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1.
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2.
3.
Yu Zhu Zhihong Zhang Yun Ling Hongwei Wan 《Women and birth : journal of the Australian College of Midwives》2017,30(2):146-152
Background
Breastfeeding knowledge, attitude, subjective norm, and perceived control are significant determinants of breastfeeding, according to the theory of planned behavior (TPB). However, evidence concerning the effectiveness of the TPB-based intervention in breastfeeding promotion is sparse. Meanwhile, the changes of these determinants with time have not been examined in previous studies.Aim
To investigate the effectiveness of the TPB-based intervention program in improving exclusive breastfeeding, and the interaction of time and intervention on these determinants of breastfeeding.Methods
285 primiparous mothers were included, with 157 mothers in the experimental group and 128 mothers in the control group. The experimental group received the TPB-based intervention program delivered during 6 weeks postpartum, while both the experimental and control groups received the standard obstetric care.Findings
Scores of breastfeeding knowledge, attitude and breastfeeding control increased with time from baseline to 6 weeks postpartum, while breastfeeding subjective norm decreased at 6 weeks both in the experimental and the control groups. Besides, scores of the four determinants were significantly higher in the experimental group than these in the control group at 3 days and 6 weeks, except for breastfeeding control at 6 weeks, which resulted in the higher exclusive breastfeeding rates at 3 days and 6 weeks in the experimental group than the control group.Discussion and conclusions
The TPB-based intervention was effective in promoting exclusive breastfeeding during 6 weeks postpartum. Future interventions are recommended to adjust intervention strategies with time, and give more focus on providing continued breastfeeding support after discharge. 相似文献4.
Karen Matvienko-Sikar Samantha Dockray 《Women and birth : journal of the Australian College of Midwives》2017,30(2):e111-e118
Problem
Low prenatal well-being has adverse outcomes for mother and infant but few interventions currently exist to promote and maintain prenatal well-being.Background
Mindfulness and gratitude based interventions consistently demonstrate benefits in diverse populations. Interventions integrating these constructs have potential to improve psychological and physiological health during pregnancy.Aim
The aim of this pilot study is to examine the effect of a novel gratitude and mindfulness based intervention on prenatal stress, cortisol levels, and well-being.Methods
A pilot randomised controlled trial was conducted with 46 pregnant women. Participants used an online mindfulness and gratitude intervention 4 times a week for 3 weeks. Measures of prenatal stress, salivary cortisol, gratitude, mindfulness, and satisfaction with life were completed at baseline, 1.5 weeks later, and 3 weeks later.Findings
Intervention participants demonstrated significant reductions in prenatal stress in comparison to the control condition (p = .04). Within subjects reductions in waking (p = .004) and evening cortisol (p > .001) measures were observed for intervention participants. Significant effects were not observed for other well-being outcomes.Discussion
Reducing self-report and physiological stress in pregnancy can improve maternal and infant outcomes. The findings of this pilot study indicate potential direct effects of the intervention on self-reported stress in comparison to a treatment-as-usual control. Effects on a biomarker of stress, cortisol, were also observed within the intervention group.Conclusion
A brief mindfulness and gratitude based intervention has the potential to reduce stress in pregnancy. Future research is needed to further explore mechanisms and potential benefits of such interventions. 相似文献5.
Shahnaz Torkzahrani Fatemeh Mahmoudikohani Kiarash Saatchi Reyhaneh Sefidkar Mojdeh Banaei 《Women and birth : journal of the Australian College of Midwives》2017,30(1):46-50
Background
Induction of labor is a common obstetric procedure. Acupressure is a natural method that is used for inducing uterine contractions. Nevertheless, few studies have examined the impact of acupressure on the induction of labor.Aim
The aim of this study was to evaluate the effect of acupressure on the initiation of labor.Material and methods
In this randomized clinical trial, 162 nulliparous pregnant women were admitted to the hospital. They were categorized into 3 groups; acupressure, sham acupressure and control. Acupressure points SP6, BL 60 and BL 32 were pressured bilaterally. The intervention was done by the researcher every other day between 9 am and 11 am. The intervention was carried out on women in the afternoon and the following day. Subjects were examined to determine the initiation of labor symptoms48 and 96 h after the start of intervention and at the time of hospitalization. Data were analyzed using the ANOVA, Kruskal–Wallis and Chi-square tests (p < 0.05).Results
There was no significant difference among the groups for spontaneous initiation of labor within 48 h (P = 0.464), and 49–96 h after beginning the intervention (P = 0.111) and 97 h after beginning the intervention to the time of hospitalization for the spontaneous initiation of labor (P = 0.897). There were no significant differences in the secondary outcomes between the groups.Conclusion
According to the finding of this study, it seems that acupressure treatment was not effective in initiating labor as compared with the sham acupressure and the routine care groups. 相似文献6.
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7.
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8.
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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.
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12.
Giuseppina Persico Laura Antolini Patrizia Vergani Walter Costantini Maria Teresa Nardi Lidia Bellotti 《Women and birth : journal of the Australian College of Midwives》2017,30(4):e214-e220
Background
Mother–infant bonding is of great importance for the development and the well-being of the baby. The aim of this Concurrent Cohort Study was to investigate the effects of mothers singing lullabies on bonding, newborns’ behaviour and maternal stress.Methods
Eighty-three (singing cohort) and 85 (concurrent cohort) women were recruited at antenatal classes at 24 weeks g.a. and followed up to 3 months after birth. The Prenatal Attachment Inventory (PAI) and the Mother-to-Infant Bonding Scale (MIBS) were used to assess maternal-foetal attachment and postnatal bonding.Findings
No significant influence was found on Prenatal Attachment; by contrast, Postnatal Bonding was significantly greater (i.e. lower MIBS) in the singing group 3 months after birth (mean 1.28 vs 1.96; p = 0.001). In the same singing group, the incidence of neonatal crying episodes in the first month was significantly lower (18.5% vs 28.2; p < 0.0001) as were the infantile colic (64.7% vs 38.3%; p = 0.003) and perceived maternal stress (29.6% vs 36.5%; p < 0.05). Infantile colic was reduced in the singing group, even in the second month after birth (22.8% vs 36.5; p = 0.002). At the same time, a reduction was observed in the neonatal nightly awakening (1.5% vs 4.7; p < 0.0001).Conclusions
Mothers singing lullabies could improve maternal-infant bonding. It could also have positive effects on neonatal behaviour and maternal stress. 相似文献13.
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14.
Julia Leinweber Debra K. Creedy Heather Rowe Jenny Gamble 《Women and birth : journal of the Australian College of Midwives》2017,30(1):40-45
Background
Midwives frequently witness traumatic birth events. Little is known about responses to birth trauma and prevalence of posttraumatic stress among Australian midwives.Aim
To assess exposure to different types of birth trauma, peritraumatic reactions and prevalence of posttraumatic stress.Methods
Members of the Australian College of Midwives completed an online survey. A standardised measure assessed posttraumatic stress symptoms.Findings
More than two-thirds of midwives (67.2%) reported having witnessed a traumatic birth event that included interpersonal care-related trauma features. Midwives recalled strong emotions during or shortly after witnessing the traumatic birth event, such as feelings of horror (74.8%) and guilt (65.3%) about what happened to the woman. Midwives who witnessed birth trauma that included care-related features were significantly more likely to recall peritraumatic distress including feelings of horror (OR = 3.89, 95% CI [2.71, 5.59]) and guilt (OR = 1.90, 95% CI [1.36, 2.65]) than midwives who witnessed non-interpersonal birth trauma. 17% of midwives met criteria for probable posttraumatic stress disorder (95% CI [14.2, 20.0]). Witnessing abusive care was associated with more severe posttraumatic stress than other types of trauma.Discussion
Witnessing care-related birth trauma was common. Midwives experience strong emotional reactions in response to witnessing birth trauma, in particular, care-related birth trauma. Almost one-fifth of midwives met criteria for probable posttraumatic stress disorder.Conclusion
Midwives carry a high psychological burden related to witnessing birth trauma. Posttraumatic stress should be acknowledged as an occupational stress for midwives. The incidence of traumatic birth events experienced by women and witnessed by midwives needs to be reduced. 相似文献15.
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16.
J. Fenwick H. Brittain J. Gamble 《Women and birth : journal of the Australian College of Midwives》2017,30(6):497-505
Background
Reporting the outcomes for women and newborns accessing private midwives with visiting rights in Australia is important, especially since this data cannot currently be disaggregated from routinely collected perinatal data.Aim
1) Evaluate the outcomes of women and newborns cared for by midwives with visiting access at one Queensland facility and 2) explore private midwives views about the structures and processes contributing to clinical outcomes.Methods
Mixed methods. An audit of the ‘all risk’ 529 women receiving private midwifery care. Data were compared with national core maternity variables using Chi square statistics. Telephone interviews were conducted with six private midwives and data analysed using thematic analysis.Findings
Compared to national data, women with a private midwife were significantly more likely to be having a first baby (49.5% vs 43.6% p = 0.007), to commence labour spontaneously (84.7% vs 52.7%, p < 0.001), experience a spontaneous vaginal birth (79% vs 54%, p < 0.001) and not require pharmacological pain relief (52.9% vs 23.1%, p < 0.001). The caesarean section rate was significantly lower than the national rate (13% vs 32.8%, p < 0.001). In addition fewer babies required admission to the Newborn Care Unit (5.1% vs 16%, p < 0.001). Midwives were proud of their achievements. Continuity of care was considered fundamental to achieving quality outcomes. Midwives valued the governance processes embedded around the model.Conclusions
Private midwives with access to the public system is safe. Ensuring national data collection accurately captures outcomes relative to model of care in both the public and private sector should be prioritised. 相似文献17.
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Che Muzaini Che’ Muda Tengku Alina Tengku Ismail Rohana Ab Jalil Suhaily Mohd Hairon Zaharah Sulaiman Nazirah Johar 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e243-e251
Background
The first week after childbirth is a crucial period for exclusive breastfeeding initiation.Objective
This study aims to determine the association of postnatal breastfeeding education with knowledge, attitude, and exclusive breastfeeding practice at six months after childbirth among women who delivered at two district hospitals in the northeast part of Peninsular Malaysia.Methods
This is a quasi-experimental study design. A newly developed and validated questionnaire was used to determine scoring for baseline and six months after childbirth. The intervention consisted of individualized postnatal breastfeeding education delivered by researchers using flipchart one week after childbirth and breastfeeding diary in addition to usual care. The comparison group received the usual postnatal care by health clinics. Repeated measure analysis of variance and multiple logistic regression analysis were used.Results
A total of 116 participants were included in this study (59 in intervention group and 57 in comparison group). Six months after childbirth, the adjusted mean score of knowledge and attitude of the intervention group were significantly higher than that of the comparison group (p < 0.001 and p = 0.002, respectively). More participants in the intervention group (n = 26, 44.1%) exclusively breastfed their infants compared with 15 (26.3%) in the comparison group (p = 0.046). Postnatal breastfeeding education was significantly associated with exclusive breastfeeding practice six months after childbirth [adjusted odds ratio 2.31; 95% confidence interval: 1.02, 5.14; p = 0.040].Conclusions
Postnatal breastfeeding education was significantly associated with an improvement in women’s knowledge, attitude and exclusive breastfeeding practice six months after childbirth. 相似文献20.
Khlood Bookari Heather Yeatman Moira Williamson 《Women and birth : journal of the Australian College of Midwives》2017,30(1):9-17