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Wu Y, Chu Y, Zhao X, Wang X, Chen L, Duan R, Li Y, Liu X. The Chinese version of rating scale of pain expression during childbirth (ESVADOPA): reliability and validity assessment. BMC Nurs 2024; 23:520. [PMID: 39080681 PMCID: PMC11290266 DOI: 10.1186/s12912-024-02195-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 07/23/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Childbirth pain is a physiological phenomenon during the delivery process, the intense pain of childbirth could bring harmful effects to pregnant women and their babies. Assessment of childbirth pain is the first step in childbirth pain intervention. Some pain assessment scales have shortcomings such as interfering in the birthing process and affecting pain perception during delivery, while the Rating Scale of Pain Expression during Childbirth (ESVADOPA) could be used as an auxiliary scale to compensate for these shortcomings. The purpose of this study was to introduce the ESVADOPA and adapt it among Chinese pregnant women to check on the psychometric properties of the translated version of ESVADOPA. METHODS A new translation model based on Brislin's classical back translation model was used to translate and cross-cultural adapt the ESVADOPA. During June 2021 and June 2022, pregnant women at Shandong Provincial Hospital Affiliated to Shandong First Medical University were invited. In the stage of translation and cross-culturally adaptation, 18 midwives and 30 pregnant women were invited to participate in the first round of pre-experiment. And in the second round of pre-experiment, 15 midwives and 20 pregnant women were invited to participate. The Chinese version of ESVADOPA was tested on a group of pregnant women (N = 487). Construct validity was evaluated by exploratory factor analysis, confirmatory factor analysis and criterion-related validity. Reliability was assessed by Cronbach's α coefficient, McDonald Omega, Spearman-Brown split-half reliability and Guttman split-half reliability. RESULTS The item statistical analysis and construct validity resulted in six items and one factor that explained 61.064% of the total variance. Confirmatory factor analysis showed that the data fit the one-factor structure. Criterion-related validity indicated that the scale is significantly and positively correlated with the Numeric Rating Scale (NRS). Cronbach's α coefficient, McDonald Omega, Spearman-Brown split-half reliability, and Guttman split-half reliability of the Chinese version of ESVADOPA were 0.868, 0.896, 0.845, 0.842, respectively. CONCLUSION The Chinese version of the ESVADOPA with good reliability and validity data could be used to assess the pain rating of pregnant women during childbirth without interfering in the birthing process.
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Affiliation(s)
- Yu Wu
- Delivery Room, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 9677 Jingshi Street, Jinan, Shandong province, 250021, China
| | - Yanxin Chu
- People's Hospital of Lixia District of Jinan, 73 Wenhua West Street, Jinan, Shandong province, 250000, China
| | - Xin Zhao
- Otorhinolaryngologic Department, Shandong Provincial Hospital, Shandong First Medical University, 324 Jingwu Street, Jinan, Shandong province, 250021, China
| | - Xiaoli Wang
- Delivery Room, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 9677 Jingshi Street, Jinan, Shandong province, 250021, China
| | - Liyuan Chen
- Delivery Room, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 9677 Jingshi Street, Jinan, Shandong province, 250021, China
| | - Ruihan Duan
- Delivery Room, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 9677 Jingshi Street, Jinan, Shandong province, 250021, China
| | - Yunfeng Li
- The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, 16766 Jingshi Street, Jinan, Shandong province, 250014, China.
| | - Xia Liu
- Department of Nursing, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 9677 Jingshi Street, Jinan, Shandong province, 250021, China.
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Shamoradifar Z, Asghari-Jafarabadi M, Nourizadeh R, Mehrabi E, Areshtanab HN, Shaigan H. The impact of effective communication-based care on the childbirth experience and satisfaction among primiparous women: an experimental study. J Egypt Public Health Assoc 2022; 97:12. [PMID: 35941334 PMCID: PMC9360278 DOI: 10.1186/s42506-022-00108-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 07/04/2022] [Indexed: 12/04/2022]
Abstract
Background There is insufficient scientific evidence on the effect of communication skills of childbirth care providers on maternal childbirth experience and satisfaction. The present study aimed to determine the effect of communication-based care on the childbirth experience and satisfaction among primiparous women. Methods A total of 80 primiparous women participated in this experimental study who were randomly assigned into the intervention and control groups. According to the World Health Organization (WHO) care model, the intervention group received effective communication-based care, and the control group received the routine care. Data were collected using demographic and obstetric questionnaires, Labor Agentry Scale (LAS) and Birth Satisfaction Scale-Revised (BSS-R), and Support and Control in Birth (SCIB) scale applied 12 to 24 h after the intervention. Results After controlling the effect of confounding variables, the mean scores of childbirth experience (51.23(1.54) and satisfaction (26.03(0.81) in the intervention group were significantly higher than that in the control group (45.33 (1.54) and 22.66 (0.81) respectively; [adjusted mean difference (AMD) = 5.90, CI = 95%: 1.17 to 10.62, P = 0.01] versus AMD =3.37, CI: 95%: 0.87 to 5.87, P = 0.001]. Conclusion Eeffective communication-based care improved childbirth experience and satisfaction of primiparous women. Therefore, it is recommended that health-care providers should be trained on the communication skills in the delivery room especially during a vital threatened crises such as the Covid pandemic.
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Affiliation(s)
- Zahra Shamoradifar
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari-Jafarabadi
- Department of Statistics and Epidemiology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.,Center for the Development of Interdisciplinary Research in Islamic Sciences and Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Roghaiyeh Nourizadeh
- Department of Nursing and Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Esmat Mehrabi
- Department of Nursing and Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Hossein Namdar Areshtanab
- Department of Psychiatric Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hoorieh Shaigan
- Department of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
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Iyengar K, Gupta M, Pal S, Kaur K, Singla N, Verma M, Dhiman A, Singla R, Rohilla M, Suri V, Aggarwal N, Singh T, Goel P, Goel NK, Pant R, Gaur KL, Gehlot H, Bhati I, Verma M, Agarwal S, Acharya R, Singh K, Chauhan M, Rastogi R, Bedi R, Pancholi P, Nayak B, Modi B, Nakum K, Trivedi A, Aggarwal S, Patel S. Baseline Assessment of Evidence-Based Intrapartum Care Practices in Medical Schools in 3 States in India: A Mixed-Methods Study. GLOBAL HEALTH, SCIENCE AND PRACTICE 2022; 10:e2100590. [PMID: 35487543 PMCID: PMC9053154 DOI: 10.9745/ghsp-d-21-00590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 03/15/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Implementation research with pre- and post-comparison was planned to improve the quality of evidence-based intrapartum care services in Indian medical schools. We present the baseline study results to assess the status of adherence to intrapartum evidence-based practices (IP-EBP) in study schools in 3 states in India and the perception of the faculty. METHODS A concurrent mixed-methods approach was used to conduct the baseline assessment in 9 medical schools in Rajasthan, Gujarat, and Union Territory from October 2018 to June 2019. IP-EBP among pregnant women in uncomplicated first (n=135), second (n=120), and third stage (n=120) of labor were observed using a predesigned, pretested checklist quantitatively. We conducted in-depth interviews with 33 obstetrics and gynecology faculty to understand their perceptions of intrapartum practices. Quantitative data were analyzed using SPSS (version 22). COM-B (Capability, Opportunity, and Motivation Behavior) model was used to understand the behaviors, and thematic analysis was done for the qualitative data. FINDINGS Unindicated augmentation of labor was done in 64.4%, fundal pressure applied in 50.8%, episiotomy done in 58.3%, and delivery in lithotomy position was performed in 86.7% of women in labor. CONCLUSIONS Intrapartum practices that are not recommended were routinely practiced in the study medical schools due to a lack of staff awareness of evidence-based practices and incorrect beliefs about their impact.
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Affiliation(s)
| | - Madhu Gupta
- Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India.
| | - Swarnika Pal
- Seth GS Medical College & KEM Hospital, Mumbai, India
| | - Kiranjit Kaur
- Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Neena Singla
- Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Madhur Verma
- All India Institute Medical Science, Bathinda, Punjab, India
| | - Anchal Dhiman
- Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Rimpi Singla
- Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Minakshi Rohilla
- Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Vanita Suri
- Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Neelam Aggarwal
- Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Tarundeep Singh
- Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Poonam Goel
- Government Medical College and Hospital, Chandigarh, India
| | - N K Goel
- Government Medical College and Hospital, Chandigarh, India
| | - Reena Pant
- Swai Maan Singh Medical College, Jaipur, Rajasthan, India
| | | | - Hanslata Gehlot
- Dr. Sampurnanand Medical College and Hospital, Jodhpur, Rajasthan, India
| | - Indra Bhati
- Dr. Sampurnanand Medical College and Hospital, Jodhpur, Rajasthan, India
| | - Manoj Verma
- Dr. Sampurnanand Medical College and Hospital, Jodhpur, Rajasthan, India
| | - Sudesh Agarwal
- Sardar Patel Medical College and PBM Hospital, Bikaner Rajasthan, India
| | - Rekha Acharya
- Sardar Patel Medical College and PBM Hospital, Bikaner Rajasthan, India
| | - Keerti Singh
- Rabindranath Tagore Medical College and Hospital, Udaipur, Rajasthan, India
| | - Madhubala Chauhan
- Rabindranath Tagore Medical College and Hospital, Udaipur, Rajasthan, India
| | - Radha Rastogi
- Rabindranath Tagore Medical College and Hospital, Udaipur, Rajasthan, India
| | - Renu Bedi
- Jawaharlal Nehru Medical College and Hospital, Ajmer Rajasthan, India
| | - Poornima Pancholi
- Jawaharlal Nehru Medical College and Hospital, Ajmer Rajasthan, India
| | - Bipin Nayak
- GMERS Medical College and Hospital, Gandhinagar, Gujarat, India
| | - Bhavesh Modi
- GMERS Medical College and Hospital, Gandhinagar, Gujarat, India
| | - Kanaklata Nakum
- Government Medical College and Hospital, Bhavnagar, Gujarat, India
| | - Atul Trivedi
- Government Medical College and Hospital, Bhavnagar, Gujarat, India
| | | | - Sangita Patel
- Government Medical College and Hospital, Baroda, Gujarat, India
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Zheng H, Zheng BX, Lin XM. The Trend of Labor Analgesia in the World and China: A Bibliometric Analysis of Publications in Recent 30 Years. J Pain Res 2020; 13:517-526. [PMID: 32214842 PMCID: PMC7082621 DOI: 10.2147/jpr.s232132] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 02/19/2020] [Indexed: 02/05/2023] Open
Abstract
Purpose Labor analgesia is part of the most important tasks an anesthesiologist needs to deal with. With the “two-child policy” in China, the number of parturients has increased significantly, labor analgesia more should be valued. There has been a tremendous change on labor analgesia research in China and around the world; however, broader trends in the prevalence and scope of labor analgesia research remain underexplored. The current study quantitatively analyzes trends in labor analgesia research publications in the past 30 years. Methods A bibliometric approach was used to search Scopus, PubMed, Web of Science and the China National Knowledge Infrastructure for all labor analgesia-related research articles. The research progress and growing trend were quantitatively analyzed by total publications, research types, research institutions, journal impact factors, and author’s contribution. Total citations frequency, average citations per item and h-index were used for evaluating literature quantity. Results From 1988 to 2018, over 8000 documents in labor analgesia research field were published worldwide. According to Scopus, 68.2% papers of all documents were articles. The USA published the largest number of articles (2204, 27.45%). China had published 175 articles (2.18%), ranking the 11th. According to WOS, there were 221 research categories for labor analgesia articles all over the world. The total citations were 76,207, average 9.086 citations per item, and the h-index was 114, average 14 citations per item worldwide. The total citations and h-index of papers published in China were as follows: 353 total citations, 7.06 citations per item, and 10 h-index. High contribution journals, authors, institutions and the top 10 most cited articles on labor analgesia in the world and China were also listed. Conclusion Labor analgesia research has grown markedly during the 1988–2018 period. Although China had made remarkable achievements, there was a gap in the high-quality studies between China and other leading countries.
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Affiliation(s)
- Huan Zheng
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, People's Republic of China.,Department of Anesthesiology, West China Second University Hospital, Sichuan University, Chengdu 610041, People's Republic of China.,Department of Anesthesiology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu 610072, People's Republic of China
| | - Bi-Xin Zheng
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, People's Republic of China.,Department of Anesthesiology, West China Second University Hospital, Sichuan University, Chengdu 610041, People's Republic of China.,Department of Pain Management, West China Hospital, Sichuan University, Chengdu 610041, People's Republic of China
| | - Xue-Mei Lin
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, People's Republic of China.,Department of Anesthesiology, West China Second University Hospital, Sichuan University, Chengdu 610041, People's Republic of China
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5
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Georgsson S, Carlsson T. Pain and pain management during induced abortions: A web‐based exploratory study of recollections from previous patients. J Adv Nurs 2019; 75:3006-3017. [DOI: 10.1111/jan.14132] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 05/06/2019] [Accepted: 05/21/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Susanne Georgsson
- The Swedish Red Cross University College Huddinge Sweden
- Department of Clinical Science, Intervention and Technology Karolinska Institutet Stockholm Sweden
| | - Tommy Carlsson
- Sophiahemmet University Stockholm Sweden
- Department of Women’s and Children’s Health Uppsala University Uppsala Sweden
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6
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Gürbüz B, Großkreutz C, Vortel M, Borde T, Rancourt RC, Stepan H, Sauzet O, Henrich W, David M, Seidel V. The influence of migration on women's satisfaction during pregnancy and birth: results of a comparative prospective study with the Migrant Friendly Maternity Care Questionnaire (MFMCQ). Arch Gynecol Obstet 2019; 300:555-567. [PMID: 31267197 DOI: 10.1007/s00404-019-05227-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 06/19/2019] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Approximately 21% of Germany's inhabitants have been born abroad or are of direct descent of immigrants. A positive birth experience has an effect on a woman's mental health and her future family planning choices. While international studies showed that immigrant women are less satisfied with their birth experience, no such study has been conducted in Germany until now. METHODS At our center of tertiary care in Berlin, with approximately 50% immigrants among patients, pregnant women of at least 18 years of age were offered participation in this study. A modified version of the Migrant Friendly Maternity Care Questionnaire (MFMCQ) designed by Gagnon et al. in German, English, French, Spanish, Arabic and Turkish was used. We compared non-immigrant women to immigrant women and women with direct descent of immigrants. For certain analysis, the latter two groups were included together under the category "migration background". RESULTS During the study period, 184 non-immigrant, 214 immigrant women and 62 direct descendants of immigrants were included. The most frequent countries of origin were Syria (19%), Turkey (17%), and Lebanon (9%). We found a slight difference between groups regarding age (non-immigrants: mean 33 years versus women with any migration background: mean 31) as well as parity with more non-immigrants delivering their first child. No difference in the satisfaction with care was observed between immigrant and any migration background groups (p ≥ 0.093 in the two-sided Fisher's exact test). At least 75.8% of all participating women reported complete satisfaction with care during labor, birth and after birth. Interestingly, the level of German language proficiency did not influence the immigrant patient's satisfaction with care. CONCLUSION The study results show no difference regarding overall satisfaction with care during labor and birth despite a relevant language barrier. We are for the first time providing the MFMCQ in German and Turkish. Further future analyses on the impact of patient expectations on satisfaction with care will be conducted.
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Affiliation(s)
- B Gürbüz
- Clinic of Obstetrics, Universitätsklinikum Leipzig, Leipzig, Germany
| | - C Großkreutz
- Clinic of Obstetrics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin,, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - M Vortel
- Clinic of Obstetrics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin,, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - T Borde
- Alice Salomon Hochschule, Berlin, Germany
| | - R C Rancourt
- Division of 'Experimental Obstetrics', Clinic of Obstetrics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Berlin, Germany
| | - H Stepan
- Clinic of Obstetrics, Universitätsklinikum Leipzig, Leipzig, Germany
| | - O Sauzet
- Bielefeld School of Public Health and Centre for Statistics, Bielefeld University, Bielefeld, Germany
| | - W Henrich
- Clinic of Obstetrics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin,, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - M David
- Clinic of Gynecology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany
| | - V Seidel
- Clinic of Obstetrics, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin,, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany. .,Berlin Institute of Health (BIH), Berlin, Germany.
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Khresheh R, Barclay L, Shoqirat N. Caring behaviours by midwives: Jordanian women's perceptions during childbirth. Midwifery 2019; 74:1-5. [DOI: 10.1016/j.midw.2019.03.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 02/16/2019] [Accepted: 03/17/2019] [Indexed: 10/27/2022]
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Simeone S, Stile F, Assunta G, Gargiulo G, Rea T. Experience of Vaginal Birth After Cesarean: A Phenomenological Study. J Perinat Educ 2019; 28:131-141. [PMID: 31341372 DOI: 10.1891/1058-1243.28.3.131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The international literature concerning cesarean surgeries (CSs) make it clear that many of these procedures are unnecessary. Using a phenomenological methodology, we seek to understand the experiences and decisions of women who have undergone vaginal birth after cesarean (VBAC). Various factors contribute to the choice of VBAC. Making VBAC a more regular practice would contribute to a decrease in the total number of repeat CSs. The purpose of this study is threefold: (a) to understand the process that women use to select a VBAC rather than a repeat cesarean, (b) to understand the mothers' lived experience of that VBAC, and (c) to use the aforementioned data to inform the development of new educational programs for mothers considering VBAC.
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Neel K, Goldman R, Marte D, Bello G, Nothnagle MB. Hospital-based maternity care practitioners' perceptions of doulas. Birth 2019; 46:355-361. [PMID: 30734958 DOI: 10.1111/birt.12420] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 01/06/2019] [Accepted: 01/07/2019] [Indexed: 11/29/2022]
Abstract
INTRODUCTION A birth doula provides continuous informational, physical, and emotional support during pregnancy, labor, and immediately postpartum. Existing data on the benefits of doulas, especially for low-resource, high-need patients, do not address how and why individual practitioners decide to recommend this model of care. This project aims to describe best practices of integrating doulas into hospital-based maternity care teams to facilitate access to this evidence-based service for improving maternal health outcomes. METHODS Semi-structured interviews using open-ended questions were conducted in person with 47 maternity care practitioners-OB/GYNs, family medicine physicians, RNs, and nurse-midwives-across three hospitals. Interview analysis was conducted using the Template Organizing Style qualitative analysis approach. RESULTS Results demonstrated varied support for doula care given practitioners' experiences. Positive experiences centered on doulas' supportive role and strong relationships with patients. Some conflicts between practitioners and doulas may stem from a cross-cultural divide between mainstream obstetric/physician culture and a natural birth "counter culture." Suggestions to facilitate good working relationships centered on three overlapping themes: mutual respect between doulas and hospital staff, education about doulas' training, and clarification of roles on maternity care teams especially among staff with overlapping roles. CONCLUSIONS Among maternity care practitioners, some frustration, anger, and resentment persist with respect to work with doulas. Adequate staff training in the doula model of care, explicit role definition, and increasing practitioner exposure to doulas may promote effective integration of doulas into hospital maternity care teams.
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Affiliation(s)
- Kira Neel
- Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Roberta Goldman
- Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Denise Marte
- Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Gisel Bello
- Warren Alpert Medical School, Brown University, Providence, Rhode Island
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Ohaeri B, Owolabi G, Ingwu J. Skilled health attendants' knowledge and practice of pain management during labour in health care facilities in Ibadan, Nigeria. Eur J Midwifery 2019; 3:3. [PMID: 33537582 PMCID: PMC7839127 DOI: 10.18332/ejm/99544] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 10/05/2018] [Accepted: 11/03/2018] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Skilled health attendants occupy an important position in the management of women's pain during labour. Their professional goal is to ensure safety and minimum pain in labour. It has been revealed that nurse-midwives are deficient in knowledge and practice of pain management during labour. Hence, this study examined skilled health attendants' knowledge and practice of pain management in health care facilities in Ibadan, Nigeria. METHODS A cross-sectional design was used to collect data from 227 skilled health attendants, in the maternity units of the three purposively selected hospitals for 12 weeks. A structured questionnaire and observational check lists were used for data collection. Data were analyzed using descriptive statistics and significants level was set with p<0.05. RESULTS Results on respondents' level of knowledge revealed that 6% had low knowledge, 40.5% moderate, and 56.8% had a high level. The majority, 79.7%, were registered nurse-midwives (RN/RM) and 90.1% employed reassurance for pain relief. No significant associations were found between respondents' level of education and reassurance, exercise, allay of fear, use of drugs, and TENS (p>0.05). However, there were significant associations between respondents' educational level and rubbing of back/massage, position change, cold/warm bath, relaxation, and social support (p<0.05). CONCLUSIONS It is recommended that seminars and workshops should be organized regularly and assessment tools should be supplied, to enhance effective pain assessment as this will provide adequate and holistic labour-pain management by nurse-midwives.
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Affiliation(s)
- Beatrice Ohaeri
- Department of Nursing, University of Ibadan, Ibadan, Nigeria
| | | | - Justin Ingwu
- Department of Nursing Sciences, Faculty of Health Sciences & Technology, University of Nigeria, Enugu, Nigeria
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Woman-centered care: Women's experiences and perceptions of induction of labor for uncomplicated post-term pregnancy: A systematic review of qualitative evidence. Midwifery 2018; 67:46-56. [DOI: 10.1016/j.midw.2018.08.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 05/30/2018] [Accepted: 08/15/2018] [Indexed: 11/16/2022]
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12
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Dai Z. Chinese News Media Discourse of Doulas and Doula Care. J Perinat Educ 2018; 27:243-252. [PMID: 31073270 PMCID: PMC6491159 DOI: 10.1891/1058-1243.27.4.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This article highlights the relationships among Chinese society, the discourse about doulas and doula care in childbirth, and Chinese women. The author used a critical feminist lens to analyze the discourse about doulas, doula care in childbirth, and women in Chinese mainstream news media. This analysis showed that the Chinese news media and government encouraged and promoted becoming a doula as a profession and doula care in labor in terms of cultural, social, and political factors. An argument was presented that these discourses obscure a nuanced understanding of Chinese women's maternal health in general.
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Maputle MS. Support provided by midwives to women during labour in a public hospital, Limpopo Province, South Africa: a participant observation study. BMC Pregnancy Childbirth 2018; 18:210. [PMID: 29871607 PMCID: PMC5989402 DOI: 10.1186/s12884-018-1860-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 05/25/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Physical presence during labour offer women opportunity of having positive childbirth experiences as well as childbirth outcomes. The study aimed to determine what support provided by midwives during intrapartum care at a public hospital in Limpopo Province. The study was conducted at a tertiary hospital in Limpopo Province. METHODS A participant observation approach was used to achieve the objectives of the study. The population comprised of all women who were admitted with labour and for delivery and midwives who were providing midwifery care in the obstetric unit of a tertiary public hospital in Limpopo Province. Non-probability, purposive and convenience sampling were used to sample 24 women and 12 midwives. Data were collected through participant observations which included unstructured conversations with the use of observational guide, field notes of all events and conversations that occurred when women interact with midwives were recorded verbatim and a Visual Analog Scale to complement the observations. Data were analysed qualitatively but were presented in the tables and bar graphs. RESULTS Five themes emerged as support provided by midwives during labour, namely; communication between women and midwives, informational support, emotional support activities, interpretation of the experienced labour pain and supportive care activities during labour. CONCLUSION The communication between woman and midwife was occurring as part of midwifery care and very limited for empowering. The information sharing focused on the assistive actions rather than on the activities that would promote mothers' participation. The emotional support activities indicated lack of respect and disregard cultural preferences and this contributed to inability to exercise choices in decision-making. The study recommended the implementation of Batho Pele principles in order to provide woman-centred care during labour.
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Affiliation(s)
- Maria S Maputle
- Department of Advanced Nursing, University of Venda, Private Bag X5050, Thohoyandou, 0950, South Africa.
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Reid HE, Wittkowski A, Vause S, Heazell AEP. 'Just an extra pair of hands'? A qualitative study of obstetric service users' and professionals' views towards 24/7 consultant presence on a single UK tertiary maternity unit. BMJ Open 2018; 8:e019977. [PMID: 29511017 PMCID: PMC5855205 DOI: 10.1136/bmjopen-2017-019977] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To explore the views of maternity service users and professionals towards obstetric consultant presence 24 hours a day, 7 days a week. DESIGN Semistructured interviews conducted face to face with maternity service users and professionals in March and April 2016. All responses were analysed together (ie, both service users' and professionals' responses) using an inductive thematic analysis. SETTING A large tertiary maternity unit in the North West of England that has implemented 24/7 obstetric consultant presence. PARTICIPANTS Antenatal and postnatal inpatient service users (n=10), midwives, obstetrics and gynaecology specialty trainees and consultant obstetricians (n=10). RESULTS Five themes were developed: (1) 'Just an extra pair of hands?' (the consultant's role), (2) the context, (3) the team, (4) training and (5) change for the consultant. Respondents acknowledged that obstetrics is an acute specialty, and consultants resolve intrapartum complications. However, variability in consultant experience and behaviour altered perception of its impact. Service users were generally positive towards 24/7 consultant presence but were not aware that it was not standard practice across the UK. Professionals were more pragmatic and discussed how the implementation of 24/7 working had affected their work, development of trainees and potential impacts on future consultants. CONCLUSIONS The findings raised several issues that should be considered by practitioners and policymakers when making decisions about the implementation of 24/7 consultant presence in other maternity units, including attributes of the consultants, the needs of maternity units, the team hierarchy, trainee development, consultants' other duties and consultant absences.
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Affiliation(s)
- Holly E Reid
- Maternal and Fetal Health Research Centre, Division of Developmental Biology and Medicine, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St. Mary's Hospital, Manchester, UK
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Department of Clinical Psychology, Wythenshawe Hospital, Manchester, UK
| | - Anja Wittkowski
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Department of Clinical Psychology, Wythenshawe Hospital, Manchester, UK
| | - Sarah Vause
- Maternal and Fetal Health Research Centre, Division of Developmental Biology and Medicine, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St. Mary's Hospital, Manchester, UK
- Manchester University NHS Foundation Trust, St. Mary's Hospital, Manchester, UK
| | - Alexander E P Heazell
- Maternal and Fetal Health Research Centre, Division of Developmental Biology and Medicine, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, St. Mary's Hospital, Manchester, UK
- Manchester University NHS Foundation Trust, St. Mary's Hospital, Manchester, UK
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Ndirima Z, Neuhann F, Beiersmann C. Listening to their voices: understanding rural women's perceptions of good delivery care at the Mibilizi District Hospital in Rwanda. BMC Womens Health 2018; 18:38. [PMID: 29433492 PMCID: PMC5809806 DOI: 10.1186/s12905-018-0530-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 01/31/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Poor quality maternity care may lead to increased maternal dissatisfaction, and subsequent decreased utilization of health services or both. In a responsive health system, determining suitable delivery care, in the mother's opinion, may lead to an improved quality of services and the mother's satisfaction. In Rwanda, there is still limited knowledge and inadequate research regarding patient satisfaction and preferences, especially for women's perceptions and needs during childbirth. This study captures rural women's perception of good delivery care to understand aspects of care they consider important during childbirth. METHODS This qualitative study was conducted in the Mibilizi District Hospital catchment area located 350 km from the capital, Kigali, in the Western Province of Rwanda. It includes 25 in-depth interviews with purposively sampled rural mothers who had delivered in the hospital and five hospital midwives. Content analysis was performed manually. RESULTS With regard to interpersonal relations at the health facility, the women agreed on the need for respectful treatment in areas of sufficient privacy and had distinct preferences for the gender of the birth attendant, or husband's presence during delivery. The women make a great effort to deliver in a health care facility and therefore, they expect to be assisted in a professional and safe manner. These expectations can be met on a personal level, but at times are counteracted by structural deficiencies and staff shortages. CONCLUSIONS In gathering rural women's perceptions of good delivery care, this study reveals what mothers in remote areas in Rwanda consider important during child birth. The women's expectations, suggestions, and needs can enhance providers' awareness of the women's priorities during childbirth and serve as a guidepost for health services to increase the quality, acceptability and uptake of maternal health services.
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Affiliation(s)
- Zack Ndirima
- Institute of Public Health, Ruprecht-Karls University Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany
| | - Florian Neuhann
- Institute of Public Health, Ruprecht-Karls University Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany
| | - Claudia Beiersmann
- Institute of Public Health, Ruprecht-Karls University Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany
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Vieira F, Guimarães JV, Souza MCS, Sousa PML, Santos RF, Cavalcante AMRZ. Scientific evidence on perineal trauma during labor: Integrative review. Eur J Obstet Gynecol Reprod Biol 2018; 223:18-25. [PMID: 29453137 DOI: 10.1016/j.ejogrb.2018.01.036] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 01/30/2018] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To assess the scientific evidence for management and preservation of perineal integrity during the expulsive stage of labor. STUDY DESIGN Integrative review that employed the Population, Intervention, Comparison, Outcome strategy to formulate the research question: Which perineal measure(s) is(are) effective in maintaining perineal integrity during labor? The search was performed in the databases MEDLINE, LILACS, BDENF and SciELO. The ten selected studies were analyzed based on their level of evidence and grade of recommendation. RESULTS Four categories of measures were located: antenatal perineal care, perineal massage during the expulsive phase of labor, manual perineal support during the expulsive phase of labor and perineal hyaluronidase injection. CONCLUSION Based on its level of evidence, perineal massage with lubricants performed by the women or their partners at the end of pregnancy may be recommended as a measure favorable for perineal protection.
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Affiliation(s)
- Flaviana Vieira
- School of Nursing, Federal University of Goiás, Goiânia, Goiás, Brazil.
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17
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Mafetoni RR, Shimo AKK. The effects of acupressure on labor pains during child birth: randomized clinical trial. Rev Lat Am Enfermagem 2017; 24:e2738. [PMID: 27508910 PMCID: PMC4990037 DOI: 10.1590/1518-8345.0739.2738] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Accepted: 12/19/2015] [Indexed: 05/29/2023] Open
Abstract
Objective: to analyze the effects of acupressure on the sanyinjiao point for pregnant women
in labor at public maternity wards. Method: single-blind controlled clinical trial, randomly done employing a pragmatic
profile. We selected 156 pregnant women in their ≥ 37 week/s, who had cervical
dilations of ≥ 4 cm and with two or more contractions in 10 minutes. The pregnant
women were randomly divided into three groups at a university hospital in the
suburbs of Sao Paulo, Brazil, in order to receive either acupressure treatment, a
placebo or participate as part of a control group. The acupressure was applied on
the sanyinjiao point during the contractions for 20 minutes. Then the intensity of
the pain was evaluated using the Visual Analogue Scale (VAS). Results: The averages for the pain measured using the VAS were not different for the three
groups that were a part of the study (p-value=0.0929), however they were less in
the acupressure groups immediately after receiving the treatment
(p-value=<0.0001). This was also the case where the treatment lasted for 1 hour
(p-value=0.0001). This was the case in comparison with placebo and control groups.
Conclusion: the use of acupressure on the sanyinjiao point is a useful way to alleviate pain
in a non-invasive manner. It can improve the quality of care given to pregnant
women in labor. Register: RBR-9mhs8r.
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Affiliation(s)
- Reginaldo Roque Mafetoni
- Doctoral Student, Faculdade de Enfermagem, Universidade Estadual de Campinas, Campinas, SP, Brazil. RN, Hospital da Mulher "Prof Dr. José Aristodemo Pinotti", CAISM, Universidade Estadual de Campinas, Campinas, SP, Brazil
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Abstract
BACKGROUND Historically, women have generally been attended and supported by other women during labour. However, in hospitals worldwide, continuous support during labour has often become the exception rather than the routine. OBJECTIVES The primary objective was to assess the effects, on women and their babies, of continuous, one-to-one intrapartum support compared with usual care, in any setting. Secondary objectives were to determine whether the effects of continuous support are influenced by:1. Routine practices and policies in the birth environment that may affect a woman's autonomy, freedom of movement and ability to cope with labour, including: policies about the presence of support people of the woman's own choosing; epidural analgesia; and continuous electronic fetal monitoring.2. The provider's relationship to the woman and to the facility: staff member of the facility (and thus has additional loyalties or responsibilities); not a staff member and not part of the woman's social network (present solely for the purpose of providing continuous support, e.g. a doula); or a person chosen by the woman from family members and friends;3. Timing of onset (early or later in labour);4. Model of support (support provided only around the time of childbirth or extended to include support during the antenatal and postpartum periods);5. Country income level (high-income compared to low- and middle-income). SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 October 2016), ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP) (1 June 2017) and reference lists of retrieved studies. SELECTION CRITERIA All published and unpublished randomised controlled trials, cluster-randomised trials comparing continuous support during labour with usual care. Quasi-randomised and cross-over designs were not eligible for inclusion. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. We sought additional information from the trial authors. The quality of the evidence was assessed using the GRADE approach. MAIN RESULTS We included a total of 27 trials, and 26 trials involving 15,858 women provided usable outcome data for analysis. These trials were conducted in 17 different countries: 13 trials were conducted in high-income settings; 13 trials in middle-income settings; and no studies in low-income settings. Women allocated to continuous support were more likely to have a spontaneous vaginal birth (average RR 1.08, 95% confidence interval (CI) 1.04 to 1.12; 21 trials, 14,369 women; low-quality evidence) and less likely to report negative ratings of or feelings about their childbirth experience (average RR 0.69, 95% CI 0.59 to 0.79; 11 trials, 11,133 women; low-quality evidence) and to use any intrapartum analgesia (average RR 0.90, 95% CI 0.84 to 0.96; 15 trials, 12,433 women). In addition, their labours were shorter (MD -0.69 hours, 95% CI -1.04 to -0.34; 13 trials, 5429 women; low-quality evidence), they were less likely to have a caesarean birth (average RR 0.75, 95% CI 0.64 to 0.88; 24 trials, 15,347 women; low-quality evidence) or instrumental vaginal birth (RR 0.90, 95% CI 0.85 to 0.96; 19 trials, 14,118 women), regional analgesia (average RR 0.93, 95% CI 0.88 to 0.99; 9 trials, 11,444 women), or a baby with a low five-minute Apgar score (RR 0.62, 95% CI 0.46 to 0.85; 14 trials, 12,615 women). Data from two trials for postpartum depression were not combined due to differences in women, hospitals and care providers included; both trials found fewer women developed depressive symptomatology if they had been supported in birth, although this may have been a chance result in one of the studies (low-quality evidence). There was no apparent impact on other intrapartum interventions, maternal or neonatal complications, such as admission to special care nursery (average RR 0.97, 95% CI 0.76 to 1.25; 7 trials, 8897 women; low-quality evidence), and exclusive or any breastfeeding at any time point (average RR 1.05, 95% CI 0.96 to 1.16; 4 trials, 5584 women; low-quality evidence).Subgroup analyses suggested that continuous support was most effective at reducing caesarean birth, when the provider was present in a doula role, and in settings in which epidural analgesia was not routinely available. Continuous labour support in settings where women were not permitted to have companions of their choosing with them in labour, was associated with greater likelihood of spontaneous vaginal birth and lower likelihood of a caesarean birth. Subgroup analysis of trials conducted in high-income compared with trials in middle-income countries suggests that continuous labour support offers similar benefits to women and babies for most outcomes, with the exception of caesarean birth, where studies from middle-income countries showed a larger reduction in caesarean birth. No conclusions could be drawn about low-income settings, electronic fetal monitoring, the timing of onset of continuous support or model of support.Risk of bias varied in included studies: no study clearly blinded women and personnel; only one study sufficiently blinded outcome assessors. All other domains were of varying degrees of risk of bias. The quality of evidence was downgraded for lack of blinding in studies and other limitations in study designs, inconsistency, or imprecision of effect estimates. AUTHORS' CONCLUSIONS Continuous support during labour may improve outcomes for women and infants, including increased spontaneous vaginal birth, shorter duration of labour, and decreased caesarean birth, instrumental vaginal birth, use of any analgesia, use of regional analgesia, low five-minute Apgar score and negative feelings about childbirth experiences. We found no evidence of harms of continuous labour support. Subgroup analyses should be interpreted with caution, and considered as exploratory and hypothesis-generating, but evidence suggests continuous support with certain provider characteristics, in settings where epidural analgesia was not routinely available, in settings where women were not permitted to have companions of their choosing in labour, and in middle-income country settings, may have a favourable impact on outcomes such as caesarean birth. Future research on continuous support during labour could focus on longer-term outcomes (breastfeeding, mother-infant interactions, postpartum depression, self-esteem, difficulty mothering) and include more woman-centred outcomes in low-income settings.
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Affiliation(s)
- Meghan A Bohren
- World Health OrganizationDepartment of Reproductive Health and Research20 Avenue AppiaGenevaGeneveSwitzerland1211
| | - G Justus Hofmeyr
- Walter Sisulu University, University of the Witwatersrand, Eastern Cape Department of HealthEast LondonSouth Africa
| | - Carol Sakala
- National Partnership for Women & Families1875 Connecticut Avenue, NW, Suite 650Washington DCUSA20009
| | - Rieko K Fukuzawa
- University of TsukubaFaculty of Medicine1‐1‐1 TennodaiTsukubaIbarakiJapan305‐8575
| | - Anna Cuthbert
- The University of LiverpoolCochrane Pregnancy and Childbirth Group, Department of Women's and Children's HealthFirst Floor, Liverpool Women's NHS Foundation TrustCrown StreetLiverpoolUKL8 7SS
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Larkin P, Begley CM, Devane D. Women's preferences for childbirth experiences in the Republic of Ireland; a mixed methods study. BMC Pregnancy Childbirth 2017; 17:19. [PMID: 28068948 PMCID: PMC5223453 DOI: 10.1186/s12884-016-1196-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 12/13/2016] [Indexed: 11/24/2022] Open
Abstract
Background How women experience childbirth is acknowledged as critical to the postnatal wellbeing of mother and baby. However there is a knowledge deficit in identifying the important elements of these experiences in order to enhance care. This study elicits women’s preferences for the most important elements of their childbirth experiences. Methods A mixed methods design was used. An initial qualitative phase (reported previously) was followed by a second quantitative one using a discrete choice experiment (DCE), which is reported on here. Participants who had experienced labour, were over 18 and had a healthy baby were recruited from four randomly selected and one pilot hospital in the Republic of Ireland. Data were collected by means of a DCE survey instrument. Questions were piloted, refined, and then arranged in eight pair-wise scenarios. Women identified their preferences by choosing one scenario over another. Nine hundred and five women were sent the DCE three months after childbirth, with a response rate of 59.3% (N =531). Results Women clearly identified priorities for their childbirth experiences as: the availability of pain relief, partnership with the midwife, and individualised care being the most important attributes. In the context of other choices, women rated decision-making, presence of a consultant, and interventions as less important elements. Comments from open questions provided contextual information about their choices. Conclusions Most women did not want to be typified as wanting the dichotomy of ‘all natural’ or ‘all technology’ births but wanted ‘the best of both worlds’. The results suggest that availability of pain relief was the most important element of women’s childbirth experiences, and superseded all other elements including partnership with the midwife which was the second most important attribute. The preferences identified might reflect the busy medicalised hospital environments, in which the vast majority of women had given birth, and may differ in settings such as midwifery led care or home births.
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Affiliation(s)
- Patricia Larkin
- School of Health and Science, Scoil na Sláinte agus na hEolaíochta, Dundalk Institute of Technology, Dublin Road, Dundalk, Co. Louth, Ireland.
| | - Cecily M Begley
- School of Nursing and Midwifery, Trinity College Dublin, Dublin 2, Ireland
| | - Declan Devane
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
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Pinar G, Avsar F, Aslantekin F. Evaluation of the Impact of Childbirth Education Classes in Turkey on Adaptation to Pregnancy Process, Concerns About Birth, Rate of Vaginal Birth, and Adaptation to Maternity: A Case-Control Study. Clin Nurs Res 2016; 27:315-342. [PMID: 28038495 DOI: 10.1177/1054773816682331] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study aims to examine the impact of childbirth education in Turkey on the adaptation to pregnancy process, concerns about birth, rate of vaginal birth, and adaptation to maternity. This quasi-experimental study with control group was conducted from December 2013 to December 2014. The sample size was 132 primiparous pregnant women ( nexperimental = 66, ncontrol = 66). The average age of the pregnant women in the experimental and control groups was 24.41 ± 3.92 and 23.68 ± 4.19, respectively. The study showed that experimental group participants had lower concerns about birth, higher levels of knowledge, and faster adaptation to pregnancy and postpartum process; they could also give positive feedback about labor pain and action and could start breastfeeding at an earlier stage when compared with those in the control group ( p < .05). Childbirth education classes increase the knowledge of pregnant women and positively contribute in pregnancy, labor, and the postpartum process.
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Affiliation(s)
- Gul Pinar
- 1 Yildirim Beyazit University, Ankara, Turkey
| | - Filiz Avsar
- 1 Yildirim Beyazit University, Ankara, Turkey
| | - Filiz Aslantekin
- 2 Ministry of Health, Public Health Institution of Turkey, Ankara, Turkey
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Congdon JL, Adler NE, Epel ES, Laraia BA, Bush NR. A Prospective Investigation of Prenatal Mood and Childbirth Perceptions in an Ethnically Diverse, Low-Income Sample. Birth 2016; 43:159-66. [PMID: 26948850 PMCID: PMC5518740 DOI: 10.1111/birt.12221] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/12/2015] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Few studies have examined prenatal mood as a means to identify women at risk for negative childbirth experiences. We explore associations between prenatal mood and birth perceptions in a socioeconomically diverse, American sample. METHODS We conducted a prospective study of 136 predominantly low-income and ethnic minority women of mixed parity. Prenatal measures of perceived stress, pregnancy-related anxiety, and depressive symptoms were used to predict maternal perceptions of birth experiences 1 month postpartum, using the childbirth experience questionnaire (CEQ; 1). RESULTS After adjusting for sociodemographic variables and mode of delivery, higher third-trimester stress predicted worse CEQ total scores. This association was predominantly explained by two CEQ domains: own capacity (e.g., feelings of control and capability), and perceived safety. Pregnancy-related anxiety and depressive symptoms correlated with perceived stress, though neither independently predicted birth experience. An unplanned cesarean delivery was associated with a worse CEQ total score. Vaginal delivery predicted greater perceived safety. Altogether, sociodemographic covariates, mode of delivery, and prenatal mood accounted for 35 percent of the variance in birth experience (p < 0.001). DISCUSSION Our finding that prenatal stress explains a significant and likely clinically meaningful proportion of the variance in birth experience suggests that women perceive and recall their birth experiences through a lens that is partially determined by preexisting personal circumstances and emotional reserves. Since childbirth perceptions have implications for maternal and child health, patient satisfaction, and health care expenditures, these findings warrant consideration of prenatal stress screening to target intervention for women at risk for negative birth experiences.
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Affiliation(s)
- Jayme L Congdon
- Department of Pediatrics at Stanford University, Stanford, CA, USA
- University of California Berkeley-University of California San Francisco Joint Medical Program, Berkeley, CA, USA
| | | | | | - Barbara A Laraia
- Community Health and Human Development in the School of Public Health at the University of California Berkeley, CA, USA
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Boryri T, Noori NM, Teimouri A, Yaghobinia F. The perception of primiparous mothers of comfortable resources in labor pain (a qualitative study). IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2016; 21:239-46. [PMID: 27186200 PMCID: PMC4857657 DOI: 10.4103/1735-9066.180386] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Natural delivery is the most painful event that women experience in their lifetime. That is why labor pain relief has long been as one of the most important issues in the field of midwifery. Thus, the present study aims to explore the perception of primiparous mothers on comfortable resources for labor pain. MATERIALS AND METHODS In the present study, qualitative content analysis technique was used. The participants had singleton pregnancy with normal vaginal delivery. These women referred to the Imam Javad Health Center within 3-5 days after delivery for screening thyroid of their babies. RESULTS During the content analysis process, five themes emerged that indicated the nature and dimensions of the primiparous mothers' perception of comfortable resources. These themes were: "religious and spiritual beliefs," "use of analgesic methods" (medicinal and non-medicinal), "support and the continuous attendance of midwife and delivery room personnel," "family's and husband's support during pregnancy and in vaginal delivery encouragement," and finally "lack of familiarity with the delivery room and lack of awareness about structured delivery process." CONCLUSIONS The results showed that mothers received more comfort from human resources than from the environment and modern equipment. Despite the need for specialized midwife with modern technical facilities, this issue shows the importance of highlighting the role of midwife and humanistic midwife care. Therefore, considering midwives and the standardization of human resources in health centers are more important than physical standardization. This will result in midwife interventions being performed with real understanding of the patients' needs.
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Affiliation(s)
- Tahereh Boryri
- Department of Midwifery, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Noor Mohammad Noori
- Department of Pediatric Cardiology, Children and Adolescent Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Alireza Teimouri
- Department of Pediatric Cardiology, Children and Adolescent Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Fariba Yaghobinia
- Department of Midwifery, Zahedan University of Medical Sciences, Zahedan, Iran
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Bever Babendure J, Reifsnider E, Mendias E, Moramarco MW, Davila YR. Reduced breastfeeding rates among obese mothers: a review of contributing factors, clinical considerations and future directions. Int Breastfeed J 2015; 10:21. [PMID: 26140049 PMCID: PMC4488037 DOI: 10.1186/s13006-015-0046-5] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 06/06/2015] [Indexed: 02/06/2023] Open
Abstract
Maternal obesity is associated with significantly lower rates of breastfeeding initiation, duration and exclusivity. Increasing rates of obesity among reproductive-age women has prompted the need to carefully examine factors contributing to lower breastfeeding rates in this population. Recent research has demonstrated a significant impact of breastfeeding to reduce the risk of obesity in both mothers and their children. This article presents a review of research literature from three databases covering the years 1995 to 2014 using the search terms of breastfeeding and maternal obesity. We reviewed the existing research on contributing factors to lower breastfeeding rates among obese women, and our findings can guide the development of promising avenues to increase breastfeeding among a vulnerable population. The key findings concerned factors impacting initiation and early breastfeeding, factors impacting later breastfeeding and exclusivity, interventions to increase breastfeeding in obese women, and clinical considerations. The factors impacting early breastfeeding include mechanical factors and delayed onset of lactogenesis II and we have critically analyzed the potential contributors to these factors. The factors impacting later breastfeeding and exclusivity include hormonal imbalances, psychosocial factors, and mammary hypoplasia. Several recent interventions have sought to increase breastfeeding duration in obese women with varying levels of success and we have presented the strengths and weaknesses of these clinical trials. Clinical considerations include specific techniques that have been found to improve breastfeeding incidence and duration in obese women. Many obese women do not obtain the health benefits of exclusive breastfeeding and their children are more likely to also be overweight or obese if they are not breastfed. Further research is needed into the physiological basis for decreased breastfeeding among obese women along with effective interventions supported by rigorous clinical research to advance the care of obese reproductive age women and their children.
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Affiliation(s)
- Jennie Bever Babendure
- />College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ 85004 USA
| | - Elizabeth Reifsnider
- />College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ 85004 USA
| | - Elnora Mendias
- />University of Texas Medical Branch at Galveston, School of Nursing, Galveston, TX 77555 USA
| | - Michael W. Moramarco
- />College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ 85004 USA
| | - Yolanda R. Davila
- />University of Texas Medical Branch at Galveston, School of Nursing, Galveston, TX 77555 USA
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Halperin O, Sarid O, Cwikel J. The influence of childbirth experiences on women׳s postpartum traumatic stress symptoms: A comparison between Israeli Jewish and Arab women. Midwifery 2015; 31:625-32. [DOI: 10.1016/j.midw.2015.02.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Revised: 01/31/2015] [Accepted: 02/28/2015] [Indexed: 10/23/2022]
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Walker KF, Wilson P, Bugg GJ, Dencker A, Thornton JG. Childbirth experience questionnaire: validating its use in the United Kingdom. BMC Pregnancy Childbirth 2015; 15:86. [PMID: 25884191 PMCID: PMC4396591 DOI: 10.1186/s12884-015-0513-4] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Accepted: 03/20/2015] [Indexed: 11/20/2022] Open
Abstract
Background The Childbirth Experience Questionnaire (CEQ) was developed in Sweden in 2010 and validated in 920 primiparous women. It has not been validated in the United Kingdom (UK). Measuring the impact of an intervention on a woman’s childbirth experience is arguably as important as measuring its impact on outcomes such as caesarean delivery and perinatal morbidity or mortality and yet surprisingly it is rarely done. The lack of a robust validated tool for evaluating labour experience in the UK is a topical issue in the UK at present. Indeed NICE say ‘A standardised method to measure and quantify women's psychological and emotional wellbeing and their birth experiences is urgently required to support any study investigating the effectiveness of interventions, techniques or strategies during birth.’ Methods The Childbirth Experience Questionnaire and part of the Care Quality Commission Maternity Survey (2010) was sent to 350 women at one month postnatal. The CEQ was sent again two weeks later. The CEQ was tested for face validity among 25 postnatal mothers. Demographic data and delivery data was used to establish construct validity of the CEQ using the method of known-groups validation. The results of the scored CEQ sent out twice were used to measure test-retest reliability of the CEQ by calculating the quadratic weighted index of agreement between the two scores. Criterion validity was measured by calculating the Pearson correlation coefficient for the CEQ and Maternity Survey scores. Results Face validity of the CEQ in a UK population was demonstrated with all respondents stating it was easy to understand and complete. A statistically significantly higher CEQ score for subgroups of women known to report a better birth outcome demonstrated construct validity of the CEQ. A weighted kappa of 0.68 demonstrated test-retest reliability of the CEQ. A Pearson correlation co-efficient of 0.73 demonstrated a strong correlation between the results of the CEQ and the results of the ‘gold standard’ assessment of childbirth experience in the UK: the Maternity Survey and hence criterion validity of the CEQ. Conclusions The Childbirth Experience Questionnaire is a valid and reliable measure of childbirth experience in the UK population.
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Affiliation(s)
- Kate F Walker
- Maternity Department, Nottingham City Hospital, Nottingham University Hospitals NHS Trust, Nottingham, NG5 1 PB, UK.
| | - Philippa Wilson
- Maternity Department, Nottingham City Hospital, Nottingham University Hospitals NHS Trust, Nottingham, NG5 1 PB, UK.
| | - George J Bugg
- Maternity Department, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK.
| | - Anna Dencker
- Centre for Person-centred Care, Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Jim G Thornton
- Division of Obstetrics and Gynaecology, University of Nottingham, Maternity Department, Nottingham City Hospital, Nottingham, NG5 1 PB, UK.
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Takács L, Seidlerová JM, Šulová L, Hoskovcová SH. Social psychological predictors of satisfaction with intrapartum and postpartum care - what matters to women in Czech maternity hospitals? Open Med (Wars) 2015; 10:119-127. [PMID: 28352687 PMCID: PMC5152969 DOI: 10.1515/med-2015-0022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2012] [Accepted: 11/28/2014] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To identify the social psychological factors affecting women's evaluation of care provided in Czech maternity hospitals using following criteria: satisfaction with intrapartum and postpartum care, willingness to return to a given hospital and to recommend the hospital to others. METHODS 762 women completed a 71-item original Czech questionnaire KLI-P designed to measure the psychosocial climate in both delivery and after-birth unit on six scales. The sample was representative of the Czech parturients population. Multivariate logistic regression was used to investigate the predictive value of the questionnaire scales for maternal satisfaction, willingness to return to and to recommend a given hospital. RESULTS For delivery unit, the satisfaction predictors were: helpfulness and empathy of midwives (Χ2=48.9), communication of information and availability of caregivers (Χ2=16.6), helpfulness and empathy of physicians (Χ2=10.9), symmetrical and respectful attitude of staff members (Χ2=9.7) and physical comfort and services (Χ2=7.6). The predictors of satisfaction with after-birth unit included helpfulness and empathy of the staff (Χ2≥42.1), communication of information and availability of caregivers (Χ2=52.5), physical comfort and services (Χ2=30.6), control and involvement in decision-making (Χ2=6.6) and parity (Χ2=8.6). The factors influencing women's willingness to return to and to recommend a hospital differed from the predictors of general satisfaction. CONCLUSIONS The satisfaction factors revealed in this research correspond predominantly to the results of studies conducted in other countries (warm, non-formal and supportive approach, sufficient and well-timed provision of information and explanation, availability of caregivers, physical environment). However, participation in decision making, which has been repeatedly shown to be among the strongest predictors of childbirth satisfaction, was not important for the Czech parturients' satisfaction with intrapartal care. This finding can be explained by different attitudes and expectations of both parturients and caregivers in a post-totalitarian country.
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Affiliation(s)
- Lea Takács
- Department of Psychology Faculty of Arts and Philosophy, Charles University, Nám. J. Palacha 2,116 38, Prague 1, Czech Republic; tel: +420 221 619 667, fax: +420 221 619 678
| | | | - Lenka Šulová
- Department of Psychology, Faculty of Arts and Philosophy, Charles University, Prague, Czech Republic
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Ampofo EA, Caine V. A narrative inquiry into women’s perception and experience of labour pain: A study in the western region of ghana. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2015. [DOI: 10.1016/j.ijans.2015.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Robertson EK. "To be taken seriously" : women's reflections on how migration and resettlement experiences influence their healthcare needs during childbearing in Sweden. SEXUAL & REPRODUCTIVE HEALTHCARE 2014; 6:59-65. [PMID: 25998872 DOI: 10.1016/j.srhc.2014.09.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Revised: 09/04/2014] [Accepted: 09/08/2014] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To use an intersectional approach to analyze women's reflections on how their migration and resettlement experiences to Sweden influenced their health and healthcare needs during childbearing. METHODS Focus-group discussions, pair interviews and individual interviews were conducted in southern Sweden between 2006 and 2009, with 25 women originating from 17 different countries with heterogeneous backgrounds that had experienced childbirth in Sweden. Qualitative content analysis was used with an intersectional approach, taking into consideration intersections of ethnicity, socio-economic status (SES) and gender. FINDINGS The hardships of migration, resettlement, and constraints in the daily life made the women feel overstrained, tense, and disembodied. Being treated as a stranger and ignored or rejected in healthcare encounters was devaluing and discriminating. The women stressed that they felt stronger and had fewer complications during pregnancy and labor when they were "taken seriously" and felt that they had a confident, caring relationship with caregivers/midwives. This, therefore, enabled the women to boost their sense of self, and to recognize their capabilities, as well as their "embodied knowledge". CONCLUSION Caregivers/midwives should be aware of the hardships the women face. Hardships stem from experiences of migration and resettlement as well as from structural constraints such as the "triple jeopardy" of ethnicity, SES and gender, which increase women's needs of support in childbearing. Such awareness is necessary when promoting health and reducing the unnecessary suffering and victimization of women, their children, and their families. It is a matter of patient safety and equity.
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Affiliation(s)
- Eva K Robertson
- Faculty of Professional Studies, University of Nordland, Bodø, Norway.
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Abstract
A male companion at antenatal care is unusual and spousal participation during labor and delivery in Nigeria is poor. This can be attributed to amongst other things the beliefs that labor is exclusively a women affair. Although there are few studies about male involvement in maternity care in Nigeria, no review has been conducted regarding spousal participation in labor and delivery. Therefore, majority of women desire their spouses as birth companions and attest to having emotional comfort and support when their spouses participate in their labor and delivery, the status and acceptability of spousal participation in labor and delivery in Nigeria is quite low due in part to socio-cultural drawbacks. This narrative review looks at existing research literatures identified through electronic sources such as Google Scholar, PubMed and EBSCO published in English between 1995 and 2013. The aim of this narrative review is to extract from these literatures the level of participation of Nigerian spouses in labor and delivery. Keys words used for the search include spouse, labor, delivery, Nigeria, maternal; childbirth and only English papers were included. Although presently weak, the spousal participation in labor and delivery in Nigeria should be encouraged and promoted as a deliberate health-care policy through the creation of an enabling environment and dissemination of information highlighting the pivotal role that spouses could play in labor and delivery.
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Affiliation(s)
| | - Au Emelonye
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
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McKenzie-McHarg K, Crockett M, Olander EK, Ayers S. Think pink! A sticker alert system for psychological distress or vulnerability during pregnancy. ACTA ACUST UNITED AC 2014. [DOI: 10.12968/bjom.2014.22.8.590] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | | | - Susan Ayers
- Professor of Maternal and Child Health City University London
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Shahshahan Z, Mehrabian F, Mashoori S. Effect of the presence of support person and routine intervention for women during childbirth in Isfahan, Iran: A randomized controlled trial. Adv Biomed Res 2014; 3:155. [PMID: 25221758 PMCID: PMC4162082 DOI: 10.4103/2277-9175.137865] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2012] [Accepted: 09/29/2012] [Indexed: 11/04/2022] Open
Abstract
Background: The aim of this study was to examine the effects of the presence of continuous support person and routine interventions during labor and delivery in Isfahan, Iran. Materials and Methods: One hundred pregnant women in spontaneous labor were assessed in four groups: Group 1; received routine intervention with a support person, Group 2; received routine intervention without support person, Group 3; received support person without routine intervention, Group 4; did not receive routine intervention or a support person. Sociodemographic, antenatal characteristics, length of stage of labor, instrumental delivery, the cervical laceration, perineal tear, labor pain, satisfaction and Apgar score collected and analyzed. Results: Based on the results there was no significant difference in regard to maternal age, BMI, maternal education and working statutes among the studied groups (P-value >0.05). Also, 1 and 5-min Apgar <7, cervical lacerations and instrumental delivery among studied groups were similar (P-value >0.05). Length of first and second stage of labor, perineal tear, satisfaction score and pain before and after labor were significant among studied groups (P-value <0.05). Conclusions: Presence of a support person and routine intervention during labor did not effect on incidence of cervical lacerations, instrumental delivery and Apgar <7. Labor pain and women's dissatisfaction, and number women with third and fourth degree of perineal tear among women who received routine intervention were increased compare to others. Interventions makes decreased the length of first and second stage of labor. In totally, the presence of a support person during labor in Iranian women decrease length of labor and improved labor outcomes.
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Affiliation(s)
- Zahra Shahshahan
- Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ferdose Mehrabian
- Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shaghyegh Mashoori
- Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Poder TG, Larivière M. [Advantages and disadvantages of water birth. A systematic review of the literature]. ACTA ACUST UNITED AC 2014; 42:706-13. [PMID: 24996877 DOI: 10.1016/j.gyobfe.2014.05.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 04/28/2014] [Indexed: 10/25/2022]
Abstract
CONTEXT Water birth is under debate among professionals. For the proponents of this approach, immersion in water during labour and birth may increase maternal relaxation, reduce analgesia requirements and promote a model of obstetric care more focused on the needs of mothers, particularly the empowerment of women to realize their full potential. In contrast, major critics cite a risk of inhalation of water for the newborn and a risk of infection for the mother and the newborn. OBJECTIVE This review tracks the state of scientific knowledge about water birth in order to determine if it can be generalized in hospitals. METHOD A systematic review of the literature was conducted in PubMed, Embase and Cochrane Database. The period covered is from January 1989 to May 2013. The level of evidence of the studies was assessed with the analysis guide of the Haute Autorité de santé. RESULTS The level of evidence of the studies identified goes from moderate to low, particularly as regard to studies analysing the expulsion phase. CONCLUSION It is possible to recommend immersion in water during the labour phase. No recommendation can be made as regard to the foetal expulsion phase.
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Affiliation(s)
- T G Poder
- UETMIS et CRCHUS, Hôtel-Dieu, CHUS, 580, rue Bowen-Sud, J1G 2E8, Sherbrooke, QC, Canada.
| | - M Larivière
- Direction interdisciplinaire des services cliniques, hôpital Fleurimont, CHUS, 3001, 12(e), avenue Nord, J1H 5N4, Sherbrooke, QC, Canada
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Thelin IL, Lundgren I, Hermansson E. Midwives' lived experience of caring during childbirth--a phenomenological study. SEXUAL & REPRODUCTIVE HEALTHCARE 2014; 5:113-8. [PMID: 25200971 DOI: 10.1016/j.srhc.2014.06.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 05/17/2014] [Accepted: 06/25/2014] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The aim of this study was to obtain a deeper understanding of midwives' lived experience of caring during childbirth in a Swedish context. METHODS Ten midwives were recruited from one university hospital with two separate delivery units in western Sweden. Data were collected by both written narratives and interviews. With an inductive approach using a descriptive phenomenological method, the answers to the question: "Can you describe a situation in which you felt that your caring was of importance for the woman and her partner?" were analysed. RESULTS A general structure of the phenomenon of caring in midwifery during childbirth, including five key constituents: sharing the responsibility, being intentionally and authentically present, creating an atmosphere of calm serenity in a mutual relationship, possessing the embodied knowledge, and balancing on the borders in transition to parenthood. CONCLUSIONS This study emphasises how the midwives shared the responsibility and their possessed embodied knowledge of childbirth and how new unique knowledge was constructed together with the woman, child and her partner. The study has the potential to increase knowledge and understanding of midwives' lived experience of caring during childbirth and therefore has implications for practice, education, and research.
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Affiliation(s)
- Ida Lyckestam Thelin
- Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, SE-431 30 Mölndal,, Sweden; Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, SE-405 30 Gothenburg, Sweden.
| | - Ingela Lundgren
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, SE-405 30 Gothenburg, Sweden
| | - Evelyn Hermansson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 457, SE-405 30 Gothenburg, Sweden
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Askari F, Atarodi A, Torabi S, Moshki M. Exploring women's personal experiences of giving birth in Gonabad city: a qualitative study. Glob J Health Sci 2014; 6:46-54. [PMID: 25168980 PMCID: PMC4825378 DOI: 10.5539/gjhs.v6n5p46] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Accepted: 02/21/2014] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Women's health is an important task in society. The aim of this qualitative study that used a phenomenological approach was to explain women's personal experiences of giving birth in Gonabad city that had positive experiences of giving birth in order to establish quality cares and the related factors of midwifery cares for this physiological phenomenon. METHODS The participants were 21 primiparae women who gave a normal and or uncomplicated giving birth in the hospital of Gonabad University of medical sciences. Based on a purposeful approach in-depth interviews were continued to reach data saturation. The data were collected through open and semi-structured interactional in-depth interviews with all the participants. All the interviews were taped, transcribed and then analyzed through a qualitative content analysis method to identify the concepts and themes. FINDINGS Some categories were emerged. A quiet and safe environment was the most urgent need of the most women giving birth. Unnecessary routine interventions that are performed on all women regardless of their needs and should be avoided were considered such as: "absolute rest, establishing vein, frequent vaginal examinations, fasting and early Amniotomy". All the women wanted to take part actively in their giving birth, because they believed it could affect their giving birth. CONCLUSION We hope that the women's experiences of giving birth will be a pleasant and enjoyable experience for all the mothers giving birth.
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Childbirth care practices in public sector facilities in Jeddah, Saudi Arabia: a descriptive study. Midwifery 2014; 30:899-909. [PMID: 24703810 DOI: 10.1016/j.midw.2014.03.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 02/01/2014] [Accepted: 03/06/2014] [Indexed: 12/30/2022]
Abstract
OBJECTIVES to explore reported hospital policies and practices during normal childbirth in maternity wards in Jeddah, Saudi Arabia, to assess and verify whether these practices are evidence-based. DESIGN quantitative design, in the form of a descriptive questionnaire, based on a tool extracted from the literature. SETTING nine government hospitals in Jeddah, Saudi Arabia. These hospitals have varied ownership, including Ministry of Health (MOH), military, teaching and other government hospitals. PARTICIPANTS key individuals responsible for the day-to-day running of the maternity ward. MEASUREMENTS nine interviews using descriptive structured questionnaire were conducted. Data were analysed using SPSS for Windows (version 16.0). FINDINGS the surveyed hospitals were found to be well equipped to deal with obstetric emergencies, and many follow evidence-based procedures. On average, the caesarean section rate was found to be 22.4%, but with considerable variances between hospitals. Some unnecessary procedures that are known to be ineffective or harmful and that are not recommended for routine use, including pubic shaving, enemas, episiotomy, electronic fetal monitoring (EFM) and intravenous (IV) infusion, were found to be frequently practiced. Only 22% of the hospitals sampled reported allowing a companion to attend labour and childbirth. KEY CONCLUSIONS many aspects of recommended EBP were used in the hospitals studied. However, the results of this study clearly indicate that there is wide variation between hospitals in Jeddah, Saudi Arabia in some obstetric practices. Furthermore, the findings suggest that some practices at these hospitals are not supported by evidence as being beneficial for mothers or infants and are positively discouraged under international guidelines. IMPLICATIONS FOR PRACTICE this study has specific implications for obstetricians, midwives and nurses working in maternity units. It gives an overview of current hospital policies and practices during normal childbirth. It is likely to contribute to improving the health and well-being of women, and have implications for service provision. It could also help in the development of technical information for policy-makers, and health care professionals for normal childbirth care.
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Hastings-Tolsma M, Nolte AGW. Reconceptualising failure to rescue in midwifery: a concept analysis. Midwifery 2014; 30:585-94. [PMID: 24685016 DOI: 10.1016/j.midw.2014.02.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Revised: 01/20/2014] [Accepted: 02/11/2014] [Indexed: 11/15/2022]
Abstract
AIM to reconceptualise the concept of failure to rescue, distinguishing it from its current scientific usage as a surveillance strategy to recognise physiologic decline. BACKGROUND failure to rescue has been consistently defined as a failure to save a patient׳s life after development of complications. The term, however, carries a richer connotation when viewed within a midwifery context. Midwives have historically believed themselves to be the vanguards of normal, physiologic processes, including birth. This philosophy mandates careful consideration of what it means to promote normal birth and the consequences of failure to rescue women from processes which challenge that outcome. DATA SOURCES the Medline, CINAHL, PsycINFO, PubMED, Web of Science and Google Scholar databases were searched from the period of 1992-2014 using the key terms of concept analysis, failure-to-rescue, childbirth, midwifery outcomes, obstetrical outcomes, suboptimal care, and patient outcomes. English language reports were used exclusively. The search yielded 45 articles which were reviewed in this paper. REVIEW METHOD a critical analysis of the published literature was undertaken as a means of determining the adequacy of the concept for midwifery practice and to detail how it relates to other concepts important in development of a conceptual framework promoting normal birth processes. FINDINGS failure to rescue within the context of the midwifery model of care requires robust attention to a midwifery managed setting and surveillance based on a caring presence, patient protection, and midwifery partnership with patient. CONCLUSION clarifying the definition of failure to rescue in childbirth and defining its attributes can help inform midwifery providers throughout the world of the ethical importance of considering failure to rescue in clinical practice. Relevance to midwifery care mandates use of failure to rescue as both a process and outcome measure.
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Affiliation(s)
- Marie Hastings-Tolsma
- University of Colorado Denver, College of Nursing, 13120 E. 19th Avenue, P.O. Box 6511, Aurora, CO 80045, USA; 2012-2013 Fulbright U.S. Scholar, University of Johannesburg, Department of Nursing Sciences, South Africa.
| | - Anna G W Nolte
- University of Johannesburg, Department of Nursing Sciences, PO Box 524, Auckland Park 2006, South Africa.
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Ayers S. Fear of childbirth, postnatal post-traumatic stress disorder and midwifery care. Midwifery 2014; 30:145-8. [DOI: 10.1016/j.midw.2013.12.001] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Varghese B, Roy R, Saha S, Roalkvam S. Fostering maternal and newborn care in India the Yashoda way: does this improve maternal and newborn care practices during institutional delivery? PLoS One 2014; 9:e84145. [PMID: 24454718 PMCID: PMC3893122 DOI: 10.1371/journal.pone.0084145] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 11/12/2013] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The Yashoda program, named after a legendary foster-mother in Indian mythology, under the Norway-India Partnership Initiative was launched as a pilot program in 2008 to improve the quality of maternal and neonatal care at facilities in select districts of India. Yashodas were placed mainly at district hospitals, which are high delivery load facilities, to provide support and care to mothers and newborns during their stay at these facilities. This study presents the results from the evaluation of this intervention in two states in India. METHODS Data collection methods included in-depth interviews with healthcare providers and mothers and a survey of mothers who had recently delivered within a quasi-experimental design. Fifty IDIs were done and 1,652 mothers who had delivered in the past three months were surveyed during 2010 and 2011. RESULTS A significantly higher proportion of mothers at facilities with Yashodas (55 percent to 97 percent) received counseling on immunization, breastfeeding, family planning, danger signs, and nutrition compared to those in control districts (34 percent to 66 percent). Mothers in intervention facilities were four to five times more likely to receive postnatal checks than mothers in control facilities. Among mothers who underwent cesarean sections, initiation of breastfeeding within five hours was 50 percent higher in intervention facilities. Mothers and families also reported increased support, care and respect at intervention facilities. CONCLUSION Yashoda as mothers' aide thus seems to be an effective intervention to improve quality of maternal and newborn care in India. Scaling up of this intervention is recommended in district hospitals and other facilities with high volume of deliveries.
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Affiliation(s)
| | - Reetabrata Roy
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Somen Saha
- Public Health Foundation of India, New Delhi, India
- Indian Institute of Public Health Gandhinagar, Gujarat, India
| | - Sidsel Roalkvam
- Centre for Development and Environment, University of Oslo, Oslo, Norway
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Social support during delivery in rural central Ghana: a mixed methods study of women's preferences for and against inclusion of a lay companion in the delivery room. J Biosoc Sci 2013; 46:669-85. [PMID: 23965280 DOI: 10.1017/s0021932013000412] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This study aimed to explore pregnant women's attitudes towards the inclusion of a lay companion as a source of social support during labour and delivery in rural central Ghana. Quantitative demographic and pregnancy-related data were collected from 50 pregnant women presenting for antenatal care at a rural district hospital and analysed using STATA/IC 11.1. Qualitative attitudinal questions were collected from the same women through semi-structured interviews; data were analysed using NVivo 9.0. Twenty-nine out of 50 women (58%) preferred to have a lay companion during facility-based labour and delivery, whereas 21 (42%) preferred to deliver alone with the nurses in a facility. Women desiring a companion were younger, had more antenatal care visits, had greater educational attainment and were likely to be experiencing their first delivery. Women varied in the type of companion they prefer (male partner vs female relative). What was expected in terms of social support differed based upon the type of companion. Male companions were expected to provide emotional support and to 'witness her pain'. Female companions were expected to provide emotional support as well as instrumental, informational and appraisal support. Three qualitative themes were identified that run counter to the inclusion of a lay helper: fear of an evil-spirited companion, a companion not being necessary or helpful, and being 'too shy' of a companion. This research challenges the assumption of a unilateral desire for social support during labour and delivery, and suggests that women differ in the type of companion and type of support they prefer during facility deliveries. Future research is needed to determine the direction of the relationship--whether women desire certain types of support and thus choose companions they believe can meet those needs, or whether women desire a certain companion and adjust their expectations accordingly.
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Talukdar S, Purandare N, Coulter-Smith S, Geary M. Is it Time to Rejuvenate the Forceps? J Obstet Gynaecol India 2013; 63:218-22. [PMID: 24431645 DOI: 10.1007/s13224-013-0465-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 07/27/2013] [Indexed: 11/24/2022] Open
Abstract
The obstetric forceps was designed to assist extraction of the foetal head and thereby accomplish delivery of the foetus in the second stage of labour. More than 700 types of obstetric forceps have been described. An understanding of the anatomy of the birth canal and the foetal head is a prerequisite to becoming a skilled and safe user of forceps. Operative vaginal delivery rates have remained stable at between 10 and 13 %. The last few decades has seen a rise in caesarean section, along with the introduction and safe use of the vacuum extractor. This has resulted in a decline both in the use of the obstetric forceps as well as in the training for the same. The forceps is less likely to fail when used as the primary instrument thereby reducing the need for the sequential use of two instruments which increase the morbidity of the neonate. Perineal trauma is more likely to occur with the use of the forceps but the evidence is that the maternal concern is less when compared to the ventouse. Simulation training is an important part of obstetric training. Application of forceps blades in the simulation setting can improve the skill level of obstetricians. The use of the forceps should not be decreasing and more senior involvement in training is necessary so that juniors develop the proper skills to perform forceps delivery in a competent and safe manner. It is vital that the art of the forceps is not lost to future generations of obstetricians and the women they care for.
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Affiliation(s)
- Sanchila Talukdar
- Department of Obstetrics and Gynaecology, Rotunda Hospital, Parnell Street, Dublin 1, Republic of Ireland
| | - Nikhil Purandare
- Department of Obstetrics and Gynaecology, Rotunda Hospital, Parnell Street, Dublin 1, Republic of Ireland
| | - Sam Coulter-Smith
- Department of Obstetrics and Gynaecology, Rotunda Hospital, Parnell Street, Dublin 1, Republic of Ireland
| | - Michael Geary
- Department of Obstetrics and Gynaecology, Rotunda Hospital, Parnell Street, Dublin 1, Republic of Ireland ; Royal College Surgeons, Dublin 2, Ireland
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Wei S, Wo BL, Qi HP, Xu H, Luo ZC, Roy C, Fraser WD. Early amniotomy and early oxytocin for prevention of, or therapy for, delay in first stage spontaneous labour compared with routine care. Cochrane Database Syst Rev 2013:CD006794. [PMID: 23926074 DOI: 10.1002/14651858.cd006794.pub4] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Caesarean section rates are over 20% in many developed countries. The main diagnosis contributing to the high rate in nulliparae is dystocia or prolonged labour. The present review assesses the effects of a policy of early amniotomy with early oxytocin administration for the prevention of, or the therapy for, delay in labour progress. OBJECTIVES To estimate the effects of early augmentation with amniotomy and oxytocin for prevention of, or therapy for, delay in labour progress on the caesarean birth rate and on indicators of maternal and neonatal morbidity. SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 May 2013), MEDLINE (1966 to 4 July 2013), Embase (1980 to 4 July 2013), CINAHL (1982 to 4 July 2013), MIDIRS (1985 to 4 July 2013) and contacted authors for data from unpublished trials. SELECTION CRITERIA Randomized and quasi-randomized controlled trials that compared oxytocin and amniotomy with expectant management. DATA COLLECTION AND ANALYSIS Three review authors extracted data independently. We stratified the analyses into 'Prevention Trials' and 'Therapy Trials' according to the status of the woman at the time of randomization. Participants in the 'Prevention Trials' were unselected women, without slow progress in labour, who were randomized to a policy of early augmentation or to routine care. In 'Treatment Trials' women were eligible if they had an established delay in labour progress. MAIN RESULTS For the 2013 update, we identified and excluded one new clinical trial. This updated review includes 14 trials, randomizing a total of 8033 women. The unstratified analysis found early intervention with amniotomy and oxytocin to be associated with a modest reduction in the risk of caesarean section; however, the confidence interval (CI) included the null effect (risk ratio (RR) 0.89; 95% CI 0.79 to 1.01; 14 trials; 8033 women). In prevention trials, early augmentation was associated with a modest reduction in the number of caesarean births (RR 0.87; 95% CI 0.77 to 0.99; 11 trials; 7753). A policy of early amniotomy and early oxytocin was associated with a shortened duration of labour (average mean difference (MD) - 1.28 hours; 95% CI -1.97 to -0.59; eight trials; 4816 women). Sensitivity analyses excluding four trials with a full package of active management did not substantially affect the point estimate for risk of caesarean section (RR 0.87; 95% CI 0.73 to 1.05; 10 trials; 5165 women). We found no other significant effects for the other indicators of maternal or neonatal morbidity. AUTHORS' CONCLUSIONS In prevention trials, early intervention with amniotomy and oxytocin appears to be associated with a modest reduction in the rate of caesarean section over standard care.
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Affiliation(s)
- Shuqin Wei
- Département d'Obstétrique-Gynécologie, Université de Montréal, Hôpital Sainte-Justine, Bureau 4986, 3175 Chemin de la côte Sainte-Catherine, Montréal, Province of Quebec, Canada, H3T 1C5
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Draper H, Ives J. Men's involvement in antenatal care and labour: Rethinking a medical model. Midwifery 2013; 29:723-9. [DOI: 10.1016/j.midw.2013.02.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Revised: 02/13/2013] [Accepted: 02/16/2013] [Indexed: 10/27/2022]
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Wilson S, McKenzie K, Quayle E, Murray GC. The postnatal support needs of mothers with an intellectual disability. Midwifery 2013; 29:592-8. [DOI: 10.1016/j.midw.2012.05.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Revised: 05/10/2012] [Accepted: 05/12/2012] [Indexed: 11/17/2022]
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Smith LA, Price N, Simonite V, Burns EE. Incidence of and risk factors for perineal trauma: a prospective observational study. BMC Pregnancy Childbirth 2013; 13:59. [PMID: 23497085 PMCID: PMC3599825 DOI: 10.1186/1471-2393-13-59] [Citation(s) in RCA: 195] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Accepted: 02/20/2013] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Our aim was to describe the range of perineal trauma in women with a singleton vaginal birth and estimate the effect of maternal and obstetric characteristics on the incidence of perineal tears. METHODS We conducted a prospective observational study on all women with a planned singleton vaginal delivery between May and September 2006 in one obstetric unit, three freestanding midwifery-led units and home settings in South East England. Data on maternal and obstetric characteristics were collected prospectively and analysed using univariable and multivariable logistic regression. The outcome measures were incidence of perineal trauma, type of perineal trauma and whether it was sutured or not. RESULTS The proportion of women with an intact perineum at delivery was 9.6% (125/1,302) in nulliparae, and 31.2% (453/1,452) in multiparae, with a higher incidence in the community (freestanding midwifery-led units and home settings). Multivariable analysis showed multiparity (OR 0.52; 95% CI: 0.30-0.90) was associated with reduced odds of obstetric anal sphincter injuries (OASIS), whilst forceps (OR 4.43; 95% CI: 2.02-9.71), longer duration of second stage of labour (OR 1.49; 95% CI: 1.13-1.98), and heavier birthweight (OR 1.001; 95% CI: 1.001-1.001), were associated with increased odds. Adjusted ORs for spontaneous perineal truama were: multiparity (OR 0.42; 95% CI: 0.32-0.56); hospital delivery (OR 1.48; 95% CI: 1.01-2.17); forceps delivery (OR 2.61; 95% CI: 1.22-5.56); longer duration of second stage labour (OR 1.45; 95% CI: 1.28-1.63); and heavier birthweight (OR 1.001; 95% CI: 1.000-1.001). CONCLUSIONS This large prospective study found no evidence for an association between many factors related to midwifery practice such as use of a birthing pool, digital perineal stretching in the second stage, hands off delivery technique, or maternal birth position with incidence of OASIS or spontaneous perineal trauma. We also found a low overall incidence of OASIS, and fewer second degree tears were sutured in the community than in the hospital settings. This study confirms previous findings of overall high incidence of perineal trauma following vaginal delivery, and a strong association between forceps delivery and perineal trauma.
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Affiliation(s)
- Lesley A Smith
- Department Social Work and Public Health, Faculty of Health and Life Sciences, Oxford Brookes University, Jack Straws Lane, Marston, Oxford, OX3 0FL, UK
| | - Natalia Price
- Department of Obstetrics & Gynaecology, Women’s Centre, Oxford University Hospitals Trust, Oxford, OX3 9DU, UK
| | - Vanessa Simonite
- Department of Mechanical Engineering and Mathematical Sciences, Faculty of Technology, Design and Environment, Oxford Brookes University, Wheatley Campus, Wheatley, Oxford, OX33 1HX, UK
| | - Ethel E Burns
- Department Social Work and Public Health, Faculty of Health and Life Sciences, Oxford Brookes University, Jack Straws Lane, Marston, Oxford, OX3 0FL, UK
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Baas C, Wiegers T, de Cock P, Koelewijn J, Hutton E. Continuous Support During Childbirth by Maternity Care Assistants: An Exploration of Opinions in the Netherlands. INTERNATIONAL JOURNAL OF CHILDBIRTH 2013. [DOI: 10.1891/2156-5287.3.2.76] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND:The Netherlands maintain a high rate of home births relative to other well-resourced countries. Maternity care assistants (MCAs) play an important role, as part of the maternity care team, assisting the midwife during birth and providing postpartum care to women and babies in their homes. A Cochrane review recently described the advantages of continuous support during childbirth. We were interested in the opinions of MCAs about them having an expanded role to include continuous emotional support during childbirth as well as medical tasks such as checking the condition of the fetus and maternal labor progress through internal examination.METHODS:To explore the opinions of MCAs, four semistructured group discussions took place and 190 questionnaires were sent out to MCAs nationally.RESULTS:In both the group discussions and questionnaires, MCAs displayed positive attitudes toward providing continuous support during childbirth. In general, MCAs were not keen on adding medical tasks. The importance of a clear distribution of responsibilities between midwives and MCAs was reported. Most (60.0%) thought midwives would appreciate MCAs providing continuous support. Furthermore, 40.5% disagreed with dividing the profession into childbirth care and postpartum care teams. Two-thirds mentioned the need for extra training in childbirth assistance.CONCLUSION:In general, MCAs were positive about providing continuous support during childbirth. Most MCAs think that it is unwise to give MCAs additional medical responsibilities. The opinions differ concerning issues of practical organization. MCAs generally thought extra schooling was important to be and feel competent to assist childbirth.
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Chervenak FA, McCullough LB, Brent RL, Levene MI, Arabin B. Planned home birth: the professional responsibility response. Am J Obstet Gynecol 2013; 208:31-8. [PMID: 23151491 DOI: 10.1016/j.ajog.2012.10.002] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Revised: 09/11/2012] [Accepted: 10/02/2012] [Indexed: 11/27/2022]
Abstract
This article addresses the recrudescence of and new support for midwife-supervised planned home birth in the United States and the other developed countries in the context of professional responsibility. Advocates of planned home birth have emphasized patient safety, patient satisfaction, cost effectiveness, and respect for women's rights. We provide a critical evaluation of each of these claims and identify professionally appropriate responses of obstetricians and other concerned physicians to planned home birth. We start with patient safety and show that planned home birth has unnecessary, preventable, irremediable increased risk of harm for pregnant, fetal, and neonatal patients. We document that the persistently high rates of emergency transport undermines patient safety and satisfaction, the raison d'etre of planned home birth, and that a comprehensive analysis undermines claims about the cost-effectiveness of planned home birth. We then argue that obstetricians and other concerned physicians should understand, identify, and correct the root causes of the recrudescence of planned home birth; respond to expressions of interest in planned home birth by women with evidence-based recommendations against it; refuse to participate in planned home birth; but still provide excellent and compassionate emergency obstetric care to women transported from planned home birth. We explain why obstetricians should not participate in or refer to randomized clinical trials of planned home vs planned hospital birth. We call on obstetricians, other concerned physicians, midwives and other obstetric providers, and their professional associations not to support planned home birth when there are safe and compassionate hospital-based alternatives and to advocate for a safe home-birth-like experience in the hospital.
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Affiliation(s)
- Frank A Chervenak
- Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York, NY, USA
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Affiliation(s)
- Inger Lindberg
- Inger Lindberg Assistant Professor Division of Nursing, Luleå University of Technology, Norrbotten, Sweden
| | - Ellinor Mella
- Ellinor Mella Midwife Maternity services, Björknäs Primary Healthcare Centre, Norrbotten County Council, Sweden
| | - Jessica Johansson
- Jessica Johansson Midwife Department of Maternity care, Sunderby Hospital, Norrbotten County Council, Sweden
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Johnston RG, Brown AE. Maternal trait personality and childbirth: the role of extraversion and neuroticism. Midwifery 2012; 29:1244-50. [PMID: 23039942 DOI: 10.1016/j.midw.2012.08.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2012] [Revised: 07/22/2012] [Accepted: 08/07/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND anxiety during pregnancy and childbirth can increase risk of complications and interventions for both mother and infant. Although considerable work has explored fear of childbirth and anxiety during labour and subsequent birth outcomes there has been less consideration of the role of more stable maternal personality upon childbirth. Traits of neuroticism and extraversion are however predictive of health outcomes in other fields potentially through biological, psychological and social mechanisms. The aim of the current research was thus to examine the relationship between trait personality and childbirth experience. METHODS seven hundred and fifty-five mothers with an infant aged 0-6 months completed a self-report questionnaire including the Ten Item Personality Measure and descriptions of birth experience including mode of birth [vaginal vs. caesarean section] and complications [failure to progress, fetal distress, post-partum haemorrhage, assisted birth and severe tear]. FINDINGS personality traits were significantly associated with birth experience. Specifically mothers scoring low in extraversion and emotional stability were significantly more likely to have a caesarean section and experience a number of complications during labour and birth including an assisted birth, fetal distress, failure to progress and a severe tear. Findings were independent of maternal age, education and parity. CONCLUSIONS the personality traits of extraversion and emotional stability appear to facilitate likelihood of normal birth. Potential explanations for this include biological (physiological reactivity, pain thresholds, oxytocin and dopamine release) and psychological (coping mechanisms, social support, self-efficacy) factors. The findings have important implications for antenatal education and support during labour.
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Affiliation(s)
- R G Johnston
- Department of Interprofessional Studies, College of Human and Health Sciences, Swansea University, SA2 8PP, UK
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Abstract
Labor support is known to support progress of normal labor. Nurses are encouraged to provide labor support yet may encounter barriers to the practice of labor support. The purpose of this secondary data analysis was to examine individual and institutional factors associated with labor support behaviors. Age and experience were individual factors related to labor support. Older and more experienced nurses reported providing more labor support. Institutional factors associated with labor support were lower rates of epidural analgesia use and cesarean surgery. These findings indicate birthing families should understand that the birth environment may influence the care that nurses give during labor. Choosing an environment that supports normal birth may be the best place for receiving labor supportive nursing care.
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Affiliation(s)
- Samantha J Barrett
- SAMANTHA J. BARRETT is a graduate of the Bronson School of Nursing and the Lee Honors College at Western Michigan University in Kalamazoo. She currently works as a critical care nurse at Munson Medical Center in Traverse City, Michigan . MARY ANN STARK is an associate professor in the Bronson School of Nursing at Western Michigan University
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