.1 ± 5.9 years. The majority of women (96.5%) declared their intention to breastfeed their babies. The main variables to affect the intention to breastfeed were the number of gestations (p = 0.001), previous breastfeeding experience (p = 0.03), and previous breastfeeding guidance (p = 0.01). Intended breastfeeding duration was significantly affected by women’s age (p = 0.04), employment (0.02), the number of gestations (p = 0.001), and previous breastfeeding experience (p = 0.04).Conclusions
Previous positive breastfeeding experience and guidance during prenatal examinations positively affected women’s intention to breastfeed; while older, unemployed women in their second or more gestation and previous breastfeeding experience intended to breastfeed their children for longer periods of time. 相似文献20.
Julia Leinweber Debra K. Creedy Heather Rowe Jenny Gamble 《Women and birth : journal of the Australian College of Midwives》2017,30(1):40-45