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Patricia M. Corcoran Christine Catling Caroline S.E. Homer 《Women and birth : journal of the Australian College of Midwives》2017,30(1):77-86
Issue
Indigenous women in many countries experience a lack of access to culturally appropriate midwifery services. A number of models of care have been established to provide services to women. Research has examined some services, but there has not been a synthesis of qualitative studies of the models of care to help guide practice development and innovations.Aim
To undertake a review of qualitative studies of midwifery models of care for Indigenous women and babies evaluating the different types of services available and the experiences of women and midwives.Methods
A meta-synthesis was undertaken to examine all relevant qualitative studies. The literature search was limited to English-language published literature from 2000–2014. Nine qualitative studies met the inclusion criteria and literature appraisal – six from Australia and three from Canada. These articles were analysed for coding and theme development.Findings
The major themes were valuing continuity of care, managing structural issues, having negative experiences with mainstream services and recognising success.Discussion
The most positive experiences for women were found with the services that provided continuity of care, had strong community links and were controlled by Indigenous communities. Overall, the experience of the midwifery services for Indigenous women was valuable. Despite this, there were still barriers preventing the provision of intrapartum midwifery care in remote areas.Conclusion
The expansion of midwifery models of care for Indigenous women and babies could be beneficial in order to improve cultural safety, experiences and outcomes in relation to pregnancy and birth. 相似文献3.
Rebecca A. Chedid Rowan M. Terrell Karen P. Phillips 《Women and birth : journal of the Australian College of Midwives》2018,31(4):e223-e231
Background
Prenatal health promotion provides information regarding pregnancy risks, protective behaviours and clinical and community resources. Typically, women obtain prenatal health information from health care providers, prenatal classes, peers/family, media and increasingly, Internet sites and mobile apps. Barriers to prenatal health promotion and related services include language, rural/remote location, citizenship and disability. Online public health platforms represent the capacity to reach underserved women and can be customised to address the needs of a heterogeneous population of pregnant women.Aim
Canadian government-hosted websites and online prenatal e-classes were evaluated to determine if accessible, inclusive, comprehensive and evidence-based prenatal health promotion was provided.Methods
Using a multijurisdictional approach, federal, provincial/territorial, municipal and public health region-hosted websites, along with affiliated prenatal e-classes, were evaluated based on four criteria: comprehensiveness, evidence-based information, accessibility and inclusivity.Findings
Online prenatal e-classes, federal, provincial/territorial and public health-hosted websites generally provided comprehensive and evidence-based promotion of essential prenatal topics, in contrast to municipal-hosted websites which provided very limited prenatal health information. Gaps in online prenatal health promotion were identified as lack of French and multilingual content, targeted information and representations of Indigenous peoples, immigrants and women with disabilities.Conclusion
Canadian online prenatal health promotion is broadly comprehensive and evidence-based, but fails to address the needs of non-Anglophones and represent the diverse population of Canadian pregnant women. It is recommended that agencies enhance the organisation of website pregnancy portals/pages and collaborate with other jurisdictions and community groups to ensure linguistically accessible, culturally-competent and inclusive prenatal online resources. 相似文献4.
Karen Adams Shannon Faulkhead Rachel Standfield Petah Atkinson 《Women and birth : journal of the Australian College of Midwives》2018,31(2):81-88
Background
The 2007 United Nations Declaration on the Rights of Indigenous Peoples states that Indigenous peoples have the right to self-determination for social and cultural development. This fundamental right has been impeded worldwide through colonisation where many Indigenous peoples have had to adapt to ensure continuation of cultural knowledge and practice. In South East Australia colonisation was particularly brutal interrupting a 65,000 year-old oral culture and archives have increasing importance for cultural revival.Aim
The aim of this research was to collate archival material on South East Australian Aboriginal women’s birthing knowledge and practice.Methods
Archivist research methods were employed involving a search for artefacts and compiling materials from these into a new collection. This process involved understanding the context of the artefact creation. Collaborative yarning methods were used to reflect on materials and their meaning.Findings
Artefacts found included materials written by non-Aboriginal men and women, materials written by Aboriginal women, oral histories, media reports and culturally significant sites. Material described practices that connected birth to country and the community of the women and their babies. Practices included active labour techniques, pain management, labour supports, songs for labour, ceremony and the role of Aboriginal midwives. Case studies of continuing cultural practice and revival were identified.Conclusion
Inclusion of Aboriginal women’s birthing practices and knowledge is crucial for reconciliation and self-determination. Challenging the colonisation of birthing, through the inclusion of Aboriginal knowledge and practice is imperative, as health practices inclusive of cultural knowledge are known to be more effective. 相似文献5.
Tania Fleming Debra K. Creedy Roianne West 《Women and birth : journal of the Australian College of Midwives》2017,30(3):245-252
Background
Cultural safety in higher education learning and teaching environments is paramount to positive educational outcomes for Aboriginal and/or Torres Strait Islander (hereafter called First Peoples) students. There is a lack of research evaluating the impact of continuing professional development on midwifery academics' awareness of cultural safety.Aim
To implement and evaluate a continuing professional development intervention to improve midwifery academics' awareness of cultural safety in supporting First Peoples midwifery students success.Methods
A pre-post intervention mixed methods design was used. Academics (n = 13) teaching into a Bachelor of Midwifery program agreed to participate. The intervention consisted of two workshops and five yarning circles across a semester. Data included the Awareness of Cultural Safety Scale, self-assessment on cultural safety and perceptions of racism, evaluation of the intervention, participants’ journal entries, and researcher’s reflections.Findings
Responses on the Awareness of Cultural Safety Scale revealed significant improvement in participants’ awareness of cultural safety. There was an upward trend in self-assessment ratings. Participants reported high levels of satisfaction with the intervention or workshops and yarning circles. Participants’ journal entries revealed themes willingness to participate and learn, confidence as well as anger and distress.Conclusion
Increased awareness of cultural safety can be transformative for midwifery academics. Workshops and yarning circles can support academics in moving beyond a ‘sense of paralysis’ and engage in challenging conversations to transform their learning and teaching and in turn foster a culturally safe learning and teaching environment for First Peoples midwifery students towards success. 相似文献6.
Britni L. Ayers Nicola L. Hawley Rachel S. Purvis Sarah J. Moore Pearl A. McElfish 《Women and birth : journal of the Australian College of Midwives》2018,31(5):e294-e301
Problem
Pacific Islanders are disproportionately burdened by poorer maternal health outcomes with higher rates of pre-term births, low birth weight babies, infant mortality, and inadequate or no prenatal care.Purpose
The purpose of this study was twofold: (1) to explore maternal health care providers’ perceptions and experiences of barriers in providing care to Marshallese women, and (2) providers perceived barriers of access to care among Marshallese women. This is the first paper to explore perceived barriers to maternal health care among a Marshallese community from maternal health care providers’ perspectives in the United States.Methods
A phenomenological, qualitative design, using a focus group and in-depth interviews with 20 maternal health care providers residing in northwest Arkansas was chosen.Findings
Several perceived barriers were noted, including transportation, lack of health insurance, communication and language, and socio-cultural barriers that described an incongruence between traditional and Western medical models of care. There was an overall discord between the collectivist cultural identity of Marshallese families and the individualistic maternal health care system that merits further research.Discussion
Solutions to these barriers, such as increased cultural competency training for maternal health care providers and the incorporation of community health workers are discussed. 相似文献7.
Helen L. McLachlan Touran Shafiei Della A. Forster 《Women and birth : journal of the Australian College of Midwives》2017,30(5):361-366
Background
Increasing breastfeeding rates is one way of improving the short and long term health of Aboriginal and Torres Strait Islander children (hereafter referred to as Aboriginal). Despite the benefits of breastfeeding and recommendations for strategies to increase breastfeeding among Aboriginal people, there is a lack of available population data.Aim
To use population-based data from Victoria, Australia to compare breastfeeding initiation for Aboriginal and non-Aboriginal women and to explore factors associated with breastfeeding initiation of Aboriginal women.Methods
Routinely collected infant feeding data obtained from the Victorian Perinatal Data Collection (VPDC) was used. The VPDC is a mandatory, population-based system where maternal and infant data on all Victorian births are collected.Findings
Compared with non-Aboriginal women, Aboriginal women were less likely to attempt to breastfeed their baby (87.2% vs 95.3%; p < 0.001); more likely to give formula in hospital (39.6% vs 30.6%; p < 0.001) and less likely to give the last feed prior to discharge exclusively from the breast (64.4% vs 75.0% p < 0.001). For Aboriginal women, factors associated with not initiating breastfeeding were being single, multiparous, smoking and length of stay. Infant factors were gestation less than 37 weeks and low birthweight (<2,500 g).Conclusion
In Victoria, breastfeeding initiation is lower for Aboriginal women compared with non-Aboriginal women. Further research is needed to explore the effectiveness of interventions that may increase breastfeeding for Aboriginal women. 相似文献8.
Lois McKellar Julie Fleet Shona Dove 《Women and birth : journal of the Australian College of Midwives》2018,31(3):177-183
It’s more than just luck: A qualitative exploration of breastfeeding in rural Australia
Problem
Despite significant public health benefits, breastfeeding for six months continues to be challenging for women.Background
In the Mid North of South Australia, healthcare professionals were concerned that breastfeeding rates were lower than the national average and that a collaborative approach was needed to promote breastfeeding.Aim
To explore the experiences of women and health professional in the Mid North, to inform interventions to improve breastfeeding longevity.Method
Two focus groups were conducted to examine breastfeeding experience in the region. Focus group one included nine mothers who had breastfed more than six months and focus group two consisted of ten health professionals from the Mid North. Thematic analysis was used to analyse the data.Findings
Two overarching themes were identified; ‘breastfeeding: It’s more than just luck’ represented the voices of the mothers and ‘breastfeeding: It’s everybody’s business’ captured the discussion between the health professionals. Women described themselves as lucky while acknowledging that their own persistence, as well as positive support was vital. Health professionals identified education and support as key foci, and a need for a holistic approach to improve breastfeeding rates.Discussion
Breastfeeding should be understood as a relationship, in which broadly applied solutions do not necessarily influence longevity, particularly in rural communities. Strategies should also reflect a realistic picture of breastfeeding and safeguard against idealistic expectation of the experience.Conclusion
A holistic approach to improve breastfeeding rates is imperative. One of the most promising antidotes to the breastfeeding dilemma is the provision of midwifery continuity of care. 相似文献9.
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10.
Marie-Clare Balaam Gill Thomson 《Women and birth : journal of the Australian College of Midwives》2018,31(5):e341-e347
Problem
The persistence of health inequalities in pregnancy and infancy amongst vulnerable/marginalised groups in the UK.Background
During pregnancy and early motherhood some women experience severe and multiple psychosocial and economic disadvantages that negatively affect their wellbeing and make them at increased risk of poor maternal and infant health outcomes.Aim
To explore vulnerable/marginalised women’s views and experiences of receiving targeted support from a specialist midwifery service and/or a charity.Methods
A mixed-methods study was undertaken that involved analysis of routinely collected birth-related/outcome data and interviews with a sample of vulnerable/marginalised women who had/had not received targeted support from a specialist midwifery service and/or a charity. In this paper we present in-depth insights from the 11 women who had received targeted support.Findings
Four key themes were identified; ‘enabling needs-led care and support’, ‘empowering through knowledge, trust and acceptance’, ‘the value of a supportive presence’ and ‘developing capabilities, motivation and confidence’.Discussion
Support provided by a specialist midwifery service and/or charity improved the maternity and parenting experiences of vulnerable/marginalised women. This was primarily achieved by developing a provider–woman relationship built on mutual trust and understanding and through which needs-led care and support was provided — leading to improved confidence, skills and capacities for positive parenting and health.Conclusion
The collaborative, multiagency, targeted intervention provides a useful model for further research and development. It offers a creative, salutogenic and health promoting approach to provide support for the most vulnerable/marginalised women as they make the journey into parenthood. 相似文献11.
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Alyson K. McClatchey Alison Shield Lynn H. Cheong Sally L. Ferguson Gabrielle M. Cooper Gregory J. Kyle 《Women and birth : journal of the Australian College of Midwives》2018,31(5):362-366
Problem
The need for medication during lactation can contribute to the early cessation of breastfeeding.Background
Breastfeeding women may require medication for acute or chronic health conditions. For some women this need for medication can become a barrier to breastfeeding; this is despite the fact that the majority of medications are considered to be compatible with lactation.Aim
This narrative review aims to investigate factors relating to medicines safety that could contribute to medication unnecessarily becoming a barrier to breastfeeding.Methods
A selective literature search using PubMed, Scopus and Google Scholar was conducted over a 6-month period using the search terms “breastfeeding”, “lactation”, “medication” and “information”. Articles were assessed to identify whether they addressed the impact of medication use on the decision to breastfeed.Findings
Fifty six articles were identified as having appropriate discussion about decision making for the safe use of medication during lactation. Themes identified included variable and conflicting safety advice for medicines; difficulty interpreting risks associated with medicine use; societal pressures faced by the breastfeeding woman; and the varied knowledge and training of health professionals involved in the care of breastfeeding women.Conclusion
Poor quality of information about medicine safety during lactation can contribute to confusion in giving recommendations. This confusion can result in early cessation of breastfeeding or insufficient health care for the breastfeeding woman. 相似文献13.
Johan Wrammert Sabitri Sapkota Kedar Baral Ashish KC Mats Målqvist Margareta Larsson 《Women and birth : journal of the Australian College of Midwives》2017,30(3):262-269
Problem
The ability of health care providers to work together is essential for favourable outcomes in neonatal resuscitation, but perceptions of such teamwork have rarely been studied in low-income settings.Background
Neonatal resuscitation is a proven intervention for reducing neonatal mortality globally, but the long-term effects of clinical training for this skill need further attention. Having an understanding of barriers to teamwork among nurse midwives can contribute to the sustainability of improved clinical practice.Aim
To explore nurse midwives’ perceptions of teamwork when caring for newborns in need of resuscitation.Methods
Nurse midwives from a tertiary-level government hospital in Nepal participated in five focus groups of between 4 and 11 participants each. Qualitative Content Analysis was used for analysis.Findings
One overarching theme emerged: looking for comprehensive guidelines and shared responsibilities in neonatal resuscitation to avoid personal blame and learn from mistakes. Participants discussed the need for protocols relating to neonatal resuscitation and the importance of shared medical responsibility, and the importance of the presence of a strong and transparent leadership.Discussion
The call for clear and comprehensive protocols relating to neonatal resuscitation corresponded with previous research from different contexts.Conclusion
Nurse midwives working at a maternity health care facility in Nepal discussed the benefits and challenges of teamwork in neonatal resuscitation. The findings suggest potential benefits can be made from clarifying guidelines and responsibilities in neonatal resuscitation. Furthermore, a structured process to deal with clinical incidents must be considered. Management must be involved in all processes. 相似文献14.
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Jeni Stevens Virginia Schmied Elaine Burns Hannah G. Dahlen 《Women and birth : journal of the Australian College of Midwives》2018,31(6):453-462
Problem
Providing skin-to-skin contact in the operating theatre and recovery is challenging.Background
Barriers are reported in the provision of uninterrupted skin-to-skin contact following a caesarean section.Aim
To explore how health professionals’ practice impacts the facilitation of skin-to-skin contact within the first 2 h following a caesarean section.Methods
Video ethnographic research was conducted utilising video recordings, observations, field notes, focus groups and interviews.Findings
The maternal body was divided in the operating theatre and mothers were perceived as ‘separate’ from their baby in the operating theatre and recovery. Obstetricians’ were viewed to ‘own’ the lower half of women; anaesthetists were viewed to ‘own’ the top half and midwives were viewed to ‘own’ the baby after birth. Midwives’ responsibility for the baby either negatively or positively affected the mother's ability to ‘own’ her baby, because midwives controlled what maternal-infant contact occurred. Mothers desired closeness with their baby, including skin-to-skin contact, however they realised that ‘owning’ their baby in the surgical environment could be challenging.Discussion
Health professionals’ actions are influenced by their environment and institutional regulations. Further education can improve the provision of skin-to-skin contact after caesarean sections. Skin-to-skin contact can help women remain with their baby and obtain a sense of control after their caesarean section.Conclusion
Providing skin-to-skin contact in the first 2 h after caesarean sections has challenges. Despite this, health professionals can meet the mother's desire to ‘own’ her baby by realising they are one entity, encouraging skin-to-skin contact and avoiding maternal and infant separation. 相似文献16.
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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18.
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Sarah E. Bledsoe Cynthia F. Rizo Traci L. Wike Candace Killian-Farrell Julia Wessel Anne-Marie O. Bellows Alison Doernberg 《Women and birth : journal of the Australian College of Midwives》2017,30(5):e248-e257
Problem
Adolescent mothers and their children are at high-risk for depression and the associated negative educational, social, health, and economic outcomes.Background
However, few pregnant adolescent women with depression receive psychiatric services, especially low-income or racial/ethnic minority adolescent women.Aim
This qualitative study explores perceptions of depression, psychiatric services, and barriers to accessing services in a sample of low-income, pregnant racial/ethnic minority adolescent women. Our goal was to better understand the experiences of depression during pregnancy for these vulnerable adolescent women, and thereby improve their engagement and retention in services for perinatal depression.Methods
We recruited 20 pregnant adolescent women who screened positive for depression from 2 public health prenatal clinics in the southeastern United States. Participants were low-income and primarily racial/ethnic minority women between 14 and 20 years old. Data were collected through individual in-depth, ethnographically informed interviews.Findings
Generally, participants lacked experience with psychiatric services and did not recognize their symptoms as depression. However, participants perceived a need for mood improvement and were interested in engaging in services that incorporated their perspective and openly addressed stigma.Discussion
Participants reported practical and psychological barriers to service engagement, but identified few cultural barriers. Family perceptions of psychiatric services served as both a barrier and support.Conclusion
Adolescent women are more likely to engage in psychiatric services if those services reduce practical and psychological barriers, promise relief from the symptoms perceived as most meaningful, and address underlying causes of depression. Culture may affect Latina adolescent women’s perceptions of depression and services. 相似文献20.
Carolyn M. Bailey Jennifer M. Newton Helen G. Hall 《Women and birth : journal of the Australian College of Midwives》2018,31(5):414-421