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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3.
Cath Rogers Laurence Lepherd Rahul Ganguly Sebastian Jacob-Rogers 《Women and birth : journal of the Australian College of Midwives》2017,30(2):e89-e95
Problem
Autistic Spectrum Disorder (ASD) is an increasingly commonly diagnosed disability. People with ASD commonly report challenges in social interaction and a heightened sensory perception. These challenges may be particularly difficult for women during pregnancy, birthing and beyond.Background
Very little is known about the experiences and needs of birthing women who have ASD. There is a large body of literature about women who have autistic children, but almost nothing about women who may have this disability themselves. Internet blogs provide some insights and suggest that birthing women with ASD may have particular challenges related to communication, decision making and sensory overload.Question
This study explores the particular issues and experiences of birthing women who have ASD, through pregnancy, birth and early mothering.Method
This qualitative research used a case study approach, with in-depth interviewing and email exchange providing the data for the study. This data was verified, transcribed and analysed thematically.Findings
The findings of this case study identified three key issues: communication and service difficulties; sensory stress and parenting challenges.Discussion and conclusion
Findings suggest that women with ASD may face particular challenges during pregnancy, birthing and early mothering. These challenges evolve from perceptions of the woman about her midwives and other caregivers. If a woman perceives that her midwife is judgemental about her, then she may withdraw from the care and support she and her baby need. 相似文献4.
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5.
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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8.
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9.
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10.
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Megan Cooper Helen McCutcheon Jane Warland 《Women and birth : journal of the Australian College of Midwives》2017,30(5):431-441
Background
Accessibility of water immersion for labour and/or birth is often dependent on the care provider and also the policies/guidelines that underpin practice. With little high quality research about the safety and practicality of water immersion, particularly for birth, policies/guidelines informing the practice may lack the evidence necessary to ensure practitioner confidence surrounding the option thereby limiting accessibility and women’s autonomy.Aim
The aims of the study were to determine how water immersion policies and/or guidelines are informed, who interprets the evidence to inform policies/guidelines and to what extent the policy/guideline facilitates the option for labour and birth.Method
Phase one of a three-phase mixed-methods study critically analysed 25 Australian water immersion policies/guidelines using critical discourse analysis.Findings
Policies/guidelines pertaining to the practice of water immersion reflect subjective opinions and views of the current literature base in favour of the risk-focused obstetric and biomedical discursive practices. Written with hegemonic influence, policies and guidelines impact on the autonomy of both women and practitioners.Conclusion
Policies and guidelines pertaining to water immersion, particularly for birth reflect opinion and varied interpretations of the current literature base. A degree of hegemonic influence was noted prompting recommendations for future maternity care policy and guidelines’.Ethical considerations
The Human Research Ethics Committee of the University of South Australia approved the research. 相似文献13.
Oluwakemi C. Amodu Bukola Salami Solina Richter 《Women and birth : journal of the Australian College of Midwives》2017,30(5):e258-e263
Background
Obstetric Fistula is a childbirth injury that disproportionately affects women in sub-Saharan Africa. Although poverty plays an important role in perpetuating obstetric fistula, sociocultural practices has a significant influence on susceptibility to the condition.Aim
This paper aims to explore narratives in the literature on obstetric fistula in the context of Hausa ethno-lingual community of Northern Nigeria and the potential role of nurses and midwives in addressing obstetric fistula.Discussion
Three major cultural practices predispose Hausa women to obstetric fistula: early marriages and early child bearing; unskilled birth attendance and female circumcision and sociocultural constraints to healthcare access for women during childbirth. There is a failure to implement the International rights of the girl child in Nigeria which makes early child marriage persist. The Hausa tradition constrains the decision making power of women for seeking health care during childbirth. In addition, there is a shortage of nurses and midwives to provide healthcare service to women during childbirth.Conclusion
To improve health access for women, there is a need to increase political commitment and budget for health human resource distribution to underserved areas in the Hausa community. There is also a need to advance power and voice of women to resist oppressive traditions and to provide them with empowerment opportunities to improve their social status. The practice of traditional birth attendants can be regulated and the primary health care services strengthened. 相似文献14.
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15.
Yvonne Meyer Franziska Frank Franziska Schläppy Muntwyler Valerie Fleming Jessica Pehlke-Milde 《Women and birth : journal of the Australian College of Midwives》2017,30(6):e272-e280
Background
Decision-making in midwifery, including a claim for shared decision-making between midwives and women, is of major significance for the health of mother and child. Midwives have little information about how to share decision-making responsibilities with women, especially when complications arise during birth.Aim
To increase understanding of decision-making in complex home-like birth settings by exploring midwives’ and women’s perspectives and to develop a dynamic model integrating participatory processes for making shared decisions.Methods
The study, based on grounded theory methodology, analysed 20 interviews of midwives and 20 women who had experienced complications in home-like births.Findings
The central phenomenon that arose from the data was “defining/redefining decision as a joint commitment to healthy childbirth”. The sub-indicators that make up this phenomenon were safety, responsibility, mutual and personal commitments. These sub-indicators were also identified to influence temporal conditions of decision-making and to apply different strategies for shared decision-making. Women adopted strategies such as delegating a decision, making the midwife’s decision her own, challenging a decision or taking a decision driven by the dynamics of childbirth. Midwives employed strategies such as remaining indecisive, approving a woman’s decision, making an informed decision or taking the necessary decision.Discussion and conclusion
To respond to recommendations for shared responsibility for care, midwives need to strengthen their shared decision-making skills. The visual model of decision-making in childbirth derived from the data provides a framework for transferring clinical reasoning into practice. 相似文献16.
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Lena Bäck Ingegerd Hildingsson Carina Sjöqvist Annika Karlström 《Women and birth : journal of the Australian College of Midwives》2017,30(1):e32-e38
Background
Midwives have a significant impact on the clinical outcome and the birthing experience of women. However, there has been a lack of research focusing specifically on clinical midwives’ learning and development of professional competence.Aim
The objective of the study was to describe how midwives reflect on learning and the development of professional competence and confidence.Methods
A qualitative study based on focus groups with midwives employed in maternity services.Findings
Four categories describe the results: (1) Feelings of professional safety evolve over time; (2) Personal qualities affect professional development; (3) Methods for expanding knowledge and competence; and (4) Competence as developing and demanding. The meaning of competence is to feel safe and secure in their professional role. There was a link between the amount of hands-on intrapartum experience and increasing confidence that is, assisting many births made midwives feel confident. Internal rotation was disliked because the midwives felt they had less time to deepen their knowledge and develop competence in a particular field. The midwives felt they were not seen as individuals, and this system made them feel split between different assignments.Discussion
External factors that contribute to the development of knowledge and competence include the ability to practise hands-on skills in an organisation that is supportive and non-threatening. Internal factors include confidence, self-efficacy, and a curiosity for learning.Conclusions
Midwives working within an organisation should be supported to develop their professional role in order to become knowledgeable, competent and confident. 相似文献18.
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19.
Hlengiwe Mohale Linda Sweet Kristen Graham 《Women and birth : journal of the Australian College of Midwives》2017,30(4):298-307
Background
Increasing global migration is resulting in a culturally diverse population in the receiving countries. In Australia, it is estimated that at least four thousand Sub-Saharan African women give birth each year. To respond appropriately to the needs of these women, it is important to understand their experiences of maternity care.Objective
The study aimed to examine the maternity experiences of Sub-Saharan African women who had given birth in both Sub-Saharan Africa and in Australia.Design
Using a qualitative approach, 14 semi-structured interviews with Sub-Saharan African women now living in Australia were conducted. Data was analysed using Braun and Clark’s approach to thematic analysis.Findings
Four themes were identified; access to services including health education; birth environment and support; pain management; and perceptions of care. The participants experienced issues with access to maternity care whether they were located in Sub-Saharan Africa or Australia. The study draws on an existing conceptual framework on access to care to discuss the findings on how these women experienced maternity care.Conclusion
The study provides an understanding of Sub-Saharan African women’s experiences of maternity care across countries. The findings indicate that these women have maternity health needs shaped by their sociocultural norms and beliefs related to pregnancy and childbirth. It is therefore arguable that enhancing maternity care can be achieved by improving women’s health literacy through health education, having an affordable health care system, providing respectful and high quality midwifery care, using effective communication, and showing cultural sensitivity including family support for labouring women. 相似文献20.
Magdalena Ohaja Jo Murphy-Lawless 《Women and birth : journal of the Australian College of Midwives》2017,30(4):e165-e171