The childbirth experience: A systematic review of predictors and outcomes

BACKGROUND

Birth is often viewed as a pathological event, consequently, there has been an increase in literature focusing on predictors, experience and implications of traumatic childbirth and childbirth-related posttraumatic stress. However, to fully understand childbirth experiences a salutogenic perspective is required. This enables an understanding of what facilitates a positive childbirth experience besides what places women at risk of experiencing traumatic childbirth.

OBJECTIVE

To identify the psychosocial factors that could contribute to or be influenced by women's subjective accounts of childbirth.

METHOD

An in-depth literature search across four databases was undertaken. Quality appraisal based on internal and external validity was conducted and a combined numerical summary and categorical description were undertaken.

FINDINGS

Nineteen papers were included in the review and the variables grouped into three categories. The variables relate to 'Measures of labour and birth experience' (discussing the impact of events and perceptions during labour and birth). The second category discusses how 'support and relationships' can potentially shape the birth experience or be altered by it and finally, 'Psychological variables: influence and impact' is examined extensively.

DISCUSSION

The results of the review highlight significant contradictory evidence of what influences birth experiences. The findings confirm the dearth of available literature concerning positive birth experiences and most variables identified were pathogenic. This review suggests that such factors for PTSD may differ from those that influence birth experiences and should be examined separately. An enhanced understanding of the range of experiences is required to support women's rights in achieving a positive birth.

Immersive simulation training: Comparing the impact on midwifery and paramedic students' confidence to perform basic life support skills

BACKGROUND

Simulated practice using high fidelity has been shown to have significant benefits in the medical and nursing field. However, the benefits amongst paramedical and midwifery students are not well known.

AIM

The aim of this study was to explore and compare the impact of Immersive Simulation Training (IST) on midwifery and paramedic students' confidence to perform a skill (basic life support) in real-life stressful and life-threatening scenarios.

DESIGN

A mixed-method approach with an explanatory sequential design was used.

SETTING AND PARTICIPANTS

Seventeen first year student midwives and paramedics were recruited from one Higher Education Institution.

MEASUREMENTS

A validated confidence questionnaire and focus groups were used to collect data.

FINDINGS

Students' confidence following IST was significantly improved when compared to confidence following conventional simulation training (CST); a statistically significant increase of 6.71 (95% CI, 3.57 to 9.84), p < 0.001. Additionally, five themes were identified; 'Needing a solid foundation', 'The role of peer support' and 'It is just not real' following CST and 'A steep learning curve' and 'A whole new world' following IST.

CONCLUSION

The study identified the important role of CST to establish a foundation but the need for escalation to IST to ensure deeper learning and preparedness for real life scenarios and should both be integrated in curricula.