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Astrid Nystedt Ingegerd Hildingsson 《Women and birth : journal of the Australian College of Midwives》2018,31(2):103-109
Background
A negative birth experience may influence both women and men and can limit their process of becoming a parent.Aims
This study aimed to analyze and describe women's and men's perceptions and experiences of childbirth.Design
A cross-sectional study of women and their partners living in one Swedish county were recruited in mid pregnancy and followed up two months after birth. Women (n = 928) and men (n = 818) completed the same questionnaire that investigated new parents’ birth experiences in relation to socio-demographic background and birth related variables.Results
Women (6%) and men (3%) with a negative birth experiences, experienced longer labours and more often emergency caesarean section compared to women (94%) and men (97%) with a positive birth experience. The obstetric factors that contributed most strongly to a negative birth experience were emergency caesarean and was found in women (OR 4.7, 95% CI 2.0–10.8) and men (OR 4.5, Cl 95% 1.4–17.3). In addition, pain intensity and elective caesarean section were also associated with a negative birth experiences in women. Feelings during birth such as agreeing with the statement; ‘It was a pain to give birth’ were a strong contributing factor for both women and men.Conclusions
A negative birth experience is associated with obstetric factors such as emergency caesarean section and negative feelings. The content of negative feelings differed between women and men. It is important to take into account that their feelings differ in order to facilitate the processing of the negative birth experience for both partners. 相似文献3.
Valgerdur Lisa Sigurdardottir Jennifer Gamble Berglind Gudmundsdottir Hildur Kristjansdottir Herdis Sveinsdottir Helga Gottfredsdottir 《Women and birth : journal of the Australian College of Midwives》2017,30(6):450-459
Background
Several risk factors for negative birth experience have been identified, but little is known regarding the influence of social and midwifery support on the birth experience over time.Objective
The aim of this study was to describe women’s birth experience up to two years after birth and to detect the predictive role of satisfaction with social and midwifery support in the birth experience.Method
A longitudinal cohort study was conducted with a convenience sample of pregnant women from 26 community health care centres. Data was gathered using questionnaires at 11–16 weeks of pregnancy (T1, n = 1111), at five to six months (T2, n = 765), and at 18–24 months after birth (T3, n = 657). Data about sociodemographic factors, reproductive history, birth outcomes, social and midwifery support, depressive symptoms, and birth experience were collected. The predictive role of midwifery support in the birth experience was examined using binary logistic regression.Results
The prevalence of negative birth experience was 5% at T2 and 5.7% at T3. Women who were not satisfied with midwifery support during pregnancy and birth were more likely to have negative birth experience at T2 than women who were satisfied with midwifery support. Operative birth, perception of prolonged birth and being a student predicted negative birth experience at both T2 and T3.Conclusions
Perception of negative birth experience was relatively consistent during the study period and the role of support from midwives during pregnancy and birth had a significant impact on women’s perception of birth experience. 相似文献4.
Joyce C.S. Camargo Vitor Varela Fernanda M. Ferreira Lucila Pougy Angela M. Ochiai Maria Elisabete Santos Maria Catarina L.R. Grande 《Women and birth : journal of the Australian College of Midwives》2018,31(5):e325-e333
Introduction
The following quantitative observational study aimed to analyse the maternal and neonatal outcomes of 90 low-risk pregnant women who gave birth in water at São Bernardo Hospital.Methods
A form containing information on the obstetric history of the parturient, the type of immersion, and the labour and birth follow-up was used by midwives to collect the data.Background
The Apgar score (at 1 min after birth) used in this study, called Aqua Apgar, was adapted by Cornelia Enning.Results
The mean water immersion time was 1 h and 46 min and had an influence on the duration of labour (mean 5 h and 37 min), with a statistically significant difference (P = 0.004). There was a decreased cervical dilatation time and a shorter duration of the expulsion phase. In the immersion scenario, 30% of the women did not undergo any examination to assess the length of the cervix, and 57.8% presented intact perennial areas or first-degree tears. As for neonatal outcomes, during maternal immersion, 97% maintained normal fetal heart rates (between 110 and 160 beats per minute) and Aqua Apgar was higher than 7, both in the first minute (mean of 9.4) and in the fifth minute of life (mean of 9.9).Conclusion
These safety outcomes, based on sound scientific evidence, should increasingly support and inform clinical decisions and increase the number of waterbirths in health facilities. The results of this study align with growing evidence that suggests waterbirth is a safe delivery option and therefore should be offered to women. 相似文献5.
Stephen J. Robson Hassan Vally Abdel-Latif Mohamed Maggie Yu Elizabeth M. Westrupp 《Women and birth : journal of the Australian College of Midwives》2017,30(6):506-510
Background
The proportion of babies born by caesarean section in Australia has almost doubled over the last 25 years. Factors known to contribute to caesarean such as higher maternal age, mothers being overweight or obese, or having had a previous caesarean do not completely account for the increased rate and it is clear that other influences exist.Aim
To identify previously unsuspected risk factors associated with caesarean using nationally-representative data from the Longitudinal Study of Australian Children.Methods
Data were from the birth cohort, a long-term prospective study of approximately 5000 children that includes richly-detailed data regarding maternal health and exposures during pregnancy. Logistic regression was used to examine the contribution of a wide range of pregnancy, birth and social factors to caesarean.Findings
28% of 4862 mothers were delivered by caesarean. The final adjusted analyses revealed that use of diabetes medication (OR = 3.1, 95% CI = 1.7–5.5, p < 0.001) and maternal mental health problems during pregnancy (OR = 1.3, CI = 1.1–1.6, p = 0.003) were associated with increased odds of caesarean. Young maternal age (OR = 0.6, CI = 0.5–0.7, p < 0.001), having two or more children (OR = 0.7, CI = 0.6–0.9, p < 0.001), and fathers having an unskilled occupation (OR = 0.7, CI = 0.6–1.0, p = 0.036) were associated with reduced odds of caesarean.Conclusion
Our findings raise the prospect that the effect of additional screening and support for maternal mental health on caesarean rate should be subject of prospective study. 相似文献6.
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7.
Ana Rubio-Álvarez Milagros Molina-Alarcón Antonio Hernández-Martínez 《Women and birth : journal of the Australian College of Midwives》2018,31(3):158-165
Background
Postpartum anaemia is a frequent and potentially preventable complication that has serious repercussions on health and maternal well-being.Aim
Determine the incidence and perinatal risk factors associated with postpartum anaemia in women who gave birth vaginally.Methods
An observational and analytical retrospective cohort study conducted at the Mancha-Centro Hospital during the 2010–2014 period. Data were collected from 2990 women who gave birth vaginally. The main outcome variable was postpartum anaemia for two cut-off points (haemoglobin (Hb) <11 g/dL and <9 g/dL at 24-h postpartum). Women with prepartum anaemia (<11 g/dL) were excluded. It included a multivariate analysis by multiple linear regression.Findings
45% (1341) of women had postpartum levels of Hb <11 g/dL, and 7.1% (212) of women had Hb <9 g/dL. The most strongly associated risk factors with more severe anaemia (Hb <9 g/dL) were episiotomy (OR 3.19. 95%CI: 2.10-4.84), first stage of labour >9 h (OR 2.50. 95%CI: 1.58-3.94), primiparity (OR 2.50. 95%CI: 1.61–3.87) and previous caesarean section (OR 2.43. 95%CI: 1.51–3.90). The other independent risk factors for both Hb cut-off points were prolonged second stage of labour, instrumental birth, tearing > first degree, non-practice of active management and heavier birth weight of newborns.Conclusion
Postpartum anaemia has a high incidence. The active management of third stage of labour, selective practice of episiotomies, and performing instrumental births only when strictly necessary are efficient measures to lower the incidence of postpartum anaemia. 相似文献8.
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Birgitta Larsson Annika Karlström Christine Rubertsson Elin Ternström Johanna Ekdahl Birgitta Segebladh Ingegerd Hildingsson 《Women and birth : journal of the Australian College of Midwives》2017,30(6):460-467
Background
Childbirth fear is the most common underlying reason for requesting a caesarean section without medical reason. The aim of this randomised controlled study was to investigate birth preferences in women undergoing treatment for childbirth fear, and to investigate birth experience and satisfaction with the allocated treatment.Methods
Pregnant women classified with childbirth fear (≥60 on the Fear Of Birth Scale) (n = 258) were recruited at one university hospital and two regional hospitals over one year. The participants were randomised (1:1) to intervention (Internet-based Cognitive Behaviour Therapy (ICBT)) (n = 127) or standard care (face-to-face counselling) (n = 131). Data were collected by questionnaires in pregnancy week 20–25 (baseline), week 36 and two months after birth.Results
Caesarean section preference decreased from 34% to 12% in the ICBT group and from 24% to 20% in the counselling group. Two months after birth, the preference for caesarean increased to 20% in the ICBT group and to 29% in the counselling group, and there was no statistically significant change over time. Women in the ICBT group were less satisfied with the treatment (OR 4.5). The treatment had no impact on or worsened their childbirth fear (OR 5.5). There were no differences between the groups regarding birth experience.Conclusion
Women’s birth preferences fluctuated over the course of pregnancy and after birth regardless of treatment method. Women felt their fear was reduced and were more satisfied with face-to-face counselling compared to ICBT. A higher percentage were lost to follow-up in ICBT group suggesting a need for further research. 相似文献10.
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11.
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12.
Iva Sklempe Kokic Marina Ivanisevic Gianni Biolo Bostjan Simunic Tomislav Kokic Rado Pisot 《Women and birth : journal of the Australian College of Midwives》2018,31(4):e232-e238
Problem
Gestational diabetes mellitus, defined as any carbohydrate intolerance first diagnosed during pregnancy, is associated with a variety of adverse outcomes, both for the mother and her child.Aim
To investigate the impact of a structured exercise programme which consisted of aerobic and resistance exercises on the parameters of glycaemic control and other health-related outcomes in pregnant women diagnosed with gestational diabetes mellitus.Methods
Thirty-eight pregnant women diagnosed with gestational diabetes mellitus were randomised to two groups. Experimental group was treated with standard antenatal care for gestational diabetes mellitus, and regular supervised exercise programme plus daily brisk walks of at least 30 min. Control group received only standard antenatal care for gestational diabetes mellitus. The exercise programme was started from the time of diagnosis of diabetes until birth. It was performed two times per week and sessions lasted 50–55 min.Findings
The experimental group had lower postprandial glucose levels at the end of pregnancy (P < 0.001). There was no significant difference between groups in the level of fasting glucose at the end of pregnancy. Also, there were no significant differences in the rate of complications during pregnancy and birth, need for pharmacological therapy, maternal body mass and body fat percentage gains during pregnancy, and neonatal Apgar scores, body mass and ponderal index. Neonatal body mass index was higher in the experimental group (P = 0.035).Conclusion
The structured exercise programme had a beneficial effect on postprandial glucose levels at the end of pregnancy. 相似文献13.
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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15.
Ronit Gilad Hagit Hochner Bella Savitsky Shay Porat Drorith Hochner-Celnikier 《Women and birth : journal of the Australian College of Midwives》2018,31(1):e26-e31
Background
Castor oil is a substance used for labor induction in an inpatient setting. However, its efficacy as an agent for the induction of labor, for post-date pregnancies in an outpatient setup is unknown.Objective
Efficacy of castor oil as an agent for the induction of labor, for post-date pregnancies in outpatient settings.Methods
Eighty-one women with a low-risk post-date singleton pregnancy with a Bishop score ≤ 7, without effective uterine contractions were randomized to the intervention, 60 ml of castor oil, or the control, 60 ml of sun-flower oil. The primary outcome was proportion of women entering the active phase of labor 24, 36, 48 h after ingestion. Secondary outcomes included meconium stained amniotic fluid, abnormal fetal heart rate tracing, cesarean section rate, instrumental deliveries, birth weight, 5 min Apgar score, chorioamnionitis, hypertensive complications, retained placenta, and post-partum hemorrhage.Findings
Intervention and control groups included 38 and 43 women, respectively. No differences in baseline characteristics, except for age were noted. The observed interaction between castor oil and parity was significant (pinteraction = 0.02). Multiparous women in the intervention group exhibited a significant beneficial effect on entering active labor within 24, 36 and 48 h after castor oil consumption compared with the placebo (Hazard Ratio = 2.93, p = 0.048; Hazard Ratio = 3.29, p = 0.026; Hazard Ratio = 2.78, p = 0.042 respectively). This effect was not noted among primiparous women. No differences in rate of obstetric complications or adverse neonatal outcomes were noted.Conclusion
Castor oil is effective for labor induction, in post-date multiparous women in outpatient settings. 相似文献16.
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Laura A. Zinsser 《Women and birth : journal of the Australian College of Midwives》2018,31(2):e73-e76
Background
The positive effects of delayed cord clamping (DCC) has been extensively researched. DCC means: waiting at least one minute after birth before clamping and cutting the cord or till the pulsation has stopped. With physiological clamping and cutting (PCC) the clamping and cutting can happen at the earliest after the pulsation has stopped. With a Lotus birth, no clamping and cutting of the cord is done. A woman called Clair Lotus Day imitated the holistic approach of PCC from an anthropoid ape in 1974. The chimpanzee did not separate the placenta from the newborn.Aim
The aim of this case report is to discuss and learn a different approach in the third stage of labour.Method
Three cases of Lotus birth by human beings were observed. All three women gave birth in an out-of-hospital setting and had ambulant postnatal care.Findings
The placenta was washed, salted and herbs were put on 2–3 h post partum. The placenta was wrapped in something that absorbs the moisture. The salting was repeated with a degreasing frequency depending on moistness of the placenta. On life day six all three Lotus babies experiences a natural separation of the cord. All three Lotus birth cases were unproblematic, no special incidence occurred.Conclusions
One should differentiate between early cord clamping (ECC), delayed cord clamping (DCC) and physiological cord clamping (PCC). Lotus birth might lead to an optimisation of the bonding and attachment. Research is needed in the areas of both PCC and Lotus birth. 相似文献18.
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Colin R. Martin Caroline J. Hollins Martin Ekaterina Burduli Celestina Barbosa-Leiker Colleen Donovan-Batson Susan E. Fleming 《Women and birth : journal of the Australian College of Midwives》2017,30(4):e172-e178
Background
The 10-item Birth Satisfaction Scale-Revised (BSS-R) is being increasingly used internationally. The use of the measure and the concept has gathered traction in the United States following the development of a US version of the tool. A limitation of previous studies of the measurement characteristics of the BSS-R is modest sample size. Unplanned pregnancy is recognised as being associated with a range of negative birth outcomes, but the relationship to birth satisfaction has received little attention, despite the importance of birth satisfaction to a range of postnatal outcomes.Aim
The current investigation sought to evaluate the measurement characteristics of the BSS-R in a large postpartum sample.Methods
Multiple Groups Confirmatory Factor Analysis (MGCFA) was used to evaluate a series of measurement and structural models of the BSS-R to evaluate fundamental invariance characteristics using planned/unplanned pregnancy status to differentiate groups.Findings
Complete data from N = 2116 women revealed that the US version of the BSS-R offers an excellent fit to data and demonstrates full measurement and structural invariance. Little difference was observed between women on the basis of planned/unplanned pregnancy stratification on measures of birth satisfaction.Discussion
The established relationship between unplanned pregnancy and negative perinatal outcomes was not found to extend to birth satisfaction in the current study. The BSS-R demonstrated exemplary measurement and structural invariance characteristics.Conclusion
The current study strongly supports the use of the US version of the BSS-R to compare birth satisfaction across different groups of women with theoretical and measurement confidence. 相似文献20.
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