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1.
Anders Linde Ingela Rådestad Karin Pettersson Linn Hagelberg Susanne Georgsson 《Women and birth : journal of the Australian College of Midwives》2017,30(5):376-381
Background
Experience of reduced fetal movements is a common reason for consulting health care in late pregnancy. There is an association between reduced fetal movements and stillbirth.Aim
To explore why women decide to consult health care due to reduced fetal movements at a specific point in time and investigate reasons for delaying a consultation.Methods
A questionnaire was distributed at all birth clinics in Stockholm during 2014, to women seeking care due to reduced fetal movements. In total, 3555 questionnaires were collected, 960 were included in this study. The open-ended question; “Why, specifically, do you come to the clinic today?” was analyzed using content analysis as well as the complementary question “Are there any reasons why you did not come to the clinic earlier?”Results
Five categories were revealed: Reaching dead line, Receiving advice from health care professionals, Undergoing unmanageable worry, Contributing external factors and Not wanting to jeopardize the health of the baby. Many women stated that they decided to consult care when some time with reduced fetal movements had passed. The most common reason for not consulting care earlier was that it was a new experience. Some women stated that they did not want to feel that they were annoying, or be perceived as excessively worried. Not wanting to burden health care unnecessarily was a reason for prehospital delay.Conclusion
Worry about the baby is the crucial reason for consulting care as well as the time which has passed since the women first experienced decreased fetal movements. 相似文献2.
Jane Warland Pauline Glover 《Women and birth : journal of the Australian College of Midwives》2017,30(1):23-28
Problem
Information that women receive about the importance of monitoring fetal movements and what to do if there are changes is inconsistent and may not be evidence based.Background
This paper reports a summary of the kind of messages a group of South Australian midwives (n = 72) currently give pregnant women.Methods
Comment data from two questions in a larger survey asking (1) what information midwives routinely provide to women about fetal movements and (2) their practice regarding advice they give to women reporting reduced fetal movements. Data were analysed using summative content analysis.Findings
Four main recurring words and phrases were identified. With respect to information midwives give all women about monitoring fetal movements, recurring words were “10”, “normal”, “kick charts” and “when to contact” their care-provider. Recurrent words and phrases arising from answers to the second question about advice midwives give to women reporting reduced fetal movement were “ask questions,” “suggest fluids,” “monitor at home and call back” or “come in for assessment”.Discussion
These findings suggest that a group of South Australian midwives are providing pregnant women with inconsistent information, often in conflict with best practice evidence.Conclusion
As giving correct, evidence based information about what to do in the event of an episode of reduced fetal movement may be a matter of life or death for the unborn baby it is important that midwives use existing guidelines in order to deliver consistent information which is based on current evidence to women in their care. 相似文献3.
Shigeki Koshida Tetsuo Ono Shunichiro Tsuji Takashi Murakami Hisatomi Arima Kentaro Takahashi 《Women and birth : journal of the Australian College of Midwives》2019,32(2):127-130
Background
Decreased fetal movements are associated with adverse perinatal outcomes, including stillbirth. Delayed maternal visits to a health care provider after perceiving decreased fetal movements are frequently observed in stillbirths. Informing pregnant women of the normal range of fetal movement frequency is essential in their earlier visits in order to prevent stillbirth.Aim
To investigate the fetal movement frequency in late pregnancy and the effects of associated perinatal factors.Methods
This prospective multicenter study was conducted in 20 obstetric facilities in our region of Japan. A total of 2337 pregnant women were asked to record the time it took to perceive 10 fetal movements by the modified ‘count to 10’ method every day from 34 weeks of gestation until delivery.Findings
The 90th percentile of the time for the maternal perception of 10 fetal movements was 18–29 min, with a gradually increasing trend toward the end of pregnancy. The numbers of both pregnant women giving birth after 39 weeks’ gestation and infants with a birth weight exceeding 3000 g were significantly higher in mothers who took ≥30 min to count 10 fetal movements than in those who took <30 min.Conclusion
The maternal perception time of fetal movements shows a gradually increasing trend within 30 min for 10 fetal movements by the modified ‘count to 10’ method. Informing pregnant women of the normal range of the fetal movement count time will help improve the maternal recognition of decreased fetal movements, which might prevent fetal death in late pregnancy. 相似文献4.
Nicole Borg Cunen Julie Jomeen Rita Borg Xuereb Angela Poat 《Women and birth : journal of the Australian College of Midwives》2017,30(4):e141-e151
Background
Expectant parents develop varying degrees of emotional affiliation with the unborn child. Interventions supporting this relationship may be beneficial given its link to maternal health behaviour during pregnancy, as well as the parental–infant bond after birth.Aim
To identify and describe the effects of programmes and strategies that have addressed the parental–fetal relationship.Method
English-language primary studies, published between 2005–2015, were identified and their methodological quality was assessed. Databases used included CINAHL, Cochrane Library, MEDLINE, PsycINFO and Web of Science. Key search terms included maternal/paternal–fetal attachment, prenatal bond, parental–fetal relationship and intervention. RCTs, non-RCTs, observational and non-comparative studies, before and after studies and case studies were included.Findings
Twenty-seven papers were included. Studies evaluated the effects of various strategies, including ultrasound and screening procedures, fetal awareness interventions, social and psychological support techniques, educational programmes and relaxation strategies. Results are inconsistent due to the diversity of interventions and significant variation in methodological quality.Conclusion
There is insufficient evidence to support definitive conclusions regarding the efficacy of any included intervention. A number of limitations, such as non-probability sampling, lack of blinding, and insufficient follow-up weaken the evidence. The inclusion of fathers in only three studies reflects the overall neglect of men in research regarding the prenatal relationship. Further in-depth study of the nature of the maternal/paternal–fetal relationship may be needed in order to allow for the identification of interventions that are consistently beneficial and worthwhile. 相似文献5.
Natsuko K. Wood Elizabeth A. Sanders Frances M. Lewis Nancy F. Woods Susan T. Blackburn 《Women and birth : journal of the Australian College of Midwives》2017,30(6):472-480
Problem
Although the World Health Organization and American Academy of Pediatrics recommend exclusive breastfeeding for the first six months, only 22% of U.S. mothers do so. Mothers’ perceived insufficient milk (PIM) is the primary reason for breastfeeding discontinuation globally. There are two changeable causes of PIM: (1) mothers’ misinterpretation of their infant’s behavior, and (2) mothers’ lack of confidence in their ability to breastfeed.Aim
The purpose of this study was to evaluate the short-term effect of a home-based intervention designed to prevent and/or reduce PIM.Methods
A mixed-methods, single-group, pretest-midtest-posttest design was used for evaluating a home-based breastfeeding program. The program was implemented during three 1.0- to 1.5-h home intervention sessions at 6, 13, and 27 days postpartum, delivered to 14 dyads of breastfeeding mothers and their full-term singleton infants.Findings
We found significant increases over time in mothers’ sensitivity to infant behavior and breastfeeding self-efficacy as well as significant decreased attribution of infant crying to PIM. Exit interviews indicated that the program was accepted by participating mothers.Discussion
This is the first intervention study that has directly targeted the causes of PIM. The home-based intervention has the potential to add to maternal competencies both in correctly assessing their infants’ behavior, thereby preventing erroneous attribution of infant behavior to PIM, as well as simultaneously bolstering maternal confidence in breastfeeding skills.Conclusion
By building maternal competencies, the home-based intervention has a longer-range potential to prevent breastfeeding discontinuation. Further evaluation is warranted. 相似文献6.
Catherine Adams Angela Dawson Maralyn Foureur 《Women and birth : journal of the Australian College of Midwives》2017,30(2):107-113
Objective
To identify the predominant culture of an organisation which could then assess readiness for change.Design
An exploratory design using the Competing Values Framework (CVF) as a self-administered survey tool.Setting
The Maternity Unit in one Australian metropolitan tertiary referral hospital.Subjects
All 120 clinicians (100 midwives and 20 obstetricians) employed in the maternity service were invited to participate; 26% responded.Main outcome measure
The identification of the predominant culture of an organisation to assess readiness for change prior to the implementation of a new policy.Results
The predominant culture of this maternity unit, as described by those who responded to the survey, was one of hierarchy with a focus on rules and regulations and less focus on innovation, flexibility and teamwork. These results suggest that this unit did not have readiness to change.Conclusion
There is value in undertaking preparatory work to gain a better understanding of the characteristics of an organisation prior to designing and implementing change. This understanding can influence additional preliminary work that may be required to increase the readiness for change and therefore increase the opportunity for successful change. The CVF is a useful tool to identify the predominant culture and characteristics of an organisation that could influence the success of change. 相似文献7.
Sandy M. Zgheib Mohammad Kacim Karel Kostev 《Women and birth : journal of the Australian College of Midwives》2017,30(6):e265-e271
Background
During the last decades, there has been an alarming and dramatic increase in the number of cesarean births in both developed and undeveloped countries. This increase has not been clinically justified but, nevertheless, has raised an important number of issues.Aim
The aim of this study was to determine the risk factors associated with the high cesarean section rates in Lebanon.Methods
This study is based on a sample of 29,270 Lebanese women who were pregnant between 2000 and 2015. Among these, 14,327 gave birth by cesarean section and 14,943 gave birth vaginally. To identify the risk factors of cesarean section, logistic regression was applied as a statistical method using the SPSS statistical package.Findings
Of the 29,270 pregnant women included in the study, 49% had cesarean sections while 51% gave birth vaginally. Repeat cesarean section accounted for 23% while vaginal birth after cesarean accounted for only 0.2% of deliveries. In addition, weekdays were associated with a preference of providers to carry out more cesarean sections. According to an analysis of our data using logistic regression, the risk factors associated with the increase in cesarean section rates were advanced maternal age, elective cesarean section, malpresentation of fetus, multiple birth, prolonged pregnancy, prolonged labor, and fetal distress.Conclusion
Based on these results, it is recommended that a new health policy be implemented to reduce the number of unnecessary cesarean deliveries in Lebanon. 相似文献8.
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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10.
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11.
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12.
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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14.
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15.
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Jenny S. Hall Mary Mitchell 《Women and birth : journal of the Australian College of Midwives》2017,30(3):214-219
Focus
There is currently limited information available on how midwifery students learn to provide care that promotes dignity and respect.Background
In recent years the importance of dignity in healthcare and treating people with respect has received considerable emphasis in both a national and international context.Aim
The aim of this discussion paper is to describe an educational workshop that enables learning to promote dignity and respect in maternity care.Discussion
An interactive workshop, using different creative methods as triggers for learning will be described. Provision of learning opportunities for students around dignity and respect is important to ensure appropriate care is provided in practice. The use of creative methods to inspire has contributed to deep learning within participants. An evaluation of the workshop illustrated how learning impacted on participants practice. Data to support this is presented in this paper.Conclusion
The use of creative teaching approaches in a workshop setting appears to provide an effective learning opportunity around dignified and respectful care. These workshops have evoked a deep emotional response for some participants, and facilitators must be prepared for this outcome to ensure a safe space for learning. 相似文献17.
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Annamagreth M. Mukwenda Columba K. Mbekenga Andrea B. Pembe Pia Olsson 《Women and birth : journal of the Australian College of Midwives》2017,30(2):114-120