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1.
Sara Molgora Valentina Fenaroli Laura Elvira Prino Luca Rollè Cristina Sechi Annamaria Trovato Laura Vismara Barbara Volpi Piera Brustia Loredana Lucarelli Renata Tambelli Emanuela Saita 《Women and birth : journal of the Australian College of Midwives》2018,31(2):117-123
Background
The prevalence of fear of childbirth in pregnant women is described to be about 20–25%, while 6–10% of expectant mothers report a severe fear that impairs their daily activities as well as their ability to cope with labour and childbirth. Research on fear of childbirth risk factors has produced heterogeneous results while being mostly done with expectant mothers from northern Europe, northern America, and Australia.Aims
The present research investigates whether fear of childbirth can be predicted by socio-demographic variables, distressing experiences before pregnancy, medical-obstetric factors and psychological variables with a sample of 426 Italian primiparous pregnant women.Methods
Subjects, recruited between the 34th and 36th week of pregnancy, completed a questionnaire packet that included the Wijma Delivery Expectancy Questionnaire, the Edinburgh Postnatal Depression Scale, the State-Trait Anxiety Inventory, the Dyadic Adjustment Scale, the Multidimensional Scale of Perceived Social Support, as well as demographic and anamnestic information. Fear of childbirth was treated as both a continuous and a dichotomous variable, in order to differentiate expectant mothers as with a severe fear of childbirth.Findings
Results demonstrate that anxiety as well as couple adjustment predicted fear of childbirth when treated as a continuous variable, while clinical depression predicted severe fear of childbirth.Conclusions
Findings support the key role of psychological variables in predicting fear of childbirth. Results suggest the importance of differentiating low levels of fear from intense levels of fear in order to promote adequate support interventions. 相似文献2.
Yael Benyamini Maya Lila Molcho Uzi Dan Miri Gozlan Heidi Preis 《Women and birth : journal of the Australian College of Midwives》2017,30(5):424-430
Problem
Rates of medical interventions in childbirth have greatly increased in the Western world.Background
Women’s attitudes affect their birth choices.Aim
To assess women’s attitudes towards the medicalization of childbirth and their associations with women’s background as well as their fear of birth and planned and unplanned modes of birth.Methods
This longitudinal observational study included 836 parous woman recruited at women’s health centres and natural birth communities in Israel. All women filled in questionnaires about attitudes towards the medicalization of childbirth, fear of birth, and planned birth choices. Women at <28 weeks gestation when filling in the questionnaire were asked to fill in a second one at ～34 weeks. Phone follow-up was conducted ～6 weeks postpartum to assess actual mode of birth.Findings
Attitudes towards medicalization were more positive among younger and less educated women, those who emigrated from the former Soviet Union, and those with a more complicated obstetric background. Baseline attitudes did not differ by parity yet became less positive throughout pregnancy only for primiparae. More positive attitudes were related to greater fear of birth. The attitudes were significantly associated with planned birth choices and predicted emergency caesareans and instrumental births.Discussion
Women form attitudes towards the medicalization of childbirth which may still be open to change during the first pregnancy. More favourable attitudes are related to more medical modes of birth, planned and unplanned.Conclusion
Understanding women’s views of childbirth medicalization may be key to understanding their choices and how they affect labour and birth. 相似文献3.
Ingegerd Hildingsson Helen Haines Annika Karlström Astrid Nystedt 《Women and birth : journal of the Australian College of Midwives》2017,30(5):e242-e247
Background
The prevalence of fear of birth has been estimated between 8–30%, but there is considerable heterogeneity in research design, definitions, measurement tools used and populations. There are some inconclusive findings about the stability of childbirth fear.Aim
to assess the prevalence and characteristics of women presenting with scores ≥60 on FOBS-The Fear of Birth Scale, in mid and late pregnancy, and to study change in fear of birth and associated factors.Methods
A prospective longitudinal cohort study of a one-year cohort of 1212 pregnant women from a northern part of Sweden, recruited in mid pregnancy and followed up in late pregnancy. Fear of birth was assessed using FOBS-The fear of birth scale, with the cut off at ≥60.Findings
The prevalence of fear of birth was 22% in mid pregnancy and 19% in late pregnancy, a statistically significant decrease. Different patterns were found where some women presented with increased fear and some with decreased fear. The women who experienced more fear or less fear later in pregnancy could not be differentiated by background factors.Conclusions
More research is needed to explore factors important to reduce fear of childbirth and the optimal time to measure it. 相似文献4.
Helén Wahlbeck Linda J. Kvist Kajsa Landgren 《Women and birth : journal of the Australian College of Midwives》2018,31(4):299-306
Background
Fear of childbirth is a serious problem that can have negative effects on both women and babies and to date treatment options are limited. The aim of this study was to elucidate the experience of undergoing art therapy in women with severe fear of childbirth.Method
Nineteen women residing in Sweden, who had undergone art therapy for severe fear of childbirth, were interviewed during 2011–2013 about their experiences of the treatment. All women had received both support from a specialist team of midwives and treatment by an art therapist who was also a midwife. The women were interviewed three months after giving birth. The transcribed interviews were analysed with a phenomenological hermeneutical method.Findings
A main theme and three themes emerged from the analysis. The main theme was Gaining hope and self confidence. The three themes were; Carrying heavy baggage, Creating images as a catalyst for healing and Gaining new insights and abilities. Through the use of images and colours the women gained access to difficult emotions and the act of painting helped them visualize these emotions and acted as a catalyst for the healing process.Discussion
Art therapy was well accepted by the women. Through sharing their burden of fear by creating visible images, they gained hope and self-confidence in the face of their impending childbirth.Conclusion
The results may contribute to knowledge about the feasibility of treating fear of childbirth by art therapy. 相似文献5.
Cherelle M.V. van Stenus Magda M. Boere-Boonekamp Erna F.G.M. Kerkhof Ariana Need 《Women and birth : journal of the Australian College of Midwives》2018,31(6):e380-e388
Problem
It is unknown if client experiences with perinatal healthcare differ between low-risk and high-risk women.Background
In the Netherlands, risk selection divides pregnant women into low- and high-risk groups. Receiving news that a pregnancy or childbirth has an increased likelihood of complications can cause elevated levels of emotional distress.Aim
The purpose of this study is to describe client experiences with perinatal healthcare and to determine which, if any, background characteristics, pregnancy circumstances, childbirth or follow-up care characteristics are explaining variables of differences in client experiences between high-risk and low-risk women.Methods
Client experiences were measured with a validated questionnaire completed by 1388 women within 12 weeks after childbirth.Findings
Women rated their experiences with perinatal healthcare with a mean score of 3.78 on a scale of 1–4; 5.5% of the women rated their experiences as “notably bad”. Client experiences with perinatal healthcare show small variations, with a lower mean score for women who were at high risk (3.75) compared to low-risk women (3.84). This difference is partially due to more unplanned medical interventions and pain relief during childbirth in the high-risk group. Also, single mothers and non-Dutch women were more susceptible to less positive experiences.Conclusion
Given the potential negative impact of adverse client experiences, this study highlights the need for healthcare professionals to be aware of what women are susceptible for having had negative experiences. It is advised that healthcare provision be altered to tailor to the needs of these women. 相似文献6.
Predictors of women’s positive childbirth pain experience: Findings from an Icelandic national study
Sigfridur Inga Karlsdottir Herdis Sveinsdottir Hildur Kristjansdottir Thor Aspelund Olof Asta Olafsdottir 《Women and birth : journal of the Australian College of Midwives》2018,31(3):e178-e184
Background
Pain in childbirth has been identified as one of the major components in the childbirth experience and an important topic that needs to be addressed during pregnancy, birth and the after-birth period.Aim
The aim of the study was to describe women’s childbirth pain experience and to identify predictors of women’s positive childbirth pain experience.Method
A population-based cross-sectional cohort study design was implemented, with convenient consecutive sampling, stratified according to residency. Pregnant women were recruited through 26 health care centers. Participants were sent a questionnaire by mail during early pregnancy and another one five to six months after childbirth. A multiple regression analysis was done, with women’s childbirth pain experiences as the dependent variable.Findings
Altogether 726 women participated in the study, with a response rate of 68%. The strongest predictors for women’s positive childbirth pain experience were positive attitude to childbirth during pregnancy; support from midwife during childbirth; use of epidural analgesia and low intensity of pain in childbirth.Discussion
The majority of the women in the study experienced childbirth pain as a positive experience, which is in line with studies that have demonstrated that pain in childbirth is different from other kinds of pain. In addition to epidural use as a predictor for positive childbirth pain experience, many other strong predictors exist and must be acknowledged.Conclusion
When planning pregnancy and childbirth services, predictors of positive experience of childbirth pain should be considered and investigated further. 相似文献7.
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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9.
Azijada Srkalović Imširagić Dražen Begić Livija Šimičević Žarko Bajić 《Women and birth : journal of the Australian College of Midwives》2017,30(1):e17-e23
Background
Following childbirth, a vast number of women experience some degree of mood swings, while some experience symptoms of postpartum posttraumatic stress disorder.Aim
Using a biopsychosocial model, the primary aim of this study was to identify predictors of posttraumatic stress disorder and its symptomatology following childbirth.Methods
This observational, longitudinal study included 372 postpartum women. In order to explore biopsychosocial predictors, participants completed several questionnaires 3–5 days after childbirth: the Impact of Events Scale Revised, the Big Five Inventory, The Edinburgh Postnatal Depression Scale, breastfeeding practice and social and demographic factors. Six to nine weeks after childbirth, participants re-completed the questionnaires regarding psychiatric symptomatology and breastfeeding practice.Findings
Using a multivariate level of analysis, the predictors that increased the likelihood of postpartum posttraumatic stress disorder symptomatology at the first study phase were: emergency caesarean section (odds ratio 2.48; confidence interval 1.13–5.43) and neuroticism personality trait (odds ratio 1.12; confidence interval 1.05–1.20). The predictor that increased the likelihood of posttraumatic stress disorder symptomatology at the second study phase was the baseline Impact of Events Scale Revised score (odds ratio 12.55; confidence interval 4.06–38.81). Predictors that decreased the likelihood of symptomatology at the second study phase were life in a nuclear family (odds ratio 0.27; confidence interval 0.09–0.77) and life in a city (odds ratio 0.29; confidence interval 0.09–0.94).Conclusion
Biopsychosocial theory is applicable to postpartum psychiatric disorders. In addition to screening for depression amongst postpartum women, there is a need to include other postpartum psychiatric symptomatology screenings in routine practice. 相似文献10.
Diana Jefferies Debbie Horsfall Virginia Schmied 《Women and birth : journal of the Australian College of Midwives》2017,30(1):e24-e31
Problem
Often, there is a sense of shock and disbelief when a mother murders her child.Background
Yet, literary texts (plays, poems and novels) contain depictions of women experiencing mental illness or feelings of desperation after childbirth who murder their children.Aim
To further understand why a woman may harm her child we examine seven literary texts ranging in time and place from fifth century BCE Greece to twenty-first century Australia.Methods
A textual analysis approach examined how the author positioned the woman in the text, how other characters in the text reacted to the woman before, during, and after the mental illness or infanticide, and how the literary or historical critical literature sees the woman.Findings
Three important points about the woman's experience were revealed: she is represented as morally ambiguous and becomes marginalised and isolated; she is depicted as murdering or abandoning her child because she is experiencing mental illness and/or she is living in desperate circumstances; and she believes there is no other option.Conclusion
Literary texts can shed light on socio-psychological struggles women experience and can be used to stimulate discussion by healthcare professionals about the development of preventative or early intervention strategies to identify women at risk. 相似文献11.
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Birgitta Larsson Ingegerd Hildingsson Elin Ternström Christine Rubertsson Annika Karlström 《Women and birth : journal of the Australian College of Midwives》2019,32(1):e88-e94
Background
Women with childbirth fear have been offered counseling by experienced midwives in Sweden for decades without evidence for its effectiveness, in terms of decrease in childbirth fear. Women are usually satisfied with the counselling. However, there is a lack of qualitative data regarding women’s views about counselling for childbirth fear.Aim
To explore women’s experiences of midwife-led counselling for childbirth fear.Method
A qualitative interview study using thematic analysis. Twenty-seven women assessed for childbirth fear who had received counselling during pregnancy at three different hospitals in Sweden were interviewed by telephone one to two years after birth.Findings
The overarching theme ‘Midwife-led counselling brought positive feelings and improved confidence in birth’ was identified. This consisted of four themes describing ‘the importance of the midwife’ and ‘a mutual and strengthening dialogue’ during pregnancy. ‘Coping strategies and support enabled a positive birth’ represent women’s experiences during birth and ‘being prepared for a future birth’ were the women’s thoughts of a future birth.Conclusions
In this qualitative study, women reported that midwife-led counselling improved their confidence for birth through information and knowledge. The women experienced a greater sense of calm and preparedness, which increased the tolerance for the uncertainty related to the birthing process. This, in turn, positively affected the birth experience. Combined with a feeling of safety, which was linked to the professional support during birth, the women felt empowered. The positive birth experience strengthened the self-confidence for a future birth and the childbirth fear was described as reduced or manageable. 相似文献14.
Mandie Scamell Roa Altaweli Christine McCourt 《Women and birth : journal of the Australian College of Midwives》2017,30(1):e39-e45
Background
The expansion of the medicalisation of childbirth has been described in the literature as being a global phenomenon. The vignette described in this paper, selected from an ethnographic study of routine intervention in Saudi Arabian hospitals illustrates how the worldwide spread of the bio-medical model does not take place within a cultural vacuum.Aim
To illuminate the ways in which the medicalisation of birth may be understood and practised in different cultural settings, through a vignette of a specific birth, drawn as a typical case from an ethnographic study that investigated clinical decision-making in the second stage of labour in Saudi Arabia.Methods
Ethnographic data collection methods, including participant observation and interviews. The data presented in this paper are drawn from ethnographic field notes collected during field work in Saudi Arabia, and informed by analysis of a wider set of field notes and interviews with professionals working in this context.Findings
While the medicalisation of care is a universal phenomenon, the ways in which the care of women is managed using routine medical intervention are framed by the local cultural context in which these practices take place.Discussion
The ethnographic data presented in this paper shows the medicalisation of birth thesis to be incomplete. The evidence presented in this paper illustrates how local belief systems are not so much subsumed by the expansion of the bio-medical model of childbirth, rather they may actively facilitate a process of localised reinterpretation of such universalised and standardised practices. In this case, aspects of the social and cultural context of Jeddah operates to intensify the biomedical model at the expense of respectful maternity care.Conclusion
In this article, field note data on the birth of one Saudi Arabian woman is used as an illustration of how the medicalisation of childbirth has been appropriated and reinterpreted in Jeddah, Saudi Arabia. 相似文献15.
Catherine R. Alexander Fiona Bogossian 《Women and birth : journal of the Australian College of Midwives》2018,31(6):442-452
Background
An allegation of negligence or an adverse outcome during childbirth can lead to clinical investigation of a midwife’s practice. Anecdotal evidence suggests midwives find this stressful and disturbing.Aim
Synthesise the evidence relating to midwives’ experiences of investigation and the effects on clinical practice and personal wellbeing.Methods
Two database searches were conducted between 2015 and 2016 to identify primary research published between 1990 and 2016. Studies were evaluated for quality using standard instruments.Findings
Despite numerous references to ‘litigation’ in peer-reviewed journals, little substantive research related specifically to midwives. 11 inclusions comprised three qualitative studies (one with two publications), reporting litigation experiences of midwives and seven quantitative studies (four research groups), identifying risk liability through cyclic surveys of midwives and law reports. Failure to identify deterioration in foetal well-being was a common finding among researchers examining reasons for litigation. Experienced midwives were at highest risk of litigation. Researchers found high levels of distress and abreaction among participants who either stopped working in birth suite or left midwifery. They also identified a level of ambiguity around defensive practices associated with fear of litigation.Conclusion
There is little research regarding experiences of midwives and clinical investigation. Midwives under investigation need appropriate support. Continuing to work during prolonged investigative processes is stressful as reported by midwives who described being “ill-equipped” and “unprepared.” Midwives in the review preferred the support of colleagues over counsellors. Educators, employers and regulators need to work collaboratively and incorporate reflective practice in targeted support. 相似文献16.
Susan Crowther Liz Smythe Deb Spence 《Women and birth : journal of the Australian College of Midwives》2018,31(1):e59-e66
Background
Rural midwifery and maternity care is vulnerable due to geographical isolation, staffing recruitment and retention. Highlighting the concerns within rural midwifery is important for safe sustainable service delivery.Method
Hermeneutic phenomenological study undertaken in New Zealand (NZ). 13 participants were recruited in rural regions through snowball technique and interviewed. Transcribed interview data was interpretively analysed. Findings are discussed through the use of philosophical notions and related published literature.Findings
Unsettling mood of anxiety was revealed in two themes (a) ‘Moments of rural practice’ as panicky moments; an emergency moment; the unexpected moment and (b) ‘Feelings of being judged’ as fearing criticism; fear of the unexpected happening to ‘me’ fear of losing my reputation; fear of feeling blamed; fear of being identified.Conclusions
Although the reality of rural maternity can be more challenging due to geographic location than urban areas this need not be a reason to further isolate these communities through negative judgement and decontextualized policy. Fear of what was happening now and something possibly happening in the future were part of the midwives’ reality. The joy and delight of working rurally can become overshadowed by a tide of unsettling and disempowering fears.Implications
Positive images of rural midwifery need dissemination. It is essential that rural midwives and their communities are heard at all levels if their vulnerability is to be lessened and sustainable safe rural communities strengthened. 相似文献17.
Ingrid Jepsen Edith Mark Maralyn Foureur Ellen A. Nøhr Erik E. Sørensen 《Women and birth : journal of the Australian College of Midwives》2017,30(1):e61-e69
Background
Caseload midwifery is expanding in Denmark. There is a need for elaborating in-depth, how caseload midwifery influences the partner and the woman during childbirth and how this model of care influences the early phases of labour.Aim
To follow, explore and elaborate women’s and their partner’s experiences of caseload midwifery.Methods
Phenomenology of practice was the analytical approach. The methodology was inspired by ethnography, and applied methods were field observations followed by interviews. Ten couples participated in the study. Most of the couples were observed from the onset of labour until childbirth. Afterwards, the couples were interviewed.Findings
The transition from home to hospital in early labour was experienced as positive. During birth, the partner felt involved and included by the midwife. The midwives remembered and recognized the couple’s stories and wishes for childbirth and therefore they felt regarded as “more than numbers”. Irrespective of different kinds of vulnerability or challenges among the participants, the relationship was named a professional friendship, characterised by equality and inclusiveness. One drawback of caseload midwifery was that the woman was at risk of being disappointed if her expectations of having a known midwife at birth were not fulfilled.Key conclusions
From the perspective of women and their partners, attending caseload midwifery meant being recognised and cared for as an individual. The partner felt included and acknowledged and experienced working in a team with the midwife. Caseload midwifery was able to solve problems concerning labour onset or gaining access to the labour ward. 相似文献18.
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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