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Women's sense of control during labour and birth with epidural analgesia: A qualitative descriptive study. Midwifery 2023; 116:103496. [PMID: 36223662 DOI: 10.1016/j.midw.2022.103496] [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: 11/23/2021] [Revised: 09/08/2022] [Accepted: 09/25/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Sense of control during childbirth is a critical issue concerning the association between high-quality maternity care and infant health. This study explored the facilitators of or barriers to a sense of control and the need for interventions to raise women's experience in childbirth. METHODS The data came from 17 participants. Data collection was conducted in the childbirth room and within three days following childbirth, respectively. For tackling the research problems, participant observation and interviewing were applied. Thematic analysis was applied to the data analyzed. RESULTS Two themes were identified: (1) facilitators of or barriers to practice a sense of control and (2) Care needed for a sense of control. The effectiveness of a sense of control is related to energy refill, mental loading subsided, control over decisions, non-pharmacological usage, and support from the meaningful person. Care needed includes showing empathy, providing information, using complementary pain-relief strategies, and adjusting care by parturient conditions. CONCLUSION This study highlights the influencing factors and interventions relating to women's sense of control during childbirth with epidural analgesia. The findings suggest that many approaches, such as white noise, benefit women's sense of control after an epidural. Using non-pharmacological methods, such as a birth ball, should be appropriately regulated by situations to enhance women's sense of control. Through the assessment, education, attention to maternal needs, and recognizing the barriers to a sense of control, women will benefit from the interventions designed to improve their sense of control during childbirth.
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Heim MA, Makuch MY. Breathing Techniques During Labor: A Multinational Narrative Review of Efficacy. J Perinat Educ 2023; 32:23-34. [PMID: 36632511 PMCID: PMC9822559 DOI: 10.1891/jpe-2021-0029] [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: 01/07/2023] Open
Abstract
We conducted a narrative review to assess the use and effectiveness of breathing techniques for pain control as the only non-pharmacological resource during labor and childbirth. A search was conducted using PubMed, PEDro, SciELO, and Scopus with publications between January 2005 and September 2021 in English, Portuguese, or Spanish. Seven publications were selected. Most of the articles reported on the use of slow and deep breathing during contractions in the first stage of labor and breathing associated with pushing-down efforts in the second stage. The information regarding the moment when guidance on the use of the techniques was provided varied across studies. According to the reviewed papers, breathing techniques offer benefits for women in labor without adverse effects on newborns.
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Dwekat IMM, Ismail TAT, Ibrahim MI, Ghrayeb F, Abbas E. Mistreatment of Women during Childbirth and Associated Factors in Northern West Bank, Palestine. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13180. [PMID: 36293759 PMCID: PMC9602547 DOI: 10.3390/ijerph192013180] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/07/2022] [Accepted: 10/09/2022] [Indexed: 06/16/2023]
Abstract
Mistreatment of women during childbirth is a clear breach of women's rights during childbirth. This study aimed to determine the prevalence and associated factors of mistreatment of women during childbirth in the north of West Bank, Palestine. A cross-sectional study was conducted among 269 women within the first 16 weeks of their last vaginal childbirth to understand the childbirth events by using proportionate stratified random sampling. An Arabic valid questionnaire was used as a study instrument. Simple and multiple logistic regression analyses were conducted to determine the factors associated with each type of mistreatment. The mean age of the women was 26.5 (SD 4.77) years. The overall prevalence of mistreatment was 97.8%. There were six types of mistreatment. Nine factors were significantly associated with the occurrence of one or more types of mistreatment. Delivery at a public childbirth facility was associated with all of the six types (aAdjOR: 2.17-16.77; p-values < 0.001-0.013). Women who lived in villages (aAdjOR 2.33; p-value = 0.047), had low education (aAdjOR 5.09; p-value = 0.004), underwent induction of labour (aAdjOR 3.03; p-value = 0.001), had a long duration of labour (aAdjOR 1.10; p-value = 0.011), did not receive pain killers (aAdjOR: 2.18-3.63; p-values = 0.010-0.020), or had an episiotomy or tear (aAdjOR 5.98; p-value < 0.001) were more likely to experience one or more types of mistreatment. With every one-hour increase in the duration of labor, women were 1.099 times more likely to experience a failure to meet the professional standard of care. Women were less likely to experience mistreatment with increasing age. Women with increasing age (aAdjOR: 0.91-0.92; p-values = 0.003-0.014) and parity (aAdjOR 0.72; p-value = 0.010) were less likely to experience mistreatment. Awareness of women's fundamental rights during childbirth, making the childbirth process as normal as possible, and improving the childbirth facilities' conditions, policies, practices and working environment may decrease mistreatment occurrence.
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Affiliation(s)
- Ibtesam Medhat Mohamad Dwekat
- Department of Community Medicine, Universiti Sains Malaysia, Kota Bharu 16150, Kelantan, Malaysia
- Faculty of Health Professions, Al-Quds University, Jerusalem 51000, Palestine
| | | | - Mohd Ismail Ibrahim
- Department of Community Medicine, Universiti Sains Malaysia, Kota Bharu 16150, Kelantan, Malaysia
| | - Farid Ghrayeb
- Faculty of Health Professions, Al-Quds University, Jerusalem 51000, Palestine
| | - Eatimad Abbas
- Faculty of Health Professions, Al-Quds University, Jerusalem 51000, Palestine
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EXAMINATION OF THE PSYCHOMETRIC PROPERTIES OF THE TURKISH VERSION OF THE PREPARATION FOR LABOR AND BIRTH (P-LAB) INSTRUMENT. Midwifery 2022; 113:103439. [DOI: 10.1016/j.midw.2022.103439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 07/22/2022] [Accepted: 07/27/2022] [Indexed: 11/18/2022]
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Tuglo LS, Agbadja C, Bruku CS, Kumordzi V, Tuglo JD, Asaaba LA, Agyei M, Boakye C, Sakre SM, Lu Q. The Association Between Pregnancy-Related Factors and Health Status Before and After Childbirth With Satisfaction With Skilled Delivery in Multiple Dimensions Among Postpartum Mothers in the Akatsi South District, Ghana. Front Public Health 2022; 9:779404. [PMID: 35178369 PMCID: PMC8843932 DOI: 10.3389/fpubh.2021.779404] [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: 09/18/2021] [Accepted: 12/21/2021] [Indexed: 11/20/2022] Open
Abstract
Background Skilled delivery has been a pronounced concern and has been investigated over the years in developing countries. An inclusive understanding of the satisfaction of postpartum mothers is vital in improving the quality of skilled delivery, which is beneath the standard in some parts of developing countries. This study assessed the association between pregnancy-related factors and health status before and after childbirth with satisfaction with skilled delivery in multiple dimensions among postpartum mothers in the Akatsi South District, Ghana. Methods A community-based, cross-sectional study was conducted among 538 postpartum mothers who participated through the systematic sampling method. Data collection was performed through a pretested and structured questionnaire developed from the WHO responsiveness concept and other prior studies. Questions on satisfaction were categorized into six dimensions. The associations were determined using bivariable and multivariable logistic regression analyses. Results The overall satisfaction of postpartum mothers with skilled delivery was 80.7%. The highest (89.6%) and the lowest (12.8%) satisfaction with skilled delivery were found in technical quality and financial dimensions. Analysis revealed that autonomously age and delivery procedure were significantly associated with the dimensions of communication and responsiveness. Postpartum mothers who delivered at private healthcare facilities [crude odds ratio (COR) = 1.70; (95% CI 1.00–2.90); p = 0.049] had preterm pregnancy before delivery [COR = 2.08; (95% CI 1.02–4.21); p = 0.043], had cesarean section [COR = 2.73; (95% CI 1.05–7.12); p = 0.040], and presented with complications after childbirth [COR = 2.63; (95% CI 1.09–6.35); p = 0.032] were more likely to be satisfied in the dimension of communication only compared to their counterparts. Regarding responsiveness, multiparous mothers [COR = 1.63; (95% CI 1.06–2.51); p = 0.007] were more likely to be satisfied than primiparous mothers. Overall satisfaction was significantly and positively correlated with the various dimensions of skilled delivery. Conclusions The majority were satisfied with five dimensions of satisfaction with skilled delivery except for the financial dimension. The District Health Directorate of Akatsi South should take into consideration these findings in their policy development for forward-looking skilled delivery.
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Affiliation(s)
- Lawrence Sena Tuglo
- Department of Epidemiology, School of Public Health, Nantong University, Nantong, China.,Department of Nutrition and Dietetics, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana.,Diettherapy Department, Ho Teaching Hospital, Ho, Ghana
| | - Comfort Agbadja
- Department of Midwifery, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Cynthia Sekyere Bruku
- Department of Midwifery, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana.,Obstetrics and Gynaecology Department, Saint (ST) Dominic Hospital, Akwatia, Ghana
| | - Vivian Kumordzi
- Department of Midwifery, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana.,Ashaiman Municipal Health Directorate, Ashaiman, Ghana
| | - Jessica Dzigbordi Tuglo
- Department of Midwifery, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana.,Community Health Department, Evangelical Presbyterian Mimi Clinic, Adaklu, Ghana
| | - Leticia Atiah Asaaba
- Department of Midwifery, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana.,Maternity Department, Madina Polyclinic Kekele, Madina, Ghana
| | - Mercy Agyei
- Department of Midwifery, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana.,Maternity Department, Ga South Municipal Hospital, Waija, Ghana
| | - Cynthia Boakye
- Department of Midwifery, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana.,Maternity Department, Eastern Regional Hospital, Koforidua, Ghana
| | | | - Qingyun Lu
- Department of Child and Adolescent Health, School of Public Health, Nantong University, Nantong, China
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Childbirth Readiness Scale (CRS): instrument development and psychometric properties. BMC Pregnancy Childbirth 2022; 22:257. [PMID: 35346093 PMCID: PMC8958764 DOI: 10.1186/s12884-022-04574-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 03/08/2022] [Indexed: 11/10/2022] Open
Abstract
Background Childbirth preparation plays an important role in reducing maternal mortality and improving women’s childbirth experience. Evaluating childbirth readiness levels before and after interventions provides a basis for formulating more targeted and effective interventions. However, existing tools only assess partial childbirth preparation or have limited evidence of reliability and validity. The aim of this study was thus to develop a new instrument for use during the third trimester to comprehensively assess the readiness level of pregnant women, and test the scale’s psychometric properties. Methods The scale was developed through exploratory mixed methods including qualitative and quantitative phases. A literature review and in-depth semi-structured interviews were utilized to identify the scale items. A Delphi expert consultation evaluated the content validity. Psychometric testing was conducted in a convenience sample of 731 pregnant women in the third trimester (recruited from 3 tertiary hospitals in Hubei province in China). Item analysis was used to screen items; exploratory factor analysis was performed to extract factors; confirmatory factor analysis was performed to evaluate fit on the factor structures. Results The final scale consisted of four dimensions and 18 items that explained 65.8% of the total variance. Confirmative factor analysis (CFA) model showed that the 4-factor model fits the data well. The total Cronbach alpha coefficient of the total scale and 4 factors was 0.935 and 0.853–0.914. The split-half reliability was 0.880. The dimensions comprised “Self-management”, “Information literacy”, “Birth confidence” and “Birth plan”. Conclusions The childbirth readiness scale we developed has good reliability and validity, and can be used to comprehensively assess the readiness level of pregnant women. In addition to understanding the overall level of women’s childbirth readiness, using subscale scores, improvements can be targeted to specific areas of the preparation for childbirth, to improve the efficiency of the intervention.
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Neerland CE, Skalisky AE. A Qualitative Study of US Women's Perspectives on Confidence for Physiologic Birth in the Birth Center Model of Prenatal Care. J Midwifery Womens Health 2022; 67:435-441. [PMID: 35246924 DOI: 10.1111/jmwh.13349] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 01/19/2022] [Accepted: 01/21/2022] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The purpose of this study was to increase understanding of the components of the US birth center model of prenatal care and how the birth center prenatal care model contributes to birthing people's confidence for physiologic childbirth. METHODS This was a qualitative descriptive study using semistructured interviews with individuals who gave birth in freestanding birth centers. Birthing people were recruited from freestanding birth centers in a Midwestern US state and were between the ages of 18 and 42, were English-speaking, and had experienced a birth center birth within the previous 6 months. Interviews were transcribed and analyzed using Glaser's constant comparative method. RESULTS Twelve women who gave birth in birth centers, representing urban and rural settings, participated. Four core categories were identified encompassing the components of birth center prenatal care and how the birth center model contributes to women's confidence for physiologic birth: birth center culture and processes, midwifery model of care within the birth center, internal influences, and outside influences. DISCUSSION Women who gave birth in birth centers believed that the birth center culture and environment, the midwifery model of care in the birth center, internal influences including the belief that birth is a normal physiologic process, and outside influences including family support and positive birth stories contributed to their confidence for physiologic birth.
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Eagen-Torkko M, Altman MR, Kantrowitz-Gordon I, Gavin A, Mohammed S. Moral Distress, Trauma, and Uncertainty for Midwives Practicing During a Pandemic. J Midwifery Womens Health 2021; 66:304-307. [PMID: 34086389 PMCID: PMC8242461 DOI: 10.1111/jmwh.13260] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 05/11/2021] [Accepted: 05/14/2021] [Indexed: 02/01/2023]
Affiliation(s)
- Meghan Eagen-Torkko
- School of Nursing and Health Studies, University of Washington Bothell, Bothell, Washington
| | - Molly R Altman
- School of Nursing, University of Washington Seattle, Seattle, Washington
| | | | - Amelia Gavin
- School of Social Work, University of Washington Seattle, Seattle, Washington
| | - Selina Mohammed
- School of Nursing and Health Studies, University of Washington Bothell, Bothell, Washington
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van der Pijl MSG, Kasperink M, Hollander MH, Verhoeven C, Kingma E, de Jonge A. Client-care provider interaction during labour and birth as experienced by women: Respect, communication, confidentiality and autonomy. PLoS One 2021; 16:e0246697. [PMID: 33577594 PMCID: PMC7880498 DOI: 10.1371/journal.pone.0246697] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 01/23/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Respectful Maternity Care is important for achieving a positive labour and birth experience. Client-care provider interaction-specifically respect, communication, confidentiality and autonomy-is an important aspect of Respectful Maternity Care. The aim of this study was twofold: (1) to assess Dutch women's experience of respect, communication, confidentiality and autonomy during labour and birth and (2) to identify which client characteristics are associated with experiencing optimal respect, communication, confidentiality and autonomy. METHODS Pregnant women and women who recently gave birth in the Netherlands were recruited to fill out a validated web-based questionnaire (ReproQ). Mean scores per domain (scale 1-4) were calculated. Domains were dichotomised in non-optimal (score 1, 2,3) and optimal client-care provider interaction (score 4), and a multivariable logistic regression analysis was performed. RESULTS Of the 1367 recruited women, 804 respondents completed the questionnaire and 767 respondents completed enough questions to be included for analysis. Each domain had a mean score above 3.5. The domain confidentiality had the highest proportion of optimal scores (64.0%), followed by respect (53.3%), communication (45.1%) and autonomy (36.2%). In all four domains, women who gave birth at home with a community midwife had a higher proportion of optimal scores than women who gave birth in the hospital with a (resident) obstetrician or hospital-based midwife. Lower education level, being multiparous and giving birth spontaneously were also significantly associated with a higher proportion of optimal scores in (one of) the domains. DISCUSSION This study shows that on average women scored high on experienced client-care provider interaction in the domains respect, communication, confidentiality and autonomy. At the same time, client-care provider interaction in the Netherlands still fell short of being optimal for a large number of women, in particular regarding women's autonomy. These results show there is still room for improvement in client-care provider interaction during labour and birth.
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Affiliation(s)
- Marit S. G. van der Pijl
- Amsterdam University Medical Centre (UMC), Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG/Amsterdam Public Health, Amsterdam, The Netherlands
- * E-mail:
| | - Marlies Kasperink
- Amsterdam University Medical Centre (UMC), Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG/Amsterdam Public Health, Amsterdam, The Netherlands
| | - Martine H. Hollander
- Amalia Children’s Hospital, Department of Obstetrics, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Corine Verhoeven
- Amsterdam University Medical Centre (UMC), Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG/Amsterdam Public Health, Amsterdam, The Netherlands
- Division of Midwifery, School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
- Department of Obstetrics and Gynaecology, Maxima Medical Centre, Veldhoven, The Netherlands
| | - Elselijn Kingma
- Department of Philosophy, University of Southampton, Southampton, United Kingdom
- Department of Industrial Engineering & Innovation Sciences, Philosophy & Ethics, Technical University Eindhoven, Eindhoven, The Netherlands
| | - Ank de Jonge
- Amsterdam University Medical Centre (UMC), Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG/Amsterdam Public Health, Amsterdam, The Netherlands
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Abstract
Comfort is a fundamental human need to seek relief, ease, and transcendence. Comfort is relevant to women in labor who experience intense pain and mixed emotions. The subjective meaning of comfort in labor for women is not fully understood. This work was part of a phenomenological study of the experience of childbirth, in which the dynamic of keeping-it-together-falling-apart was identified as an essential quality of women's perceptions of childbirth. Comfort was a salient element of keeping-it-together-falling-apart. In this report, the concept of comfort is explored in greater depth, using qualitative descriptive analysis. Eight participants, aged 23 to 38 years, with spontaneous vaginal births, were each interviewed twice about the childbirth experience. Comfort was a holistic experience of relaxation and relief, where the needs of the body and the person were being met. Comfort and pain coexisted with each other, and relief of pain did not always provide comfort. Women had an innate knowledge of comfort, but their capacity for choice was at times restricted by caregivers in the hospital. There are aspects of labor care that do not support comfort, particularly as it relates to mobility and choice. Prioritizing comfort as well as pain relief may contribute to a more holistic, satisfying birth experience for women.
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