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Lindsay Cole Amanda LeCouteur Rebecca Feo Hannah Dahlen 《Women and birth : journal of the Australian College of Midwives》2019,32(1):e95-e101
Problem
Studies of women’s childbirth preferences repeatedly show that natural birth remains highly valued, yet the majority of births involve some form of medical intervention. Reasons for this lack of correspondence have typically been investigated through interviews and focus-groups with women. Relatively little research explores the ways in which women describe their experiences of childbirth outside of such research settings.Background
Most maternity services promote woman-centred care, whereby women are encouraged to take active roles in deciding how to give birth. However, recent research indicates that women often report feeling disempowered during labour and birth in hospital settings.Aim
We sought to examine how women account for use of medical intervention in hospitals by examining narratives posted on online discussion forums.Method
A thematic analysis of 106 publically available birth stories, sourced using the Internet search terms ‘birth story’, and ‘birth narrative’, was undertaken.Findings
Medical interventions in childbirth were routinely described as unwanted, yet as unavoidable, and two types of account were typically drawn on to explain their use: Protection of the baby/mother; and inflexible hospital policy/practice. We examine these two types of account, focusing on how their design oriented to the discordance between mothers’ reported desires for a natural birth, and their experiences in hospital.Conclusion
The experience of medical intervention in childbirth is routinely oriented to as a matter that requires explanation or account in online birth narratives. Women repeatedly referred to their preference to avoid intervention, but described being unable to do so in hospital. 相似文献4.
Lena B. Mårtensson Eileen K. Hutton Nigel Lee Sue Kildea Yu Gao Ingrid Bergh 《Women and birth : journal of the Australian College of Midwives》2018,31(5):380-385
Background
About 30% of women in labour suffer from lower back pain. Studies of sterile water injections for management of low back pain have consistently shown this approach to be effective. The objective of this evidence-based guide is to facilitate the clinical use of sterile water injections to relieve lower back pain in labouring women.Methods
To identify relevant publications our search strategy was based on computerised literature searches in scientific databases. The methodological quality of each study was assessed using the modified version of the Jadad scale, 12 studies were included.Findings
Recommendations regarding the clinical use of sterile water injections for pain relief in labour are reported in terms of the location of injection administration, various injection techniques, number of injections used, amount of sterile water in each injection and adverse effects.Discussion
Both injection techniques provide good pain relief for lower back pain during labour. The subcutaneous injection technique is possibly less painful than the intracutaneous technique administered, but we are unsure if this impacts on effectiveness. The effect seems to be related to the number of injections and the amount of sterile water in each injection.Conclusion
The recommendation at present, based on the current state of knowledge, is to give four injections. Notwithstanding the differences in injection technique and number of injections the method appears to provide significant levels of pain relief and can be repeated as often as required with no adverse effect (apart from the administration pain) on the woman or her foetus. 相似文献5.
Natasha Reid Jenny Gamble Debra K. Creedy Amy Finlay-Jones 《Women and birth : journal of the Australian College of Midwives》2019,32(1):3-5
Background
Exposure to alcohol prenatally can result in a child being diagnosed with fetal alcohol spectrum disorder. Affected infants experience lifelong impairments that can involve, physical, cognitive, behavioural and emotional difficulties that impact on their functional capacity. Effective prevention of fetal alcohol spectrum disorder is critically needed in Australia. Reduction in the prevalence of this disorder will only be possible if we prevent alcohol consumption during pregnancy.Aim
This paper provides an overview of fetal alcohol spectrum disorder and discusses the role of caseload midwifery as part of a multi-level prevention approach.Findings
Drawing on previous research, caseload midwifery has potential to support the prevention of fetal alcohol spectrum disorder through continuity of care.Conclusion
Prevention of fetal alcohol spectrum disorder will be more likely if women experience a supportive relationship with a known midwife, who has received appropriate training and can enable women to feel comfortable in discussing and addressing alcohol use. 相似文献6.
Ingegerd Hildingsson Annika Karlström Christine Rubertsson Helen Haines 《Women and birth : journal of the Australian College of Midwives》2019,32(1):58-63
Aim
Having a known midwife at birth is valued by women across the world, however it is unusual for women with fear of childbirth to have access to this model of care. The aim of this study was to describe the prevalence and factors related to having access to a known midwife for women referred to counseling due to childbirth fear. We also wanted to explore if women’s levels of childbirth fear changed over time.Methods
A pilot study of 70 women referred to counseling due to fear of birth in 3 Swedish hospitals, and where the counseling midwife, when possible, also assisted during labour and birth.Results
34% of the women actually had a known midwife during labour and birth. Women who had a known midwife had significantly more counseling visits, they viewed the continuity of care as more important, were more satisfied with the counseling and 29% reported that their fear disappeared. Fear of birth decreased significantly over time for all women irrespective of whether they were cared for in labour by a known midwife or not.Conclusions
Although the women in the present study had limited access to a known midwife, the results indicate that having a known midwife whom the women met on several occasions made them more satisfied with the counseling and had a positive effect on their fear. Building a trustful midwife–woman relationship rather than counseling per se could be the key issue when it comes to fear of birth. 相似文献7.
Predictors of women’s positive childbirth pain experience: Findings from an Icelandic national study
Sigfridur Inga Karlsdottir Herdis Sveinsdottir Hildur Kristjansdottir Thor Aspelund Olof Asta Olafsdottir 《Women and birth : journal of the Australian College of Midwives》2018,31(3):e178-e184
Background
Pain in childbirth has been identified as one of the major components in the childbirth experience and an important topic that needs to be addressed during pregnancy, birth and the after-birth period.Aim
The aim of the study was to describe women’s childbirth pain experience and to identify predictors of women’s positive childbirth pain experience.Method
A population-based cross-sectional cohort study design was implemented, with convenient consecutive sampling, stratified according to residency. Pregnant women were recruited through 26 health care centers. Participants were sent a questionnaire by mail during early pregnancy and another one five to six months after childbirth. A multiple regression analysis was done, with women’s childbirth pain experiences as the dependent variable.Findings
Altogether 726 women participated in the study, with a response rate of 68%. The strongest predictors for women’s positive childbirth pain experience were positive attitude to childbirth during pregnancy; support from midwife during childbirth; use of epidural analgesia and low intensity of pain in childbirth.Discussion
The majority of the women in the study experienced childbirth pain as a positive experience, which is in line with studies that have demonstrated that pain in childbirth is different from other kinds of pain. In addition to epidural use as a predictor for positive childbirth pain experience, many other strong predictors exist and must be acknowledged.Conclusion
When planning pregnancy and childbirth services, predictors of positive experience of childbirth pain should be considered and investigated further. 相似文献8.
Kiri A. Latuskie Naomi C.Z. Andrews Mary Motz Tom Leibson Zubin Austin Shinya Ito Debra J. Pepler 《Women and birth : journal of the Australian College of Midwives》2019,32(1):e57-e64
Background
Substance use during pregnancy is a major public health concern, stemming from potential physical and psychosocial harms to both the mother and child.Purpose
To understand women’s experiences using substances during pregnancy and the reasons that women continue and/or discontinue using substances.Methods
Focus groups were conducted with women who attended an early intervention program for pregnant or parenting women with substance use issues.Results
Women identified that external and internal stressors, feelings of guilt and low-self efficacy, and a lack of understanding of the scientific and medical consequences of substance use contributed to their continued substance use. Conversely, women highlighted the importance of high self-efficacy and the quality of relationships when trying to make positive changes to their substance use during pregnancy.Conclusions
Recommendations are proposed for easier access to and more comprehensive services. Healthcare professionals and service providers should offer non-judgmental care by building high-quality relationships with pregnant women with substance use issues, to increase these women’s self-efficacy and empower them to discontinue substance use. 相似文献9.
Meta Weltens Jascha de Nooijer Marianne J. Nieuwenhuijze 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e197-e203
Background
Dutch maternity care is based on the principle that pregnancy and childbirth are physiological processes. However, the last decade an increase of intra-partum referrals to obstetric-led care has been observed. Most of these referrals are among nulliparous women, non-urgent and occur during the first stage of labour. The increase in referrals seems not associated with better perinatal outcomes.Objective
Gain understanding of underlying factors in the decision-making process prior to referral to obstetric-led care among midwives attending childbirth in midwifery-led care.Method
A qualitative study based on in-depth interviews with Dutch midwives (n = 10) working in midwifery-led care. We performed a thematic analysis based on the hypothetico-deductive and the intuitive-humanist theory.Results
Midwives mentioned knowledge as the basis of a reasoned decision. This included both theoretical knowledge, and knowledge from clinical experience. Influences of others, like the needs and wishes of labouring women were another factor influencing the decision-making, especially in non-urgent situations. Under subjective factors, the fear of being held responsible for professional choices emerged.Key conclusion
The decision-making process during childbirth is multi-factorial. The women’s needs and wishes are recognized as of great influence on the decision-making process during childbirth, which is not included as a factor in the hypothetico-deductive or the intuitive-humanist theory.Implication for practice
The influence of women’s needs and wishes should be part of models about the intra-partum decision-making process. Midwives should find strategies to support women to make well-informed choices that include adequate information on the consequences of medicalisation in obstetric-led care. 相似文献10.
Birgitta Larsson Ingegerd Hildingsson Elin Ternström Christine Rubertsson Annika Karlström 《Women and birth : journal of the Australian College of Midwives》2019,32(1):e88-e94
Background
Women with childbirth fear have been offered counseling by experienced midwives in Sweden for decades without evidence for its effectiveness, in terms of decrease in childbirth fear. Women are usually satisfied with the counselling. However, there is a lack of qualitative data regarding women’s views about counselling for childbirth fear.Aim
To explore women’s experiences of midwife-led counselling for childbirth fear.Method
A qualitative interview study using thematic analysis. Twenty-seven women assessed for childbirth fear who had received counselling during pregnancy at three different hospitals in Sweden were interviewed by telephone one to two years after birth.Findings
The overarching theme ‘Midwife-led counselling brought positive feelings and improved confidence in birth’ was identified. This consisted of four themes describing ‘the importance of the midwife’ and ‘a mutual and strengthening dialogue’ during pregnancy. ‘Coping strategies and support enabled a positive birth’ represent women’s experiences during birth and ‘being prepared for a future birth’ were the women’s thoughts of a future birth.Conclusions
In this qualitative study, women reported that midwife-led counselling improved their confidence for birth through information and knowledge. The women experienced a greater sense of calm and preparedness, which increased the tolerance for the uncertainty related to the birthing process. This, in turn, positively affected the birth experience. Combined with a feeling of safety, which was linked to the professional support during birth, the women felt empowered. The positive birth experience strengthened the self-confidence for a future birth and the childbirth fear was described as reduced or manageable. 相似文献11.
Christine A. Marsh Jenny Browne Jan Taylor Deborah Davis 《Women and birth : journal of the Australian College of Midwives》2019,32(1):e1-e11
Background
Being involved in any child protection system is complex and multifaceted and none more so than in non-voluntary Assumption of Care which occurs in New South Wales when, for child protection concerns, the Department of Family and Community Services removes a newborn baby from her/his mother.Objective
This research studied childbearing women’s and professionals’ experiences of Assumption of Care at birth to increase understanding of individual participants’ stories, how they made sense of meanings and how these experiences framed their lives.Method
A narrative inquiry framework guided interviews with four groups: childbearing women, midwives, social workers and Family and Community Services case managers. Holistic form was used for reading, interpreting and analysing the narratives.Findings
This research found unwanted emotional (isolation, shame, guilt, loss, disenfranchised grief) and physical consequences (depression, substance abuse complications) for women experiencing an Assumption of Care at the time of birth. There were also conflicting ethical and moral positions for the professionals involved. The use/abuse of power, concealment of facts and disenfranchised grief were identified as intertwined plots that caused or increased tensions.Discussion
Both the women and the professionals felt pressure from trying to achieve competing and overlapping roles. The unwanted effects of Assumption of Care are exacerbated by the current child protection and maternity care systems.Conclusion
To address the tensions raised in this study, we suggest a two-fold change to maternity care for women at risk of an Assumption of Care: a therapeutic justice model of maternity care and continuity of midwifery care with a dedicated midwife. Introducing these changes could increase women’s and children’s safety and wellbeing. 相似文献12.
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Pranee Liamputtong Sandra Benza 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e216-e222
Problem
In non-Western societies, childlessness carries numerous social consequences and has a significant impact on the gender identity and well-being of the women.Background
The desire of women in non-Western societies is governed by numerous socio-cultural expectations including social norms and their own social position. At present, little is known about how Zimbabwean migrant women living in Australia perceive and experience childlessness and motherhood.Aim
To discuss how children are seen in Zimbabwean culture and examine the personal and social ramification of infertility and cultural expectations of motherhood among Zimbabwean migrant women living in Australia. The perspectives and experiences of this migrant community are crucial so that we can avoid misunderstanding about the essence of motherhood among Zimbabwean women. This will ultimately lead to sensitive and culturally appropriate health and social care for migrants in a multicultural society of Australia.Methods
The study is situated within the constructivist paradigm. Qualitative methods (in-depth interviewing, drawings and photo elicitation) were conducted with 15 Zimbabwean women. Data were analysed using thematic analysis method.Findings
Being able to bear a child in Zimbabwean culture had a significant meaning to the women. Not only children could ensure the continuity of the society, having children was a form of social security as parents would be cared for by their children in old age. Childlessness threatens the social position of a woman and carries social consequences which significantly impact on their gender identity and well-being. Cultural expectations of motherhood placed the sole responsibility of caring for the children emotionally and physically on the mother.Conclusion
The procreative value has not diminished despite having settled in Australia. An increased awareness of procreative needs for Zimbabwean women in a culturally and sensitive manner would enhance the emotional well-being of these women. 相似文献15.
Anna Dencker Christina Nilsson Cecily Begley Elisabeth Jangsten Margareta Mollberg Harshida Patel Helena Wigert Eva Hessman Helen Sjöblom Carina Sparud-Lundin 《Women and birth : journal of the Australian College of Midwives》2019,32(2):99-111
Problem
Fear of childbirth negatively affects women during pregnancy and after birth.Aim
To summarise the findings of published studies regarding possible causes/predisposing factors and outcomes of fear of childbirth for childbearing women.Design
A systematic review, searching five databases in March 2015 for studies on causes/predisposing factors and outcomes of fear of childbirth, as measured during pregnancy and postpartum. Quality of included studies was assessed independently by pairs of authors. Data were extracted independently by reviewer pairs and described in a narrative analysis.Findings
Cross-sectional, register-based and case-control studies were included (n = 21). Causes were grouped into population characteristics, mood-related aspects, and pregnancy and birth-related aspects. Outcomes were defined as mood-related or pregnancy and birth-related aspects. Differing definitions of fear of childbirth were found and meta-analysis could only be performed on parity, in a few studies.Conclusions
Stress, anxiety, depression and lack of social support are associated with fear during pregnancy. Need for psychiatric care and presence of traumatic stress symptoms are reported outcomes together with prolonged labour, longer labours, use of epidural and obstetric complications. Nulliparous and parous women have similar levels of fear but for different reasons. Since the strongest predictor for fear in parous women is a previous negative birth experience or operative birth, we suggest it is important to distinguish between fear of childbirth and fear after birth. Findings demonstrate the need for creating woman-centred birthing environments where women can feel free and secure with low risk of negative or traumatic birth experiences and consequent fear. 相似文献16.
Heidi Preis Michal Eisner Rony Chen Yael Benyamini 《Women and birth : journal of the Australian College of Midwives》2019,32(1):e110-e117
Problem
Birth preferences, such as mode and place of birth and other birth options, have important individual and societal implications, yet few studies have investigated the mechanism which predicts a wide range of childbirth options simultaneously.Background
Basic beliefs about birth as a natural and as a medical process are both predictive factors for childbirth preferences. Studies investigating birth beliefs, preferences, and actual birth are rare.Aim
To test a predictive model of how these beliefs translate into birth preferences and into actual birth related-options.Methods
Longitudinal observational study including 342 first-time expectant mothers recruited at women’s health centres and natural birth communities in Israel. All women filled out questionnaires including basic birth beliefs and preferred birth options. Two months postpartum, they filled out a questionnaire including detailed questions regarding actual birth.Findings
Stronger beliefs about birth being natural were related to preferring a more natural place and mode of birth and preferring more natural birth-related options. Stronger beliefs about birth being medical were associated with opposite options. The preferences mediated the association between the birth beliefs and actual birth. The beliefs predicted the preferences better than they predicted actual birth.Discussion
Birth beliefs are pivotal in the decision-making process regarding preferred and actual birth options. In a medicalized obstetric system, where natural birth is something women need to actively seek out and insist on, the predictive powers of beliefs and of preferences decrease.Conclusion
Women’s beliefs should be recognized and birth preferences respected. 相似文献17.
Susanne Åhlund Sofia Zwedberg Ingegerd Hildingsson Malin Edqvist Helena Lindgren 《Women and birth : journal of the Australian College of Midwives》2018,31(2):e115-e121
Problem and background
In an earlier research project midwives were asked to perform women-centered care focusing on the assumption that the physiological process in the second stage of labour could be trusted and that the midwives role should be encouraging and supportive rather than instructing. There is no knowledge about how midwives participating in such a research project, uses their skills and experience from the study in their daily work.Aim
The aim in this study was to investigate how midwives experienced implementing woman-centered care during second stage of labour.Methods
A qualitative study was designed. Three focus groups and two interviews were conducted. The material was analysed using content analysis.Findings
The participating midwives’ experiences were understood as increased awareness of their role as midwives. The overarching theme covers three categories 1) establishing a new way of working, 2) developing as midwife, 3) being affected by the prevailing culture. The intervention was experienced as an opportunity to reflect and strengthen their professional role, and made the midwives see the women and the birth in a new perspective.Conclusions
Implementing woman-centered care during second stage of labour gave the midwives an opportunity to develop in their professional role, and to enhance their confidence in the birthing women and her ability to have a physiological birth. To promote participation in, as well as conduct midwifery research, can enhance the development of the midwives professional role as well as contribute new knowledge to the field. 相似文献18.
A. Rota L. Antolini E. Colciago A. Nespoli S.E. Borrelli S. Fumagalli 《Women and birth : journal of the Australian College of Midwives》2018,31(4):313-318
Background
Hospitalization of women in latent labour often leads to a cascade of unnecessary intrapartum interventions, to avoid potential disadvantages the recommendation should be to stay at home to improve women’s experience and perinatal outcomes.Aim
The primary aim of this study was to investigate the association between hospital admission diagnosis (latent vs active phase) and mode of birth. The secondary aim was to explore the relationship between hospital admission diagnosis, intrapartum intervention rates and maternal/neonatal outcomes.Methods
A correlational study was conducted in a large Italian maternity hospital. Data from January 2013 to December 2014 were collected from the hospital electronic records. 1.446 records of low risk women were selected. These were dichotomized into two groups based on admission diagnosis: ‘latent phase’ or ‘active phase’ of labour.Findings
52.7% of women were admitted in active labour and 47.3% in the latent phase. Women in the latent phase group were more likely to experience a caesarean section or an instrumental birth, artificial rupture of membranes, oxytocin augmentation and epidural analgesia. Admission in the latent phase was associated with higher intrapartum interventions, which were statistically correlated to the mode of birth.Conclusions
Women admitted in the latent phase were more likely to experience intrapartum interventions, which increase the probability of caesarean section. Maternity services should be organized around women and families needs, providing early labour support, to enable women to feel reassured facilitating their admission in labour to avoid the cascade of intrapartum interventions which increases the risk of caesarean section. 相似文献19.
Rima Kaddoura Jocelyn DeJong Huda Zurayk Tamar Kabakian Christine Abbyad Fadi G. Mirza 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e223-e228
Problem
There is lack of data on the rate of episiotomy in Lebanon and the study’s hospital.Background
Only a few studies have addressed episiotomy practice in Lebanon and the Middle East and they show varying rates.Aim
To identify the rate, and change in rate, of episiotomy practice over the years at a teaching hospital in Lebanon and to assess whether maternal age, parity, fetal weight, woman’s hospital admission class, and physician’s gender were associated with episiotomy. We also tested the association between episiotomy and postpartum hemorrhage and/or high degree perineal tears.Methods
A retrospective observational study was conducted on 1756 records for women having a normal vaginal birth at a single centre from January 2009 to January 2014.Findings
The rate of episiotomy at the hospital was very high, with 97.4% of women receiving an episiotomy in 2009. A major decrease in the rate was identified with a decline from 97.4% in 2009 to 73.3% in January 2014. Episiotomy was found to be associated with parity, maternal age, and with high degree perineal tears.Discussion
The episiotomy rate at this centre remains higher than the 10% rate recommended by the World Health Organization, although there has been a significant reduction after a call for restrictive rather than liberal use.Conclusion
Raising awareness among providers appeared to play a significant role in reducing this rate, although more efforts remain warranted. Other strategies – such as raising awareness of women about potential risks of episiotomy – are also worth exploring. 相似文献20.
Joëlle Darwiche Anne Milek Jean-Philippe Antonietti Yvan Vial 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e264-e271