共查询到20条相似文献，搜索用时 484 毫秒
1.
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2.
Samantha J. Charlick Andrea Fielder Jan Pincombe Lois McKellar 《Women and birth : journal of the Australian College of Midwives》2017,30(4):325-331
Background
Given the significant benefits of breastfeeding, the World Health Organization (WHO) recommend exclusive breastfeeding for six months. Despite numerous strategies aimed at increasing the percentage of babies who are exclusively breastfed, Australia currently has one of the lowest six-month exclusive breastfeeding rates in the developed world. Notably, most research focuses on the early postnatal period (birth-two months) yet the largest decline in exclusive breastfeeding rates is observed between two and six months.Aim
This study aimed to understand what enabled a first-time mother to continue exclusively breastfeeding between two and six months in Australia.Methods
The qualitative approach known as interpretative phenomenological analysis (IPA) was used to explore how the new mother understood her exclusive breastfeeding journey. Data was collected retrospectively through a face-to-face, semi-structured interview, then transcribed in full and analyzed using IPA’s approach to data analysis.Findings
Three main themes were identified as self-determination to achieve exclusive breastfeeding, the influence of social norms in Australian culture, and the impact social supports have on maintaining exclusive breastfeeding.Conclusion
For this mother, her self-determination to exclusively breastfeed, along with positive social support, outweighed the impact of perceived social norms and negative pressure from significant others to stop exclusive breastfeeding. This qualitative reflection contributes to an understanding of the individual in the breastfeeding journey, uncovering nuances around exclusive breastfeeding that may be helpful in providing support for mothers and direction for further research. 相似文献3.
G. López-Fernández M. Barrios J. Goberna-Tricas J. Gómez-Benito 《Women and birth : journal of the Australian College of Midwives》2017,30(6):e292-e300
Background
The consequences of breastfeeding during pregnancy (BDP) have not been clearly established. Available studies have addressed isolated aspects of this issue using different methodologies, often resulting in contradictory results. To our knowledge, no systematic review has assessed and compared these studies, making it difficult to obtain a clear picture of the consequences of BDP.Aim
To review and summarise all the scientific evidence relating to BDP, and determine whether this evidence is sufficient to establish clear implications for the mother, breastmilk, breastfed child, current pregnancy, and ultimately, the newborn.Methods
We conducted a systematic review of the English and Spanish literature published between 1990 and 2015 using Cinahl, PubMed, IME, CUIDEN, Cochrane Library, Web of Science and PyscINFO.Findings
3278 publications were identified from databases, their titles and abstracts were checked to ensure the studies were related to the subject and met the selection criteria. Only 19 studies met all requirements and were included in the review.Conclusions and implications
Data suggest that BDP does not affect the way pregnancies end or even birth weights. However, several questions remain unanswered. Specifically, it is unclear how BDP affects maternal nutritional status in developed countries, the growth and health of breastfed siblings, the composition of breastmilk, or the growth of the newborn after delivery. Further studies of BDP are needed with larger samples, adequate methodology and proper control of the main confounders. 相似文献4.
5.
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6.
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7.
8.
Marjorie Atchan Deborah Davis Maralyn Foureur 《Women and birth : journal of the Australian College of Midwives》2017,30(1):51-62
Background
Breastfeeding has many known benefits yet its support across Australian health systems was suboptimal throughout the 20th Century. The World Health Organization launched a global health promotion strategy to help create a ‘breastfeeding culture’. Research on the programme has revealed multiple barriers since implementation.Aim
To analyse the sociopolitical challenges associated with implementing a global programme into a national setting via an examination of the influences on the early period of implementation of the Baby Friendly Hospital Initiative in Australia.Methods
A focused historical document analysis was attended as part of an instrumental case study. A purposeful sampling strategy obtained a comprehensive sample of public and private documents related to the introduction of the BFHI in Australia. Analysis was informed by a ‘documents as commentary’ approach to gain insight into individual and collective social practices not otherwise observable.Findings
Four major themes were identified: “a breastfeeding culture”; “resource implications”; “ambivalent support for breastfeeding and the BFHI” and “business versus advocacy”. “A breastfeeding culture” included several subthemes. No tangible support for breastfeeding generally, or the Baby Friendly Hospital Initiative specifically, was identified. Australian policy did not follow international recommendations. There were no financial or policy incentives for BFHI implementation.Conclusions
Key stakeholders’ decisions negatively impacted on the Baby Friendly Hospital Initiative at a crucial time in its implementation in Australia. The potential impact of the programme was not realised, representing a missed opportunity to establish and provide sustainable standardised breastfeeding support to Australian women and their families. 相似文献9.
10.
Hlengiwe Mohale Linda Sweet Kristen Graham 《Women and birth : journal of the Australian College of Midwives》2017,30(4):298-307
Background
Increasing global migration is resulting in a culturally diverse population in the receiving countries. In Australia, it is estimated that at least four thousand Sub-Saharan African women give birth each year. To respond appropriately to the needs of these women, it is important to understand their experiences of maternity care.Objective
The study aimed to examine the maternity experiences of Sub-Saharan African women who had given birth in both Sub-Saharan Africa and in Australia.Design
Using a qualitative approach, 14 semi-structured interviews with Sub-Saharan African women now living in Australia were conducted. Data was analysed using Braun and Clark’s approach to thematic analysis.Findings
Four themes were identified; access to services including health education; birth environment and support; pain management; and perceptions of care. The participants experienced issues with access to maternity care whether they were located in Sub-Saharan Africa or Australia. The study draws on an existing conceptual framework on access to care to discuss the findings on how these women experienced maternity care.Conclusion
The study provides an understanding of Sub-Saharan African women’s experiences of maternity care across countries. The findings indicate that these women have maternity health needs shaped by their sociocultural norms and beliefs related to pregnancy and childbirth. It is therefore arguable that enhancing maternity care can be achieved by improving women’s health literacy through health education, having an affordable health care system, providing respectful and high quality midwifery care, using effective communication, and showing cultural sensitivity including family support for labouring women. 相似文献11.
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12.
Oluwakemi C. Amodu Bukola Salami Solina Richter 《Women and birth : journal of the Australian College of Midwives》2017,30(5):e258-e263
Background
Obstetric Fistula is a childbirth injury that disproportionately affects women in sub-Saharan Africa. Although poverty plays an important role in perpetuating obstetric fistula, sociocultural practices has a significant influence on susceptibility to the condition.Aim
This paper aims to explore narratives in the literature on obstetric fistula in the context of Hausa ethno-lingual community of Northern Nigeria and the potential role of nurses and midwives in addressing obstetric fistula.Discussion
Three major cultural practices predispose Hausa women to obstetric fistula: early marriages and early child bearing; unskilled birth attendance and female circumcision and sociocultural constraints to healthcare access for women during childbirth. There is a failure to implement the International rights of the girl child in Nigeria which makes early child marriage persist. The Hausa tradition constrains the decision making power of women for seeking health care during childbirth. In addition, there is a shortage of nurses and midwives to provide healthcare service to women during childbirth.Conclusion
To improve health access for women, there is a need to increase political commitment and budget for health human resource distribution to underserved areas in the Hausa community. There is also a need to advance power and voice of women to resist oppressive traditions and to provide them with empowerment opportunities to improve their social status. The practice of traditional birth attendants can be regulated and the primary health care services strengthened. 相似文献13.
Helen L. McLachlan Touran Shafiei Della A. Forster 《Women and birth : journal of the Australian College of Midwives》2017,30(5):361-366
Background
Increasing breastfeeding rates is one way of improving the short and long term health of Aboriginal and Torres Strait Islander children (hereafter referred to as Aboriginal). Despite the benefits of breastfeeding and recommendations for strategies to increase breastfeeding among Aboriginal people, there is a lack of available population data.Aim
To use population-based data from Victoria, Australia to compare breastfeeding initiation for Aboriginal and non-Aboriginal women and to explore factors associated with breastfeeding initiation of Aboriginal women.Methods
Routinely collected infant feeding data obtained from the Victorian Perinatal Data Collection (VPDC) was used. The VPDC is a mandatory, population-based system where maternal and infant data on all Victorian births are collected.Findings
Compared with non-Aboriginal women, Aboriginal women were less likely to attempt to breastfeed their baby (87.2% vs 95.3%; p < 0.001); more likely to give formula in hospital (39.6% vs 30.6%; p < 0.001) and less likely to give the last feed prior to discharge exclusively from the breast (64.4% vs 75.0% p < 0.001). For Aboriginal women, factors associated with not initiating breastfeeding were being single, multiparous, smoking and length of stay. Infant factors were gestation less than 37 weeks and low birthweight (<2,500 g).Conclusion
In Victoria, breastfeeding initiation is lower for Aboriginal women compared with non-Aboriginal women. Further research is needed to explore the effectiveness of interventions that may increase breastfeeding for Aboriginal women. 相似文献14.
S.A.S. Moimaz N.B. Rocha C.A.S. Garbin T.A. Rovida N.A. Saliba 《Women and birth : journal of the Australian College of Midwives》2017,30(2):e119-e124
Background
Knowing the intention of mothers is important to plan actions to improve exclusive breastfeeding rates.Aim
The objective of this retrospective study was to verify the intention to breastfeed and the intended breastfeeding duration of a group of women participating in a public prenatal dental care program in the city of Araçatuba, Brazil.Methods
The records of 933 childbearing women were analyzed and their intention to breastfeed and intended breastfeeding duration were associated to women’s age, ethnicity, marital status, education, employment, number of gestations, previous breastfeeding experience, previous breastfeeding guidance, presence of complications during pregnancy, and systemic diseases. Data were inserted into Epi Info 2000 and analyzed with Biostat, at a 5% level of significance, and confidence interval of 95%.Findings
Participants mean age was 26.1 ± 5.9 years. The majority of women (96.5%) declared their intention to breastfeed their babies. The main variables to affect the intention to breastfeed were the number of gestations (p = 0.001), previous breastfeeding experience (p = 0.03), and previous breastfeeding guidance (p = 0.01). Intended breastfeeding duration was significantly affected by women’s age (p = 0.04), employment (0.02), the number of gestations (p = 0.001), and previous breastfeeding experience (p = 0.04).Conclusions
Previous positive breastfeeding experience and guidance during prenatal examinations positively affected women’s intention to breastfeed; while older, unemployed women in their second or more gestation and previous breastfeeding experience intended to breastfeed their children for longer periods of time. 相似文献15.
16.
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17.
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18.
Sue V. Kildea Yu Gao Margaret Rolfe Jacqueline Boyle Sally Tracy Lesley M. Barclay 《Women and birth : journal of the Australian College of Midwives》2017,30(5):398-405
Objective
To identify the risk factors for preterm birth, low birthweight and small for gestational age babies among remote-dwelling Aboriginal women.Methods
The study included 713 singleton births from two large remote Aboriginal communities in Northern Territory, Australia in 2004–2006 (retrospective cohort) and 2009–2011 (prospective cohort). Demographic, pregnancy characteristics, labour and birth outcomes were described. Multivariate logistic regression analysis was conducted and adjusted odds ratios were reported.Results
The preterm birth rate was 19.4%, low birthweight rate was 17.4% and small for gestational age rate was 16.3%. Risk factors for preterm birth were teenage motherhood, previous preterm birth, smoker status not recorded, inadequate antenatal visits, having pregnancy-induced hypertension, antepartum haemorrhage or placental complications. After adjusting for gender and birth gestation, the only significant risk factor for low birthweight was first time mother. The only significant risk factor for small for gestational age baby was women having their first baby.Conclusions
Rates of these events are high and have changed little over time. Some risk factors are modifiable and treatable but need early, high quality, culturally responsive women centred care delivered in the remote communities themselves. A different approach is recommended. 相似文献19.
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