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López-Gimeno E, Falguera-Puig G, García-Sierra R, Vicente-Hernández MM, Cubero LB, Seguranyes G. Impact of shared decision-making on women's childbirth preferences: A cluster randomised controlled trial. Midwifery 2024; 133:103999. [PMID: 38643600 DOI: 10.1016/j.midw.2024.103999] [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: 05/14/2023] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND Midwives provide counselling for birth plans (BPs) to women during prenatal care; however, the impact of individualised BP counselling interventions based on shared decision-making (SDM) regarding women's preferences is unknown. METHODS This randomised cluster trial included four primary healthcare units. Midwives provided BP counselling based on SDM to women in the intervention group (IG) during prenatal care along with a handout about evidence-based recommendations. Women in the control group (CG) received standard BP counselling from midwives. The main outcome was preference changes concerning BPs. RESULTS A total of 461 (95.5 %) pregnant women received BP counselling (IG, n = 247; CG, n = 214). Women in the IG changed their BP preferences for 13 items compared with those in the CG. These items were: using an unique space during birth (81.1 % vs 51.6 %; p < 0.001), option for light graduation (63 % vs 44.7 %; p < 0.001), listening to music (57.3 % vs 43.6 %; p = 0.006), drinking fluids during labour (84.6 % vs 93.6 %; p = 0.005), continuous monitoring (59 % vs 37.8 %; p < 0.001); desire for natural childbirth (36.6 % vs 25 %; p = 0.014), epidural analgesia (55.1 % vs 43.6 %; p = 0.023); breathing techniques (65.2 % vs 50.5 %; p = 0.003), massage (74.9 % vs 55.3 %; p < 0.001); birthing ball use (81.9 % vs 56.9 %; p < 0.001), spontaneous pushing (49.3 % vs 28.7 %; p < 0.001), choosing birth position (69.6 % vs 41.5 %) and delayed umbilical cord clamping (67.8 % vs 44.1 %; p = 0.001). CONCLUSION SDM counselling, together with a handout about evidence-based recommendations on childbirth and newborn care, produced more changes in women's preferences expressed in the BP than standard counselling.
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Affiliation(s)
- Encarnación López-Gimeno
- Sexual and Reproductive Healthcare Services (ASSIR), Barcelona, Catalan Health Institute (ICS), Research Group on Sexual and Reproductive Healthcare (GRASSIR) (2021-SGR-01489), 08007 Barcelona, Spain; Department of Public Health, Mental Health and Maternal and Child Health Nursing, Faculty of Nursing, University of Barcelona, Hospitalet LL, Spain; Sexual and Reproductive Healthcare Services (ASSIR), Nord Metropolitan Area, Catalan Health Institut (ICS), Research Group on Sexual and Reproductive Healthcare (GRASSIR) (2021-SGR-01489), 08007 Barcelona, Spain.
| | - Gemma Falguera-Puig
- Sexual and Reproductive Healthcare Services (ASSIR), Nord Metropolitan Area, Catalan Health Institut (ICS), Research Group on Sexual and Reproductive Healthcare (GRASSIR) (2021-SGR-01489), 08007 Barcelona, Spain
| | - Rosa García-Sierra
- Research Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP JGol), Spain; Nursing Department, Faculty of Medicine, Campus Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain; Primary Care Group, Germans Trias i Pujol Research Institute (IGTP), Badalona, Spain; Multidisciplinary Research Group in Health and Society (GREMSAS) (2021-SGR-01484), Barcelona, Spain
| | - Mª Mercedes Vicente-Hernández
- Sexual and Reproductive Healthcare Services (ASSIR), Nord Metropolitan Area, Catalan Health Institut (ICS), Research Group on Sexual and Reproductive Healthcare (GRASSIR) (2021-SGR-01489), 08007 Barcelona, Spain; Sexual and Reproductive Healthcare Services (ASSIR), Badalona, Catalan Health Institute (ICS), Research Group on Sexual and Reproductive Healthcare (GRASSIR) (2021-SGR-01489), 08007 Barcelona, Spain
| | - Lucia Burgos Cubero
- Sexual and Reproductive Healthcare Services (ASSIR), Catalan Health Institute (ICS), Mollet del Vallés, Spain
| | - Gloria Seguranyes
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Faculty of Nursing, University of Barcelona, Hospitalet LL, Spain; Sexual and Reproductive Healthcare Services (ASSIR), Nord Metropolitan Area, Catalan Health Institut (ICS), Research Group on Sexual and Reproductive Healthcare (GRASSIR) (2021-SGR-01489), 08007 Barcelona, Spain
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Morris K, Lane F, Nelson AL, Stohl HE. How Do Women Vote: What Women Post About Home Birth Versus Hospital Birth on Popular Social Media Platforms. Cureus 2024; 16:e57621. [PMID: 38707150 PMCID: PMC11070205 DOI: 10.7759/cureus.57621] [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] [Accepted: 03/29/2024] [Indexed: 05/07/2024] Open
Abstract
INTRODUCTION The rates of home birth have been increasing; reliance on social media as a source of medical advice and support for patients has also been increasing. This is the first study that directly evaluates birthing people's perceptions, attitudes, and advice about planned home births expressed in public posts and comments on two popular social media platforms - Reddit and TikTok. METHODS Posts on each platform were searched from January 2017 through July 2022 using the terms "home birth" and "home vs. hospital birth". Included posts were from the United States written in English, with at least 10 comments and 10 upvotes or likes. Up to five themes were collected per post or comment and were categorized as supportive, opposing, or neutral. The Institutional Review Board (IRB) determined that the project did not include human subjects. RESULTS Collectively, 777 posts and 47,452 comments were evaluated for inclusion; 257 posts and 2,408 comments met the inclusion criteria for analysis. In posts, 69% supported, 20% opposed, and 11% were neutral toward home birth (n = 257). Similarly, in comments, 53% supported, 28% opposed, and 19% were neutral (n = 2,408). Supportive themes included concerns about the safety of hospital delivery and reassurance about home birth safety, enhanced patient control with home deliveries, positive personal stories reinforcing home birth, concerns about excessive interventions in hospital birth, and advice about preparing for home birth. Opposing themes included concerns about risks of home birth, negligence of those attempting it, reassurance that hospital birth does offer women control, greater financial costs of home birth and that medical interventions can be lifesaving. CONCLUSION These results can help physicians recognize some of the women's concerns about hospital births and what information they may find on social media guiding them as they formulate their birth plans. Overall, this information helps with the goal of balancing patient safety with the need to respect patient autonomy.
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Affiliation(s)
- Kelsey Morris
- Obstetrics and Gynecology, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, USA
| | - Fiona Lane
- Obstetrics and Gynecology, College of Osteopathic Medicine of the Pacific - Northwest, Western University of Health Sciences, Lebanon, USA
| | - Anita L Nelson
- Obstetrics and Gynecology, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, USA
| | - Hindi E Stohl
- Obstetrics and Gynecology, Harbor-UCLA Medical Center, David Geffen School of Medicine at UCLA, Torrance, USA
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Chantry AA, Merrer J, Blondel B, Le Ray C. Preferences for labor and childbirth, expressed orally or as a written birth plan: Prevalence and determinants from a nationwide population-based study. Birth 2023; 50:847-857. [PMID: 37382211 DOI: 10.1111/birt.12728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/08/2023] [Accepted: 05/06/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Shared decision-making is an important component of a patient-centered healthcare system. We assessed the prevalence of parturients with preferences for their labor and childbirth, expressed verbally in the birthing room or as a written birth plan, and studied maternal, obstetric, and organizational factors associated with their expression. METHODS Data came from the 2016 National Perinatal Survey, a cross-sectional nationwide population-based survey conducted in France. Preferences for labor and childbirth were studied in three categories: expressed verbally, in writing (birth plan), or unexpressed or nonexistent. Analyses used multinomial multilevel logistic regression. RESULTS The analysis included 11,633 parturients: 3.7% had written a birth plan, 17.3% expressed their preferences verbally, and 79.0% either did not have or did not express any preferences. Compared with the latter group, written or verbal preferences were both significantly associated with prenatal care by independent midwives (respectively, adjusted odds ratio (aOR) 2.19; 95% confidence interval (CI), [1.59-3.03], and aOR 1.43; 95% CI [1.19-1.71]) and with attendance at childbirth education classes (respectively, aOR 4.99; 95% CI [3.49-7.15], and aOR 2.27; 95% CI [1.98-2.62]). As years in traditional schooling increased, so did its association with preferences. Conversely, parturients from African countries were significantly less likely than French mothers to express preferences. A written birth plan was also associated with characteristics of maternity unit organization. CONCLUSION Only one in five parturients reported having expressed preferences for labor and childbirth to healthcare professionals in the birthing room. This expression of preferences was associated with maternal characteristics and the organization of care.
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Affiliation(s)
- Anne Alice Chantry
- Université Paris Cité, Center of Research in Epidemiology and Statistics/CRESS/Obstetrical Pediatric and Perinatal Epidemiology Research Team (EPOPé), INSERM, INRA, Paris, France
- Baudelocque Midwifery School, AP-HP, Université Paris Cité, Paris, France
| | - Jade Merrer
- Université Paris Cité, Center of Research in Epidemiology and Statistics/CRESS/Obstetrical Pediatric and Perinatal Epidemiology Research Team (EPOPé), INSERM, INRA, Paris, France
| | - Béatrice Blondel
- Université Paris Cité, Center of Research in Epidemiology and Statistics/CRESS/Obstetrical Pediatric and Perinatal Epidemiology Research Team (EPOPé), INSERM, INRA, Paris, France
| | - Camille Le Ray
- Université Paris Cité, Center of Research in Epidemiology and Statistics/CRESS/Obstetrical Pediatric and Perinatal Epidemiology Research Team (EPOPé), INSERM, INRA, Paris, France
- Port-Royal Maternity Unit, Department of Obstetrics, Cochin Broca Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), FHU PREMA, Paris, France
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Bell CH, Dahlen HG, Davis D. Finding a way forward for the birth plan and maternal decision making: A discussion paper. Midwifery 2023; 126:103806. [PMID: 37696185 DOI: 10.1016/j.midw.2023.103806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/04/2023] [Accepted: 08/28/2023] [Indexed: 09/13/2023]
Affiliation(s)
| | - Hannah G Dahlen
- School of Nursing and Midwifery, Western Sydney University, Australia
| | - Deborah Davis
- Faculty of Health, University of Canberra, Australia; ACT Government Health Directorate, Australia
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Kohan S, Hajihashemi M, Valiani M, Beigi M, Mohebbi-Dehnavi Z. Maternal-infant outcomes of birth planning: A review study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:315. [PMID: 38023070 PMCID: PMC10670885 DOI: 10.4103/jehp.jehp_1450_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 12/26/2022] [Indexed: 12/01/2023]
Abstract
The birth and delivery plan is the center of clinical communication between the pregnant woman and the midwife, which is in the scope of health care services and is designed and provided to specialists with the participation of the woman and her husband during pregnancy. This document reflects the preferences, expectations, and fears of pregnant women regarding the birth process. This study was conducted with the aim of determining the maternal and neonatal outcomes of the birth plan: a review study. In this review study, Persian databases Magiran, SID, and English databases Pubmed, Scopus, SID Elsevier, Web of Sciences, and Google Scholar search engine using English keywords including Maternal outcome, neonatal outcome, birth schedule, delivery plan, birth plan, and their Persian equivalents were searched from 2000 to 2022. Numerous studies were selected and analyzed in a quantitative and qualitative manner that was related to the purpose of the present study in terms of content. Among 948 articles, 13 of the most relevant ones were selected and analyzed for this study. The results of the review of the studies showed that the birth plan has an effect on women's empowerment, satisfaction with childbirth, positive experience of childbirth, cesarean section rate, epidural use rate, episiotomy rate, Apgar, and umbilical cord pH of the newborn. The maternal and neonatal consequences of the birth plan prevail over its negative consequences, and the use of the birth plan can increase women's empowerment, satisfaction with childbirth, positive experience of childbirth, and reduce the rate of cesarean section and negative maternal-neonatal consequences.
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Affiliation(s)
- Shahnaz Kohan
- Professor of Reproductive Health, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Reproductive Sciences and Sexual Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Hajihashemi
- Associate Professor of Female Pelvic Floor Medicine and Surgery, Department of Obstetrics and Gynecology, School of Medicine, Shahid Beheshti Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahboubeh Valiani
- Reproductive Sciences and Sexual Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marjan Beigi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Mohebbi-Dehnavi
- PhD Student in Reproductive Health, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
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6
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Mohebbi-Dehanvi Z, Hajihashemi M, Kohan S. Promoting the participation of low-risk pregnant women in the child birth process by developing a birth plan: The protocol of an action research study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:285. [PMID: 37849882 PMCID: PMC10578542 DOI: 10.4103/jehp.jehp_1039_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 10/22/2022] [Indexed: 10/19/2023]
Abstract
BACKGROUND The birth plan reflects the preferences and expectations of women in the delivery process and can be designed with the participation of women and her partner and implement as a basis for midwifery care during childbirth. This research was designed to promote the participation of low-risk pregnant women in the child birth process by developing a birth plan. MATERIALS AND METHODS The present study is a participatory action research designed in a single specialized, main maternity hospital in Isfahan, Iran. This study was conducted in four stages proposed by the Kemmis, including planning, action, observation, and reflection with the participation of all midwives, gynecologists, and managers who involved in childbirth. CONCLUSIONS Considering the importance of childbirth as an opportunity for participation and empowerment of women, it seems that designing a birth plan based on the preferences of these women and all people involved in this process can strengthen women's participation in child birth process.
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Affiliation(s)
- Zahra Mohebbi-Dehanvi
- PhD Candidate in Reproductive Health, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Hajihashemi
- Associate Professor of Female Pelvic Floor Medicine and Surgery, Department of Obstetrics and Gynecology, School of Medicine, Shahid Beheshti Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahnaz Kohan
- Professor of Reproductive Health, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Reproductive Sciences and Sexual Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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7
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Whittington JR, Ghahremani T, Whitham M, Phillips AM, Spracher BN, Magann EF. Alternate Birth Strategies. Int J Womens Health 2023; 15:1151-1159. [PMID: 37496517 PMCID: PMC10368118 DOI: 10.2147/ijwh.s405533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 07/11/2023] [Indexed: 07/28/2023] Open
Abstract
Community birth is defined as birth that occurs outside the hospital setting. Birthing in a birth center can be safe for certain patient populations. Home birth can also be safe in well-selected patient with a well-established transfer infrastructure should an emergency occur. Unfortunately, many areas of the United States and the world do not have this infrastructure, limiting access to safe community birth. Immersion during labor has been associated with decreased need for epidural and pain medication. Delivery should not occur in water due to concerns for infection and cord avulsion. Umbilical cord non-severance (also called lotus birth) and placentophagy should be counseled against due to well-documented risks without clear benefit. Birth plans and options should be regularly discussed during pregnancy visits.
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Affiliation(s)
- Julie R Whittington
- Department of Obstetrics and Gynecology, Navy Medicine Readiness and Training Command Portsmouth, Portsmouth, VA, USA
| | - Taylor Ghahremani
- Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Megan Whitham
- Department of Obstetrics and Gynecology, Virginia Tech Carilion School of Medicine, Roanoke, VA, USA
| | - Amy M Phillips
- Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Bethany N Spracher
- Department of Obstetrics and Gynecology, Edward via College of Osteopathic Medicine, Blacksburg, VA, USA
| | - Everett F Magann
- Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Ghahremani T, Bailey K, Whittington J, Phillips AM, Spracher BN, Thomas S, Magann EF. Birth plans: definitions, content, effects, and best practices. Am J Obstet Gynecol 2023; 228:S977-S982. [PMID: 37164502 DOI: 10.1016/j.ajog.2022.12.011] [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: 09/21/2022] [Revised: 12/08/2022] [Accepted: 12/09/2022] [Indexed: 05/12/2023]
Abstract
The first written guide for birth plans was introduced in 1980 as a means for birthing people to document their choices in the child birthing experience. The birth plan offers an opportunity for the patient and the provider to discuss the birthing process and determine how to safely accommodate patient preferences. Patient satisfaction with birthing plans is variable and may depend on how many requests they have, how many of their plans are accomplished, route of delivery, and whether complications arise during or after delivery. Unmet expectations may lead to posttraumatic stress disorder, but following a birth plan may also be protective against it. Birthing people who use a birth plan may be less likely to use epidural anesthesia, have early amniotomy, or use oxytocin. The first stage of labor may be longer when a birth plan is used; however, there does not seem to be a decrease in the length of the second stage of labor among patients with a birth plan. Some providers believe that a disadvantage of birth plans is disappointment when birth plans are not able to be followed, and others consider that birth plans interfere with professional autonomy.
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Affiliation(s)
- Taylor Ghahremani
- Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Kathleen Bailey
- Department of Obstetrics and Gynecology, Landstuhl Regional Medical Center, Landstuhl, Germany
| | - Julie Whittington
- Department of Obstetrics and Gynecology, Naval Medical Center Portsmouth, Portsmouth, VA
| | - Amy M Phillips
- Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR
| | | | - Sheila Thomas
- Department of Library Sciences, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Everett F Magann
- Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR.
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Mohaghegh Z, Javadnoori M, Najafian M, Montazeri S, Abedi P, Leyli EK, Bakhtiari S. Implementation of birth plans integrated into childbirth preparation classes for vaginal birth: a qualitative study of women, their husbands and clinicians' perspectives in Iran. BMC Pregnancy Childbirth 2022; 22:969. [PMID: 36575405 PMCID: PMC9792921 DOI: 10.1186/s12884-022-05305-7] [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: 05/04/2022] [Accepted: 12/13/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Understanding women's experience of birth planning is necessary for introducing and implementing this process in the Iranian maternity services. This study aims to explore perceptions of birth plan implementation in Iran from the perspective of women, their husbands, and clinicians. METHODS This qualitative study was conducted in Iran. Qualitative data were collected from November 2020 to March 2021 by conducting semi-structured in-depth interviews with ten mothers who prepared a birth plan, and 15 key informants (obstetricians, midwives, and husbands) who were involved in the implementation process of birth plans. Data were analyzed using conventional qualitative content analysis. RESULTS Data reduction process resulted in 380 codes that were categorized in 16 subcategories and five main categories. The main categories were "Guide and pattern of preparing for childbirth pathway", "Maternal empowerment and sense of triumph", "Facilitating and enhancing communication", "Successful transition to parenthood and women's satisfaction", and "Challenges associated with implementation of the birth plan". The overarching theme "Birth plan: The missing link in promotion of vaginal birth in Iran" was constructed from these categories. CONCLUSION Findings of this study highlight the effectiveness of the implementation of birth plan along with childbirth preparation classes for increasing the likelihood of a successful vaginal birth and promoting empowerment and satisfaction in women during the childbirth process. The findings of this study could pave the way for developing, introducing, and implementing of birth plan in Iran.
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Affiliation(s)
- Zaynab Mohaghegh
- grid.411230.50000 0000 9296 6873Midwifery Department, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mojgan Javadnoori
- grid.411230.50000 0000 9296 6873Reproductive Health Promotion Research Center, Department of Midwifery, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahin Najafian
- grid.411230.50000 0000 9296 6873Department of Obstetrics and Gynecology, School of Medicine, Fertility, Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Simin Montazeri
- grid.411230.50000 0000 9296 6873Reproductive Health Promotion Research Center, Department of Midwifery, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Parvin Abedi
- grid.411230.50000 0000 9296 6873Department of Midwifery, Menopause Andropause Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ehsan Kazemnejad Leyli
- grid.411874.f0000 0004 0571 1549Biostatistics Department, Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Shahla Bakhtiari
- grid.24029.3d0000 0004 0383 8386Midwifery Department, Rosie Hospital, Cambridge University Hospitals NHS, Cambridge, UK
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The role of birth plans for shared decision-making around birth choices of pregnant women in maternity care: A scoping review. Women Birth 2022:S1871-5192(22)00354-7. [DOI: 10.1016/j.wombi.2022.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/20/2022] [Accepted: 11/20/2022] [Indexed: 12/05/2022]
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Hopes expressed in birth plans by women diagnosed with fetal anomalies: a qualitative study in Japan. BMC Pregnancy Childbirth 2022; 22:788. [PMID: 36274153 PMCID: PMC9588248 DOI: 10.1186/s12884-022-05115-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 10/10/2022] [Indexed: 11/17/2022] Open
Abstract
Background Recent advances in prenatal screening and diagnosis have resulted in an increasing number of women receiving a diagnosis of fetal anomalies. In this study, we aimed to clarify the hopes for childbirth and parenting of women diagnosed with fetal anomalies and to suggest a family-centered care tailored for this situation in perinatal settings. Methods A descriptive qualitative study was performed. We recruited women diagnosed with fetal anomalies who were over 22 years old, beyond 22 weeks of gestation, and had scheduled pregnancy and delivery management at a tertiary perinatal medical center specializing in neonatal and pediatric care in a metropolitan area of Japan from April 2019 to December 2019. Women who were willing to participate received support from a midwife to create birth plans. Data were collected from the documented birth plans submitted by 24 women and analyzed using content analysis. Results We identified three themes of women’s hopes based on the descriptions of the submitted birth plans: (1) Hopes as women who are expecting childbirth, (2) Hopes as mothers of a baby, (3) Hopes of being involved in the family needs. Several distinctive hopes were clarified in the context of the women’s challenging situations. In describing their hopes, the women were neither overoptimistic or overstated their actual situations, nor caused embarrassment to the healthcare providers. The importance of supporting their involvement in baby matters in the way each family wants also emerged. However, several barriers to fulfilling the women’s hopes were identified including the babies’ conditions and hospital regulations against family visits or presence. Conclusion All three themes identified in the study provide important insights for analyzing more deeply ways of implementing a family-centered care for women diagnosed with fetal anomalies in perinatal settings. To improve women’s engagement in decision-making as a team member, women’s hopes should be treated with dignity and respect, and included in the perinatal care of women with abnormal fetuses. Further research is needed to improve the inclusion of women’s hopes in their care in clinical settings. Trial registration UMIN Clinical Trials Registry: UMIN000033622 (First registration date: 03/08/2018). Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-05115-x.
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Barnes C, Mignacca E, Mabbott K, Officer K, Hauck Y, Bradfield Z. Using a scheduled caesarean birth plan: A cross-sectional exploration of women's perspectives. Women Birth 2022; 36:264-270. [PMID: 36137931 DOI: 10.1016/j.wombi.2022.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/02/2022] [Accepted: 09/02/2022] [Indexed: 11/17/2022]
Abstract
PROBLEM There is minimal evidence regarding the role or impact of birth plans from the perspective of women experiencing scheduled caesarean birth. BACKGROUND Quality maternity care requires respect for women's preferences. Evidence suggests birth plans enable communication of women's preferences and may enhance agency when vaginal birth is intended, however there is limited evidence of how this translates in the perioperative environment where caesarean birth is the intended outcome. AIM Explore the experiences and perspectives of women who had utilised a scheduled caesarean birth plan at an Australian tertiary maternity hospital. METHODS A cross-sectional design was used; 294 participants completed the survey within two weeks post-birth. Descriptive statistics were used to analyse quantitative data, qualitative responses were analysed using content analysis. FINDINGS Over half of the women requested lowering of the surgical-screen at birth, most requested immediate skin-to-skin with their babies; around two-thirds of these preferences were met. Use of a birth plan for scheduled caesarean section supported women's ability to communicate their desires and choices, enhancing agency and reinforcing the significance of the caesarean birth experience. Qualitative data revealed two main categories: Perceptions and experiences; and Recommendations for improvement, with corresponding sub-categories. DISCUSSION Findings provide unique opportunities to consider the provision of woman-centred care within the highly technocratic perioperative environment. CONCLUSION All women, regardless of birth mode, have a right to respectful maternity care that prioritises their wishes and agency. This study provides evidence for the positive utility of birth plans in caesarean birth, local adaptation is encouraged.
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Affiliation(s)
| | - Emily Mignacca
- King Edward Memorial Hospital, Western Australia, Australia
| | - Kelly Mabbott
- King Edward Memorial Hospital, Western Australia, Australia
| | - Kirsty Officer
- King Edward Memorial Hospital, Western Australia, Australia
| | - Yvonne Hauck
- School of Nursing, Curtin University, Western Australia, Australia; King Edward Memorial Hospital, Western Australia, Australia
| | - Zoe Bradfield
- School of Nursing, Curtin University, Western Australia, Australia; King Edward Memorial Hospital, Western Australia, Australia.
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López-Gimeno E, Seguranyes G, Vicente-Hernández M, Burgos Cubero L, Vázquez Garreta G, Falguera-Puig G. Effectiveness of birth plan counselling based on shared decision making: A cluster randomized controlled trial (APLANT). PLoS One 2022; 17:e0274240. [PMID: 36094935 PMCID: PMC9467369 DOI: 10.1371/journal.pone.0274240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 08/23/2022] [Indexed: 11/19/2022] Open
Abstract
Background A birth plan (BP) is a written document in which the pregnant woman explains her wishes and expectations about childbirth to the health professionals and aims to facilitate her decision-making. Midwives’ support to women during the development of the BP is essential, but it’s unknown if shared decision making (SDM) is effective in birth plan counselling. We hypothesized that women who receive counselling based on SDM during their pregnancy are more likely to present their BP to the hospital, more satisfied with the childbirth experience, and have better obstetric outcomes than women who receive standard counselling. We also aimed to identify if women who presented BP to the hospital have better obstetric outcomes and more satisfied with the childbirth experience. Methods This was a randomised cluster trial involving four Primary Care Units. Midwives provided BP counselling based on SDM to the women in the intervention group (IG) during their pregnancy, along with a leaflet with evidence-based recommendations. Women in the control group (CG) only received the standard birth plan counselling from midwives. The primary outcomes were birth plan presentation to the hospital, obstetrics outcomes and satisfaction with childbirth experience. The Mackey Satisfaction with Childbirth Scale (MCSRS) was used to measure childbirth satisfaction. Results A total of 461 (95.5%) pregnant women received BP counselling (IG n = 214 and CG n = 247). Fewer women in the intervention group presented their BP to the hospital compared to those in the control group (57.8% vs 75.1%; p <0.001). Mean satisfaction with childbirth experience was high in the IG as well as the CG: 150.2 (SD:22.6) vs. 153.4 (SD:21.8); p = 0.224). The information received about childbirth during pregnancy was high in both groups (95.1% vs 94.8%; p = 1.0). Fewer women in the IG used analgesia epidural compared to those in the CG (84.7% vs 91.7%; p = 0.034); women who combined non-pharmacological and pharmacological methods for pain relief were more in number in the IG (48.9% vs 29.5%; p = 0.001) and women who began breastfeeding in the delivery room were more in number in the IG (83.9% vs 66.3%; p = 0.001). Women who presented their BP had a greater probability of using combined non-pharmacological and pharmacological methods for pain relief aOR = 2.06 (95% CI: 1.30–4.30) and early skin-to-skin contact aOR = 2.08 (95% CI: 1.07–4.04). Conclusion This counselling intervention was not effective to increase the presentation of the BP to the hospital and women’s satisfaction with childbirth; however, it was related to a lower usage of analgesia epidural, a higher combination of pharmacological and non-pharmacological methods for pain relief and the initiation of breastfeeding in the delivery room. Presenting the BP to the hospital increased the likelihood of using pharmacological and non-pharmacological methods for pain relief, and early skin-to-skin contact.
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Affiliation(s)
- Encarnación López-Gimeno
- Midwife, Catalan Health Institute (ICS), Sexual and Reproductive Healthcare Services (ASSIR), Barcelona, Spain
- Research Group GRASSIR, Barcelona, Spain
- * E-mail:
| | - Gloria Seguranyes
- Research Group GRASSIR, Barcelona, Spain
- Faculty of Medicine and Health Sciences, Nursing School, University of Barcelona, Barcelona, Spain
| | - Mercedes Vicente-Hernández
- Research Group GRASSIR, Barcelona, Spain
- Midwife, Catalan Health Institute (ICS), Sexual and Reproductive Healthcare Services (ASSIR), Badalona, Spain
| | - Lucia Burgos Cubero
- Midwife, Catalan Health Institute (ICS), Sexual and Reproductive Healthcare Services (ASSIR), Mollet del Vallés, Spain
| | - Griselda Vázquez Garreta
- Midwife, Catalan Health Institute (ICS), Sexual and Reproductive Healthcare Services (ASSIR), Barcelona, Spain
| | - Gemma Falguera-Puig
- Research Group GRASSIR, Barcelona, Spain
- Catalan Health Institute (ICS), Sexual and Reproductive Healthcare Services of Metropolitan North Area (ASSIR), Sabadell, Spain
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Levy KS, Smith MK, Lacroix M, Yudin MH. Patient Satisfaction with Informed Consent for Cesarean and Operative Vaginal Delivery. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2022; 44:785-790. [DOI: 10.1016/j.jogc.2022.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/08/2022] [Accepted: 03/09/2022] [Indexed: 10/18/2022]
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Trigueiro TH, Arruda KAD, Santos SDD, Wall ML, Souza SRRK, Lima LSD. Experiência de gestantes na consulta de Enfermagem com a construção do plano de parto. ESCOLA ANNA NERY 2022. [DOI: 10.1590/2177-9465-ean-2021-0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivo Descrever a experiência das gestantes atendidas na Consulta de Enfermagem a partir de 37 semanas e que elaboraram seu plano de parto. Método Pesquisa exploratória qualitativa, com 19 gestantes a partir de 37 semanas vinculadas à maternidade de risco habitual em Curitiba, Paraná, e que passaram pela consulta de enfermagem entre novembro de 2019 e março de 2020. Os dados foram coletados mediante entrevista e submetidos a análise de conteúdo temática. Resultados As gestantes apresentaram desconhecimento sobre assuntos relacionados ao parto, o que contribui para o surgimento de dúvidas, medos e inseguranças. Também não conheciam, ou conheciam de forma superficial, o plano de parto. A consulta de enfermagem e o plano de parto na maternidade contribuíram para o esclarecimento de dúvidas, redução da ansiedade, possibilidade de fortalecimento e empoderamento da gestante e do acompanhante diante da oferta de informações para o parto vaginal e o estabelecimento de vínculo com a maternidade. Conclusões e implicações para a prática Adequados à realidade e focados na individualidade da gestante, a consulta de enfermagem e o plano de parto foram respectivamente evidenciados como espaço para educação em saúde e ferramenta educativa, mostrando-se eficientes para a atuação do enfermeiro e melhora da assistência pré-natal.
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Rousseau S, Polachek IS, Frenkel TI. A machine learning approach to identifying pregnant women's risk for persistent post-traumatic stress following childbirth. J Affect Disord 2022; 296:136-149. [PMID: 34601301 DOI: 10.1016/j.jad.2021.09.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 08/11/2021] [Accepted: 09/12/2021] [Indexed: 10/20/2022]
Abstract
INTRO Recent literature identifies childbirth as a potentially traumatic event, following which mothers may develop symptoms of Post-Traumatic-Stress-Following-Childbirth (PTS-FC). Especially when persistent, PTS-FC may interfere with mothers' caregiving and associated infant development, underscoring the need for accurate predictive screening of risk. Drawing on recent developments in advanced statistical modeling, the aim of the current study was to identify a set of prenatal indicators and prediction rules that may accurately identify pregnant women's risk for developing symptoms of PTS-FC which persist throughout the early postpartum period. METHODS 182 women from the general population completed a comprehensive set of approximately 200 potentially predictive questions during pregnancy, and subsequently reported on their acute stress and PTS-FC at three days, one month, and three months postpartum (self-report and clinician-administered interview). Based on the postpartum acute stress and PTS-FC data, women were classified into profiles of "Stable-High-PTS-FC" and "Stable-Low-PTS-FC" by means of Latent-Class Analyses. Prenatal data were modeled to identify women at risk for "Stable-High PTS-FC". RESULTS Employing machine-learning decision-tree analyses, a total of 36 questions and 7 prediction-rules were selected. Based on a cost-rate of 15 versus 100 for false-negative "Stable-Low-PTS-FC" versus false-negative "Stable-High-PTS-FC", the final model showed 80.6% accuracy for "Stable-High-PTS-FC" prediction. DISCUSSION This study identifies a short set of questions and prediction rules that may be included in future large-scale validation studies aimed at developing and validating a brief PTS-FC screening instrument that could be implemented in general population prenatal healthcare practice. Accurate screening would allow for selective administering of preventive interventions towards women at risk.
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Affiliation(s)
- Sofie Rousseau
- Ziama Arkin Infancy Institute, Interdisciplinary Center (IDC) Herzliya, Hanadiv 71, 1st floor, Herzliya 46485, Israel; Baruch Ivcher School of Psychology, Interdisciplinary Center (IDC) Herzliya, HaUniversity 8, Herzliya 4610101, Israel
| | - Inbal Shlomi Polachek
- Be'er Ya'akov Medical Center, Israel; Tel Aviv University, Sackler School of Medicine, Tel Aviv, Israel
| | - Tahl I Frenkel
- Ziama Arkin Infancy Institute, Interdisciplinary Center (IDC) Herzliya, Hanadiv 71, 1st floor, Herzliya 46485, Israel; Baruch Ivcher School of Psychology, Interdisciplinary Center (IDC) Herzliya, HaUniversity 8, Herzliya 4610101, Israel.
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17
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Furr A, Brackney DE, Turpin RL. Perinatal Nurses Respond to Shared Decision-Making Education: A Quasi-Experimental Study. J Perinat Educ 2021; 30:168-176. [DOI: 10.1891/j-pe-d-20-00039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Women describe a loss of autonomy during childbirth as a contributing factor to labor dissatisfaction. Shared decision-making with choice, option, and decision talk may improve satisfaction. Nurses (n = 29) received education on supporting women's autonomy with a standardized communication tool (SUPPORT) to facilitate shared decision-making and create an evolving birth plan. This quasi-experimental pre-/post-test design evaluated participant responses to the education module. Participants supported the use of the SUPPORT tool for shared decision-making and developing evolving birth plans. Most recommended initiation between 13- and 26-weeks' gestation. Nurses' willingness to advocate for women's autonomy increased significantly after education (p = .022). Shared decision-making with standardized perinatal communication may support a woman's perinatal education and her satisfaction with labor.
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Webb R, Ayers S, Bogaerts A, Jeličić L, Pawlicka P, Van Haeken S, Uddin N, Xuereb RB, Kolesnikova N. When birth is not as expected: a systematic review of the impact of a mismatch between expectations and experiences. BMC Pregnancy Childbirth 2021; 21:475. [PMID: 34215219 PMCID: PMC8252193 DOI: 10.1186/s12884-021-03898-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 05/20/2021] [Indexed: 12/02/2022] Open
Abstract
Background Pregnancy and childbirth are significant events in women’s lives and most women have expectations or plans for how they hope their labour and birth will go. It is possible that strong expectations about labour and birth lead to dissatisfaction or other negative outcomes if these expectations are not met, but it is not clear if this is the case. The aim was therefore to synthesise prospective studies in order to understand whether unmet birth expectations are associated with adverse outcomes for women, their partners and their infants. Method Searches were carried out in Academic Search Complete; CINAHL; Medline; PsycINFO, PsychArticles, PubMed, SCOPUS and Web of Science. Forward and backward searches were also completed. Studies were included if they reported prospective empirical research that examined the association between a mismatch in birth expectations/experience and postnatal outcomes in women, their children and/or their partners. Data were synthesised qualitatively using a narrative approach where study characteristics, context and methodological quality were extracted and summarised and then the differences and similarities among studies were used to draw conclusions. Results Eleven quantitative studies were identified for inclusion from nine countries. A mismatch between birth expectations and experiences was associated with reduced birth satisfaction. Three studies found a link between a mismatch and the development of postnatal post-traumatic stress disorder (PTSD). The evidence was inconsistent for postnatal depression, and fear of childbirth. Only one study looked at physical outcomes in the form of health-related quality of life. Conclusions A mismatch between birth expectations and experiences is associated with birth satisfaction and it may increase the risk of developing postnatal PTSD. However, it is not clear whether a mismatch is associated with other postnatal mental health conditions. Further prospective research is needed to examine gaps in knowledge and provide standardised methods of measuring childbirth expectations-experiences mismatch. To ensure women’s expectations are met, and therefore experience a satisfying birth experience, maternity providers should provide sensitive care, which acknowledges women’s needs and preferences, is based on open and clear communication, is delivered as early in pregnancy as possible, and enables women to make their own decisions about care. Trial registration Protocol registration: PROSPERO CRD42020191081. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-03898-z.
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Affiliation(s)
- Rebecca Webb
- Centre for Maternal and Child Health Research, City, University of London, London, EC1V 0HB, UK.
| | - Susan Ayers
- Centre for Maternal and Child Health Research, City, University of London, London, EC1V 0HB, UK
| | - Annick Bogaerts
- KU Leuven, Department of Development and Regeneration, Research Unit Women and Child, B-3000, Leuven, Belgium.,Faculty of Medicine and Health Sciences, Centre for Research and Innovation Care (CRIC), University of Antwerp, Antwerp, Belgium.,Faculty of Health, University of Plymouth, Plymouth, Devon, PL4 8AA, UK
| | - Ljiljana Jeličić
- Cognitive Neuroscience Department, Institute for Research and Development "Life Activities Advancement Center", Belgrade, Serbia.,Department of Speech, Language and Hearing Sciences, Institute for Experimental Phonetics and Speech Pathology, Belgrade, Serbia
| | - Paulina Pawlicka
- Department of Social Sciences, Institute of Psychology, University of Gdańsk, Gdańsk, Poland
| | - Sarah Van Haeken
- KU Leuven, Department of Development and Regeneration, Research Unit Women and Child, B-3000, Leuven, Belgium.,Research and Expertise, Resilient People, University College Leuven-Limburg, Diepenbeek, Belgium
| | - Nazihah Uddin
- Centre for Maternal and Child Health Research, City, University of London, London, EC1V 0HB, UK
| | - Rita Borg Xuereb
- Department of Midwifery, Faculty of Health Sciences, University of Malta, Msida, Malta
| | - Natalija Kolesnikova
- Centre for Maternal and Child Health Research, City, University of London, London, EC1V 0HB, UK
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Peckham A, Wright JG, Marani H, Abdelhalim R, Laxer D, Allin S, Alam N, Marchildon G. Putting the Patient First: A Scoping Review of Patient Desires in Canada. Healthc Policy 2021; 16:46-69. [PMID: 34129478 PMCID: PMC8200834 DOI: 10.12927/hcpol.2021.26499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Patient-centred care is a key priority for governments, providers and stakeholders, yet little is known about the care preferences of patient groups. We completed a scoping review that yielded 193 articles for analysis. Five health states were used to account for the diversity of possible preferences based on health needs. Five broad themes were identified and expressed differently across the health states, including personalized care, navigation, choice, holistic care and care continuity. Patients' perspectives must be considered to meet the diverse needs of targeted patient groups, which can inform health system planning, quality improvement initiatives and targeting of investments.
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Affiliation(s)
- Allie Peckham
- Assistant Professor, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ; North American Observatory on Health Systems and Policies, University of Toronto, Toronto, ON
| | - James G Wright
- Chief, Economics, Policy and Research, Ontario Medical Association, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public HealthUniversity of Toronto, Toronto, ON
| | - Husayn Marani
- Research Assistant, North American Observatory on Health Systems and Policies, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public HealthUniversity of Toronto, Toronto, ON
| | - Reham Abdelhalim
- Research Assistant, North American Observatory on Health Systems and Policies, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public HealthUniversity of Toronto, Toronto, ON
| | - Dara Laxer
- Executive Director, Health Policy and Promotion, Ontario Medical Association, Toronto, ON
| | - Sara Allin
- Director of Operations, North American Observatory on Health Systems and Policies; Assistant Professor, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON
| | - Nadia Alam
- Past President, Ontario Medical Association, Toronto, ON
| | - Greg Marchildon
- Director, North American Observatory on Health Systems and Policies; Professor, Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON
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20
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López-Gimeno E, Falguera-Puig G, Vicente-Hernández MM, Angelet M, Garreta GV, Seguranyes G. Birth plan presentation to hospitals and its relation to obstetric outcomes and selected pain relief methods during childbirth. BMC Pregnancy Childbirth 2021; 21:274. [PMID: 33794803 PMCID: PMC8017698 DOI: 10.1186/s12884-021-03739-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 03/19/2021] [Indexed: 11/10/2022] Open
Abstract
Background The information on birth plan (BP) usage in Spanish hospitals is scant. Aim To identify the percentage of pregnant women presenting a BP at five hospitals in Spain, the reasons why some women failed to do so and how BP presentation relates to obstetric outcomes and selected pain relief methods. Methods In this descriptive, multi-centre study, data were retrospectively collected. During the postpartum visits at primary healthcare centres in various health districts in Barcelona (Catalonia, Spain), a data collection sheet about obstetric outcomes and analgesia was administered to 432 mothers who had completed a BP during their pregnancies. The main outcome was the rate of BP presentation to the hospital. The sociodemographic and obstetric characteristics and pain relief measures were compared to identify any differences between mothers who presented a BP and those who did not. Results A total of 422 (99.7%) women were studied; 51.2% of women (95% confidence interval (CI): 46.4–55.9) had presented a BP. The main reason for not presenting a BP was because the hospital midwives did not request them (61.2%). No differences were observed in BP presentation according to age, the country of origin, education, employment or hospital. Mothers who presented a BP were more likely to start breastfeeding in the birthing room (82.4% vs. 73.3%; p = 0.024). Epidural analgesia was the most common method used for pain relief (88.9%), and women who presented a BP attempted to use concomitant non-pharmacological methods more often (50.5% vs. 38.8%; p = 0.012). Conclusion Almost half of the mothers failed to present a BP, usually because midwives did not request it.
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Affiliation(s)
- Encarnación López-Gimeno
- Sexual and Reproductive Healthcare Services (ASSIR), Catalan Health Institute (ICS), Gran Via de les Corts Catalans, 587, 08006, Barcelona, Spain. .,Cap Sant Felix, Carretera de Barcelona 473, 08206, Sabadell Barcelona, Spain.
| | - Gemma Falguera-Puig
- Cap Sant Felix, Carretera de Barcelona 473, 08206, Sabadell Barcelona, Spain.,Sexual and Reproductive Healthcare Services (ASSIR), Directorate of Primary Healthcare Service - North Metropolitan Area, Catalan Health Institute (ICS), Barcelona, Spain
| | - Mª Mercedes Vicente-Hernández
- Sexual and Reproductive Healthcare Services (ASSIR), Catalan Health Institute (ICS), Gran Via de les Corts Catalans, 587, 08006, Barcelona, Spain.,Cap Sant Felix, Carretera de Barcelona 473, 08206, Sabadell Barcelona, Spain
| | - Meritxell Angelet
- Sexual and Reproductive Healthcare Services (ASSIR), Catalan Health Institute (ICS), Gran Via de les Corts Catalans, 587, 08006, Barcelona, Spain
| | - Griselda Vázquez Garreta
- Sexual and Reproductive Healthcare Services (ASSIR), Catalan Health Institute (ICS), Gran Via de les Corts Catalans, 587, 08006, Barcelona, Spain
| | - Gloria Seguranyes
- Cap Sant Felix, Carretera de Barcelona 473, 08206, Sabadell Barcelona, Spain.,Faculty of Medicine and Health Sciences, Nursing School, Campus Bellvitge, Universitat de Barcelona, L'Hospitalet del Llobregat, Barcelona, Spain
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Hadizadeh-Talasaz F, Ghoreyshi F, Mohammadzadeh F, Rahmani R. Effect of shared decision making on mode of delivery and decisional conflict and regret in pregnant women with previous cesarean section: a randomized clinical trial. BMC Pregnancy Childbirth 2021; 21:144. [PMID: 33596854 PMCID: PMC7890798 DOI: 10.1186/s12884-021-03615-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 02/03/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The promotion of vaginal birth after cesarean section (VBAC) is the best method for the reduction of repeated cesarean sections. Nonetheless, the decisional conflict which often results from inadequate patient involvement in decision making, may lead to delayed decision making and regret about the choices that were made. The present study aimed to determine the effect of shared decision making on the mode of delivery and decisional conflict and regret in pregnant women with previous cesarean section. METHODS This randomized clinical trial was conducted on 78 pregnant women with a previous cesarean section referring to community health centers in Torbat-e Jam, Iran, in 2019. They were randomly assigned to two groups of intervention and control. During weeks 24-30 of pregnancy, the Decisional Conflict Scale (DCS) was completed by pregnant mothers. Apart from the routine care, the experimental group received a counseling session which was held based on the three-talk model of shared decision making. This session was moderated by a midwife; moreover, a complementary counseling session was administered by a gynecologist. During weeks 35-37 of pregnancy, DCS was completed, and the Decision Regret Scale (DRS) was filled out for both groups at the 8th weeks postpartum and they were asked about the mode of delivery. Data were analyzed in SPSS software (version 19) using the Mann-Whitney, Chi-squared and Fisher's exact tests. p-value less than 0.05 was considered statistically significant. RESULTS After the intervention, the decisional conflict score was significantly lower in the shared decision making (SDM) group, compared to that in the control group (14.90 ± 9.65 vs. 25.41 ± 13.38; P < 0.001). Moreover, in the SDM group, the rate of vaginal birth was significantly higher than that in the control group (P < 0.001). Two month after the delivery, the mean score of decision regret was lower in the SDM group, in comparison to that in the control group (15.67 ± 23.37 vs. 27. 30± 26.75; P = 0.007). CONCLUSIONS Based on the results of the study, shared counseling can be effective in the reduction of decisional conflict and regret, as well as rate enhancement of VBAC. Therefore, it can be concluded that this counseling method can be used in prenatal care to reduce the rate of repeated cesarean section. TRIAL REGISTRATION IRCT20190506043499N1; Name of the registry: Iranian Registry of Clinical Trials; Registered 10. August 2019. URL of registry: https://en.irct.ir/trial/39538. Date of enrolment of the first participant to the trial: August 2019.
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Affiliation(s)
- Fatemeh Hadizadeh-Talasaz
- Department of Midwifery, Faculty of Medicine, Social Development & Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Faezeh Ghoreyshi
- Student Research Committee, Faculty of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Fatemeh Mohammadzadeh
- Department of Epidemiology & Biostatistics, School of Health, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Roghaieh Rahmani
- Department of Midwifery, Faculty of Medicine, Social Development & Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran.
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Evaluation of the birth plan implementation: a parallel convergent mixed study. Reprod Health 2020; 17:138. [PMID: 32894145 PMCID: PMC7487561 DOI: 10.1186/s12978-020-00989-6] [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: 08/12/2020] [Accepted: 09/02/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pregnancy, birth, and motherhood are among the most important events of every woman's life. Training and participation of mothers in the decision-making process of delivery play an essential role in physical as well as psychosocial preparation of the mother. The healthcare system can improve and enhance the level of care by involving the patient in their self-care process. The aim of the present study is to assess the implementation of the birth plan for the first time in Iran in Tabriz city. METHODS/DESIGN The present study uses a mixed-method with a parallel convergence approach, including both quantitative and qualitative phases. The quantitative phase is a randomized controlled clinical trial performed on 106 pregnant women, 32-36 weeks of pregnancy, referring to Taleghani educational hospital in Tabriz city. The participants will be assigned into intervention and control groups using a randomized block method. A training session will be held about the items of the birth plan checklist at weeks 32-36 of gestation for the participants in the intervention group, whereby a mother-requested birth plan will be developed. It will then be implemented by the researcher after admitting them to the delivery ward. Also, those in the control group will receive routine care. During and after the delivery, the questionnaire of delivery information, neonatal information, and Delivery Fear Scale (DFS) will be completed. Also, a partogram will be completed for all participants by the researcher. The participants in both groups will be followed up until six weeks post-delivery, whereby the instruments of Childbirth Experience Questionnaire (CEQ2.0), Edinburgh's Postpartum Depression Scale and PTSD Symptom Scale 1 (PSS-I) will be completed six weeks 4-6 weeks postpartum by the researcher through an interview with participants in Taleghani educational hospital. The general linear model and multivariate logistic regression model will be used while controlling the possible confounding variables. The qualitative phase will be performed to explore the women's perception of the effect of the birth plan on childbirth experience within 4-6 weeks postpartum. The sampling will be of a purposeful type on the women who would receive the birth plan and will continue until data saturation. In-depth, semi-structured individual interviews would be used for data collection. The data analysis will be done through content analysis with a conventional approach. The results of the quantitative and qualitative phases will be analyzed separately, and then combined in the interpretation stage. DISCUSSION By investigating the effect of implementing the birth plan on the childbirth experience of women as well as other maternal and neonatal outcomes, an evidence-based insight can be offered using a culturally sensitive approach. The presentation of the results obtained from this study using the mixed method may be effective in improving the quality of care provided for women during labor. TRIAL REGISTRATION Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N58. Date of registration: July 7, 2020. URL: https://en.irct.ir/user/trial/47007/view.
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Mselle LT, Eustace L. Why do women assume a supine position when giving birth? The perceptions and experiences of postnatal mothers and nurse-midwives in Tanzania. BMC Pregnancy Childbirth 2020; 20:36. [PMID: 31931780 PMCID: PMC6958681 DOI: 10.1186/s12884-020-2726-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 01/07/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Before the advent of Western medicine in Tanzania, women gave birth in an upright position either by sitting, squatting or kneeling. Birthing women would hold ropes or trees as a way of gaining strength and stability in order to push the baby with sufficient force. Despite the evidence supporting the upright position as beneficial to the woman and her unborn child, healthcare facilities consistently promote the use of the supine position. The purpose of this study was to explore the perceptions and experiences of mothers and nurse-midwives regarding the use of the supine position during labour and delivery. METHODS We used a descriptive qualitative design. We conducted seven semi-structured interviews with nurse-midwives and two focus group discussions with postnatal mothers who were purposively recruited for the study. Qualitative content analysis guided the analysis. RESULTS Four themes emerged from mothers' and midwives' description of their experiences and perceptions of using supine position during childbirth. These were: women adopted the supine position as instructed by midwives; women experience of using alternative birthing positions; midwives commonly decide birthing positions for labouring women and supine position is the best-known birthing position. CONCLUSION Women use the supine position during childbirth because they are instructed to do so by the nurse-midwives. Nurse-midwives believe that the supine position is the universally known and practised birthing position, and prefer it because it provides flexibility for them to continuously monitor the progress of labour and assist delivery most efficiently. Mothers in this study had no other choice than to labour and deliver their babies in the supine position as instructed because they trusted midwives as skilled professionals who knew what was best given the condition of the mother and her baby.
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Affiliation(s)
- Lilian Teddy Mselle
- Department of Clinical Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Lucia Eustace
- Department of Nursing and Midwifery, Missenyi District Council, Bukoba, Kagera Tanzania
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Konheim-Kalkstein YL, Miron-Shatz T. "If only I had . . .": Regrets from women with an unplanned cesarean delivery. J Health Psychol 2019; 26:1939-1950. [PMID: 31793798 DOI: 10.1177/1359105319891543] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Two hundred twenty-seven women with an unplanned cesarean delivery as their only birth were surveyed on their regrets during childbirth, their personality, childbirth preparation, labor and delivery support, and birth satisfaction. Seventy-three percent of women reported regret which mostly centered on inaction, particularly not advocating for the self. Those with regrets reported lower birth satisfaction (t(220) = 4.84, p < .001). Only emotional support was associated with lower likelihood of experiencing regret (p < .001). Our results suggest the role of support in ameliorating regret and illustrate a need for further study on the role of advocacy in regret and in birth.
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Medeiros RMK, Figueiredo G, Correa ÁCDP, Barbieri M. Repercussions of using the birth plan in the parturition process. ACTA ACUST UNITED AC 2019; 40:e20180233. [PMID: 31188973 DOI: 10.1590/1983-1447.2019.20180233] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 11/20/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To analyze the repercussions of using the Birth Plan in the parturition process from the national and international scientific production. METHODS Integrative literature review performed in the LILACS, PUBMED, CINAHL and SciELO, comprising 13 articles published in English, Spanish and Portuguese, in the period from 2008 through 2018. RESULTS The construction of the Birth Plan during prenatal influences positively the process of parturition and maternal-fetal outcomes. Unrealistic expectations can cause dissatisfaction with the experience of childbirth. Care providers play a central role in supporting its planning and fulfillment. CONCLUSIONS The analyzed publications justify the clinical implementation of the Birth Plan, once it represents an intensifying technology of humanized care and maternal satisfaction. There are still some challenges related to the use of this instrument concerning women's adherence and professional support to improve the fulfillment of the Birth Plans.
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Affiliation(s)
- Renata Marien Knupp Medeiros
- Universidade Federal de Mato Grosso (UFMT), Faculdade de Enfermagem, Programa de Pós-Graduação em Enfermagem. Mato Grosso, Cuiabá, Brasil
| | - Graziele Figueiredo
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Enfermagem, Departamento de Enfermagem na Saúde da Mulher. São Paulo, São Paulo, Brasil
| | - Áurea Christina de Paula Correa
- Universidade Federal de Mato Grosso (UFMT), Faculdade de Enfermagem, Programa de Pós-Graduação em Enfermagem. Mato Grosso, Cuiabá, Brasil
| | - Márcia Barbieri
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Enfermagem, Departamento de Enfermagem na Saúde da Mulher. São Paulo, São Paulo, Brasil
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Ghanbari-Homayi S, Hasani S, Meedya S, Asghari Jafarabadi M, Mirghafourvand M. Nonpharmacological approaches to improve women's childbirth experiences: a systematic review and meta-analysis. J Matern Fetal Neonatal Med 2019; 34:479-491. [PMID: 30983443 DOI: 10.1080/14767058.2019.1608434] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Childbirth is considered a significant experience in women's life. Different models of care and interventions without pharmacological approaches have been used to enhance women's positive childbirth experiences, but the most effective interventions have not been clearly identified.Objective: To assess the effectiveness of nonpharmacological approaches in improving women's childbirth experiences.Methods: We searched Cochrane Library, Medline, Web of Science, Embase, Scopus, ProQuest, Google Scholar, and Persian databases (Magiran, Scientific Information Database, and Barakat) from inception until December 2017. Randomized controlled trials and quasi-randomized controlled trials comparing interventions designed to improve women's childbirth experiences with standard cares were included in this review. Pharmacological interventions were excluded from the study. The outcome measure was women's childbirth experience. Heterogeneity was determined using the Cochrane's test and I2 index. The standardized mean differences were pooled based on random effect models.Results: We included 19 studies (10,141 women) in the review. Results of the meta-analysis of 18 studies (8487 women) demonstrated that all the interventions with nonpharmacological approaches improved childbirth experiences (standardized mean difference: 0.49; 95% confidence interval: 0.33-0.66). But, subgroup meta-analysis showed that different models of midwifery care, support during labor and natural therapies were the most effective interventions in improving women's childbirth experience.Conclusions: Nonpharmacological interventions that enable women to feel supported, safe and respected can lead to improved childbirth experiences. However, there is a need for further studies with larger sample sizes and standardized tool to better assess the effectiveness of specific interventions on women's childbirth experiences.
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Affiliation(s)
- Solmaz Ghanbari-Homayi
- Students' Research Committee, Midwifery Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sonia Hasani
- Students' Research Committee, Midwifery Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shahla Meedya
- Member of South Asia Infant Feeding Research Network (SAIFRN), School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Mohammad Asghari Jafarabadi
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
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Birth Plans and Childbirth Education: What Are Provider Attitudes, Beliefs, and Practices? J Perinat Educ 2019; 28:10-18. [PMID: 31086471 DOI: 10.1891/1058-1243.28.1.10] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
We describe the perception and practices of obstetric providers on birth plans and childbirth education (CBE) classes. Using a national online survey, we collected provider and patient demographics, practice settings, and perceptions. Of 567 surveys, 77% were physicians and 22% were midwives. This cohort believed prenatal care and CBE were predictors of patient satisfaction, while they had unfavorable views of birth plans. Most providers routinely recommended (69.7%) and had favorable views on CBE (84%). Most providers (66.5%) did not recommend birth plans and 31% felt they were predictors of poor obstetrical outcomes. Further research is needed to bridge the gap between provider beliefs and patient desires about their birth experience as well as to understand how to improve childbirth-related patient satisfaction.
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Mirghafourvand M, Mohammad Alizadeh Charandabi S, Ghanbari-Homayi S, Jahangiry L, Nahaee J, Hadian T. Effect of birth plans on childbirth experience: A systematic review. Int J Nurs Pract 2019; 25:e12722. [PMID: 30675962 DOI: 10.1111/ijn.12722] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 04/17/2018] [Accepted: 12/15/2018] [Indexed: 11/29/2022]
Abstract
AIM The birth plans were developed as an approach for pregnant women to present their expectations for labour and childbirth. The aim of this study was to assess whether birth plans (a written document in which pregnant women describe preferences about their care during labour and childbearing) compared with standard or routine approach (supine position, continuous fetal monitoring, enema, episiotomy) affect the birth experience (woman's perception of labour and childbirth as positive or negative experience) or satisfaction with birth. METHODS This systematic review was performed by searching several databases, including Cochrane Library, Web of Science, MEDLINE, Embase, CINAHL, Scopus, PsycINFO, ACP Journal Club, Google Scholar, and Persian databases (SID, Magiran, and Barakat) up to February 10, 2018. RESULTS By searching the databases, 1006 published articles were found, of which 480 and 114 articles were excluded by review of the titles and the abstracts, respectively. Finally, we included three clinical trials (1132 women) in the review. The results of two study showed that the mean score of birth experience in the birth plan group was significantly higher than the control group (P ≤ 0.01). However, the results of a study showed that there were no statistically significant differences between birth plan and control groups (P > 0.05). Quality of included studies was very low. CONCLUSIONS There is not enough evidence to support or refute that birth plan can improve the birth experience or satisfaction with birth.
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Affiliation(s)
- Mojgan Mirghafourvand
- Midwifery Department, Social Determinants of Health Research Center, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sakineh Mohammad Alizadeh Charandabi
- Midwifery Department, Social Determinants of Health Research Center, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Solmaz Ghanbari-Homayi
- Students' Research Committee, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Leila Jahangiry
- Health Education and Health Promotion Department, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Jila Nahaee
- Students' Research Committee, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Tahereh Hadian
- Students' Research Committee, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
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Konheim-Kalkstein YL, Miron-Shatz T, Israel LJ. How Women Evaluate Birth Challenges: Analysis of Web-Based Birth Stories. JMIR Pediatr Parent 2018; 1:e12206. [PMID: 31518300 PMCID: PMC6715066 DOI: 10.2196/12206] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 11/17/2018] [Accepted: 11/20/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Birth stories provide an intimate glimpse into women's birth experiences in their own words. Understanding the emotions elicited in women by certain types of behaviors during labor and delivery could help those in the health care community provide better emotional care for women in labor. OBJECTIVE The aim of this study was to understand which supportive reactions and behaviors contributed to negative or positive emotions among women with regard to their labor and delivery experience. METHODS We sampled 10 women's stories from a popular blog that described births that strayed from the plan. Overall, 90 challenging events that occurred during labor and delivery were identified. Each challenge had an emotionally positive, negative, or neutral evaluation by the woman. We classified supportive and unsupportive behaviors in response to these challenges and examined their association with the woman's emotional appraisal of the challenges. RESULTS Overall, 4 types of behaviors were identified: informational inclusion, decisional inclusion (mostly by health care providers), practical support, and emotional support (mostly by partners). Supportive reactions were not associated with emotional appraisal; however, unsupportive reactions were associated with women appraising the challenge negatively (Fisher exact test, P=.02). CONCLUSIONS Although supportive behaviors did not elicit any particular emotion, unsupportive behaviors did cause women to view challenges negatively. It is worthwhile conducting a larger scale investigation to observe what happens when patients express their needs, particularly when challenges present themselves during labor, and health care professionals strive to cater to them.
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Affiliation(s)
- Yasmine L Konheim-Kalkstein
- Division of Social Sciences, Mount Saint Mary College, Newburgh, NY, United States.,Center for Medical Decision Making, Ono Academic College, Kiryat Ono, Israel
| | - Talya Miron-Shatz
- Center for Medical Decision Making, Ono Academic College, Kiryat Ono, Israel.,Winton Centre for Risk and Evidence Communication, Cambridge University, Cambridge, United Kingdom
| | - Leah Jenny Israel
- Interdisciplinary Center, Psychology Department, Interdisciplinary Center, Herzliya, Israel
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Martucci J, Barnhill A. Examining the use of 'natural' in breastfeeding promotion: ethical and practical concerns. JOURNAL OF MEDICAL ETHICS 2018; 44:615-620. [PMID: 29680805 DOI: 10.1136/medethics-2017-104455] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 02/27/2018] [Accepted: 03/06/2018] [Indexed: 06/08/2023]
Abstract
References to the 'natural' are common in public health messaging about breastfeeding. For example, the WHO writes that 'Breast milk is the natural first food for babies' and the U.S. Department of Health and Human Services has a breastfeeding promotion campaign called 'It's only natural', which champions breastfeeding as the natural way to feed a baby. This paper critically examines the use of 'natural' language in breastfeeding promotion by public health and medical bodies. A pragmatic concern with selling breastfeeding as 'natural' is that this may reinforce the already widespread perspective that natural options are presumptively healthier, safer and better, a view that works at cross-purposes to public health and medicine in other contexts. An additional concern is that given the history of breastfeeding in the USA, 'natural' evokes specific and controversial conceptions of gender and motherhood.
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Affiliation(s)
- Jessica Martucci
- Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Anne Barnhill
- Berman Institute of Bioethics, Johns Hopkins University, Baltimore, Maryland, USA
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31
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Soriano-Vidal F, Vila-Candel R, Soriano-Martín P, Tejedor-Tornero A, Castro-Sánchez E. The effect of prenatal education classes on the birth expectations of Spanish women. Midwifery 2018; 60:41-47. [DOI: 10.1016/j.midw.2018.02.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2017] [Revised: 02/02/2018] [Accepted: 02/02/2018] [Indexed: 11/29/2022]
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Afshar Y, Mei JY, Gregory KD, Kilpatrick SJ, Esakoff TF. Birth plans-Impact on mode of delivery, obstetrical interventions, and birth experience satisfaction: A prospective cohort study. Birth 2018; 45:43-49. [PMID: 29094374 DOI: 10.1111/birt.12320] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 09/21/2017] [Accepted: 09/22/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To examine whether the presence of a birth plan was associated with mode of delivery, obstetrical interventions, and patient satisfaction. METHODS This was a prospective cohort study of singleton pregnancies greater than 34 weeks' gestation powered to evaluate a difference in mode of delivery. Maternal characteristics, antenatal factors, neonatal characteristics, and patient satisfaction measures were compared between groups. Differences between groups were analyzed using chi-squared for categorical variables, Fisher exact test for dichotomous variables, and Wilcoxon rank sum test for continuous or ordinal variables. RESULTS Three hundred women were recruited: 143 (48%) had a birth plan. There was no significant difference in the risk of cesarean delivery for women with a birth plan compared with those without a birth plan (21% vs 16%, adjusted odds ratio [adjOR] 1.11 [95% confidence interval (CI) 0.61-2.04]). Women with a birth plan were 28% less likely to receive oxytocin (P < .01), 29% less likely to undergo artificial rupture of membranes (P < .01), and 31% less likely to have an epidural (P < .01). There was no difference in the length of labor (P = .12). Women with a birth plan were less satisfied (P < .01) and felt less in control (P < .01) of their birth experience than those without a birth plan. CONCLUSION Women with and without a birth plan had similar odds of cesarean delivery. Though they had fewer obstetrical interventions, they were less satisfied with their birth experience, compared with women without birth plans. Further research is needed to understand how to improve childbirth-related patient satisfaction.
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Affiliation(s)
- Yalda Afshar
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Los Angeles, CA, USA
| | - Jenny Y Mei
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Los Angeles, CA, USA
| | - Kimberly D Gregory
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Sarah J Kilpatrick
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Tania F Esakoff
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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Yarrington CD, Radoff K, Zera CA. Online Birth Plans and Anticipatory Guidance: A Critical Review Using Web Analytics and Crowdsourcing. J Perinat Educ 2018; 27:32-37. [PMID: 30858679 DOI: 10.1891/1058-1243.27.1.32] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
We assessed the content of online birth plans using Web analytics and crowdsourcing to identify the most commonly accessed online birth plans. We analyzed the first 14 websites of 6 different searches across time. We repeated this search using 200 individuals recruited by a commercial crowdsourcing service. We identified the 12 URLs that appeared most frequently from all searches then categorized the content by relevance to stages of labor or newborn care. Twenty-five different URLs with customizable birth plans were identified by clinical and crowdsourced searches, with considerable overlap. Among the most commonly identified birth plans, we found prompts for outdated practices in a minority (18%-37%). The majority of online birth plans can be positive tools for shared decision making.
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Hidalgo-Lopezosa P, Hidalgo-Maestre M, Rodríguez-Borrego MA. Birth plan compliance and its relation to maternal and neonatal outcomes. Rev Lat Am Enfermagem 2017; 25:e2953. [PMID: 29236838 PMCID: PMC5738855 DOI: 10.1590/1518-8345.2007.2953] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Accepted: 08/27/2017] [Indexed: 11/30/2022] Open
Abstract
Objective: to know the degree of fulfillment of the requests that women reflect in their
birth plans and to determine their influence on the main obstetric and neonatal
outcomes. Method: retrospective, descriptive and analytical study with 178 women with birth plans in
third-level hospital. Inclusion criteria: low risk gestation, cephalic
presentation, single childbirth, delivered at term. Scheduled and urgent cesareans
without labor were excluded. A descriptive and inferential analysis of the
variables was performed. Results: the birth plan was mostly fulfilled in only 37% of the women. The group of women
whose compliance was low (less than or equal to 50%) had a cesarean section rate
of 18.8% and their children had worse outcomes in the Apgar test and umbilical
cord pH; while in women with high compliance (75% or more), the percentage of
cesareans fell to 6.1% and their children had better outcomes. Conclusion: birth plans have a low degree of compliance. The higher the compliance, the better
is the maternal and neonatal outcomes. The birth plan can be an effective tool to
achieve better outcomes for the mother and her child. Measures are needed to
improve its compliance.
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Divall B, Spiby H, Nolan M, Slade P. Plans, preferences or going with the flow: An online exploration of women's views and experiences of birth plans. Midwifery 2017; 54:29-34. [PMID: 28826035 DOI: 10.1016/j.midw.2017.07.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 06/30/2017] [Accepted: 07/31/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To explore women's views of birth plans, and experiences of their completion and use. DESIGN A qualitative, descriptive study, using Internet-mediated research methods. SETTING The discussion boards of two well-known, UK-based, online parenting forums, where a series of questions relating to birth plans were posted. PARTICIPANTS Members of the selected parenting forums who had written and used, or who had chosen not to write or use, a birth plan. FINDINGS Women responded with a range of views and experiences relating to the completion and use of birth plans. The benefits of birth plans were described in terms of communication with healthcare professionals, potentially enhancing awareness of available options, and maintaining a sense of control during labour and birth. However, many respondents believed the idea of 'planning' birth was problematic, and described a reluctance to write a formal plan. The support of healthcare professionals, particularly midwives, was considered essential to the success of both writing and using birth plans. KEY CONCLUSIONS Our findings show a continued debate among women on the benefits and challenges involved in writing and using birth plans, suggesting problems for a 'one size fits all' approach often seen in the use of birth plan templates. In the context of maternity policy supporting women's choice and personalised care, and as a way of acknowledging perceived problems of 'planning' for birth, a flexible approach to birth plans is required, including the consideration of employing alternative nomenclature. IMPLICATIONS FOR PRACTICE Birth plans remain a point of contention in care contexts around the world. Midwives and other healthcare providers play a central role in supporting women to discuss available options, whether or not they decide to complete a formal birth plan.
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Affiliation(s)
- Bernie Divall
- Division of Midwifery, School of Health Sciences, University of Nottingham, Floor 12, Tower Building, University Park, Nottingham NG7 2RD, United Kingdom.
| | - Helen Spiby
- Division of Midwifery, School of Health Sciences, University of Nottingham, Floor 12, Tower Building, University Park, Nottingham NG7 2RD, United Kingdom.
| | - Mary Nolan
- Institute of Health&Society, University of Worcester, Henwick Grove, Worcester WR2 6AJ, United Kingdom.
| | - Pauline Slade
- Institute of Psychology, Health&Society, University of Liverpool, Liverpool L69 3BX, United Kingdom.
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Biescas H, Benet M, Pueyo MJ, Rubio A, Pla M, Pérez-Botella M, Escuriet R. A critical review of the birth plan use in Catalonia. SEXUAL & REPRODUCTIVE HEALTHCARE 2017; 13:41-50. [PMID: 28844357 DOI: 10.1016/j.srhc.2017.05.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Revised: 03/23/2017] [Accepted: 05/23/2017] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The birth plan allows the woman to express her expectations and needs with regards to the childbearing continuum but its use has been debated in the clinical context and in published literature. The birth plan was first introduced in the Spanish Health Service in 2008 through the Strategy for the Care in Normal Childbirth. In Catalonia, the Normal Childbirth Care Programme has promoted the use of birth plans in hospitals participating in this Programme. OBJECTIVE This works describes and analyses the birth plans produced by the participating hospitals in order to gather knowledge about the options available to women. METHOD Qualitative study in which the content of birth plans is systematically and quantitatively described in order to evaluate options available to women. The final sample includes all the birth plans provided by 30 Catalonian public hospitals. Following an initial assessment, it was decided to devise a grading scale which allowed to code and assign a value to each of the items contained in the birth plans. RESULTS Three different types of birth plan are identified: a) those which present a list of items with no (or very little) associated explanations, b) list of items with some explanations and c) plans without items which only explain normal working practices in the hospital and/or protocols.
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Affiliation(s)
- Herminia Biescas
- General Directorate for Health Planning, Ministry of Health of Catalonia, Spain.
| | - Marta Benet
- Inclusive Societies, Policies and Communities Research Group, Faculty of Health and Welfare Sciences, University of Vic - Central University of Catalonia, Spain.
| | - Maria J Pueyo
- General Directorate for Health Planning, Ministry of Health of Catalonia, Department of Experimental and Health Sciences, University Pompeu Fabra, Spain.
| | - Anna Rubio
- General Directorate for Health Planning, Ministry of Health of Catalonia, Spain.
| | - Margarita Pla
- University of Barcelona, Department of Public Health, Mental Health and Perinatal Nursing, Inclusive Societies, Policies and Communities Research Group, Spain.
| | - Mercedes Pérez-Botella
- University of Central Lancashire, School of Community Health and Midwifery, Brook Building, 222, Preston PR1 2HE, UK.
| | - Ramón Escuriet
- General Directorate for Health Planning, Ministry of Health of Catalonia, Mar School of Nursing, University Pompeu Fabra, Travessera de les Corts 131-159, Pavelló Ave Maria, Barcelona 08028, Spain.
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McMullen S, Szabo S, Halbert R, Lai C, Parikh A, Bunce M, Khoury R, Small A, Masaquel A. Tools for Communication: Novel Infrastructure to Address Patient-Perceived Gaps in Oncology Care. Clin J Oncol Nurs 2017; 21:E38-E48. [DOI: 10.1188/17.cjon.e38-e48] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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38
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DeBaets AM. From birth plan to birth partnership: enhancing communication in childbirth. Am J Obstet Gynecol 2017; 216:31.e1-31.e4. [PMID: 27664497 DOI: 10.1016/j.ajog.2016.09.087] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 08/31/2016] [Accepted: 09/14/2016] [Indexed: 11/28/2022]
Abstract
Birth plans were developed with the intention of enhancing a woman's prepared decision-making in the labor and delivery process and to offer obstetric care providers with important details about those decisions. Through the use of birth plans, women can reflect on their values and choices regarding what care practices and interventions they do and do not want in birth; they can communicate these values in advance to their care providers. However, birth plans are often ineffective at accomplishing their goals for a number of reasons. They may reflect outdated concerns about routine practices or overly emphasize minor matters. Many popular pregnancy websites offer birth plans that use checklist formats, and women who use these are not counseled about which options may require or preclude other options. Some women may have inappropriately rosy expectations of how their labor and delivery processes will progress or have received poor advice. The use of a birth plan may invoke hostility from hospital staff members who may disregard the plans and look down on the women who make them. An alternative approach to the use of birth plans to enhance a woman's participation and informed consent in the birth process is the birth partnership, in which women and their obstetric care providers take time to discuss thoroughly the choices to be made in birth in advance to have those choices best reflect the values of the woman giving birth. Meeting to discuss values and choices before labor offers the opportunity for mutual education between provider and patient about the choices to be made and the values that inform those choices. Effective communication and working to build mutual trust can serve as preventive measures to avoid many conflicts that arise in the birth process.
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Mei JY, Afshar Y, Gregory KD, Kilpatrick SJ, Esakoff TF. Birth Plans: What Matters for Birth Experience Satisfaction. Birth 2016; 43:144-50. [PMID: 26915304 DOI: 10.1111/birt.12226] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/12/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND To categorize individual birth plan requests and determine if number of requests and request fulfillment is associated with birth experience satisfaction. METHODS This is a sub-analysis of a prospective cohort study of 302 women with singleton pregnancies with and without birth plans. Women with a hard copy of their birth plans who completed a postdelivery satisfaction survey were included in this study. We described the number and type of birth plan requests and associated the number of requests and request fulfillment with overall satisfaction, expectations met, and sense of control. Differences between groups were analyzed using chi-square, Spearman rank correlation, and logistic regression. RESULTS One hundred and nine women presented to Labor and Delivery with a hard copy of their prewritten birth plan. We identified 23 unique requests. The most common requests were no intravenous analgesia (82%) and exclusive breastfeeding (74%). The requests most fulfilled were avoidance of episiotomy (100%) and no operative vaginal delivery (89%). Having a higher number of requests fulfilled correlated with greater overall satisfaction (p = 0.03), higher chance of expectations being met (p < 0.01), and feeling more in control (p < 0.01). Having a high number of requests was associated with an 80 percent reduction in overall satisfaction with the birth experience (p < 0.01). CONCLUSIONS Having a higher number of requests fulfilled was positively associated with birth experience satisfaction, while having a high number of requests was inversely associated with birth experience satisfaction. Further research is needed to understand how to improve birth plan-related birth experience satisfaction.
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Affiliation(s)
- Jenny Y Mei
- David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Yalda Afshar
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
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Abstract
OBJECTIVE: To describe and summarize the current body of evidence on the subject of birth plans to develop a research agenda.METHOD: A narrative review was undertaken to offer a comprehensive overview of themes emerging from previous research in this area.FINDINGS: Thirty-five papers from 33 studies were retrieved and grouped into three main themes: the impact of birth plans on obstetric outcomes, women’s experiences and opinions of completing and using birth plans, and health care professionals’ beliefs about and experiences of the use of birth plans. Key findings relate to beliefs about the benefits and challenges of birth plans, as described by women and health care professionals and the impact of birth plans on a range of obstetric outcomes.CONCLUSION: This review brings together a range of studies around birth plans and synthesizes key themes. Little homogeneity was seen in the studies identified, and a wide variety of care contexts and childbirth philosophies were represented. Findings suggest the need for further research into whether there are ideal circumstances and environments for the completion of birth plans antenatally and whether disparities between expectations described in women’s plans and experiences in labor and birth can be reduced.
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Welsh JV, Symon AG. Unique and proforma birth plans: a qualitative exploration of midwives׳ experiences. Midwifery 2014; 30:885-91. [PMID: 24703440 DOI: 10.1016/j.midw.2014.03.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Revised: 01/30/2014] [Accepted: 03/02/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND birth plans detailing a woman׳s preferences for intrapartum care are a common feature in British maternity units, and are a means of encouraging the implementation of choice. Proforma versions may be incorporated routinely in antenatal case notes, or the woman may devise her own unique birth plan. Although women׳s views of birth plans have been explored, the views of midwives have not to date been evaluated. The growth of midwife-led units in the UK has highlighted different philosophies of care, some of which can be reflected in the different types of birth plan. Given the increasingly diverse nature of UK midwifery workplaces we set out to explore and compare the experience of midwives working in midwife-led and obstetric-led settings in relation to unique and proforma birth plans. METHOD qualitative study using focus groups of midwives in a midwife-led unit (MLU; n=5) and obstetric-led unit (OLU; n=4) in the East of England. We used an interpretative phenomenological analytical approach. FINDINGS three main themes arose from the data. Firstly, the term 'birth plan' can be misleading, and was criticised for encouraging the belief that birth can be 'planned'. In addition, midwives claimed that 'unique' birth plans, especially those influenced by some consumer advocacy groups, are becoming standardised in their rejection of policies and procedures and requests for intervention-free birth. Secondly, birth plans were a source of irritation for midwives in both groups, although the cause of the irritation differed between groups. Finally, it was found that midwives in both groups felt that birth plans put pressure on them, although again, the source of the pressure, and therefore the way in which midwives reacted to this pressure, differed between groups. CONCLUSIONS the term 'birth plan' can be misleading and create false expectations. If 'unique' birth plans are becoming 'standardised' in the sense that they routinely request the same things, they are little different to proforma birth plans. Some midwives perceive pressure both from women and the wider multidisciplinary team as a result of birth plans, a perception that causes some irritation.
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Affiliation(s)
- Joanne V Welsh
- Addenbrooke׳s Hospital, Hills Road, Cambridge CB2 0QQ, UK.
| | - Andrew G Symon
- Mother and Infant Research Unit, School of Nursing & Midwifery, University of Dundee, 11 Airlie Place, Dundee DD1 4HJ, UK.
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