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Nieuwenhuijze M, Leahy-Warren P, Healy M, Aktaş S, Aydin R, Calleja-Agius J, Goberna-Tricas J, Hadjigeorgiou E, Hartmann K, Henriksen L, Horsch A, Lange U, Murphy M, Pierron A, Schäfers R, Pajalic Z, Verhoeven C, Berdun DR, Hossain S. The impact of severe perinatal events on maternity care providers: a scoping review. BMC Health Serv Res 2024; 24:171. [PMID: 38326880 PMCID: PMC10848539 DOI: 10.1186/s12913-024-10595-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 01/12/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Severe events during the perinatal period can be experienced as traumatic by pregnant women, their partners or others who are closely involved. This includes maternity care providers who can be affected by being involved in or observing these events. This may have an impact on their personal well-being and professional practice, influencing quality of care. The aim of this study is to map research investigating the impact of severe events during the perinatal period on maternity care providers, and how these experiences affect their well-being and professional practice. METHOD A scoping review following the manual of the Joanna Briggs Institute was undertaken. The electronic bibliographic databases included PubMed/MEDLINE, CINAHL, PsycINFO, PsycARTICLES, SocINDEX, Cochrane, Scopus, Web of Science and databases for grey literature. Records passing the two-stage screening process were assessed, and their reference lists hand searched. We included primary research papers that presented data from maternity care professionals on the impact of severe perinatal traumatic events. A descriptive content analysis and synthesis was undertaken. RESULTS Following a detailed systematic search and screening of 1,611 records, 57 papers were included in the scoping review. Results of the analysis identified four categories, which highlighted the impact of traumatic perinatal events on maternity care providers, mainly midwives, obstetricians and nurses: Traumatic events, Impact of traumatic events on care providers, Changes in care providers' practice and Support for care providers; each including several subcategories. CONCLUSION The impact of traumatic perinatal events on maternity care providers ranged from severe negative responses where care providers moved position or resigned from their employment in maternity care, to responses where they felt they became a better clinician. However, a substantial number appeared to be negatively affected by traumatic events without getting adequate support. Given the shortage of maternity staff and the importance of a sustainable workforce for effective maternity care, the impact of traumatic perinatal events requires serious consideration in maintaining their wellbeing and positive engagement when conducting their profession. Future research should explore which maternity care providers are mostly at risk for the impact of traumatic events and which interventions can contribute to prevention.
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Affiliation(s)
- Marianne Nieuwenhuijze
- CAPHRI, Maastricht University, Universiteitssingel 60, 6229 ER, Maastricht, The Netherlands.
| | | | | | | | | | | | | | | | | | | | | | - Ute Lange
- University of Applied Sciences Bochum, Bochum, Germany
| | | | | | | | | | - Corine Verhoeven
- Amsterdam University Medical Centres, Amsterdam, The Netherlands
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Kuipers Y, Thomson G, Škodová Z, Bozic I, Lísa Sigurðardóttir V, Goberna-Tricas J, Zurera A, Neves DM, Barata C, Klier C. A multidisciplinary evaluation, exploration, and advancement of the concept of a traumatic birth experience. Women Birth 2024; 37:51-62. [PMID: 37658018 DOI: 10.1016/j.wombi.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 07/17/2023] [Accepted: 08/15/2023] [Indexed: 09/03/2023]
Abstract
BACKGROUND Understanding a woman's traumatic birth experience benefits from an approach that considers perspectives from various fields of healthcare and social sciences. AIM To evaluate and explore the multidisciplinary perspectives surrounding a traumatic birth experience to form a theory and to capture its structure. METHODS A multidisciplinary advanced principle-based concept analysis was conducted, including the following systematic steps: literature review, assessment of concept maturity, principle-based evaluation, concept exploration and advancement, and formulating a multidisciplinary concept theory. We drew on knowledge from midwifery, psychology, childbirth education, bioethics, obstetric & gender violence, sociology, perinatal psychiatry, and anthropology. RESULTS Our evaluation included 60 records which were considered as 'mature'. Maturity was determined by the reported concept definition, attributes, antecedents, outcomes, and boundaries. The four broad principles of the philosophy of science epistemology, pragmatics, linguistics, and logic illustrated that women live in a political, and cultural world that includes social, perceptual, and practical features. The conceptual components antecedents, attributes, outcomes, and boundaries demonstrated that a traumatic birth experience is not an isolated event, but its existence is enabled by social structures that perpetuate the diminished and disempowered position of women in medical and institutionalised healthcare regulation and management. CONCLUSION The traumatic childbirth experience is a distinctive experience that can only occur within a socioecological system of micro-, meso-, and macro-level aspects that accepts and allows its existence and therefore its sustainability - with the traumatic experience of the birthing woman as the central construct.
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Affiliation(s)
- Yvonne Kuipers
- School of Health & Social Care, Edinburgh Napier University, 9 Sighthill Court, Edinburgh EH11 4BN, Scotland, UK; Artesis Plantijn University of Applied Sciences, Noorderplaats 2, 2000 Antwerp, Belgium.
| | - Gill Thomson
- School of Community Health & Midwifery, University of Central Lancashire, Preston, Lancashire PR1 2HE, United Kingdom.
| | - Zuzana Škodová
- Institute of Midwifery, Jessenius Faculty of Medicine in Martin, Comenius University Malá Hora 5, 036 01 Martin, Slovak republic.
| | - Ina Bozic
- Ina Bozic, Hospital KH Wels/Griesskirchen in Wels, Grieskirchner Str. 42, 4600 Wels, Austria.
| | - Valgerður Lísa Sigurðardóttir
- University of Iceland, Faculty of Nursing and Midwifery, Eiríksgata 34, 101 Reykjavík,Iceland; National University Hospital, Women's Clinic Hringbraut, 101 Reykjavík, Iceland.
| | - Josefina Goberna-Tricas
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Faculty of Medicine and Health Sciences, University of Barcelona, Bellvitge Health Sciences Campus, c/ Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907 Barcelona, Spain.
| | - Alba Zurera
- University of Barcelona, Faculty of Law, Avinguda Diagonal, 684, 08028 Barcelona, Spain.
| | - Dulce Morgado Neves
- ISCTE - Instituto Universitário de Lisboa (ISCTE-IUL), Centro de Investigação e Estudos de Sociologia, Lisboa, Portugal.
| | - Catarina Barata
- Instituto de Ciências Sociais, Universidade de Lisboa, Av. Professor Aníbal de Bettencourt 9, 1600-189 Lisboa, Portugal.
| | - Claudia Klier
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Pulmonology, Allergology and Endocrinology, Comprehensive Center for Pediatrics, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
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Kuipers YJ, Thomson G, Goberna-Tricas J, Zurera A, Hresanová E, Temesgenová N, Waldner I, Leinweber J. The social conception of space of birth narrated by women with negative and traumatic birth experiences. Women Birth 2023; 36:e78-e85. [PMID: 35514007 DOI: 10.1016/j.wombi.2022.04.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/14/2022] [Accepted: 04/18/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Many women experience giving birth as a negative or even as a traumatic event. Birth space and its occupants are fundamentally interconnected with negative and traumatic experiences, highlighting the importance of the social space of birth. AIM To explore experiences of women who have had a negative or traumatic birth to identify the value, sense and meaning they assign to the social space of birth. METHODS A feminist standpoint theory guided the research. Secondary discourse analysis of 51 qualitative data sets/transcripts from Dutch and Czech Republic postpartum women and 551 free-text responses of the Babies Born Better survey from women in the United Kingdom, Netherlands, Belgium, Germany, Austria, Spain, and the Czech Republic. FINDINGS Three themes and associated sub-themes emerged: 1. The institutional dimension of social space related to staff-imposed boundaries, rules and regulations surrounding childbirth, and a clinical atmosphere. 2. The relational dimension of social space related to negative women-healthcare provider interactions and relationships, including notions of dominance, power, authority, and control. 3. The personal dimension of social space related to how women internalised and were affected by the negative social dimensions including feelings of faith misplaced, feeling disconnected and disembodied, and scenes of horror. DISCUSSION/CONCLUSION The findings suggest that improving the quality of the social space of birth may promote better birth experiences for women. The institutional, relational, and personal dimensions of the social space of birth are key in the planning, organisation, and provision of maternity care.
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Affiliation(s)
- Yvonne J Kuipers
- Artesis Plantijn University College, Noorderplaats 2, 2000 Antwerp, Belgium; Edinburgh Napier University, School of Health and Social Care, Sighthill Court, Edinburgh EH11 4BN, Scotland, United Kingdom.
| | - Gill Thomson
- School of Community Health & Midwifery, University of Central Lancashire, Preston, United Kingdom.
| | - Josefina Goberna-Tricas
- University of Barcelona, Faculty of Medicine and Health Sciences, Bellvitge Health Sciences Campus, Carrer de la Feixa Llarga, s/n. 08907 L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Alba Zurera
- University of Barcelona, Faculty of Law, Avinguda Diagonal, 684, 08028 Barcelona, Spain.
| | - Ema Hresanová
- Charles University, Faculty of Social Sciences, U Krize 8, 158 00 Prague, Czech Republic.
| | - Natálie Temesgenová
- Charles University, Faculty of Social Sciences, U Krize 8, 158 00 Prague, Czech Republic.
| | - Irmgard Waldner
- Universitätsklinik Graz, Auenbruggerplatz 14, 8036 Graz, Austria.
| | - Julia Leinweber
- Institute for Midwifery, Charite Universitätsmedizin Berlin, Berlin, Germany.
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Martín-Badia J, Obregón-Gutiérrez N, Goberna-Tricas J. Obstetric Violence as an Infringement on Basic Bioethical Principles. Reflections Inspired by Focus Groups with Midwives. Int J Environ Res Public Health 2021; 18:ijerph182312553. [PMID: 34886279 PMCID: PMC8656655 DOI: 10.3390/ijerph182312553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/21/2021] [Accepted: 11/24/2021] [Indexed: 11/22/2022]
Abstract
Background: obstetric violence is still far too invisible; the word “violence” generates rejection and obstetric violence is complex to define and typify, as it is a subjective experience. It has been widely analyzed from legal, sociological, and clinical perspectives, but not equally so from the bioethical point of view. This article sets out to take a more in-depth look at the experiences of midwives in order to describe the ethical perspectives of obstetric violence. We intend to describe the effects that malpractice and violence within obstetric care have on American and European bioethical principles. Methodology: A qualitative methodology of the phenomenological tradition was used: 24 midwives participated in three focus groups. Results and Discussion: four categories were arrived at; they are “the maleficence of forgetting my vulnerability”, “beneficence requires respect for my integrity and dignity”, “my autonomy is being removed from me” and “a problem of social justice towards us, women”. Conclusion: obstetric violence infringes on the main bioethical principles (non-maleficence, beneficence, autonomy, justice, vulnerability, dignity, and integrity). Beyond whether it is called violence or not, what matters from an ethical perspective is that, as long as women have such negative experiences during pregnancy and childbirth, obstetric care needs better humanizing.
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Affiliation(s)
- Júlia Martín-Badia
- Department of Philosophy, University of Barcelona, 08001 Barcelona, Spain;
| | - Noemí Obregón-Gutiérrez
- University Hospital Parc Taulí, Sabadell, 08208 Barcelona, Spain;
- The Nursing Council of Barcelona, 08019 Barcelona, Spain
| | - Josefina Goberna-Tricas
- Department of Public Health, Mental Health and Perinatal Nursing, Faculty of Medicine and Health Sciences, ADHUC–Research Center for Theory, Gender and Sexuality, University of Barcelona, 08907 Barcelona, Spain
- Correspondence: ; Tel.: +34-934021068
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Goberna-Tricas J, Biurrun-Garrido A, Perelló-Iñiguez C, Rodríguez-Garrido P. The COVID-19 Pandemic in Spain: Experiences of Midwives on the Healthcare Frontline. Int J Environ Res Public Health 2021; 18:ijerph18126516. [PMID: 34204286 PMCID: PMC8296391 DOI: 10.3390/ijerph18126516] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 06/12/2021] [Accepted: 06/14/2021] [Indexed: 11/16/2022]
Abstract
Background: Midwives look after women during pregnancy, childbirth and puerperium. In Spain, the first wave of COVID was particularly virulent. There are few studies about the experiences of midwives providing care during the COVID pandemic and very few have been undertaken in the countries of southern Europe such as Spain. This article sets out to take a more in-depth look at the experiences of midwives who were on the frontline of care during the early months of the COVID-19 pandemic as well as to identify new needs and resilience strategies that can help midwives. Methods: A qualitative methodology of phenomenological tradition was used, interviewing 10 midwives from primary care, hospital and independent care. Results: After content analysis, three central categories emerged: (a) cascade of emotions; (b) professional occupation and concern for the women; (c) resisting the day-to-day; resilience and resistance strategies. Conclusions: Despite the difficulties, midwives are concerned about the loss of rights and autonomy and about the increased vulnerability of women. Midwives have become aware of the power they have in their actions both in health management and administration, as well as in the care of women, creating strategies to provide dignified care to their users.
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Affiliation(s)
- Josefina Goberna-Tricas
- Department of Public Health, Mental Health and Perinatal Nursing, Universitat de Barcelona, 08007 Barcelona, Spain
- Correspondence: (J.G.-T.); (A.B.-G.)
| | - Ainoa Biurrun-Garrido
- Campus Docent, Sant Joan de Déu, Fundació Privada, School of Nursing, Universitat de Barcelona, 08034 Barcelona, Spain
- Sexual and Reproductive Health Clinic, Parc Salut Mar, 08003 Barcelona, Spain
- Correspondence: (J.G.-T.); (A.B.-G.)
| | - Carme Perelló-Iñiguez
- PhD Program in Citizenship and Human Rights, Universitat de Barcelona, 08007 Barcelona, Spain;
| | - Pía Rodríguez-Garrido
- Nursing and Health PhD Program, Universitat de Barcelona, 08007 Barcelona, Spain;
- Area of Sexuality and Diversity of the Department of Equity and Gender, University of O’Higgins, Rancagua 2820000, Chile
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Abstract
BACKGROUND Birth cultures have been transforming in recent years mainly affecting birth care and its socio-political contexts. This situation has affected the feeling of well-being in women at the time of giving birth. AIM For this reason, our objective was to analyse the social meaning that women ascribe to home births in the Chilean context. METHOD We conducted thirty semi-structured interviews with women living in diverse regions ranging from northern to southern Chile, which we carried out from a theoretical-methodological perspective of phenomenology and situated knowledge. Qualitative thematic analysis was used to analyse the information collected in the field work. FINDINGS A qualitative thematic analysis produced the following main theme: 1) Home birth journeys. Two sub-categories: 1.1) Making the decision to give birth at home, 1.2) Giving birth: (re)birth. And four sub-categories also emerged: 1.1.1) Why do I need to give birth at home? 1.1.2) The people around me don't support me; 1.2.1) Shifting emotions during home birth, 1.2.2) I (don't) want to be alone. CONCLUSION We concluded that home births involve an intense and diverse range of satisfactions and tensions, the latter basically owing to the sociocultural resistance surrounding women. For this reason, they experienced home birth as an act of protest and highly valued the presence of midwives and their partners.
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Affiliation(s)
- Pía Rodríguez-Garrido
- Department of Public Health, Mental Health and Perinatal Nursing, Faculty of Medicine and Health Sciences, ADHUC Research Centre: Theory, Gender and Sexuality, University of Barcelona, Barcelona, Spain
- Department of Health, University of O’Higgins, O’Higgins, Chile
| | - Josefina Goberna-Tricas
- Department of Public Health, Mental Health and Perinatal Nursing, Faculty of Medicine and Health Sciences, ADHUC Research Centre: Theory, Gender and Sexuality, University of Barcelona, Barcelona, Spain
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Abstract
BACKGROUND Induced lactation enables a woman who has not given birth to breastfeed a child. Lactation may be induced through both pharmacological and non-pharmacological methods, although the desired outcome cannot always be achieved. RESEARCH AIMS The aims of this scoping review was to assess the different methods used to induce lactation, as well as the factors related to sucking the breast effectively and the production of human milk. METHODS We searched five databases from June 2019-February 2020 for studies referring to methods and factors related to breast suckling and/or the volume of milk produced after inducing lactation, using the following search terms and Boolean operators: breastfeeding AND induced lactation AND adoptive mothers OR surrogate mothers OR female homosexuality OR non-gestating. The final review included a total of 24 articles. RESULTS Pharmacological methods were not always used to produce milk, although breast stimulation was essential. The age of the child, interference due to bottle feeding, breast stimulation, and the support received were important factors in the induction of lactation. There were several factors that may account for the differences between developing and higher income countries in methods of induced lactation and the amount of milk that study participants produced. There was no consensus over whether previous pregnancy and/or breastfeeding experience influenced induced lactation. CONCLUSION Health professionals need to have adequate knowledge about induction methods, the preferences of each woman, and the reasons for inducing lactation, to provide proper assistance. However, the lack of standardization about induction of lactation makes it difficult.
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Affiliation(s)
- Gemma Cazorla-Ortiz
- 59534 Department of Public Health, Mental Health and Perinatal Nursing, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Bellvitge Campus (HUBc), Pavelló de Govern, L'Hospitalet de Llobregat, Barcelona, Spain.,203277 Hospital Universitari Parc Taulí, Barcelona, Spain
| | | | - Maria Rosa Rozas-Garcia
- Department of Public Health, Mental Health and Perinatal Nursing, Faculty of Medicine and Health Services, ADHUC-Research Center for Theory, Gender and Sexuality, Universitat de Barcelona, Barcelona, Spain
| | - Josefina Goberna-Tricas
- Department of Public Health, Mental Health and Perinatal Nursing, Faculty of Medicine and Health Services, ADHUC-Research Center for Theory, Gender and Sexuality, Universitat de Barcelona, Barcelona, Spain
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Cazorla-Ortiz G, Galbany-Estragués P, Obregón-Gutiérrez N, Goberna-Tricas J. Understanding the Challenges of Induction of Lactation and Relactation for Non-Gestating Spanish Mothers. J Hum Lact 2020; 36:528-536. [PMID: 31237797 DOI: 10.1177/0890334419852939] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Induced lactation and relactation are the processes that enable breastfeeding in non-gestating mothers. RESEARCH AIM The aim of this study was to describe and interpret the challenges faced by mothers who undergo induced breastfeeding and relactation for adopted infants, infants born via surrogacy, and infants born to same-sex female partners. METHODS A qualitative study was performed using in-depth interviews conducted with Spanish women (N = 9) who had decided to undergo induced lactation or relactation. The data were collected between October 2014 and May 2017. The length of the study was due to the difficulty in locating and recruiting the sample. Interviews were transcribed and coded with the ATLAS.ti v.7.5.7 software. We performed a deductive thematic analysis, creating categories based on the interview questions, which we developed on the basis of previous literature about induced lactation and relactation. RESULTS Participants described the following challenges: the physical hardships of the process; breastfeeding problems; difficulty with accessing information about induced lactation or relactation; and lack of support from health professionals. Breastfeeding periods lasted from 1.5 months to 4 years. Participants reported that breastfeeding increased the closeness between the mother and child and that this feeling of closeness tended to decrease after breastfeeding cessation. CONCLUSION We offer data and analysis that can improve our understanding of the lived experiences of women undergoing the process of relactation or induced lactation and may help guide intervention strategies to support women in this situation.
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Affiliation(s)
- Gemma Cazorla-Ortiz
- Department of Public Health, Mental Health and Perinatal Nursing, Faculty of Medicine and Health Sciences, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.,203277 Hospital Universitari Parc Taulí, Sabadell, Barcelona, Spain
| | - Paola Galbany-Estragués
- 220996 Research group on Methodology, Models, Methods and Outcomes of Health and Social Sciences (M3O) Faculty of Health Sciences and Welfare, University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain.,AFIN. Social and Cultural Department, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Noemí Obregón-Gutiérrez
- Department of Public Health, Mental Health and Perinatal Nursing, Faculty of Medicine and Health Sciences, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.,203277 Hospital Universitari Parc Taulí, Sabadell, Barcelona, Spain
| | - Josefina Goberna-Tricas
- 88007 Department of Public Health, Mental Health and Perinatal Nursing, Faculty of Medicine and Health Services, ADHUC-Research Center for Theory, Gender and Sexuality, Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
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Rodríguez-Garrido P, Pino-Morán JA, Goberna-Tricas J. Exploring social and health care representations about home birth: An Integrative Literature Review. Public Health Nurs 2020; 37:422-438. [PMID: 32215962 DOI: 10.1111/phn.12724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 02/26/2020] [Accepted: 02/27/2020] [Indexed: 11/29/2022]
Abstract
AIMS Exploring social and health care representations of home birth by conducting an integrative review of the literature. DESIGN Integrative Literature Review. DATA SOURCES The search was based on the following keywords: "birth, home," "home birth," "childbirth, home." And the terms: "planned home birth," and "empowerment women homebirth" (in English). "partos en casa," and "partos domiciliarios" (in Spanish) in the following databases: Biomedical Central, Cochrane Library, Dialnet, DOAJ, Lilacs, PubMed, Scopus, Scielo, and Web of Science. REVIEW METHODS A total of 156 publications dated between 2004 and 2017 were initially obtained and a total of 41 articles were finally selected according to the criteria of inclusion, methodological rigor, and researchers' triangulation. RESULTS Four dimensions of the issue emerged out of the 41 articles analyzed: (a) the Dimension of "Empowerment in Childbirth;" (b) the Dimension of "Comparative Socio-Medical Childbirth Studies;" (c) the "Institutional Dimension of Childbirth;" (d) the "Cultural Dimension of Childbirth." CONCLUSION From the health management perspective, home birth is not widely accepted today as a valid and safe alternative. However, women's social representations indicate an interest in returning to birth at home as a response to the excessive medicalization and institutionalization of childbirth, and value highly its autonomy and comfort.
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Affiliation(s)
- Pía Rodríguez-Garrido
- Department of Public Health, Mental Health and Perinatal Nursing, Faculty of Medicine and Health Sciences, ADHUC Research Centre: Theory, Gender and Sexuality, University of Barcelona, Spain
| | | | - Josefina Goberna-Tricas
- Department of Public Health, Mental Health and Perinatal Nursing, Faculty of Medicine and Health Sciences, ADHUC Research Centre: Theory, Gender and Sexuality, University of Barcelona, Spain
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Gómez-Fernández MA, Goberna-Tricas J, Payá-Sánchez M. El saber experiencial de las matronas de Atención Primaria en la detección de violencia de género durante el embarazo. Estudio cualitativo. Enfermería Clínica 2019; 29:344-351. [DOI: 10.1016/j.enfcli.2019.05.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 05/11/2019] [Accepted: 05/19/2019] [Indexed: 11/25/2022]
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Gómez-Fernández MA, Goberna-Tricas J, Payà-Sánchez M. Intimate partner violence as a subject of study during the training of nurses and midwives in Catalonia (Spain): A qualitative study. Nurse Educ Pract 2017; 27:13-21. [DOI: 10.1016/j.nepr.2017.08.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Revised: 08/01/2017] [Accepted: 08/01/2017] [Indexed: 10/19/2022]
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Escuriet-Peiró R, Goberna-Tricas J, Pueyo-Sanchez MJ, Garriga-Comas N, Úbeda-Bonet I, Caja-López C, Espiga-López I, Ortún-Rubio V. Impact of maternity care policy in Catalonia: a retrospective cross-sectional study of service delivery in public and private hospitals. BMC Pregnancy Childbirth 2015; 15:23. [PMID: 25881263 PMCID: PMC4337058 DOI: 10.1186/s12884-015-0446-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 01/20/2015] [Indexed: 11/10/2022] Open
Abstract
Background As a result of the growing number of interventions that are now performed in the context of maternity care, health authorities have begun to examine the possible repercussions for service provision and for maternal and neonatal health. In Spain the Strategy Paper on Normal Childbirth was published in 2008, and since then the authorities in Catalonia have sought to implement its recommendations. This paper reviews the current provision of maternity care in Catalonia. Methods This was a descriptive study. Hospitals were grouped according to their source of funding (public or private) and were stratified (across four strata) on the basis of the annual number of births recorded within their respective maternity service. Data regarding the distribution of obstetric professionals were taken from an official government survey of hospitals published in 2010. The data on obstetric interventions (caesarean, use of forceps, vacuum or non-specified instruments) performed in 2007, 2010 and 2012 were obtained by consulting discharge records of 44 public and 20 private hospitals, which together provide care in 98% of all births in Catalonia. Proportions and confidence intervals were calculated for each intervention performed in all full-term (37–42 weeks) singleton births. Results Analysis of staff profiles according to the stratification of hospitals showed that almost all the hospitals had more obstetricians than midwives among their maternity care staff. Public hospitals performed fewer caesareans [range between 19.20% (CI 18.84-19.55) and 28.14% (CI 27.73-28.54)] than did private hospitals [range between 32.21% (CI 31.78-32.63) and 39.43% (CI 38.98-39.87)]. The use of forceps has decreased in public hospitals. The use of a vacuum extractor has increased and is more common in private hospitals. Conclusions Caesarean section is the most common obstetric intervention performed during full-term singleton births in Catalonia. The observed trend is stable in the group of public hospitals, but shows signs of a rise among private institutions. The number of caesareans performed in accredited public hospitals covers a limited range with a stable trend. Among public hospitals the highest rate of caesareans is found in non-accredited hospitals with a lower annual number of births.
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Affiliation(s)
- Ramón Escuriet-Peiró
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain. .,Directorate-General for Health Planning and Research, Ministry of Health of the Government of Catalonia, Barcelona, Spain.
| | - Josefina Goberna-Tricas
- Department of Public Health, Mental Health and Perinatal Nursing, Universitat de Barcelona, Bellvitge Health Sciences Campus, Pavelló de Govern, 3a planta, C/Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Maria J Pueyo-Sanchez
- Directorate-General for Health Planning and Research, Ministry of Health of the Government of Catalonia, Barcelona, Spain.
| | - Neus Garriga-Comas
- Department of Public Health, Mental Health and Perinatal Nursing, Universitat de Barcelona, Bellvitge Health Sciences Campus, Pavelló de Govern, 3a planta, C/Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain. .,Hospital de Manresa, Fundació Althaia, Manresa, Spain.
| | - Immaculada Úbeda-Bonet
- Department of Public Health, Mental Health and Perinatal Nursing, Universitat de Barcelona, Bellvitge Health Sciences Campus, Pavelló de Govern, 3a planta, C/Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Carmen Caja-López
- Department of Public Health, Mental Health and Perinatal Nursing, Universitat de Barcelona, Bellvitge Health Sciences Campus, Pavelló de Govern, 3a planta, C/Feixa Llarga s/n, 08907, L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Isabel Espiga-López
- Observatory on Women's Health, Subdirectorate for Quality and Cohesion, Ministry of Health, Social Services and Equality, Madrid, Spain.
| | - Vicente Ortún-Rubio
- Faculty of Economic and Business Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain.
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Falcó-Pegueroles A, Lluch-Canut T, Roldan-Merino J, Goberna-Tricas J, Guàrdia-Olmos J. Ethical conflict in critical care nursing: Correlation between exposure and types. Nurs Ethics 2014; 22:594-607. [PMID: 25335920 DOI: 10.1177/0969733014549883] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Ethical conflicts in nursing have generally been studied in terms of temporal frequency and the degree of conflict. This study presents a new perspective for examining ethical conflict in terms of the degree of exposure to conflict and its typology. OBJECTIVES The aim was to examine the level of exposure to ethical conflict for professional nurses in critical care units and to analyze the relation between this level and the types of ethical conflict and moral states. RESEARCH DESIGN This was a descriptive correlational study. Central and dispersion, normality tests, and analysis of variance were carried out. PARTICIPANTS AND RESEARCH CONTEXT A total of 203 nurses were from two third-level teaching hospitals in Spain. Both centers are part of the University of Barcelona Health Network. Participants filled out the Ethical Conflict in Nursing Questionnaire-Critical Care Version. ETHICAL CONSIDERATIONS This investigation received the approval of the ethical committees for clinical investigation of the two participating hospitals. Participants were informed of the authorship and aims of the study. FINDINGS The index of exposure to ethical conflict was [Formula: see text]. The situations involving analgesic treatment and end-of-life care were shown to be frequent sources of conflict. The types of ethical conflict and moral states generally arranged themselves from lesser to greater levels of index of exposure to ethical conflict. DISCUSSION The moderate level of exposure to ethical conflict was consistent with other international studies. However, the situations related with family are infrequent, and this presents differences with previous research. The results suggest that there is a logical relationship between types of conflict and levels of exposure to ethical conflict. CONCLUSION The types of ethical conflict and moral states were related with the levels of exposure to ethical conflict. The new perspective was shown to be useful for analyzing the phenomenon of ethical conflict in the nurse.
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Muñoz-Sellés E, Vallès-Segalés A, Goberna-Tricas J. Use of alternative and complementary therapies in labor and delivery care: a cross-sectional study of midwives' training in Catalan hospitals accredited as centers for normal birth. BMC Complement Altern Med 2013; 13:318. [PMID: 24238197 PMCID: PMC4225673 DOI: 10.1186/1472-6882-13-318] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 10/30/2013] [Indexed: 12/18/2022]
Abstract
BACKGROUND The use of complementary and alternative medicine (CAM) and complementary and alternative therapies (CAT) during pregnancy is increasing. Scientific evidence for CAM and CAT in the field of obstetrics mainly covers pain relief in labor. Midwives are responsible for labor and delivery care: hence, their knowledge of CAM and CAT is important. The aims of this study are to describe the professional profile of midwives who provide care for natural childbirth in Catalan hospitals accredited as centers for normal birth, to assess midwives' level of training in CAT and their use of these therapies, and to identify specific resources for CAT in labor wards. METHODS A descriptive, cross-sectional, quantitative method was used to assess the level of training and use of CAT by midwives working at 28 hospitals in Catalonia, Spain, accredited as public normal birth centers. RESULTS Just under a third of midwives (30.4%) trained in CAT after completion of basic training. They trained in an average of 5.97 therapies (SD 3.56). The number of CAT in which the midwives were trained correlated negatively with age (r = - 0.284; p < 0.001) and with their time working at the hospital in years (r = - 0.136; p = 0.036). Midwives trained in CAT considered that the following therapies were useful or very useful for pain relief during labor and delivery: relaxation techniques (64.3%), hydrotherapy (84.8%) and the application of compresses to the perineum (75.9%). The availability of resources for providing CAT during normal birth care varied widely from center to center. CONCLUSIONS Age may influence attitudes towards training. It is important to increase the number of midwives trained in CAM for pain relief during childbirth, in order to promote the use of CAT and ensure efficiency and safety. CAT resources at accredited hospitals providing normal childbirth care should also be standardized.
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Affiliation(s)
- Ester Muñoz-Sellés
- Department of Public Health, Mental Health and Perinatal Nursing, University School of Nursing, University of Barcelona, Barcelona, Spain
| | - Antoni Vallès-Segalés
- Department of Public Health, Faculty of Medicine, University of Barcelona, Barcelona, Spain
| | - Josefina Goberna-Tricas
- Department of Public Health, Mental Health and Perinatal Nursing, University School of Nursing, University of Barcelona, Barcelona, Spain
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15
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Goberna-Tricas J, Banús-Giménez MR, Palacio-Tauste A, Linares-Sancho S. Satisfaction with pregnancy and birth services: The quality of maternity care services as experienced by women. Midwifery 2011; 27:e231-7. [DOI: 10.1016/j.midw.2010.10.004] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2010] [Revised: 08/18/2010] [Accepted: 10/03/2010] [Indexed: 11/16/2022]
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