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Norris G, Hollins Martin CJ, Moylan A, Greig Y. A qualitative descriptive training needs analysis of midwives perceived continuous professional development in providing intranatal respectful maternal care. NURSE EDUCATION TODAY 2024; 136:106144. [PMID: 38471361 DOI: 10.1016/j.nedt.2024.106144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 02/07/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND The Vietnam midwifery report acknowledges that while health services are available in Vietnam, there is growing need to increase levels of respectful maternal care provided to women in labour. OBJECTIVE In conjunction with newborns Vietnam charity, our objective was to assess the perceived continuous professional development needs of midwives working in Vietnam to inform development of an intranatal respectful maternal care education resource. METHOD A qualitative exploratory descriptive method was used to conduct a training needs analysis, which identified perceived education requirements of midwives in Vietnam in relation to providing respectful maternal care. PARTICIPANTS A convenience sample of midwives (n = 49) participated in the study. DATA-COLLECTION Eight on-line focus groups were carried out in four hospitals (maternity units) across Vietnam using WebEx, with the interview schedule informed by the World Health Organization guide for delivering intrapartum care for a positive birth experience. DATA-ANALYSIS Data were transcribed into English and analysed using the 6-steps of thematic analysis outlined by Braun and Clark. FINDINGS Three themes and 9 sub-themes were developed from the data. The first theme addressed aspects that contribute towards creating a positive birth experience; the second theme observed barriers to changing practice; and the third theme noted that there are a variety of preferred teaching methods. CONCLUSIONS In response to the training needs analysis, a respectful maternal care education resource has been designed to transform selected areas of intranatal care in Vietnam. Integrating the respectful maternal care educational resource into midwives' continuous professional development in Vietnam is intended to increase women's rights to have safe childbirth, which accommodates choice and control, and promotes a positive birth experience. RECOMMENDATIONS FOR PRACTICE Post-completion and evaluation, we hope that the intranatal respectful maternal care educational resource will be rolled out to all practising midwives in Vietnam.
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Affiliation(s)
- Gail Norris
- School of Health and Social Care, Edinburgh Napier University (ENU), Sighthill Campus, Edinburgh, Scotland, UK.
| | - Caroline J Hollins Martin
- Maternal Health, School of Health and Social Care, Edinburgh Napier University (ENU), Sighthill Campus, Edinburgh, Scotland, UK.
| | - Anne Moylan
- Advanced Neonatal Practitioner, School of Health and Social Care, Edinburgh Napier University (ENU), Sighthill Campus, Edinburgh, Scotland, UK.
| | - Yvonne Greig
- School of Health and Social Care, Edinburgh Napier University (ENU), Sighthill Campus, Edinburgh, Scotland, UK.
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Tabib M, Humphrey T, Forbes-McKay K. 'Doing' is never enough, if 'being' is neglected. Exploring midwives' perspectives on the influence of an emotional intelligence education programme, a qualitative study. Women Birth 2024; 37:101587. [PMID: 38508067 DOI: 10.1016/j.wombi.2024.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 12/21/2023] [Accepted: 02/04/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND The role of the midwife is emotionally demanding with many midwives experiencing high levels of stress and burnout, and a great number considering leaving the profession. This has serious implications for the delivery of high-quality, safe maternity care. One of the major factors leading to job dissatisfaction is the conflict between midwives' aspiration of truly 'being' with the woman and the institutional expectations of the role which focuses on the 'doing' aspects of the job. 'Being' present to a woman's psychological needs, whilst meeting the institutional demands, requires high levels of emotional intelligence (EI) in the midwife. Therefore, enhancing midwives' EI could be beneficial. EI EDUCATION PROGRAMME An EI programme was made available to midwives with the intention to promote their emotional intelligence and enable them to utilise relaxation techniques for those in their care. AIM To explore midwives' perspectives on the influence of the EI education programme on their emotional wellbeing and experiences of practice. METHOD The study took a descriptive qualitative approach. Thirteen midwives participated in focus group interviews. The data were analysed using thematic analysis. FINDINGS The overarching theme of 'The Ripple Effect' included three themes of 'Me and my relationships', 'A different approach to practice' and 'Confidence and empowerment'. The programme was seen to create a positive ripple effect, influencing midwives personally, their approach to practice, and feelings of confidence in their role. CONCLUSION EI education can reduce emotional stress in midwives, enhance their empathy and feelings of confidence, thus, improving the quality of care they provide.
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Affiliation(s)
- Mo Tabib
- School of Nursing, Midwifery & Paramedic Practice, Robert Gordon University, Garthdee Campus, Garthdee Road, Aberdeen AB10 7AQ, Scotland, UK.
| | - Tracy Humphrey
- Clinical and Health Sciences, University of South Australia, City East Campus, Playford Building, Level 5, Office: P5-03, IPC CEA-17, Adelaide, SA 5001, Australia
| | - Katrina Forbes-McKay
- School of Applied Social Studies, Robert Gordon University, Garthdee Campus, Garthdee Road, Aberdeen AB10 7QG, Scotland, UK
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Long T, Aggar C, Grace S. Trauma-informed care education for midwives: Does education improve attitudes towards trauma-informed care? Midwifery 2024; 131:103950. [PMID: 38359645 DOI: 10.1016/j.midw.2024.103950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 12/13/2023] [Accepted: 02/05/2024] [Indexed: 02/17/2024]
Abstract
INTRODUCTION Continuing education is important to improve midwives' attitudes to trauma-informed care in addressing the needs of women during the perinatal period. This study aimed to evaluate if there was a significant difference in attitudes towards trauma-informed care between midwives who participated in a 2-day trauma-informed care education program and those who did not. METHOD A static group comparison design was adopted with a convenience sample of midwives to analyse differences in attitudes towards trauma-informed care between midwives who received a 2-day TIC education (n = 19, intervention group) and their peers who did not receive the education (n = 18, comparison group). RESULTS The results suggest that midwives who participated in a 2-day trauma-informed care education program had significantly higher scores for positive attitudes towards trauma-informed care compared to those who did not take part in the program and that this effect was sustained at 6 months. CONCLUSION To minimise perinatal trauma for mothers and babies, midwives require specific trauma-informed care education. This study proposes that trauma-informed care education is a foundational pathway for implementing a trauma-informed care framework across a maternity service.
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Affiliation(s)
- Trish Long
- Northern NSW Local Health District, Australia.
| | - Christina Aggar
- Northern NSW Local Health District, Australia; Southern Cross University, Faculty of Health, Australia
| | - Sandra Grace
- Southern Cross University, Faculty of Health, Australia
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Keedle H, Lockwood R, Keedle W, Susic D, Dahlen HG. What women want if they were to have another baby: the Australian Birth Experience Study (BESt) cross-sectional national survey. BMJ Open 2023; 13:e071582. [PMID: 37666545 PMCID: PMC10496680 DOI: 10.1136/bmjopen-2023-071582] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 08/04/2023] [Indexed: 09/06/2023] Open
Abstract
OBJECTIVES To explore if Australian women would do anything differently if they were to have another baby. DESIGN AND SETTING The Birth Experience Study (BESt) online survey explored pregnancy, birth and postnatal experiences for women who had given birth during 2016-2021 in Australia. PARTICIPANTS In 2021, 8804 women responded to the BESt survey and 6101 responses to the open text responses to the survey question 'Would you do anything different if you were to have another baby?' were analysed using inductive content analysis. RESULTS A total of 6101 women provided comments in response to the open text question, resulting in 10 089 items of coding. Six categories were found: 'Next time I'll be ready' (3958, 39.2%) described how women reflected on their previous experience, feeling the need to better advocate for themselves in the future to receive the care or experience they wanted; 'I want a specific birth experience' (2872, 28.5%) and 'I want a specific model of care' (1796, 17.8%) highlighted the types of birth and health provider women would choose for their next pregnancy. 'I want better access' (294, 2.9%) identified financial and/or geographical constraints women experience trying to make choices for birth. Two categories included comments from women who said 'I don't want to change anything' (1027, 10.2%) and 'I don't want another pregnancy' (142, 1.4%). Most women birthed in hospital (82.9%) and had a vaginal birth (59.2%) and 26.7% had a caesarean. CONCLUSION Over 85% of comments left by women in Australia were related to making different decisions regarding their next birth choices. Most concerningly women often blamed themselves for not being more informed. Women realised the benefits of continuity of care with a midwife. Many women also desired a vaginal birth as well as better access to birthing at home.
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Affiliation(s)
- Hazel Keedle
- School of Nursing and Midwifery, Western Sydney University, Penrith South, New South Wales, Australia
| | - Risharda Lockwood
- School of Nursing and Midwifery, Western Sydney University, Penrith South, New South Wales, Australia
| | - Warren Keedle
- School of Nursing and Midwifery, Western Sydney University, Penrith South, New South Wales, Australia
| | - Daniella Susic
- Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Hannah G Dahlen
- School of Nursing and Midwifery, Western Sydney University, Penrith South, New South Wales, Australia
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Emmens B, Hollins Martin CJ, Martin CR. Translation and validation of the Dutch version of the Birth Satisfaction Scale-Revised (BSS-R). J Reprod Infant Psychol 2023; 41:213-227. [PMID: 34792408 DOI: 10.1080/02646838.2021.1979200] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Recent observations suggest birth satisfaction may be significantly associated with postpartum post-traumatic stress disorder (PP-PTSD). The Birth Satisfaction Scale-Revised (BSS-R) is increasingly used Internationally as a short, valid and reliable multi-dimensional measure of birth experience. The current study sought to develop a Dutch version of the BSS-R (D-BSS-R) for clinical and research application in the Netherlands. METHODS Post-translation, a cross-sectional design with an embedded between-subjects component was used to evaluate key indices of validity and reliability of the D-BSS-R in a purposive sampled cohort of 244 Dutch-speaking women in the Netherlands. Confirmatory factor analysis, divergent, convergent and known-groups discriminant validity were evaluated as was the internal consistency of the measure. RESULTS The D-BSS-R was found to be a generally valid and reliable measure of birth experience with the key measurement characteristics of the original English-language measure transferring well to the Dutch context. Statistically significant negative correlations were observed between all D-BSS-R sub-scales and a validated measure of PTSD. CONCLUSIONS The D-BSS-R represents a valid and reliable measure of birth experience suitable and appropriate for use in the Netherlands. The study corroborates previous suggestions of linkage between birth satisfaction and PP-PTSD using a robust and diagnostically valid measure of trauma.
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Affiliation(s)
- Berbel Emmens
- Independent Researcher, Counselor, MSc Applied Psychology
| | - Caroline J Hollins Martin
- Maternal Health, School of Nursing, Midwifery and Social Care Edinburgh Napier University, Scotland, UK
| | - Colin R Martin
- Institute for Health and Wellbeing, University of Suffolk, Ipswich, UK
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Darwin Z, Blower SL, Nekitsing C, Masefield S, Razaq R, Padgett L, Endacott C, Willan K, Dickerson J. Addressing inequalities in the identification and management of perinatal mental health difficulties: The perspectives of minoritised women, healthcare practitioners and the voluntary sector. Front Glob Womens Health 2022; 3:1028192. [PMID: 36619590 PMCID: PMC9813385 DOI: 10.3389/fgwh.2022.1028192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
Background Perinatal mental health (PMH) difficulties affect approximately one in five birthing women. If not identified and managed appropriately, these PMH difficulties can carry impacts across generations, affecting mental health and relationship outcomes. There are known inequalities in identification and management across the healthcare pathway. Whilst barriers and facilitators have been identified there is a lack of clarity about how these relate to the avoidable and unfair inequalities experienced by various groups of women. Further research is required to understand how to address inequalities in PMH. Aim To understand the key factors that enable and hinder access to PMH care for women from minoritised groups across the PMH care pathway, and how these have been affected by the COVID-19 pandemic. Methods A sequential mixed-methods approach gathered views and experiences from stakeholders in one region in northern England. This included an online survey with 145 NHS healthcare practitioners and semi-structured interviews with 19 women from ethnic minority and/or socio-economically deprived backgrounds who had experienced PMH difficulties, and 12 key informants from the voluntary and community sector workforce. Quantitative data were analysed using descriptive statistics and framework analysis was applied to qualitative data. Findings Barriers and facilitators were mapped using a socio-technical framework to understand the role of (i) processes, (ii) people (organised as women, practitioners and others), (iii) technology, and (iv) the system as a whole in deepening or alleviating inequalities. Influences that were identified as pertinent to inequalities in identification and management included provision of interpreters, digital exclusion, stigma, disempowerment, distrust of services, practitioner attitudes, data capture, representation in the workforce, narrow rules of engagement and partnership working. Stakeholder groups expressed that several barriers were further compounded by the COVID-19 pandemic. Discussion The findings highlight the need for change at the system level to tackle inequalities across the PMH care pathway. Four inter-connected recommendations were developed to enable this systems change: building emotional safety between professionals and women; making PMH a part of core healthcare business; increasing cultural competency specific to PMH; and enhanced partnership working.
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Affiliation(s)
- Zoe Darwin
- School of Human and Health Sciences, Department of Allied Health Professions, Sport and Exercise, University of Huddersfield, Huddersfield, United Kingdom,Correspondence: Zoe Darwin Sarah Blower
| | - Sarah L. Blower
- Department of Health Sciences, Faculty of Sciences, University of York, York, United Kingdom,Correspondence: Zoe Darwin Sarah Blower
| | - Chandani Nekitsing
- Department of Health Sciences, Faculty of Sciences, University of York, York, United Kingdom
| | - Sarah Masefield
- Department of Health Sciences, Faculty of Sciences, University of York, York, United Kingdom
| | - Rifat Razaq
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, United Kingdom
| | - Louise Padgett
- Department of Health Sciences, Faculty of Sciences, University of York, York, United Kingdom
| | - Charlotte Endacott
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, United Kingdom
| | - Kathryn Willan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, United Kingdom
| | - Josie Dickerson
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, United Kingdom
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Ayawine A, Atinga RA. User and community coping responses to service delivery gaps in emergency obstetric care provision in a rural community in Ghana. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e4513-e4521. [PMID: 35611655 DOI: 10.1111/hsc.13855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 04/04/2022] [Accepted: 05/05/2022] [Indexed: 06/15/2023]
Abstract
The study sought to explore user and community responses to service delivery gaps in emergency obstetric care provision in rural Ghana. A qualitative design was employed to draw evidence from observations, interviews and focus group discussion among healthcare providers, clients and community members. Data processing and analysis followed a thematic approach. Findings reveal community interference in obstetric care delivery processes, reliance on unskilled providers, recourse to local oxytocin use, non-compliance to prescribed treatment and mistrust in healthcare providers as user and community coping mechanisms to perceived poor quality obstetric care. These behaviours have serious consequences on the life chances of pregnant and parturient women. The need to adapt to a more responsive and affordable maternal healthcare delivery system is essential for uptake of services in rural areas. Also, standardised guidelines to regulate health worker behaviour is critical to instil trust in the healthcare system.
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Affiliation(s)
- Alice Ayawine
- Faculty of Health and Allied Sciences, Catholic University College, Fiapre-Sunyani, Ghana
| | - Roger A Atinga
- Department of Public Administration and Health Services Management, University of Ghana Business School, Accra, Ghana
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Factors that influence father’s experiences of childbirth and their implications upon postnatal mental health: a narrative systematic review. Nurse Educ Pract 2022; 65:103460. [DOI: 10.1016/j.nepr.2022.103460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 09/23/2022] [Indexed: 11/20/2022]
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Molise NA, Botma Y, VanJaarsveldt D. Exploring the influence of culture in curriculum transformation using the Mmogo Method™. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022. [DOI: 10.1016/j.ijans.2022.100448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Turner S, Crowther S, Lau A. A grounded theory study on midwifery managers' views and experiences of implementing and sustaining continuity of carer models within the UK maternity system. Women Birth 2021; 35:e421-e431. [PMID: 34810140 DOI: 10.1016/j.wombi.2021.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 10/23/2021] [Accepted: 10/23/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Current UK health policy recommends the transition of maternity services towards provision of Midwifery Continuity of Carer (MCoCer) models. Quality of healthcare is correlated with the quality of leadership and management yet there is little evidence available to identify what is required from midwifery managers when implementing and sustaining MCoCer. AIM To develop a theoretical framework that represents midwifery managers' experiences of implementing and sustaining MCoCer models within the UK's National Health Service (NHS). METHODS Charmaz's grounded theory approach was used for this study. Five experienced UK based midwifery managers were interviewed to elicit views and understanding of the social processes underlying the implementation and sustaining of MCoCer. Interviews were transcribed and analysed and focus codes developed into theoretical codes resulting in an emergent core category. FINDINGS The theoretical framework illustrates the core category 'Leading Meaningful Midwifery'. To manage MCoCer models midwifery managers require a trust and belief in woman centred philosophy of care. They need the skills to focus on non-hierarchical transformational leadership and the courage to assimilate alternative models of care into the NHS. Promoting and protecting the MCoCer model within current services is essential whilst forming a culture based on high quality, safe MCoCer. DISCUSSION MCoCer models that have sustained within the NHS have had supportive leadership from midwifery managers who have the necessary skills, attitudes, aptitudes and behaviours identified within the findings. Sustainable implementation of MCoCer is achieved through development of a values-based recruitment and retention policy within all areas of midwifery and encouraging midwives with previous experience in MCoCer or supportive philosophies towards it, to manage the model. CONCLUSION Providing the appropriate support for MCoCer is time consuming and personally demanding for midwifery managers, however, implementing and sustaining MCoCer was shown by participants who valued MCoCer models to be rewarding, bringing meaning to their midwifery leadership.
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Affiliation(s)
- Sarah Turner
- NHS Education for Scotland, Westport, Edinburgh, United Kingdom.
| | | | - Annie Lau
- Robert Gordon University, United Kingdom.
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Long T, Aggar C, Grace S, Thomas T. Trauma informed care education for midwives: An integrative review. Midwifery 2021; 104:103197. [PMID: 34788724 DOI: 10.1016/j.midw.2021.103197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 10/26/2021] [Accepted: 10/29/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Nearly half of new mothers describe their childbirth as traumatic. Perinatal trauma impacts both short and long-term biopsychosocial outcomes for mother and child. Midwife trauma-informed care education and practice is essential to mitigate this risk. OBJECTIVE This review aimed to identify and describe the nature and extent of trauma informed care education provided for midwives and midwifery students. DESIGN An integrative review. METHODS Five databases (Medline, Embase, CINAHL, Psycinfo, and Emcare) were searched to identify primary research regarding trauma informed care education for midwives and midwifery students. Quality appraisal was conducted using the Mixed Methods Appraisal Tool. RESULTS Three papers were identified. None of the papers were midwifery focused, with midwives representing a small proportion of the participants. Most midwives reported receiving no previous trauma informed care education and lacked confidence to provide quality care to women with lived trauma. Midwives reported trauma informed care education as essential and relevant for providing quality practice. Improvements in knowledge, skills and attitudes was demonstrated following trauma informed care education. More in-depth content and content delivered in multiple ways were recommended. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Midwives are well placed to deliver trauma informed care. Trauma informed care education for midwives is limited. Given the impact of perinatal trauma, further trauma informed care education and research is paramount.
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Affiliation(s)
- Trish Long
- Northern New South Wales Local Health District, 89 Tamar St, Ballina NSW 2478 Australia.
| | - Christina Aggar
- Northern New South Wales Local Health District, 89 Tamar St, Ballina NSW 2478 Australia; Southern Cross University, School of Health & Human Sciences, School of Health & Human Sciences, Southern Cross Drive, Bilinga QLD 4225 Australia
| | - Sandra Grace
- Southern Cross University, School of Health & Human Sciences, School of Health & Human Sciences, Southern Cross Drive, Bilinga QLD 4225 Australia
| | - Tamsin Thomas
- Southern Cross University, School of Health & Human Sciences, School of Health & Human Sciences, Southern Cross Drive, Bilinga QLD 4225 Australia
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Aydın R, Aktaş S. Midwives' experiences of traumatic births: A systematic review and meta-synthesis. Eur J Midwifery 2021; 5:31. [PMID: 34386725 PMCID: PMC8312097 DOI: 10.18332/ejm/138197] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 02/25/2021] [Accepted: 05/24/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Midwives experiencing traumatic births are emotionally affected by this process, lose their self-confidence, and may intend to leave the profession. This study aims to carry out a meta-synthesis of current qualitative research exploring the experiences of midwives witnessing traumatic births. METHODS The meta-synthesis consisted of 18 full-text studies in English, obtained from PubMed, Scopus, Web of Sciences, Cumulative Index of Nursing and Allied Health Literature (CINAHL), EMBASE, and PsycINFO databases. The results of the studies were analyzed using the thematic analysis technique. The study includes qualitative, mixedmethod, and full-text studies published between 2000 and 2020 that explored the experiences of midwives and obstetric nurses witnessing birth trauma. RESULTS The thematic analysis identified seven themes: post-traumatic feelings, posttraumatic stress symptoms, the impact of trauma on professional values, social support, learning from experience, legal process, and reflection of emotions of women experiencing traumatic birth on the midwife. CONCLUSIONS Midwives who witnessed traumatic birth were mostly emotionally affected. They lost their self-confidence and intended to leave their profession. They emphasized the importance of peer support through which they could share their experiences after trauma. Psychological education should be provided to midwives who witness the trauma by specialists, and midwives should be strengthened against the effects of trauma in terms of both the institutional policies where the birth takes place and midwifery-specific legal policies.
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Affiliation(s)
- Ruveyde Aydın
- Department of Birth, Women Health and Disease Nursing, Faculty of Health Sciences, Karadeniz Technical University, Trabzon, Turkey
| | - Songül Aktaş
- Department of Birth, Women Health and Disease Nursing, Faculty of Health Sciences, Karadeniz Technical University, Trabzon, Turkey
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Curtin M, Savage E, Murphy M, Leahy-Warren P. A meta-synthesis of the perspectives and experiences of healthcare professionals on the humanisation of childbirth using a meta-ethnographic approach. Women Birth 2021; 35:e369-e378. [PMID: 34274257 DOI: 10.1016/j.wombi.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 07/03/2021] [Accepted: 07/05/2021] [Indexed: 11/25/2022]
Abstract
PROBLEM The humanisation of childbirth has been identified as a practice of care focusing on the physical, psychological, and emotional wellbeing of women. Healthcare professionals (HCPs) are expected to understand and embed humanised practice when supporting women in childbirth. AIM The aim of this paper is to present a meta-synthesis of the experiences and perspectives of HCPs who undertake care for women at the time of birth regarding the humanisation of childbirth. METHODS A systematic search of the electronic databases CINAHL, Medline, PsycINFO, and SocINDEX were conducted in July 2020. Qualitative studies exploring HCPs' experiences and perspectives of humanisation in childbirth were eligible. Studies were synthesised using a meta-ethnographic approach. FINDINGS Fourteen studies involving 197 participants were included. Two themes were identified: 'Women at the centre' and 'Professional dissonance'. Two line of argument synthesis were identified: 'invisible boundaries' and 'unconscious undermining'. DISCUSSION HCPs recognised that women required positive interactions which met both their emotional and physical needs. Human touch supported bonding between HCPs and women. HCPs understood humanisation as the reduction of unnecessary intervention and/or technology but had difficulties enacting this and often used disempowering language when discussing women's choices. The management of pain and the presence of a companion were considered important by HCPs. CONCLUSION This synthesis revealed that HCPs do understand the humanisation of childbirth but have difficulties in enacting it in practice. Women classified as high risk were identified as having specific needs such as increased emotional support. Further research is required for women classified as high risk who may require technology and/or interventions to maintain a safe birth.
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Affiliation(s)
- Mary Curtin
- School of Nursing, Midwifery and Health Systems, University College Dublin, Ireland; School of Nursing and Midwifery, University College Cork, Ireland.
| | - Eileen Savage
- School of Nursing and Midwifery, University College Cork, Ireland. https://twitter.com/@EileenSavage20
| | - Margaret Murphy
- School of Nursing and Midwifery, University College Cork, Ireland. https://twitter.com/@mgtmurphy123
| | - Patricia Leahy-Warren
- School of Nursing and Midwifery, University College Cork, Ireland. https://twitter.com/@pleahy_w
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Akin B, Yurteri Türkmen H, Yalnız Dilcen H, Sert E. The Effect of Labor Dance on Traumatic Childbirth Perception and Comfort: A Randomized Controlled Study. Clin Nurs Res 2021; 31:909-917. [PMID: 34229473 DOI: 10.1177/10547738211030745] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aims to evaluate the effect of labor dance on traumatic childbirth perception and comfort. This is a randomized controlled experimental study. The study was conducted with 120 primiparous pregnant women (60 in experiment group, 60 in control group). The pregnant women in the experiment group performed labor dance with the researcher midwife during the active phase of labor. The researcher implemented the Childbirth Comfort Questionnaire (CCQ) when the cervical dilation was 8 cm. The Postpartum Comfort Scale (PCS) and Traumatic Childbirth Perception Scale (TCPS) were implemented almost 2 hours after giving birth. The scores of the women in the experiment group in TCPS were significantly lower than those in the control group while their mean scores in CCQ and PCS were significantly higher. Labor dance contributed to the women's more positive childbirth experiences, perceptions of childbirth as less traumatic, and increased their comfort levels.
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AKIN B, YILMAZ S, ALAKAŞ E. The Relation Between Emphatic Tendency and Level of Compassion in the Midwifery Students. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2021. [DOI: 10.33808/clinexphealthsci.785324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Harrison SE, Ayers S, Quigley MA, Stein A, Alderdice F. Prevalence and factors associated with postpartum posttraumatic stress in a population-based maternity survey in England. J Affect Disord 2021; 279:749-756. [PMID: 33234280 PMCID: PMC7758780 DOI: 10.1016/j.jad.2020.11.102] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/10/2020] [Accepted: 11/12/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Studies on prevalence and factors associated with postpartum posttraumatic stress (PTS) typically do not distinguish between PTS related to childbirth (PTS-C) and PTS related to other stressors (PTS-O). This study aimed to describe the prevalence, clinical characteristics, and factors associated with PTS-C and PTS-O in postpartum women. METHODS The study was a cross-sectional population-based survey of 16,000 postpartum women, selected at random from birth registrations in England to receive a postal questionnaire, including the Primary Care Posttraumatic Stress Disorder Screen. RESULTS Questionnaires were returned by 4,509 women. The median age was 32 years (IQR=29-36), 64% were married, 77% were UK-born, and 76% were White-British. Prevalence of PTS-C was 2.5% (95%CI:2.0-3.0) and prevalence of PTS-O was 6.8% (95%CI:6.0-7.8). Women with PTS-C were significantly more likely to report re-experiencing symptoms (Chi-Square=7.69,p<0.01). Factors associated with PTS-C were: higher level of deprivation, not having a health professional to talk to about sensitive issues during pregnancy, and the baby being admitted for neonatal intensive care. Factors associated with PTS-O were: age ≤24 years, depression during pregnancy, and having a pregnancy affected by long-term health problems. Factors associated with both were: living without a partner, anxiety during pregnancy, pregnancy-specific health problems, and lower birth satisfaction. CONCLUSIONS PTS during the postpartum period is relatively common and, for many women, unrelated to childbirth. Increased awareness among health professionals of prevalence, clinical characteristics and factors associated with postpartum PTS-C and PTS-O will aid the development of appropriate management protocols to identify and support women during the perinatal period. Posttraumatic stress, posttraumatic stress disorder, postpartum PTSD/PTS, birth-related PTSD/PTS, birth trauma, perinatal mental health.
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Affiliation(s)
- SE Harrison
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, UK,Corresponding author: NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford OX3 7LF
| | - S Ayers
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, UK
| | - MA Quigley
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, UK
| | - A Stein
- Department of Psychiatry, Medical Sciences Division, University of Oxford, UK
| | - F Alderdice
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, UK
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Women's experiences of birth trauma: A scoping review. Women Birth 2020; 34:417-424. [PMID: 33020046 DOI: 10.1016/j.wombi.2020.09.016] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/09/2020] [Accepted: 09/22/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND A high number of Australian women report experiencing traumatic birth events. Despite high incidence and potential wide spread and long-lasting effects, birth trauma is poorly recognised and insufficiently treated. Birth trauma can trigger ongoing psychosocial symptoms for women, including anxiety, tokophobia, bonding difficulties, relationship issues and PTSD. Additionally, women's future fertility choices can be inhibited by birth trauma. AIM To summarize the existing literature to provide insight into women's experiences of birth trauma unrelated to a specific pre-existing obstetric or contextual factor. METHODS The review follows 5 stages of Arksey and O'Malley's framework. 7 databases were searched using indexed terms and boolen operators. Data searching identified 1354 records, 5 studies met inclusion criteria. FINDINGS Three key themes emerged; (1) health care providers and the maternity care system. (2) Women's sense of knowing and control. (3) Support. DISCUSSION Continuity of carer creates the foundations for facilitative interactions between care provider and woman which increases the likelihood of a positive birth experience. Women are able to gain a sense of feeling informed and being in control when empowering and individualized care is offered. Functional social supports and forms of debriefing promotes psychological processing and can enable post traumatic growth. CONCLUSION Existing literature highlights how birth trauma is strongly influenced by negative health care provider interactions and dysfunctional operation of the maternity care system. A lack of education and support limited informed decision-making, resulting in feelings of losing control and powerlessness which contributes to women's trauma. Insufficient support further compounds women's experiences.
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Pezaro S, Patterson J, Moncrieff G, Ghai I. A systematic integrative review of the literature on midwives and student midwives engaged in problematic substance use. Midwifery 2020; 89:102785. [PMID: 32570093 DOI: 10.1016/j.midw.2020.102785] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 05/20/2020] [Accepted: 06/13/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The objective of this systematic integrative review was to review the literature in relation to problematic substance use (PSU) in midwifery populations. Associated aims were to aggregate existing knowledge about midwives and student midwives' personal engagement in PSU, to generate a holistic conceptualisation and synthesis of the existing literature regarding midwives and student midwives personally engaged in PSU and to present new understandings and perspectives to inform the development of future research questions. This review is the first of its kind. DESIGN Systematic searches were conducted in CINAHL, Academic Search Complete, MEDLINE, PSYCInfo, Scopus and the Cochrane Library. Findings were grouped into themes and subthemes relating to both midwives and student midwives and then analysed critically in relation to the wider literature. A quality assessment was conducted using the Mixed Methods Appraisal Tool (MMAT). The PRISMA statement was used to guide reporting. SETTING Included studies were conducted in Scotland, Ireland, Australia and New Zealand. PARTICIPANTS Studies included a total of 6,182 participants. FINDINGS A total of 3 studies were included. All included study types comprised quantitative survey designs, yet one also included a mixed methods design with the use of semi structured interviews. Two overarching themes emerged relating to both midwives and student midwives engaged in problematic substance use. For midwives, three subthemes are described: harmful daily alcohol consumption, working hours and harmful daily alcohol consumption and features associated with harmful daily alcohol consumption. For student midwives, two subthemes are presented: escape avoidance and alcohol, tobacco and cannabis use. KEY CONCLUSIONS There is limited evidence available in relation to problematic substance use in midwifery populations in comparison to that available for other healthcare populations. Further research is required, and could usefully focus upon midwives and student midwives as distinct professions to be separated out from the wider healthcare workforce. IMPLICATIONS FOR PRACTICE Problematic substance use among the healthcare workforce is associated with an increase in medical errors and inadequate care. Those affected can be reluctant to seek help, experience psychological distress and even contemplate suicide. Whilst evidence remains lacking for midwifery populations, they form a part of the general healthcare workforce and are exposed to similar workplace stressors. As such, it is likely that they too would be affected in similar ways.
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Affiliation(s)
- Sally Pezaro
- School of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Coventry University, Coventry CV1 5FB, England.
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