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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3.
Fatemeh Darsareh Teamur Aghamolaei Minoo Rajaei Abdoulhossain Madani Shahram Zare 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e166-e172
Problem
The steep increase and inappropriateness of caesarean birth represent a healthcare problem in Iran.Aim
The purpose of study was to evaluate the effect of a campaign based on social marketing to promote normal childbirth.Method
The study was designed as a prospective case control study. The social marketing campaign was implemented from March 2016 to January 2017. A demographic data questionnaire, obstetrical history questionnaire, maternal knowledge assessment questionnaire, and maternal health belief questionnaire comprised the instruments for this study. Only women planning a caesarean birth without any medical indications for the caesarean were enrolled in the study as a case. Those who met the same inclusion criteria and did not want to participate in the campaign were assigned to the control group.Findings
In total, 350 first-time pregnant women who composed the campaign group (n = 194) and control group (n = 156) completed the study. The mean baseline level of knowledge and Health Belief Model component score did not differ between the two groups at baseline. However, after the campaign, knowledge scores, perceived severity, perceived susceptibility, self-efficacy, and cues to action scores differed significantly between the campaign and control groups. The follow-up of all participants in both groups showed that 35.6% (n = 69) of participants in the campaign group chose natural birth as their birth method, whereas only 13.5% (n = 21) in the control group delivered their newborn vaginally.Conclusion
The B Butterfly social marketing campaign successfully targeted first-time pregnant women who chose to have unnecessary elective cesarean births. 相似文献4.
Catherine Kilgour Fiona Elizabeth Bogossian Leonie Callaway Cindy Gallois 《Women and birth : journal of the Australian College of Midwives》2019,32(1):e24-e33
Problem
The reasons for low postnatal screening rates for women with gestational diabetes mellitus are not well understood. Multiple care providers, settings and changes to diagnostic criteria, may contribute to confusion over postnatal care. Quality of communication between clinicians may be an important influence for the completion of postnatal gestational diabetes mellitus follow-up.Aim
Describe and analyse communication processes between hospital clinicians (midwives, medical, allied staff) and general practitioners who provide postnatal gestational diabetes mellitus care.Methods
Purposive sampling and convergent interviews explored participants’ communication experiences providing gestational diabetes mellitus postnatal follow-up. Data were analysed with Leximancer automated content analysis software; interpretation was undertaken using Communication Accommodation Theory.Setting and participants
Clinicians who provided maternity care at a tertiary referral hospital (n = 13) in Queensland, Australia, and general practitioners (n = 16) who provided maternity shared care with that hospital between December 2012 and July 2013.Findings
Thematic analysis identified very different perspectives between the experiences of General Practitioners and hospital clinicians; six themes emerged. General practitioners were concerned about themes relating to discharge summaries and follow-up guidelines. In contrast, hospital clinicians were more concerned about themes relating to gestational diabetes mellitus antenatal care and specialist clinics. Two themes, gestational diabetes mellitus women and postnatal checks were shared.Conclusion
Gestational diabetes mellitus follow-up is characterised by communication where general practitioners appear to be information seekers whose communication needs are not met by hospital clinicians. Midwives are ideally placed to assist in improving communication and postnatal gestational diabetes mellitus follow-up. 相似文献5.
Anna Clara F. Vieira Cláudia M.C. Alves Vandilson P. Rodrigues Cecília C.C. Ribeiro Isaac S. Gomes-Filho Fernanda F. Lopes 《Women and birth : journal of the Australian College of Midwives》2019,32(1):e12-e16
Background
The rates of preterm births have been increasing worldwide. Complications related to preterm births are associated with increased costs of care, and have a direct impact on the health system of the countries. Therefore, it is important to address factors associated with preterm birth in order to provide prevention strategies.Objective
This case–control study investigated oral, systemic, and socioeconomic factors associated with preterm birth in postpartum women. Participants were 279 postpartum women that gave birth to a singleton live-born infant. Cases were women giving birth before 37 completed weeks of gestation (preterm birth). Controls were women giving birth at term (≥37 weeks). Data were collected through questionnaires, medical records and intra-oral clinical examinations, which included dental caries registration according to World Health Organization criteria and oral biofilm evaluation through visible plaque index.Results
Ninety-one women had preterm birth (cases) and 188 women had birth at term (controls), ratio 1:2. Caries lesions were present in 62.3% of the cases and in 62.5% of the controls. The univariate analysis showed no association between dental caries and preterm birth (Odds Ratio = 1.08, p = 0.90). The multivariate analysis showed that maternal educational level (Odds Ratio = 2.56, p = 0.01) and arterial hypertension (Odds Ratio = 2.32, p = 0.01) were associated with prematurity.Conclusion
This study demonstrated that dental caries is frequent in postpartum women, but it does not appear to be associated with preterm birth. Meanwhile, maternal education level and arterial hypertension were associated with prematurity in this population. 相似文献6.
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7.
Ahmed H. Al-Shahethi Rafdzah Ahmad Zaki Abdul Wahed A. Al-Serouri Awang Bulgiba 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e204-e215
Background
Perinatal mortality remains a major international problem responsible for nearly six million stillbirths and neonatal deaths.Objectives
To estimate the perinatal mortality rate in Sana’a, Yemen and to identify risk factors for perinatal deaths.Methods
A community-based prospective cohort study was carried out between 2015 and 2016. Nine-hundred and eighty pregnant women were identified and followed up to 7 days following birth. A multi-stage cluster sampling was used to select participants from community households’, residing in the five districts of the Sana’a City, Yemen.Results
Total of 952 pregnant women were tracked up to 7 days after giving birth. The perinatal mortality rate, the stillbirth rate and the early neonatal mortality rate, were 89.3 per 1000, 46.2 per 1000 and 45.2 per 1000, respectively. In multivariable analysis older age (35+ years) of mothers at birth (Relative Risk = 2.83), teenage mothers’ age at first pregnancy (<18 years) (Relative Risk = 1.57), primipara mothers (Relative Risk = 1.90), multi-nuclear family (Relative Risk = 1.74), mud house (Relative Risk = 2.02), mothers who underwent female genital mutilation (Relative Risk = 2.92) and mothers who chewed khat (Relative Risk = 1.60) were factors associated with increased risk of perinatal death, whereas a positive mother’s tetanus vaccination status (Relative Risk = 0.49) were significant protective factors against perinatal deaths.Conclusion
Rates of perinatal mortality were higher in Sana’a City compared to perinatal mortality at the national level estimated by World Health Organization. It is imperative there be sustainable interventions in order to improve the country’s maternal and newborn health. 相似文献8.
Annabel Sheehy Rachel M. Smith Joanne E. Gray Caroline S.E. Homer 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e182-e188
Background
Midwives in Australia are educated through a range of routes providing flexible ways to become a midwife. Little is known about whether the route to registration impacts on mid-career experiences, in particular, whether the pathway (post-nursing pathway compared with ‘direct-entry’) makes any difference.Aim
The aim of this study was to explore the midwifery workforce experiences and participation in graduates six to seven years after completing either a post-nursing Graduate Diploma in Midwifery (GradDip) or an undergraduate degree, the Bachelor of Midwifery (BMid), from one university in New South Wales, Australia.Methods
Data were collected from mid-career midwives having graduated from one NSW university from 2007–2008 using a survey. The survey included validated workforce participation instruments — the Maslach Burnout Inventory (MBI), the Practice Environment Scale-Nursing Work Index (PES-NWI) and the Perceptions of Empowerment in Midwifery Scale (PEMS).Results
There were 75 respondents: 40% (n = 30) Bachelor of Midwifery and 60% (n = 45) GradDip graduates. The age range was 27–56 years old (mean age = 36 years) Bachelor of Midwifery graduates being on average 7.6 years older than Graduate Diploma in Midwifery graduates (40 vs 33 years; p < 0.01). Almost 80% (59), were currently working in midwifery. Nine of the 12 not working in midwifery (75%) planned to return. There were no differences in workforce participation measures between the two educational pathways. Working in a continuity of care model was protective in regards to remaining in the profession.Conclusion
Most mid-career graduates were still working in midwifery. There were no differences between graduates from the two pathways in relation to burnout, practice experiences or perceptions of empowerment. 相似文献9.
Robin S. Cronin Minglan Li Kate Culliney Robyn Maude Katherine Nelson 《Women and birth : journal of the Australian College of Midwives》2018,31(5):422-429
Background
Second-degree tears are the most common form of perineal trauma occurring after vaginal birth managed by New Zealand midwives, although little is known about midwives’ perineal practice.Aim
The aim of this study was to identify how midwives managed the last second-degree perineal tear they treated and the level to which their practice reflects National Institute for Health and Care Excellence guidelines.Methods
An (anonymous) online survey was conducted over a six-week period in 2013. New Zealand midwives who self-identified as currently practising perineal management and could recall management of the last second-degree tear they treated were included in the analysis.Findings
Of those invited, 645 (57.1% self-employed, 42.9% employed) were eligible and completed surveys. Self-employed midwives reported greater confidence (88.0% vs 74.4%, p < 0.001) and more recent experience (85.1% vs 57.4%, p < 0.001) with perineal repair than employed midwives. Midwives who left the last second-degree tear unsutured (7.3%) were more likely to report low confidence (48.9% vs 15.4%, p < 0.001) and less recent experience with repair (53.2% vs 24.7%, p < 0.001), and were less likely to report a digital-rectal examination (10.6% vs 49.0%, p < 0.001), compared to midwives who sutured. Care consistent with evidence-based guidelines (performing a digital-rectal examination, 59.4% vs 49.3% p = 0.005; optimal suturing techniques, 62.2% vs 48.7%, p = 0.001) was associated with recent perineal education.Conclusions
Midwives’ management of the last second-degree perineal tear is variable and influenced by factors including: employment status, experience, confidence, and perineal education. There is potential for improvement in midwives’ management through increased uptake of evidence-based guidelines and through ongoing education. 相似文献10.
Aurora Fernández-Cañadas Morillo Modesto Durán Duque Ana B. Hernández López Cristina Muriel Miguel Pilar Pérez Riveiro Angel Salcedo Mariña Ana Royuela Vicente María L. Casillas Santana Miguel A. Marín Gabriel 《Women and birth : journal of the Australian College of Midwives》2019,32(1):e43-e48
Background
Some studies have suggested an association between synthetic oxytocin administration and type of birth with the initiation and consolidation of breastfeeding.Aim
This study aimed to test whether oxytocin administration and type of birth are associated with cessation of exclusive breastfeeding at different periods. A second objective was to investigate whether the administered oxytocin dose is associated with cessation of exclusive breastfeeding.Methods
We conducted a prospective cohort study (n = 529) in a tertiary hospital. Only full-term singleton pregnancies were included. Four groups were established based on the type of birth (vaginal or cesarean) and the intrapartum administration of oxytocin. Follow-up was performed to evaluate the consolidation of exclusive breastfeeding at 1, 3 and 6 months.Findings
During follow-up, the proportion of exclusive breastfeeding decreased in all groups. After adjusting for confounding variables, the group with cesarean birth without oxytocin (planned cesarean birth) had the highest risk of cessation of exclusive breastfeeding (odds ratio [95% confidence interval], 2.51 [1.53–4.12]). No association was found between the oxytocin dose administered during birth and puerperium period and the cessation of exclusive breastfeeding.Conclusion
Planned cesarean birth without oxytocin is associated with the cessation of exclusive breastfeeding at 1, 3 and 6 months of life. It would be desirable to limit elective cesarean births to essentials as well as to give maximum support to encourage breastfeeding in this group of women. The dose of oxytocin given during birth and puerperium period is not associated with cessation of exclusive breastfeeding. 相似文献11.
Jennifer Fenwick Mary Sidebotham Jenny Gamble Debra K. Creedy 《Women and birth : journal of the Australian College of Midwives》2018,31(1):38-43
Background
Continuity of midwifery care contributes to significant positive outcomes for women and babies. There is a perception that providing continuity of care may negatively impact on the wellbeing and professional lives of midwives.Aim
To compare the emotional and professional wellbeing as well as satisfaction with time off and work-life balance of midwives providing continuity of care with midwives not providing continuity.Method
Online survey. Measures included; Copenhagen Burnout Inventory (CBI); Depression, Anxiety and Stress Scale-21; and Perceptions of Empowerment in Midwifery Scale (PEMS-Revised). The sample (n = 862) was divided into two groups; midwives working in continuity (n = 214) and those not working in continuity (n = 648). Mann Whitney U tests were used to compare the groups.Results
The continuity group had significantly lower scores on each of the burnout subscales (CBI Personal p = .002; CBI Work p < .001; CBI Client p < .001) and Anxiety (p = .007) and Depression (p = .004) sub-scales. Midwives providing continuity reported significantly higher scores on the PEMs Autonomy/Empowerment subscale (p < .001) and the Skills and Resources subscale (p = .002). There was no difference between the groups in terms of satisfaction with time off and work-life balance.Conclusion
Our results indicate that providing continuity of midwifery care is also beneficial for midwives. Conversely, midwives working in shift-based models providing fragmented care are at greater risk of psychological distress. Maternity service managers should feel confident that re-orientating care to align with the evidence is likely to improve workforce wellbeing and is a sustainable way forward. 相似文献12.
Maria Noonan Julie Jomeen Rose Galvin Owen Doody 《Women and birth : journal of the Australian College of Midwives》2018,31(6):e358-e366
Background
Midwives have a primary role in facilitating the first stage of perinatal mental health risk reduction through inquiring about perinatal mental health, identifying risk factors and current perinatal mental health problems, providing support or crisis intervention, referring for treatment and decreasing stigmatisation.Aims
The aims of this study were to determine midwives’ (a) knowledge of and confidence to identify and manage perinatal mental health problems, (b) attitudes towards women who experience severe mental illness and (c) perceived learning needs.Design
A cross-sectional survey design.Methods
The study was conducted between September 2016 and April 2017 in seven Maternity services in the Republic of Ireland with a purposeful non-random convenience sample of midwives (n = 157). Data was anonymously collected utilising the Perinatal Mental Health Questionnaire, the Mental Illness: Clinician’s Attitudes scale and the Perinatal Mental Health Learning Needs questionnaire.Findings
Midwives indicated high levels of knowledge (71.1%) and confidence (72%) in identifying women who experience depression and anxiety however, they reported less confidence in caring (43.9%) for women. Only 17.8% (n = 28) of midwives felt equipped to support women whilst 15.3% (n = 24) reported having access to sufficient information. Midwives desire education on the spectrum of perinatal mental health problems. The mean score for the Mental Illness: Clinician’s Attitudes scale was 36.31 (SD = 7.60), indicating positive attitudes towards women with severe mental illness.Conclusion
Midwives require further education on perinatal mental health across cultures with a skill focus and which explores attitudes delivered in a study day format. 相似文献13.
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14.
Chunxiang Qin Yulong Deng Wei-ti Chen Chunmei Mi Weiyan Wang Mei Sun Jiarui Chen Wei Liu Siyuan Tang 《Women and birth : journal of the Australian College of Midwives》2019,32(1):e71-e76
Background
Since the One-child Policy was revised to a Two-child policy in 2013, the number of pregnancies with previous cesarean section suddenly increased in China. The aim of this study was to test if a previous cesarean section influenced the neonatal birth weight under Chinese background.Methods
A retrospective study was conducted. Path analysis was used to test the hypothesized model for the association among previous cesarean section, placenta previa, gestational age and neonatal birth weight. Comparative fit index, the root-mean-square error of approximation and weighted root-mean-square residual were used to evaluate the model fit.Results
3466 electronic records for second pregnancies met the criteria; a modified model was established (the root-mean-square error of approximation = 0.049, comparative fit index = 0.992, weighted root-mean-square residual = 0.960). The effects of previous cesarean section on neonatal birth weight were mediated via four paths. The direct effects (coefficient: 0.056) showed opposite signs compared to indirect effects (coefficient: ?0.127) in this path analysis. It meant that the negative effects of the previous cesarean section were suppressed by other factors which bring positive effects.Conclusion
This study showed that previous cesarean section had negative effects on neonatal birth weight with increasing incidence of placenta previa and preterm birth. But these effects were suppressed by other positive factors, such as maternal body mass index, just after the child policy updated in China. 相似文献15.
Bethany L. Carr Beverley Copnell Meredith McIntyre 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e259-e263
Background
Meconium stained amniotic fluid commonly occurs postdates (?>40 weeks gestation) indicating fetal maturity. Previous literature indicates that different ethnicities mature at different rates.Aim
To compare the rate of meconium stained amniotic fluid of Australian-born and non-Australian born women.Methods
A retrospective correlation study design was implemented, using data collected in the birth outcomes system at one tertiary hospital. Data was collected from all women who gave birth to a term (>/=37 weeks gestation), singleton, liveborn baby between January 1st to December 31st, 2014. Maternal country of birth was used for comparison. Categorical data was analyzed using Chi-Square test for Independence. Continuous variables were assessed for normality, and differences were compared using an Independent t-test or a Mann–Whitney U test. All tests were two-tailed and p < 0.05 was considered statistically significant.Results
3,041 women were included; 1131 Australian-born and 1910 non-Australian born. Meconium stained amniotic fluid occurred more frequently in non-Australian born women compared to Australian-born women (23.5% vs. 19.8 p = 0.02). Their babies were significantly smaller (Mean = 3265 g, Standard Deviation 463.8 vs Mean = 3442 g, Standard Deviation 499.2, p < 0.001), with no difference in gestational length (Mean = 39.4, Standard Deviation 1.28 vs Mean = 39.5, Standard Deviation 1.18, p = 0.06). Increasing gestational age had the strongest association with meconium stained amniotic fluid;?>/=42 weeks gestation occurring 3.52 (95% Confidence Interval: 2.00, 6.22, p = <0.001) more than <40 weeks gestation.Conclusion
Maternity health services should record ethnicity and region of birth to provide individualised care as women born overseas often have poorer perinatal outcomes when compared to Australian-born women. 相似文献16.
April M. Miller Kristy Sanderson Raimondo B. Bruno Monique Breslin Amanda L. Neil 《Women and birth : journal of the Australian College of Midwives》2019,32(2):e272-e278
Background
The increasing prevalence and adverse outcomes associated with opioid analgesia use in women of reproductive age have become a significant public health issue internationally, with use during pregnancy potentially affecting maternal and infant health outcomes.Objective
This study aims to provide national estimates of chronic pain, pain severity and analgesia use in Australian women of reproductive age by pregnancy status.Method
Data were obtained from the Australian Bureau of Statistics 2011–12 National Health Survey (n = 20,426). Weighting was applied to sample data to obtain population estimates. For this study data were analysed for pregnant (n = 166, N = 192,617) and non-pregnant women (n = 4710, N = 5,256,154) of reproductive age (15–49 years).Results
Chronic or reoccurring pain was reported in 5.1% of pregnant women and 9.7% of non-pregnant women, and 0.7% and 2.6% of pregnant and non-pregnant women reported recent opioid analgesia use respectively. Moderate-to-very severe pain was more common in pregnant than non-pregnant women taking opioid analgesics, and no pain and very mild-to-mild pain in non-pregnant women.Conclusion
Approximately 1 in 20 pregnant Australian women have chronic or reoccurring pain. Opioid analgesia was used by around 1% of Australian pregnant women during a two-week period, with use associated with moderate-to-very severe pain. Given that the safety of many analgesic medications in pregnancy remains unknown, pregnant women and health professionals require accurate, up-to-date information on the risks and benefits of analgesic use during pregnancy. Further evidence on the decision-making processes of pregnant women with pain should assist health professionals maximise outcomes for mothers and infants. 相似文献17.
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18.
Rebecca L. Greco Rosalie Grivell Jennie Louise Andrea Deussen Jodie Dodd Lisa J. Moran 《Women and birth : journal of the Australian College of Midwives》2019,32(1):e65-e70
Background
Awareness of Listeriosis and Methylmercury toxicity recommendations are associated with decreased intake of high-risk foods. Whether awareness of the recommendations affect dietary quality of pregnant women in Australian is unknown.Aim
To evaluate awareness of Listeriosis and Methylmercury toxicity recommendations during pregnancy and its impact on dietary quality.Methods
Pregnant women (n = 81) were recruited from antenatal clinics. Awareness of Listeriosis and Methylmercury toxicity recommendations and high-risk foods consumption were assessed via questionnaire at 10–23 weeks gestation. Diet quality was measured using the 2005 Healthy Eating Index using a validated food frequency questionnaire at 10–23 and 34–36 weeks gestation.Findings
A higher proportion of women were aware of Methylmercury toxicity compared with Listeriosis recommendations (75.3 vs. 59.2%, p < 0.001). The proportion of women who decreased or avoided consumption of certain high-risk Listeriosis foods were higher in those who were aware compared with those who were unaware of Listeriosis recommendations [raw fish (96.0 vs 69.2%, p = 0.046), soft-serve ice cream (93.9 vs 58.3%, p = 0.004) and alfalfa/bean sprouts (68.7 vs 28.5%, p = 0.006)]. A large proportion of women (96.8%) met recommendations for limiting consumption of high Methylmercury fish. There was no difference in the change in dietary quality over pregnancy regardless of women’s awareness of the recommendations.Discussion and conclusions
Awareness of Listeriosis and Methylmercury toxicity recommendations has little impact on dietary quality of pregnant women in this small study. Further research in a large representative population of pregnant women is needed to confirm our findings and to optimise dietary quality during pregnancy. 相似文献19.
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20.
Kathleen M. Baird Amornrat S. Saito Jennifer Eustace Debra K. Creedy 《Women and birth : journal of the Australian College of Midwives》2018,31(4):285-291