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1.
Ingrid Jepsen Edith Mark Maralyn Foureur Ellen A. Nøhr Erik E. Sørensen 《Women and birth : journal of the Australian College of Midwives》2017,30(1):e61-e69
Background
Caseload midwifery is expanding in Denmark. There is a need for elaborating in-depth, how caseload midwifery influences the partner and the woman during childbirth and how this model of care influences the early phases of labour.Aim
To follow, explore and elaborate women’s and their partner’s experiences of caseload midwifery.Methods
Phenomenology of practice was the analytical approach. The methodology was inspired by ethnography, and applied methods were field observations followed by interviews. Ten couples participated in the study. Most of the couples were observed from the onset of labour until childbirth. Afterwards, the couples were interviewed.Findings
The transition from home to hospital in early labour was experienced as positive. During birth, the partner felt involved and included by the midwife. The midwives remembered and recognized the couple’s stories and wishes for childbirth and therefore they felt regarded as “more than numbers”. Irrespective of different kinds of vulnerability or challenges among the participants, the relationship was named a professional friendship, characterised by equality and inclusiveness. One drawback of caseload midwifery was that the woman was at risk of being disappointed if her expectations of having a known midwife at birth were not fulfilled.Key conclusions
From the perspective of women and their partners, attending caseload midwifery meant being recognised and cared for as an individual. The partner felt included and acknowledged and experienced working in a team with the midwife. Caseload midwifery was able to solve problems concerning labour onset or gaining access to the labour ward. 相似文献2.
3.
Dahlen H Schmied V Tracy SK Jackson M Cummings J Priddis H 《Women and birth : journal of the Australian College of Midwives》2011,24(4):148-155
Background
In February 2009 the Improving Maternity Services in Australia – The Report of the Maternity Services Review (MSR) was released, with the personal stories of women making up 407 of the more than 900 submissions received. A significant proportion (53%) of the women were said to have had personal experience with homebirth. Little information is provided on what was said about homebirth in these submissions and the decision by the MSR not to include homebirth in the funding and insurance reforms being proposed is at odds with the apparent demand for this option of care.Method
Data for this study comprised 832 submissions to the MSR that are publicly available on the Commonwealth of Australia Department of Health and Aging website. All 832 submissions were downloaded, coded and then entered into NVivo. Content analysis was used to analyse the data that related to homebirth.Findings
450 of the submissions were from consumers of maternity services (54%). Four hundred and seventy (60%) of the submissions mentioned homebirth. Overall there were 715 references to home birth in the submissions. The submissions mentioning homebirth most commonly discussed the ‘Benefits’ and ‘Barriers’ in accessing this option of care. Benefits to the baby, mother and family were described, along with the benefits obtained from having a midwife at the birth, receiving continuity of care and having a good birth experience. Barriers were described as not having access to a midwife, no funding, no insurance and lack of clinical privileging for midwives.Conclusion
Many positive recommendations have come from the MSR, however the decision to exclude homebirth from these reforms is perplexing considering the large number of submissions describing the benefits of and barriers to homebirth in Australia. A concerning number of submissions discuss having had or having considered an unattended birth at home due to these barriers. Overall there is the belief that not enabling access to funded, insured homebirth in Australia is a violation of human rights. It appears that homebirth was considered by the MSR as ‘too hot to handle’ and by dismissing it as a minority issue the government sought to avoided dealing with homebirth as a ‘sensitive and controversial issue.’ 相似文献4.
5.
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6.
7.
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8.
Hazel Keedle Virginia Schmied Elaine Burns Hannah Grace Dahlen 《Women and birth : journal of the Australian College of Midwives》2018,31(1):69-79
Background
Vaginal birth after caesarean can be a safe and satisfying option for many women who have had a previous caesarean, yet rates of vaginal birth after caesarean remain low in the majority of countries. Exploring women’s experiences of vaginal birth after caesarean can improve health practitioners’ understanding of the factors that facilitate or hinder women in the journey to have a vaginal birth after caesarean.Methods
This paper reports on a meta-ethnographic review of 20 research papers exploring women’s experience of vaginal birth after caesarean in a variety of birth locations. Meta-ethnography utilises a seven-stage process to synthesise qualitative research.Results
The overarching theme was ‘the journey from pain to power’. The theme ‘the hurt me’ describes the previous caesarean experience and resulting feelings. Women experience a journey of ‘peaks and troughs’ moving from their previous caesarean to their vaginal birth after caesarean. Achieving a vaginal birth after caesarean was seen in the theme ‘the powerful me,’ and the resultant benefits are described in the theme ‘the ongoing journey’.Conclusion
Women undergo a journey from their previous caesarean with different positive and negative experiences as they move towards their goal of achieving a vaginal birth after caesarean. This ‘journey from pain to power’ is strongly influenced by both negative and positive support provided by health care practitioners. Positive support from a health care professional is more common in confident practitioners and continuity of care with a midwife. 相似文献9.
Astrid Nystedt Ingegerd Hildingsson 《Women and birth : journal of the Australian College of Midwives》2018,31(2):103-109
Background
A negative birth experience may influence both women and men and can limit their process of becoming a parent.Aims
This study aimed to analyze and describe women's and men's perceptions and experiences of childbirth.Design
A cross-sectional study of women and their partners living in one Swedish county were recruited in mid pregnancy and followed up two months after birth. Women (n = 928) and men (n = 818) completed the same questionnaire that investigated new parents’ birth experiences in relation to socio-demographic background and birth related variables.Results
Women (6%) and men (3%) with a negative birth experiences, experienced longer labours and more often emergency caesarean section compared to women (94%) and men (97%) with a positive birth experience. The obstetric factors that contributed most strongly to a negative birth experience were emergency caesarean and was found in women (OR 4.7, 95% CI 2.0–10.8) and men (OR 4.5, Cl 95% 1.4–17.3). In addition, pain intensity and elective caesarean section were also associated with a negative birth experiences in women. Feelings during birth such as agreeing with the statement; ‘It was a pain to give birth’ were a strong contributing factor for both women and men.Conclusions
A negative birth experience is associated with obstetric factors such as emergency caesarean section and negative feelings. The content of negative feelings differed between women and men. It is important to take into account that their feelings differ in order to facilitate the processing of the negative birth experience for both partners. 相似文献10.
Birth centres and the national maternity services review: response to consumer demand or compromise?
Dahlen H Jackson M Schmied V Tracy S Priddis H 《Women and birth : journal of the Australian College of Midwives》2011,24(4):165-172
Background
In February 2009 the Improving Maternity Services in Australia – The Report of the Maternity Services Review (MSR) was released and recommended improving women's access to and availability of birth centres. It was unclear if this was in response to an overwhelming request for birth centres in the submissions received by the commonwealth or a compromise for excluding homebirth from the maternity service reforms.Aim
The aim of this paper was to examine what was said in the submissions to the MSR about birth centres.Methods
Data for this study comprised 832 submissions to the MSR that are publicly available on the Commonwealth of Australia Department of Health and Ageing website. All 832 submissions were downloaded, and read for any mention of the words ‘birth centre’, ‘birth center’. Content analysis was used to categorise and report the data.Results
Of the 832 submissions to the MSR 197 (24%) mentioned birth centres while 470 (60%) of the submissions mentioned homebirth. Only 31 (4%) of the submissions to the Maternity Review mentioned birth centres without mentioning home birth also. Most of the submissions emphasised that ‘everything should be on the menu’ when it came to place of birth and care provider. Reasons for choosing a birth centre were identified as: ‘the best compromise available, ‘the right and natural way’ and ‘the birth centre as safe’. Women had certain requirements of a birth centre that included: ‘continuity of carer’, ‘midwife led’, ‘a sanctum from medicalised care’, ‘resources to cope with demand’, ‘close to home’, and ‘flexible guidelines and admission criteria’. Women weighed up a series of requirements when deciding whether to give birth in a birth centre.Discussion
The recommendation by the MSR to expand birth centres and ignore home birth is at odds with the strong view expressed that ‘everything should be on the menu’. The requirements women described of birth centre care are also at odds with current trends.Conclusion
If there is to be an expansion of birth centres, service providers need to make sure that women's views are central to the design. Women will not cease having homebirths due to expanded birth centre options. 相似文献11.
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13.
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14.
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15.
Robyn E. Thompson Sue V. Kildea Lesley M. Barclay Sue Kruske 《Women and birth : journal of the Australian College of Midwives》2011,24(3):97-104
Background
Low breastfeeding duration rates reflect the pain and distress experienced by many women who discontinue breastfeeding in the early weeks and months of life. This paper explores modern key historical events that have significantly influenced Australian breastfeeding education and practice.Method
Relevant literature reviewed from 1970 to 2010 identified key events that appear to have contributed to the decrease in Australian breastfeeding rates and the increase in women experiencing breastfeeding complications, particularly nipple pain and trauma.Findings and discussion
The rise in institutionalisation and medical intervention in labour and birth has also medicalised midwifery practice. Technocratic intrusion and institutionalised care is contributing to the separation of the mother and newborn at birth. Delayed mother–baby initiation of breastfeeding and interruption of the duration of the first, and subsequent breastfeeds, negatively affects the innate ability of the mother and newborn to establish and sustain breastfeeding. The ‘pathologising’ of breastfeeding that involve midwives teaching women complicated and unnatural breastfeeding techniques interfere with instinctive sensory and mammalian behaviours and further contributes to the high complication rates.Conclusion
Midwives are encouraged to reflect on their role as ‘experts’ in the breastfeeding process and give confidence to women so that they utilise their instinctive ability to breastfeed by self-determined techniques that encourage mammalian skills for newborn sustenance and survival. 相似文献16.
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17.
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18.
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19.
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20.
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