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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3.
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Leonie Hewitt Holly Priddis Hannah G. Dahlen 《Women and birth : journal of the Australian College of Midwives》2019,32(2):168-177
Background
Despite well-known benefits of continuity of midwifery care, less than 10% of women have access to this model of care in Australia. Staff retention and satisfaction are strongly related to the quality of management; however, little is known about the attributes required to effectively manage a midwifery group practice.Purpose
To explore the attributes midwifery group practice managers require to be effective managers and how these attributes can be developed to promote service sustainability.Methods
A qualitative interpretive approach, employing in-depth interviews with eight midwifery leaders was undertaken and analysed using thematic analysis.Results
The overarching theme described the ideal midwifery group practice manager as someone who stands up for midwives and women and is ‘Holding the ground for midwifery, for women’. Subthemes demonstrate midwifery group practice management is complex: ‘having it’, describes the intrinsic traits of an effective leader; ‘someone with their hand on the steering wheel’ illustrates the day to day job of being a manager and the role of ‘juggling the forces’ that surround group practice; ‘helping managers to manage better’ explored the need for managers to be educated and supported for the role.Conclusions
Managers require certain attributes to effectively manage these unique services, whilst also juggling the needs of the organisation as a whole. Having transformational leadership qualities with vision to lead the practice into the future are key. There needs to be better support and preparation for the role if midwifery group practice is to be a sustainable option for women and midwives. 相似文献6.
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7.
Pranee Liamputtong Sandra Benza 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e216-e222
Problem
In non-Western societies, childlessness carries numerous social consequences and has a significant impact on the gender identity and well-being of the women.Background
The desire of women in non-Western societies is governed by numerous socio-cultural expectations including social norms and their own social position. At present, little is known about how Zimbabwean migrant women living in Australia perceive and experience childlessness and motherhood.Aim
To discuss how children are seen in Zimbabwean culture and examine the personal and social ramification of infertility and cultural expectations of motherhood among Zimbabwean migrant women living in Australia. The perspectives and experiences of this migrant community are crucial so that we can avoid misunderstanding about the essence of motherhood among Zimbabwean women. This will ultimately lead to sensitive and culturally appropriate health and social care for migrants in a multicultural society of Australia.Methods
The study is situated within the constructivist paradigm. Qualitative methods (in-depth interviewing, drawings and photo elicitation) were conducted with 15 Zimbabwean women. Data were analysed using thematic analysis method.Findings
Being able to bear a child in Zimbabwean culture had a significant meaning to the women. Not only children could ensure the continuity of the society, having children was a form of social security as parents would be cared for by their children in old age. Childlessness threatens the social position of a woman and carries social consequences which significantly impact on their gender identity and well-being. Cultural expectations of motherhood placed the sole responsibility of caring for the children emotionally and physically on the mother.Conclusion
The procreative value has not diminished despite having settled in Australia. An increased awareness of procreative needs for Zimbabwean women in a culturally and sensitive manner would enhance the emotional well-being of these women. 相似文献8.
Ling-ling Gao Hong Lu Nicky Leap Caroline Homer 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e279-e283
Background
With the recent surging economic and social development in China, midwifery has undergone transformation.Aim
A narrative review of literature relating to midwifery in mainland China was undertaken to examine the characteristics of midwifery’s potential development within relevant historical, economic and sociopolitical contexts. The aim was to assist future planning and the setting of strategic directions in policy in China.Methods
Online bibliographic databases from 2000 to 2015 were searched including MEDLINE, WanFang Data and Chinese National Knowledge Infrastructure. A process of narrative synthesis was used to analyse the selected papers and major issues were identified.Results
Twenty-one papers were included in the review. Two overarching issues were identified in relation to midwifery in mainland China: the history and status of midwifery education; and the practice and regulation of the midwifery profession. In recent decades, midwifery education, regulation and practice have occurred within systems that view midwifery as a specialisation of nursing. This means that there continues to be little opportunity for midwives to practise according to the international definition and scope of practice of the midwife.Conclusion
Midwifery in China must continue to develop in parallel with international trends. Investment in midwifery education alone will not suffice; it will have to operate within strong government policy regarding regulation, effective human resources management, visibility of the role of the midwife and development of the service delivery environment in which future midwives will work in China. 相似文献9.
Clare Bellhouse Meredith Temple-Smith Shaun Watson Jade Bilardi 《Women and birth : journal of the Australian College of Midwives》2019,32(2):137-146
Background
Miscarriage is a common event in Australia and is estimated to occur in up to one in four confirmed pregnancies. Prior research has demonstrated that miscarriage is associated with significant distress, grief and loss, and in some cases clinically significant levels of depression, anxiety, and Post Traumatic Stress Disorder. Despite these consequences for women’s emotional and mental health, studies have commonly found that women feel that healthcare providers often lack empathy, support, and acknowledgement of their loss.Aim
The aim of this study is to explore the psychological distress experienced by women as a result of miscarriage, as well as the perceived support provided by healthcare professionals.Methods
Fifteen women were recruited in Australia and participated in semi-structured interviews either in person or over the telephone.Findings
It was found that for most women, the levels of distress, grief, and loss associated with their miscarriages were significant. While women experienced both positive and negative interactions with healthcare providers throughout their miscarriage journeys, all women interviewed expressed their increased distress following negative experiences.Conclusion
A number of recommendations have been provided by women to improve the service of healthcare providers in the event of a miscarriage, including referral to a psychologist, and ongoing follow-up after their miscarriage, which women felt would assist them with managing their distress. 相似文献10.
Shefaly Shorey Lina Ang Wilson W.S. Tam 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e145-e158
Problem
The perinatal period is a stressful transition for new parents.Background
Various forms of educational interventions are available and are found to be efficacious in improving maternal and child outcomes. Such interventions for fathers were scarce and western-centric. Fathers should be educated as they have an impact on maternal and child outcomes.Aim
This review aims to evaluate the efficacy of quantitatively-studied informational support-focused interventions for fathers using paternal outcomes only.Methods
The search was carried out in six databases: Cumulative Index to Nursing and Allied Health Literature, PubMed, Scopus, Embase, Psychological Information Database, and MedNar. Cochrane Collaboration’s tools were used to assess the eligibility of the studies.Findings
A total of 17 studies with 18 interventions were identified and included in the narrative synthesis. Most interventions were delivered to the Western population during the antenatal or postpartum period. The method of delivery for these interventions was mainly face-to-face, with inconclusive findings on various paternal psychosocial outcomes.Discussion
Limited father-inclusive interventions were available. Technology-based longitudinal studies with interventions carried out across the perinatal period with longer follow-up periods were recommended for interventions providing informational support for fathers. Future studies can also examine paternal physical health and behavioural outcomes. Interventions in culturally-diverse populations should be designed and tested for their efficacies as fathers have different informational needs, especially in Asia.Conclusion
Informational interventions for fathers were found to be lacking and recommendations for future studies on educational interventions for fathers were discussed. 相似文献11.
Puremeluan B. Major Shuby Puthussery Yannis Pappas 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e189-e196
Background
Mother-to-child transmission of Human Immunodeficiency Virus continues to be a major problem in Nigeria. Despite several initiatives, the number of infected pregnant women receiving Anti-Retroviral Therapy to prevent mother-to-child transmission of the virus remains low in Nigeria. Evidence suggests that attitudes and perceptions of the pregnant women influence their use of Anti-Retroviral Therapy.Aim
To understand the attitudes and perceptions of Human Immunodeficiency Virus infected pregnant women towards the use of Anti-Retroviral Therapy for prevention of mother-to-child transmission in Nigeria.Method
Twenty four Human Immunodeficiency Virus infected pregnant women were purposively selected from antenatal clinics. Women’s attitudes and perceptions towards the use of Anti-Retroviral Therapy were explored using semi-structured in-depth interviews conducted in May/June 2016. All interviews were recorded, transcribed and analysed using thematic approach.Findings
Overall, participants reflected a positive attitude about using Anti-Retroviral Therapy to prevent mother-to-child transmission and perceived the treatment as beneficial. The main themes identified included: perceived benefits of Anti-Retroviral Therapy; barriers to using Anti-Retroviral Therapy; threat from the susceptibility to the illness and the severity; perceived roles in treatment; and the negative behaviours of healthcare providers.Conclusion
The findings provide useful insights to inform Nigeria’s health policies on Anti-Retroviral Therapy. There is a need to educate the women on the benefits of the treatment as well as how they can cope with side effects and the daily regimen of the therapy during pregnancy. The findings also indicate the need for training healthcare providers on facilitative patient-provider relationship. 相似文献12.
Narges Alianmoghaddam Suzanne Phibbs Cheryl Benn 《Women and birth : journal of the Australian College of Midwives》2019,32(2):147-156
Background
Little qualitative research has been done to explore the quality of breastfeeding support through social media in New Zealand.Aim
This article aims to explore the influence of social media on exclusive breastfeeding practice.Methods
A qualitative study involving face-to-face postpartum interviews with 30 mothers who were recruited from the lower North Island of New Zealand. Each participant was followed via short monthly audio-recorded telephone interviews until giving up exclusive breastfeeding or until six months after the birth. The theories “strength of weak ties” and “landscapes of care” are applied to the thematic analysis of the interview material to illuminate the influence of social media on breastfeeding practices.Results
Qualitative analysis of the interview material identified four themes: 1) Mothers need reliable online infant feeding information; 2) Smartphone apps can be a good option for promoting breastfeeding; 3) Information is accessed through weak ties among breastfeeding mothers on Facebook, and 4) the utility of geographically distant infant feeding support via Skype.Discussion
Most participants sourced post-partum information and advice to support breastfeeding through the Internet, while those with geographically distant family members accessed emotional and practical breastfeeding support via Skype.Implications for Practice
Breastfeeding advocates should use social media to promote and support exclusive breast-feeding practice.Conclusion
The influence of social media on breastfeeding points to the relational nature of breastfeeding which is embedded in ‘real’ world and virtual social networks as well as the cultural, geographic and social contexts of a mother’s life. 相似文献13.
Julia Leinweber Debra K. Creedy Heather Rowe Jenny Gamble 《Women and birth : journal of the Australian College of Midwives》2017,30(1):40-45
Background
Midwives frequently witness traumatic birth events. Little is known about responses to birth trauma and prevalence of posttraumatic stress among Australian midwives.Aim
To assess exposure to different types of birth trauma, peritraumatic reactions and prevalence of posttraumatic stress.Methods
Members of the Australian College of Midwives completed an online survey. A standardised measure assessed posttraumatic stress symptoms.Findings
More than two-thirds of midwives (67.2%) reported having witnessed a traumatic birth event that included interpersonal care-related trauma features. Midwives recalled strong emotions during or shortly after witnessing the traumatic birth event, such as feelings of horror (74.8%) and guilt (65.3%) about what happened to the woman. Midwives who witnessed birth trauma that included care-related features were significantly more likely to recall peritraumatic distress including feelings of horror (OR = 3.89, 95% CI [2.71, 5.59]) and guilt (OR = 1.90, 95% CI [1.36, 2.65]) than midwives who witnessed non-interpersonal birth trauma. 17% of midwives met criteria for probable posttraumatic stress disorder (95% CI [14.2, 20.0]). Witnessing abusive care was associated with more severe posttraumatic stress than other types of trauma.Discussion
Witnessing care-related birth trauma was common. Midwives experience strong emotional reactions in response to witnessing birth trauma, in particular, care-related birth trauma. Almost one-fifth of midwives met criteria for probable posttraumatic stress disorder.Conclusion
Midwives carry a high psychological burden related to witnessing birth trauma. Posttraumatic stress should be acknowledged as an occupational stress for midwives. The incidence of traumatic birth events experienced by women and witnessed by midwives needs to be reduced. 相似文献14.
Joëlle Darwiche Anne Milek Jean-Philippe Antonietti Yvan Vial 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e264-e271
Background
Pregnancy after infertility is a challenging experience. The first-trimester screening test may add stress. Partner support reduces psychological distress in pregnant women after spontaneous conception. No data are available for women who conceive via assisted reproductive technology.Aim
To assess whether there was a difference between couples who underwent assisted reproductive technology and couples who conceived spontaneously in the support they felt they provided to their partner and whether their perception of support received from their partner reduced their distress.Methods
This longitudinal prospective study included 52 women (spontaneous conception) and 53 women (assisted reproductive technology), as well as their partners. Participants completed the state scale of the State-Trait Anxiety Inventory, the Edinburgh Depression Scale, and two partner-support subscales of the Dyadic Coping Inventory: before prenatal testing (gestational age 12 weeks), immediately after receiving the results (gestational age of approximately 14 weeks), and once all the prenatal screenings had been completed (gestational age 22 weeks).Findings
Women who underwent assisted reproductive technology felt less able to help their partner cope with stress and felt their partner was less able to help them cope with stress than women with spontaneous pregnancy. This difference was not observed in men. Higher perceived partner support lowered the anxiety and depression of couples who conceived spontaneously, but did not benefit couples who followed fertility treatment.Conclusion
These results add to our knowledge of the emotional state of women and their partners during pregnancy after infertility. This knowledge may allow prenatal care providers to offer specialized counselling to women and their partners in the transition from infertility to parenthood. 相似文献15.
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Yvonne Meyer Franziska Frank Franziska Schläppy Muntwyler Valerie Fleming Jessica Pehlke-Milde 《Women and birth : journal of the Australian College of Midwives》2017,30(6):e272-e280
Background
Decision-making in midwifery, including a claim for shared decision-making between midwives and women, is of major significance for the health of mother and child. Midwives have little information about how to share decision-making responsibilities with women, especially when complications arise during birth.Aim
To increase understanding of decision-making in complex home-like birth settings by exploring midwives’ and women’s perspectives and to develop a dynamic model integrating participatory processes for making shared decisions.Methods
The study, based on grounded theory methodology, analysed 20 interviews of midwives and 20 women who had experienced complications in home-like births.Findings
The central phenomenon that arose from the data was “defining/redefining decision as a joint commitment to healthy childbirth”. The sub-indicators that make up this phenomenon were safety, responsibility, mutual and personal commitments. These sub-indicators were also identified to influence temporal conditions of decision-making and to apply different strategies for shared decision-making. Women adopted strategies such as delegating a decision, making the midwife’s decision her own, challenging a decision or taking a decision driven by the dynamics of childbirth. Midwives employed strategies such as remaining indecisive, approving a woman’s decision, making an informed decision or taking the necessary decision.Discussion and conclusion
To respond to recommendations for shared responsibility for care, midwives need to strengthen their shared decision-making skills. The visual model of decision-making in childbirth derived from the data provides a framework for transferring clinical reasoning into practice. 相似文献19.
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20.
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