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1.
Christina Nilsson Joan Lalor Cecily Begley Margaret Carroll Mechthild M. Gross Susanne Grylka-Baeschlin Ingela Lundgren Andrea Matterne Sandra Morano Jane Nicoletti Patricia Healy 《Women and birth : journal of the Australian College of Midwives》2017,30(6):481-490
Problem and background
Vaginal birth after caesarean section is a safe option for the majority of women. Seeking women’s views can be of help in understanding factors of importance for achieving vaginal birth in countries where the vaginal birth rates after caesarean is low.Aim
To investigate women’s views on important factors to improve the rate of vaginal birth after caesareanin countries where vaginal birth rates after previous caesarean are low.Methods
A qualitative study using content analysis. Data were gathered through focus groups and individual interviews with 51 women, in their native languages, in Germany, Ireland and Italy. The women were asked five questions about vaginal birth after caesarean. Data were translated to English, analysed together and finally validated in each country.Findings
Important factors for the women were that all involved in caring for them were of the same opinion about vaginal birth after caesarean, that they experience shared decision-making with clinicians supportive of vaginal birth, receive correct information, are sufficiently prepared for a vaginal birth, and experience a culture that supports vaginal birth after caesarean.Discussion and conclusion
Women’s decision-making about vaginal birth after caesarean in these countries involves a complex, multidimensional interplay of medical, psychosocial, cultural, personal and practical considerations. Further research is needed to explore if the information deficit women report negatively affects their ability to make informed choices, and to understand what matters most to women when making decisions about vaginal birth after a previous caesarean as a mode of birth. 相似文献2.
Yael Benyamini Maya Lila Molcho Uzi Dan Miri Gozlan Heidi Preis 《Women and birth : journal of the Australian College of Midwives》2017,30(5):424-430
Problem
Rates of medical interventions in childbirth have greatly increased in the Western world.Background
Women’s attitudes affect their birth choices.Aim
To assess women’s attitudes towards the medicalization of childbirth and their associations with women’s background as well as their fear of birth and planned and unplanned modes of birth.Methods
This longitudinal observational study included 836 parous woman recruited at women’s health centres and natural birth communities in Israel. All women filled in questionnaires about attitudes towards the medicalization of childbirth, fear of birth, and planned birth choices. Women at <28 weeks gestation when filling in the questionnaire were asked to fill in a second one at ～34 weeks. Phone follow-up was conducted ～6 weeks postpartum to assess actual mode of birth.Findings
Attitudes towards medicalization were more positive among younger and less educated women, those who emigrated from the former Soviet Union, and those with a more complicated obstetric background. Baseline attitudes did not differ by parity yet became less positive throughout pregnancy only for primiparae. More positive attitudes were related to greater fear of birth. The attitudes were significantly associated with planned birth choices and predicted emergency caesareans and instrumental births.Discussion
Women form attitudes towards the medicalization of childbirth which may still be open to change during the first pregnancy. More favourable attitudes are related to more medical modes of birth, planned and unplanned.Conclusion
Understanding women’s views of childbirth medicalization may be key to understanding their choices and how they affect labour and birth. 相似文献3.
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4.
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5.
Sarah Munro Patricia Janssen Kitty Corbett Elizabeth Wilcox Nick Bansback Jude Kornelsen 《Women and birth : journal of the Australian College of Midwives》2017,30(2):129-136
Problem
Clinical practice guidelines indicate that over 80% of women with a previous caesarean should be offered a planned vaginal birth after caesarean (VBAC), however only one third of eligible women choose to plan a VBAC. To support informed choices for birth after caesarean, it is necessary to understand the factors that influence women’s decision-making.Aim
The goal of this study was to explore attitudes towards and experiences with decision-making for mode of delivery after caesarean from the perspectives of Canadian women.Methods
In-depth, semi-structured interviews were conducted with 23 women eligible for VBAC in three rural and two urban communities in British Columbia, Canada, during summer 2015. Constructivist grounded theory informed iterative data collection and analysis.Findings
Women’s decision-making experiences were a process of “seeking control in the midst of uncertainty.” Women formed early preferences for mode of delivery after their primary caesareans and engaged in careful deliberation during their inter-pregnancy interval, consisting of: reflecting on their birth, clarifying their values, becoming informed, considering the feasibility of options, deliberating with the care team, and making an actual choice. Women struggled to make trade-offs between having a healthy baby and social attributes of delivery, such as uninterrupted bonding with their newborn.Conclusions
Women begin decision-making for birth after caesarean earlier than previously reported and their choices are influenced by personal experience and psychosocial concerns. Future interventions to support choice of mode of delivery should begin early after the primary caesarean, to reflect when women begin to form preferences. 相似文献6.
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Mandie Scamell Roa Altaweli Christine McCourt 《Women and birth : journal of the Australian College of Midwives》2017,30(1):e39-e45
Background
The expansion of the medicalisation of childbirth has been described in the literature as being a global phenomenon. The vignette described in this paper, selected from an ethnographic study of routine intervention in Saudi Arabian hospitals illustrates how the worldwide spread of the bio-medical model does not take place within a cultural vacuum.Aim
To illuminate the ways in which the medicalisation of birth may be understood and practised in different cultural settings, through a vignette of a specific birth, drawn as a typical case from an ethnographic study that investigated clinical decision-making in the second stage of labour in Saudi Arabia.Methods
Ethnographic data collection methods, including participant observation and interviews. The data presented in this paper are drawn from ethnographic field notes collected during field work in Saudi Arabia, and informed by analysis of a wider set of field notes and interviews with professionals working in this context.Findings
While the medicalisation of care is a universal phenomenon, the ways in which the care of women is managed using routine medical intervention are framed by the local cultural context in which these practices take place.Discussion
The ethnographic data presented in this paper shows the medicalisation of birth thesis to be incomplete. The evidence presented in this paper illustrates how local belief systems are not so much subsumed by the expansion of the bio-medical model of childbirth, rather they may actively facilitate a process of localised reinterpretation of such universalised and standardised practices. In this case, aspects of the social and cultural context of Jeddah operates to intensify the biomedical model at the expense of respectful maternity care.Conclusion
In this article, field note data on the birth of one Saudi Arabian woman is used as an illustration of how the medicalisation of childbirth has been appropriated and reinterpreted in Jeddah, Saudi Arabia. 相似文献9.
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10.
Yvonne Meyer Franziska Frank Franziska Schläppy Muntwyler Valerie Fleming Jessica Pehlke-Milde 《Women and birth : journal of the Australian College of Midwives》2017,30(6):e272-e280
Background
Decision-making in midwifery, including a claim for shared decision-making between midwives and women, is of major significance for the health of mother and child. Midwives have little information about how to share decision-making responsibilities with women, especially when complications arise during birth.Aim
To increase understanding of decision-making in complex home-like birth settings by exploring midwives’ and women’s perspectives and to develop a dynamic model integrating participatory processes for making shared decisions.Methods
The study, based on grounded theory methodology, analysed 20 interviews of midwives and 20 women who had experienced complications in home-like births.Findings
The central phenomenon that arose from the data was “defining/redefining decision as a joint commitment to healthy childbirth”. The sub-indicators that make up this phenomenon were safety, responsibility, mutual and personal commitments. These sub-indicators were also identified to influence temporal conditions of decision-making and to apply different strategies for shared decision-making. Women adopted strategies such as delegating a decision, making the midwife’s decision her own, challenging a decision or taking a decision driven by the dynamics of childbirth. Midwives employed strategies such as remaining indecisive, approving a woman’s decision, making an informed decision or taking the necessary decision.Discussion and conclusion
To respond to recommendations for shared responsibility for care, midwives need to strengthen their shared decision-making skills. The visual model of decision-making in childbirth derived from the data provides a framework for transferring clinical reasoning into practice. 相似文献11.
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12.
José-Matías Triviño-Juárez Dulce Romero-Ayuso Beatriz Nieto-Pereda Maria-João Forjaz Juan-José Criado-Álvarez Begoña Arruti-Sevilla Beatriz Avilés-Gamez Cristina Oliver-Barrecheguren Sonia Mellizo-Díaz Consuelo Soto-Lucía Rosa Plá-Mestre 《Women and birth : journal of the Australian College of Midwives》2017,30(1):29-39
Background
Health-related quality of life of women in the postpartum period may depend on the mode of birth. However, previous findings are contradictory.Aim
To explore health-related quality of life of women at the sixth week and sixth month postpartum by mode of birth.Methods
We performed a longitudinal prospective study in Spain that included 546 healthy primiparae aged 18 to 45 years who gave birth to a healthy newborn. At the sixth week and sixth month postpartum, we analysed sociodemographic and clinical characteristics and compared health-related quality of life (measured using the SF-36) by mode of birth (normal vaginal, forceps, vacuum-extraction, elective caesarean section, emergency caesarean section). In addition, we analysed the change in health-related quality of life between the two time points for each mode of birth.Findings
We did not find differences in health-related quality of life by mode of birth at the sixth week or sixth month postpartum. At the sixth week postpartum, regardless of the mode of birth, women with postpartum urinary incontinence reported lower health-related quality of life. Between the sixth week and sixth month postpartum, health-related quality of life improved for all modes of birth.Conclusion
While mode of birth is not directly associated with health-related quality of life, it does have an indirect relationship in the short term. Women who reported the lowest health-related quality of life were those with postpartum urinary incontinence. Most women with postpartum urinary incontinence were in the forceps group. 相似文献13.
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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15.
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Melissa Buultjens Gregory Murphy Priscilla Robinson Jeannette Milgrom Melissa Monfries 《Women and birth : journal of the Australian College of Midwives》2017,30(5):406-414
Background
While the provision of maternity education across the perinatal period can increase the confidence and self-efficacy in childbearing women, there is still thought to be a lack of effective educational resources for parenthood. This study, conducted in Victoria, Australia, investigated women’s experiences of, and attitudes to education communicated in maternity service provision.Methods
189 women were recruited from a variety of settings to participate in a mixed-methods survey about their experiences of perinatal health service education.Findings
Of the sample of childbearing women, 153 (81%) reported attending antenatal classes. Women perceived their antenatal education as beneficial, though many women still felt unprepared beyond labour and birth. With respect to the hospital postnatal stay, findings suggested a variation among the content imparted to women across different Victorian maternity services, (e.g. rural women tended to be more dissatisfied with information received in relation to maternal emotional and physical health). Overall, women wished they had been more informed about breastfeeding and settling techniques, while a lack of information relating to social support initiatives for the postnatal period was also indicated. Women reported that they were missing educational and practical reinforcement of mothercraft skills.Conclusions
There is a need for a reorientation of perinatal health service education. A health promotion approach is suggested as it extends beyond the physical recovery from birth to encompass psychosocial factors; including perinatal morbidities that can disrupt the quality and experience of the transition to parenthood. 相似文献18.
Megan Cooper Helen McCutcheon Jane Warland 《Women and birth : journal of the Australian College of Midwives》2017,30(5):431-441
Background
Accessibility of water immersion for labour and/or birth is often dependent on the care provider and also the policies/guidelines that underpin practice. With little high quality research about the safety and practicality of water immersion, particularly for birth, policies/guidelines informing the practice may lack the evidence necessary to ensure practitioner confidence surrounding the option thereby limiting accessibility and women’s autonomy.Aim
The aims of the study were to determine how water immersion policies and/or guidelines are informed, who interprets the evidence to inform policies/guidelines and to what extent the policy/guideline facilitates the option for labour and birth.Method
Phase one of a three-phase mixed-methods study critically analysed 25 Australian water immersion policies/guidelines using critical discourse analysis.Findings
Policies/guidelines pertaining to the practice of water immersion reflect subjective opinions and views of the current literature base in favour of the risk-focused obstetric and biomedical discursive practices. Written with hegemonic influence, policies and guidelines impact on the autonomy of both women and practitioners.Conclusion
Policies and guidelines pertaining to water immersion, particularly for birth reflect opinion and varied interpretations of the current literature base. A degree of hegemonic influence was noted prompting recommendations for future maternity care policy and guidelines’.Ethical considerations
The Human Research Ethics Committee of the University of South Australia approved the research. 相似文献19.
Christina M. Bertilone Suzanne P. McEvoy Dena Gower Nola Naylor June Doyle Val Swift-Otero 《Women and birth : journal of the Australian College of Midwives》2017,30(2):121-128
Background
Pregnancy, labour and neonatal health outcomes for Australian Aboriginal women and their infants are frequently worse than those of the general population. Provision of culturally competent services may reduce these differences by improving access to timely and regular antenatal care. In an effort to address these issues, the Aboriginal Maternity Group Practice Program commenced in south metropolitan Perth, Western Australia, in 2011. The program employed Aboriginal Grandmothers, Aboriginal Health Officers and midwives working in a partnership model with pre-existing maternity services in the area.Aim
To identify elements of the Aboriginal Maternity Group Practice Program that contributed to the provision of a culturally competent service.Methods
The Organisational Cultural Competence Assessment Tool was used to analyse qualitative data obtained from surveys of 16 program clients and 22 individuals from partner organisations, and interviews with 15 staff.Findings
The study found that the partnership model positively impacted on the level of culturally appropriate care provided by other health service staff, particularly in hospitals. Two-way learning was a feature. Providing transport, team home visits and employing Aboriginal staff improved access to care. Grandmothers successfully brought young pregnant women into the program through their community networks, and were able to positively influence healthy lifestyle behaviours for clients.Conclusion
Many elements of the Aboriginal Maternity Group Practice Program contributed to the provision of a culturally competent service. These features could be considered for inclusion in antenatal care models under development in other regions with culturally diverse populations. 相似文献20.
Sandra Healy Eileen Humphreys Catriona Kennedy 《Women and birth : journal of the Australian College of Midwives》2017,30(5):367-375