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Lyndall Mollart Virginia Skinner Jon Adams Maralyn Foureur 《Women and birth : journal of the Australian College of Midwives》2018,31(1):44-51
Complementary and Alternative Medicine (CAM) have increasingly been used by pregnant women with a steady rise in interest by midwives. Literature describing CAM and self-help options midwives recommend to women experiencing a post-date pregnancy is sparse. This study aimed to investigate if Australian midwives’ personal CAM use impacts on discussions and recommendations of CAM/Self-help strategies.
Methodology/design
A survey of a national midwifery association midwifery members (n = 3,552) was undertaken at a midwifery conference (October 2015) and via e-bulletins (November 2015–March 2016). The self-administered survey included questions on what self-help and CAM strategies midwives discuss and recommend to women with a post-date pregnancy, midwives’ confidence levels on discussing or recommending CAM, midwives’ own personal use of CAM.Findings
A total of 571 registered midwives completed the survey (16%). Demographics (age, years as a midwife, state of residence) reflected Australian midwives and the midwifery association membership. Most respondents discuss (91.2%) and recommend (88.6%) self-help/CAM strategies to women with a post-date pregnancy. The top five CAM recommended were Acupuncture (65.7%), Acupressure (58.1%), Raspberry Leaf (52.5%), Massage (38.9%) and Hypnosis/Calmbirthing/Hypnobirthing (35.7%). Midwives were more likely to discuss strategies if they personally used CAM (p < .001), were younger (p < .001) or had worked less years as midwives (p = .004). Midwives were more likely to recommend strategies if they used CAM in their own pregnancies (p = .001).Conclusion
Midwives’ personal use of CAM influenced their discussions and recommendations of CAM/self-help strategies to women experiencing a post-date pregnancy. This study has implications for inclusion of CAM in midwifery education curricula. 相似文献3.
Shahnaz Torkzahrani Fatemeh Mahmoudikohani Kiarash Saatchi Reyhaneh Sefidkar Mojdeh Banaei 《Women and birth : journal of the Australian College of Midwives》2017,30(1):46-50
Background
Induction of labor is a common obstetric procedure. Acupressure is a natural method that is used for inducing uterine contractions. Nevertheless, few studies have examined the impact of acupressure on the induction of labor.Aim
The aim of this study was to evaluate the effect of acupressure on the initiation of labor.Material and methods
In this randomized clinical trial, 162 nulliparous pregnant women were admitted to the hospital. They were categorized into 3 groups; acupressure, sham acupressure and control. Acupressure points SP6, BL 60 and BL 32 were pressured bilaterally. The intervention was done by the researcher every other day between 9 am and 11 am. The intervention was carried out on women in the afternoon and the following day. Subjects were examined to determine the initiation of labor symptoms48 and 96 h after the start of intervention and at the time of hospitalization. Data were analyzed using the ANOVA, Kruskal–Wallis and Chi-square tests (p < 0.05).Results
There was no significant difference among the groups for spontaneous initiation of labor within 48 h (P = 0.464), and 49–96 h after beginning the intervention (P = 0.111) and 97 h after beginning the intervention to the time of hospitalization for the spontaneous initiation of labor (P = 0.897). There were no significant differences in the secondary outcomes between the groups.Conclusion
According to the finding of this study, it seems that acupressure treatment was not effective in initiating labor as compared with the sham acupressure and the routine care groups. 相似文献4.
Anna Clara F. Vieira Cláudia M.C. Alves Vandilson P. Rodrigues Cecília C.C. Ribeiro Isaac S. Gomes-Filho Fernanda F. Lopes 《Women and birth : journal of the Australian College of Midwives》2019,32(1):e12-e16
Background
The rates of preterm births have been increasing worldwide. Complications related to preterm births are associated with increased costs of care, and have a direct impact on the health system of the countries. Therefore, it is important to address factors associated with preterm birth in order to provide prevention strategies.Objective
This case–control study investigated oral, systemic, and socioeconomic factors associated with preterm birth in postpartum women. Participants were 279 postpartum women that gave birth to a singleton live-born infant. Cases were women giving birth before 37 completed weeks of gestation (preterm birth). Controls were women giving birth at term (≥37 weeks). Data were collected through questionnaires, medical records and intra-oral clinical examinations, which included dental caries registration according to World Health Organization criteria and oral biofilm evaluation through visible plaque index.Results
Ninety-one women had preterm birth (cases) and 188 women had birth at term (controls), ratio 1:2. Caries lesions were present in 62.3% of the cases and in 62.5% of the controls. The univariate analysis showed no association between dental caries and preterm birth (Odds Ratio = 1.08, p = 0.90). The multivariate analysis showed that maternal educational level (Odds Ratio = 2.56, p = 0.01) and arterial hypertension (Odds Ratio = 2.32, p = 0.01) were associated with prematurity.Conclusion
This study demonstrated that dental caries is frequent in postpartum women, but it does not appear to be associated with preterm birth. Meanwhile, maternal education level and arterial hypertension were associated with prematurity in this population. 相似文献5.
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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7.
Maria Noonan Julie Jomeen Rose Galvin Owen Doody 《Women and birth : journal of the Australian College of Midwives》2018,31(6):e358-e366
Background
Midwives have a primary role in facilitating the first stage of perinatal mental health risk reduction through inquiring about perinatal mental health, identifying risk factors and current perinatal mental health problems, providing support or crisis intervention, referring for treatment and decreasing stigmatisation.Aims
The aims of this study were to determine midwives’ (a) knowledge of and confidence to identify and manage perinatal mental health problems, (b) attitudes towards women who experience severe mental illness and (c) perceived learning needs.Design
A cross-sectional survey design.Methods
The study was conducted between September 2016 and April 2017 in seven Maternity services in the Republic of Ireland with a purposeful non-random convenience sample of midwives (n = 157). Data was anonymously collected utilising the Perinatal Mental Health Questionnaire, the Mental Illness: Clinician’s Attitudes scale and the Perinatal Mental Health Learning Needs questionnaire.Findings
Midwives indicated high levels of knowledge (71.1%) and confidence (72%) in identifying women who experience depression and anxiety however, they reported less confidence in caring (43.9%) for women. Only 17.8% (n = 28) of midwives felt equipped to support women whilst 15.3% (n = 24) reported having access to sufficient information. Midwives desire education on the spectrum of perinatal mental health problems. The mean score for the Mental Illness: Clinician’s Attitudes scale was 36.31 (SD = 7.60), indicating positive attitudes towards women with severe mental illness.Conclusion
Midwives require further education on perinatal mental health across cultures with a skill focus and which explores attitudes delivered in a study day format. 相似文献8.
Kathleen M. Baird Amornrat S. Saito Jennifer Eustace Debra K. Creedy 《Women and birth : journal of the Australian College of Midwives》2018,31(4):285-291
Background
Asking women about experiences of domestic violence in the perinatal period is accepted best practice. However, midwives and nurses may be reluctant to engage with, or effectively respond to disclosures of domestic violence due a lack of knowledge and skills.Aim
To evaluate the impact of training on knowledge and preparedness of midwives and nurses to conduct routine enquiry about domestic violence with women during the perinatal period.Method
A pre-post intervention design was used. Midwives and nurses (n = 154) attended a full day workshop. Of these, 149 completed pre-post workshop measures of knowledge and preparedness. Additional questions at post-training explored participants’ perceptions of organisational barriers to routine enquiry, as well as anticipated impact of training on their practice. Training occurred between July 2015 and October 2016.Findings
Using the Wilcoxon signed-rank test, all post intervention scores were significantly higher than pre intervention scores. Knowledge scores increased from a pre-training mean of 21.5–25.6 (Z = ?9.56, p < 0.001) and level of preparedness increased from 40.8 to 53.2 (Z = ?10.12, p < 0.001). Most participants (93%) reported improved preparedness to undertake routine enquiry after training. Only a quarter (24.9%) felt their workplace allowed adequate time to respond to disclosures of DV.Conclusions
Brief training can improve knowledge, preparedness, and confidence of midwives and nurses to conduct routine enquiry and support women during the perinatal period. Training can assist midwives and nurses to recognise signs of DV, ask women about what would be helpful to them, and address perceived organisational barriers to routine enquiry. Practice guidelines and clear referral pathways following DV disclosure need to be implemented to support gains made through training. 相似文献9.
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Amelia Lee Michelle Newton Jessica Radcliffe Regina Belski 《Women and birth : journal of the Australian College of Midwives》2018,31(4):269-277
Background
Dietary intake of pregnant women do not appear to meet the dietary recommendations. Nutrition knowledge and practices of pregnant women and their antenatal care clinicians are factors that may be influential on dietary intakes of pregnant women.Aim
To assess and compare pregnancy nutrition recommendation knowledge and to explore how nutrition knowledge impacts on food choices in pregnant women and nutrition education practices of antenatal care providers.Methods
An explanatory sequential research mixed methods study design was applied. All participants were recruited from a metropolitan maternity hospital in Melbourne, Australia. The first phase assessed pregnancy nutrition knowledge and sources of nutrition information using a questionnaire (n = 202) then followed semi-structured interviews with women and clinicians (n = 31).Findings
The clinicians obtained significantly higher nutrition scores than compared to women, however, nutrition knowledge gaps were highlighted for both women and clinicians. Women reported receiving limited nutrition advice, a reflection of the clinicians reporting they provided limited nutrition advice.Conclusion
A key challenge for women adhering to dietary recommendations was having inadequate knowledge of the dietary recommendations and receiving limited information from their care providers. Similarly, as well as time constraints, limited nutrition knowledge and a lack of nutrition training impacted on the capacity of clinicians to provide adequate nutrition education. 相似文献11.
Ana Rubio-Álvarez Milagros Molina-Alarcón Antonio Hernández-Martínez 《Women and birth : journal of the Australian College of Midwives》2017,30(5):382-388
Background
Postpartum anaemia is a problem with high prevalence that significantly affects maternal recovery. Among the causal factors is perineal trauma. However, it is still not known what degree of perineal trauma produces a greater reduction of haemoglobin.Aim
To assess the relationship between the degree of perineal trauma and change in haemoglobin concentration at vaginal birth.Methods
An observational, analytical retrospective cohort study was performed at the Mancha-Centro Hospital (Spain) during the period 2010–2014. Data were collected regarding 3479 women who gave birth vaginally. The main outcome variable was the change in haemoglobin concentration. Multivariate analysis by means of multiple linear regression was performed to control possible confounding factors and to determine the net effect of each degree of perineal trauma on haemoglobin reduction.Findings
Of the total sample, 20.1% of women (699) had an intact perineum, 41.6% (1446) experienced some form of perineal trauma, but not episiotomy, and the remaining 38.3% of women (1334) underwent an episiotomy. The average reduction of haemoglobin was 1.46 g/dL (Standard Deviation (SD) = 1.09 g/dL) for women without episiotomy with a second degree tear and 2.07 g/dL (SD = 1.24 g/dL) for women who had an episiotomy and no perineal tear. The greatest reduction occurred among women with episiotomy and a third or fourth degree tear with a decrease of 3.10 g/dL (SD = 1.32 g/dL).Conclusion
Episiotomy is related to greater reduction of haemoglobin concentration in comparison with all degrees of spontaneous perineal trauma. The use of episiotomy should be strictly limited. 相似文献12.
Nuria Infante-Torres Milagros Molina-Alarcón Ana Rubio-Álvarez Julián Rodríguez-Almagro Antonio Hernández-Martínez 《Women and birth : journal of the Australian College of Midwives》2018,31(5):e318-e324
Aim
To assess the relationship between the duration of the second stage of labour and postpartum anaemia during vaginal birth.Methods
An observational, analytical retrospective cohort study was performed at the “Mancha-Centro Hospital” (Spain) during the 2013–2016 period. Data were collected from 3437 women who had a vaginal birth. Postpartum anaemia was defined as a haemoglobin level below 11 g/dL at 24 h postpartum. A univariate analysis was used for potential risk factors and a multivariate analysis with binary logistic regression to control for possible confounding factors.Findings
The incidence of postpartum anaemia was 42.0%. The risk of postpartum anaemia did not increase in nulliparous women whose duration of the second stage of labour exceeded 4 h. Compared with multiparous women who delivered between 0 and 3 h, multiparous women with a duration of the second stage of labour beyond 3 h were at higher risk of postpartum anaemia (OR = 2.43 [1.30–4.52]).Conclusion
The duration of the second stage of labour beyond 4 h is safe for postpartum anaemia in nulliparous women. However in multiparous women, monitoring should increase if the second stage of labour exceeds 3 h given the increased risk of postpartum anaemia. 相似文献13.
Paula Olsen Moira Williamson Victoria Traynor Chris Georgiou 《Women and birth : journal of the Australian College of Midwives》2018,31(1):31-37
Objective
To perform a pilot project to determine if this research design was appropriate to explore potential causal relationships between oral probiotic use and vaginal Group B Streptococcal (GBS) colonisation rates in pregnant women.Method
Thirty-four GBS-positive women at 36 weeks pregnant were recruited. The participants were randomly allocated to the control group, who received standard antenatal care, or to the intervention group, who received standard antenatal care and a daily oral dose of probiotics for three weeks or until they gave birth. A vaginal GBS swab was collected three weeks post consent or during labour.Findings
No significant difference was found in vaginal GBS rates between the control and intervention groups. Only seven of 21 women in the intervention group completed the entire 21 days of probiotics. A subgroup analysis, including only those who had completed 14 days or more of probiotics (n = 16), also showed no significant difference in vaginal GBS when compared to the control. The findings did show significantly more vaginal commensals in the probiotics group (p = 0.048).Discussion
Five possible reasons for the lack of significant results are: the length of the intervention was too short; the dosage of the probiotics was too low; the wrong strains of probiotics were used; the sample size was inadequate; or oral probiotics are ineffective in impacting vaginal GBS.Implications
The finding of a significant increase of vaginal commensals in women who completed 14 days or more of probiotics supports the potential of probiotics to impact vaginal GBS in pregnancy. 相似文献14.
Sahar Ghale Askari Masomeh Khatbasreh Mohammad Hassan Ehrampoush Mohammad Hassan Sheikhha Hadi Eslami Mahmoud Taghavi Samira Shahrokhi Sodeh Andishmand 《Women and birth : journal of the Australian College of Midwives》2018,31(3):e204-e209
Problem
The process of industrialization and lifestyle changes have gradually exposed human ?societies to a larger number of environmental risk factors, which may cause hormonal ?abnormalities and congenital anomalies.Background
The current study aimed to investigate the relationship ?between environmental factors and hormonal abnormalities among pregnant women in Yazd, ?Iran.Methods
A hundred participants were randomly selected from among a group of pregnant women. According to the screening tests (AFP, free β-?HCG, uE3, PAPP-A, and inhibin-A) performed at the genome clinic in Yazd in 2016, the risk of Down Syndrome (DS) was sufficiently high in this group of pregnant women from which the participants were selected. A ?questionnaire was used to collect data on the degree of the participants’ exposure to pesticides ?at home, use of canned and fast foods, and consumption of greenhouse fruits. The collected data were ?analyzed by One-way ANOVA and Kruskal–Wallis Test.Findings
The mean of Multiple of Median (MoM) for inhibin-A was significantly higher among pregnant ?women who often or always used pesticides at home (p = 0.047). The mean MoM ?for free β-HCG was significantly higher among pregnant women who often or always used canned ?foods (p = 0.024). Finally, the mean MoM for uE3 (1.85 ± 1.30) was significantly higher among ?pregnant women who never consumed greenhouse fruits (p = 0.003).Conclusion
It can be concluded that it is possible to reduce environmental exposures affecting hormonal abnormalities among pregnant women by improving nutritional patterns, minimizing the use of pesticides at home, and reducing the intake of canned foods and greenhouse fruits. 相似文献15.
Marjon De Roose Dimitri Beeckman Katrijn Eggermont Elke Vanhouche Ann Van Hecke Sofie Verhaeghe 《Women and birth : journal of the Australian College of Midwives》2018,31(3):e197-e203
Problem
To date, it is unclear which factors are associated with parenting stress.Background
There are no studies investigating the association between parenting stress and coping strategies such as coparenting and social support, while simultaneously considering demographic and obstetric factors, in mothers of singletons and twins.Aim
To investigate if parenting stress is associated with personal, and obstetric characteristics, the level of coparenting, and the availability of and satisfaction with social support in mothers of singletons and twins until one year postpartum.Methods
A cross-sectional study was conducted. A total of 151 singleton mothers and 101 twin mothers were included.Results
Both singleton and twin mothers experiencing lower parenting stress levels indicated a better coparenting relationship quality (β = ?0.253, p < 0.01; β = ?0.341, p = 0.001). Elevated parenting stress levels positively influenced the level of satisfaction with social support in only mothers of twins (β = 0.273, p < 0.01). The availability of social support, personal, and obstetric characteristics were not associated with the level of parenting stress in neither singleton nor twin mothers.Conclusion
Coparenting seems to be a significant coping strategy reducing the level of parenting stress in singleton and twin mothers, irrespective of their personal and obstetric characteristics. Large-scale longitudinal research is needed to identify predictors of parenting stress, which may help to develop parenting stress reducing interventions. The acknowledgement and support of an adequate coparenting relationship quality by health care professionals might be an important factor to include in such interventions. 相似文献16.
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17.
Shih-Yi Wen Yi-Li Ko Hei-Jen Jou Li-Yin Chien 《Women and birth : journal of the Australian College of Midwives》2018,31(6):e367-e373
Background
Poor sleep quality is related to old age among the general population, but few studies have focused on postpartum women of advanced maternal age. The present study aimed to describe and compare sleep quality between women younger or older than 35 years of age at 3 months postpartum, and to examine the related factors.Methods
A cross-sectional survey was conducted with 160 postpartum women who had given birth at a teaching hospital in Taiwan. The participants were assigned to two groups according to age (≥35 years, n = 80; and 20–34 years, n = 80). Sleep quality was measured using the Pittsburgh Sleep Quality Index with a cut-off score of 5.Results
The prevalence of poor sleep quality at 3 months postpartum was higher in older mothers (61.6%) than in younger mothers (38.4%, p < 0.01). Multiple logistic regression revealed that poor sleep quality was positively correlated with the severity of postpartum physical symptoms, lack of exercise, and room-sharing with infants. After adjustment for those variables, older mothers were three times more likely to have poor sleep quality than younger mothers (odds ratio = 3.08; 95% confidence interval 1.52–6.23).Conclusion
Health care providers should pay attention to sleep problems among postpartum women, especially mothers of advanced maternal age. In particular, health care providers should evaluate sleep quality among postpartum women, instruct them not to share the bed with their infants at night, perform exercise, and manage their postpartum physical symptoms to improve the sleep quality. 相似文献18.
Jennifer Fenwick Mary Sidebotham Jenny Gamble Debra K. Creedy 《Women and birth : journal of the Australian College of Midwives》2018,31(1):38-43
Background
Continuity of midwifery care contributes to significant positive outcomes for women and babies. There is a perception that providing continuity of care may negatively impact on the wellbeing and professional lives of midwives.Aim
To compare the emotional and professional wellbeing as well as satisfaction with time off and work-life balance of midwives providing continuity of care with midwives not providing continuity.Method
Online survey. Measures included; Copenhagen Burnout Inventory (CBI); Depression, Anxiety and Stress Scale-21; and Perceptions of Empowerment in Midwifery Scale (PEMS-Revised). The sample (n = 862) was divided into two groups; midwives working in continuity (n = 214) and those not working in continuity (n = 648). Mann Whitney U tests were used to compare the groups.Results
The continuity group had significantly lower scores on each of the burnout subscales (CBI Personal p = .002; CBI Work p < .001; CBI Client p < .001) and Anxiety (p = .007) and Depression (p = .004) sub-scales. Midwives providing continuity reported significantly higher scores on the PEMs Autonomy/Empowerment subscale (p < .001) and the Skills and Resources subscale (p = .002). There was no difference between the groups in terms of satisfaction with time off and work-life balance.Conclusion
Our results indicate that providing continuity of midwifery care is also beneficial for midwives. Conversely, midwives working in shift-based models providing fragmented care are at greater risk of psychological distress. Maternity service managers should feel confident that re-orientating care to align with the evidence is likely to improve workforce wellbeing and is a sustainable way forward. 相似文献19.
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Kathleen Baird Debra K. Creedy Amornrat S. Saito Jennifer Eustace 《Women and birth : journal of the Australian College of Midwives》2018,31(5):398-406