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Ranchoff BL, Paterno MT, Attanasio LB. Continuity of Clinician Type and Intrapartum Experiences During the Perinatal Period in California. J Midwifery Womens Health 2024; 69:224-235. [PMID: 38164766 DOI: 10.1111/jmwh.13603] [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] [Revised: 10/21/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION Continuity of care with an individual clinician is associated with increased satisfaction and better outcomes. Continuity of clinician type (ie, obstetrician-gynecologist or midwife) may also impact care experiences; however, it is unknown how common it is to experience discontinuity of clinician type and what its implications are for the birth experience. We aimed to identify characteristics associated with having a different clinician type for prenatal care than for birth and to compare intrapartum experiences by continuity of clinician type. METHODS For this cross-sectional study, data were from the 2017 Listening to Mothers in California survey. The analytic sample was limited to individuals with vaginal births who had midwifery or obstetrician-gynecologist prenatal care (N = 1384). Bivariate and multivariate analysis examined characteristics of individuals by continuity of clinician type. We then examined associations of clinician type continuity with intrapartum care experiences. RESULTS Overall, 74.4% of individuals had the same type of clinician for prenatal care and birth. Of individuals with midwifery prenatal care, 45.1% had a different birth clinician type, whereas 23.5% of individuals who had obstetrician-gynecologist prenatal care had a different birth clinician type. Continuity of clinician type was positively associated with having had a choice of perinatal care clinician. There were no statistically significant associations between clinician type continuity and intrapartum care experiences. DISCUSSION Findings suggest individuals with midwifery prenatal care frequently have a different type of clinician attend their birth, even among those with vaginal births. Further research should examine the impact of multiple dimensions of continuity of care on perinatal care quality.
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Affiliation(s)
- Brittany L Ranchoff
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, Massachusetts
| | - Mary T Paterno
- Baystate Midwifery and Women's Health, Springfield, Massachusetts
| | - Laura B Attanasio
- Department of Health Promotion and Policy, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, Massachusetts
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Siddiqui S, Smith-Morris C. Professional competition amidst intractable maternal mortality: Midwifery in rural Pakistan during the COVID-19 pandemic. Soc Sci Med 2022; 313:115426. [PMID: 36242801 PMCID: PMC9549742 DOI: 10.1016/j.socscimed.2022.115426] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 09/27/2022] [Accepted: 10/03/2022] [Indexed: 01/26/2023]
Abstract
Low-income countries with intransigent maternal mortality rates often follow WHO guidelines that prioritize access to skilled, or professionalized, prenatal and birthing care. Yet the impact of these initiatives in areas still suffering high maternal mortality is opaque. Despite heavy and long investments, the professionalization of midwifery in Pakistan is incomplete, and declines in maternal mortality have plateaued. Traditional midwives have lost status, but they continue to see clients and have influence in their rural communities. We conducted a rapid ethnography among traditional midwives (Dais) and trained Lady Health Workers (LHWs) in two communities of Attock, Pakistan from May to July of 2020. Our findings underscore the importance of long-term presence and trust to maternal care, especially in conditions of resource scarcity or fear (e.g., fear of COVID). We provide evidence of overt disparagement of Dais by LHWs; (2) illustration of the conflicts between gender norms and biomedical priorities of hospitalized births; and (3) exacerbated fear of hospitals during COVID, which served to highlight the advantages of Dai care. Professionalization programs for midwifery must include structures and training to ensure collaborative communications across the country's midwives. Failure to respect the rational decisions of traditional midwives and their patients in circumstances of scarcity, high stress, and isolation only ignores the material and cultural conditions of these vulnerable communities.
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Mattison CA, Bourret K, Dion ML. Leveling up evidence syntheses: filling conceptual gaps of the role of midwifery in health systems through a network analysis. BMC Res Notes 2022; 15:216. [PMID: 35729666 PMCID: PMC9210622 DOI: 10.1186/s13104-022-06094-0] [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: 12/22/2021] [Accepted: 06/07/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE In the research note, our main objective is to explore the value of combining an evidence synthesis with a network analysis. The discussion is based on a critical interpretive synthesis, which combines systematic review methodology with qualitive inquiry, and 'research concept' network analysis focused on understanding the roles of midwives in health systems. The interpretative analytic approach of a critical interpretive synthesis has a high explanatory value by allowing for the review of a diverse body of literature and is well-suited to delving into areas that are not well understood, such as midwifery. RESULTS Network analyses use graphs to represent relationships between concepts and brought to light important additional insights into the literature that were not present in the evidence synthesis alone. Given the lack of theoretical development in the area of midwifery in health systems, the critical interpretive synthesis allowed for the generation of concepts used to inform a theoretical framework, while the novel application of an exploratory network analysis deepened understanding of conceptual areas of saturation within the field, as well as identifying critical gaps in the literature.
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Affiliation(s)
- Cristina A Mattison
- Department of Women and Children's Health, 2Karolinska Institutet, Tomtebodavägen 18A, Solna, 171 77, Sweden. .,Department of Obstetrics and Gynecology, McMaster University, McMaster Midwifery Research Centre, 1280 Main St. West, HSC-4H26, L8S 4K1, Hamilton, Canada.
| | - Kirsty Bourret
- Department of Women and Children's Health, 2Karolinska Institutet, Tomtebodavägen 18A, Solna, 171 77, Sweden.,Department of Obstetrics and Gynecology, McMaster University, McMaster Midwifery Research Centre, 1280 Main St. West, HSC-4H26, L8S 4K1, Hamilton, Canada
| | - Michelle L Dion
- Department of Political Science, McMaster University, 1280 Main St. West, KTH-533, Hamilton, ON, L8S 4M4, Canada
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LoGiudice JA. Reducing Racial Disparities in Maternal Healthcare: A Midwifery Focus. SAGE Open Nurs 2022; 8:23779608221138430. [PMID: 36419773 PMCID: PMC9677161 DOI: 10.1177/23779608221138430] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 10/15/2022] [Accepted: 10/23/2022] [Indexed: 01/19/2024] Open
Abstract
When compared with other developed nations, the United States (U.S.) has the highest maternal mortality rate. Furthermore, in the U.S. Black women are dying during pregnancy or the postpartum period at a rate three times higher than that of white women. This disparity points to the question of why inequities in maternal healthcare exist and, of critical importance, what is being done to combat them. The stark reality is that systemic racism is at the core of these health disparities and must be addressed by both the individuals providing care and the healthcare systems themselves. The underpinnings of systematic racism in maternal healthcare, as well as ways to both dismantle this racism and move forward with constructive changes, are explained in this practice update. Specifically, the positive impact that midwifery care has on maternal health outcomes will be discussed.
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Affiliation(s)
- Jenna A. LoGiudice
- Egan School of Nursing and Health Studies, Fairfield University, Fairfield, CT, USA
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Mattison C, Bourret K, Hebert E, Leshabari S, Kabeya A, Achiga P, Robinson J, Darling E. Health systems factors impacting the integration of midwifery: an evidence-informed framework on strengthening midwifery associations. BMJ Glob Health 2021; 6:bmjgh-2020-004850. [PMID: 34083246 PMCID: PMC8174493 DOI: 10.1136/bmjgh-2020-004850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 05/08/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction Midwifery associations are organisations that represent midwives and the profession of midwifery. They support midwives to reduce maternal and newborn mortality and morbidity by promoting the overall integration of midwifery in health systems. Our objective was to generate a framework for evidence-informed midwifery association strengthening. Methods A critical interpretive synthesis complemented by key informant interviews, focus groups, observations, and document review was used to inform the development of concepts and theory. Three electronic bibliographical databases (CINAHL, EMBASE and MEDLINE) were searched through to 2 September 2020. A coding structure was created to guide the synthesis across the five sources of evidence. Results A total of 1634 records were retrieved through electronic searches and 57 documents were included in the critical interpretive synthesis. Thirty-one (31) key informant interviews and five focus groups were completed including observations (255 pages) and audio recordings. Twenty-four (24) programme documents were reviewed. The resulting theoretical framework outlines the key factors by context, describes the system drivers that impact the sustainability of midwifery associations and identifies the key-enabling elements involved in designing programmes that strengthen midwifery associations. Conclusion Midwifery associations act as the web that holds the profession together and are key to the integration of the profession in health systems, supporting enabling environments and improving gender inequities. Our findings highlight that in order to strengthen midwifery (education, regulation and services), we have to lead with association strengthening. Building strong associations is the foundation necessary to create formal quality midwifery education systems and to support midwifery regulation and accreditation mechanisms.
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Affiliation(s)
- Cristina Mattison
- Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
| | - Kirsty Bourret
- Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
| | - Emmanuelle Hebert
- University of Quebec at Trois-Rivières, Trois-Rivieres, Quebec, Canada.,Congolese Society of Midwifery Practice, Kinshasa, Democratic Republic of Congo
| | - Sebalda Leshabari
- Obstetrics and Gynaecology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Ambrocckha Kabeya
- Congolese Society of Midwifery Practice, Kinshasa, Democratic Republic of Congo
| | - Patrick Achiga
- Vice-secretary, South Sudan Nurses and Midwives Association, Juba, South Sudan
| | - Jamie Robinson
- Global Programs Manager, Canadian Association of Midwives, Montreal, Quebec, Canada
| | - Elizabeth Darling
- Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
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Mattison CA, Lavis JN, Wilson MG, Hutton EK, Dion ML. A critical interpretive synthesis of the roles of midwives in health systems. Health Res Policy Syst 2020; 18:77. [PMID: 32641053 PMCID: PMC7346500 DOI: 10.1186/s12961-020-00590-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 06/14/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Midwives' roles in sexual and reproductive health and rights continues to evolve. Understanding the profession's role and how midwives can be integrated into health systems is essential in creating evidence-informed policies. Our objective was to develop a theoretical framework of how political system factors and health systems arrangements influence the roles of midwives within the health system. METHODS A critical interpretive synthesis was used to develop the theoretical framework. A range of electronic bibliographic databases (CINAHL, EMBASE, Global Health database, HealthSTAR, Health Systems Evidence, MEDLINE and Web of Science) was searched through to 14 May 2020 as were policy and health systems-related and midwifery organisation websites. A coding structure was created to guide the data extraction. RESULTS A total of 4533 unique documents were retrieved through electronic searches, of which 4132 were excluded using explicit criteria, leaving 401 potentially relevant records, in addition to the 29 records that were purposively sampled through grey literature. A total of 100 documents were included in the critical interpretive synthesis. The resulting theoretical framework identified the range of political and health system components that can work together to facilitate the integration of midwifery into health systems or act as barriers that restrict the roles of the profession. CONCLUSIONS Any changes to the roles of midwives in health systems need to take into account the political system where decisions about their integration will be made as well as the nature of the health system in which they are being integrated. The theoretical framework, which can be thought of as a heuristic, identifies the core contextual factors that governments can use to best leverage their position when working to improve sexual and reproductive health and rights.
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Affiliation(s)
- Cristina A Mattison
- Department of Obstetrics and Gynecology, McMaster Midwifery Research Centre, 1280 Main St. West, HSC-4H26, Hamilton, ON, L8S 4K1, Canada.
| | - John N Lavis
- McMaster Health Forum, 1280 Main St West, MML-417, Hamilton, ON, L8S 4L6, Canada
| | - Michael G Wilson
- McMaster Health Forum, 1280 Main St West, MML-417, Hamilton, ON, L8S 4L6, Canada
| | - Eileen K Hutton
- Department of Obstetrics and Gynecology, McMaster Midwifery Research Centre, 1280 Main St. West, HSC-4H26, Hamilton, ON, L8S 4K1, Canada
| | - Michelle L Dion
- Department of Political Science, McMaster University, 1280 Main St. West, KTH-533, Hamilton, ON, L8S 4M4, Canada
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Bruns DP, Pawloski L, Robinson C. Can Adoption of Cuban Maternity Care Policy Guide the Rural United States to Improve Maternal and Infant Mortality? WORLD MEDICAL & HEALTH POLICY 2019. [DOI: 10.1002/wmh3.312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Ranchoff BL, Declercq ER. The Scope of Midwifery Practice Regulations and the Availability of the Certified Nurse‐Midwifery and Certified Midwifery Workforce, 2012‐2016. J Midwifery Womens Health 2019; 65:119-130. [DOI: 10.1111/jmwh.13007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 05/09/2019] [Accepted: 05/14/2019] [Indexed: 11/29/2022]
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Soliday E, Ord G. Developing the Learning about Midwives and Birth Settings Video for Teaching About Birth Care Options. INTERNATIONAL JOURNAL OF CHILDBIRTH 2019. [DOI: 10.1891/2156-5287.8.4.242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUNDU.S. women's reports have indicated misconceptions about midwifery care and related birth options, yet these care approaches are associated with healthy birth outcomes. From the perspective of person-centered care, we aimed to address existing knowledge gaps on midwifery care by creating an accessible learning tool help inform future parents and community educators of evidence-based birth care options.METHODApplied action research (AR) principles to develop a learning tool for public use. We conducted focus groups with nulliparous young adults who were university students, those who were nonstudent community members, and medical professionals to build content. We collected pre–post viewing data on knowledge, attitudes, and future behavioral intentions with university and community samples.RESULTSOur resultant 17-minute video contains content in three areas: (a) narratives from midwives, (b) narratives from parents, (c) information on midwives' credentialing and scope of care, birth settings, and safety studies. Evaluation data indicated that the video positively influenced viewers' related knowledge, attitudes, and future behavioral intentions.DISCUSSIONOur iterative developmental process yielded a learning tool responsive to viewer input on communicating about nonnormative, safe birth care options. Initial data indicated promise of positively influencing viewers' attitudes and behavioral intentions toward midwife-attended birth in- and out-of-hospital. Future plans include publicly releasing the video and assessing long-term learning impact with initial study samples.
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Baah FO, Teitelman AM, Riegel B. Marginalization: Conceptualizing patient vulnerabilities in the framework of social determinants of health-An integrative review. Nurs Inq 2018; 26:e12268. [PMID: 30488635 DOI: 10.1111/nin.12268] [Citation(s) in RCA: 102] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Revised: 08/29/2018] [Accepted: 09/15/2018] [Indexed: 11/29/2022]
Abstract
Scientific advances in health care have been disproportionately distributed across social strata. Disease burden is also disproportionately distributed, with marginalized groups having the highest risk of poor health outcomes. Social determinants are thought to influence health care delivery and the management of chronic diseases among marginalized groups, but the current conceptualization of social determinants lacks a critical focus on the experiences of people within their environment. The purpose of this article was to integrate the literature on marginalization and situate the concept in the framework of social determinants of health. We demonstrate that social position links marginalization and social determinants of health. This perspective provides a critical lens to assess the societal power dynamics that influence the construction of the socio-environmental factors affecting health. Linking marginalization with social determinants of health can improve our understanding of the inequities in health care delivery and the disparities in chronic disease burden among vulnerable groups.
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Affiliation(s)
- Foster Osei Baah
- NewCourtland Center for Transitions & Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Anne M Teitelman
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Barbara Riegel
- School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
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Vedam S, Stoll K, MacDorman M, Declercq E, Cramer R, Cheyney M, Fisher T, Butt E, Yang YT, Powell Kennedy H. Mapping integration of midwives across the United States: Impact on access, equity, and outcomes. PLoS One 2018; 13:e0192523. [PMID: 29466389 PMCID: PMC5821332 DOI: 10.1371/journal.pone.0192523] [Citation(s) in RCA: 127] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 01/16/2018] [Indexed: 12/02/2022] Open
Abstract
METHODS Our multidisciplinary team examined published regulatory data to inform a 50-state database describing the environment for midwifery practice and interprofessional collaboration. Items (110) detailed differences across jurisdictions in scope of practice, autonomy, governance, and prescriptive authority; as well as restrictions that can affect patient safety, quality, and access to maternity providers across birth settings. A nationwide survey of state regulatory experts (n = 92) verified the 'on the ground' relevance, importance, and realities of local interpretation of these state laws. Using a modified Delphi process, we selected 50/110 key items to include in a weighted, composite Midwifery Integration Scoring (MISS) system. Higher scores indicate greater integration of midwives across all settings. We ranked states by MISS scores; and, using reliable indicators in the CDC-Vital Statistics Database, we calculated correlation coefficients between MISS scores and maternal-newborn outcomes by state, as well as state density of midwives and place of birth. We conducted hierarchical linear regression analysis to control for confounding effects of race. RESULTS MISS scores ranged from lowest at 17 (North Carolina) to highest at 61 (Washington), out of 100 points. Higher MISS scores were associated with significantly higher rates of spontaneous vaginal delivery, vaginal birth after cesarean, and breastfeeding, and significantly lower rates of cesarean, preterm birth, low birth weight infants, and neonatal death. MISS scores also correlated with density of midwives and access to care across birth settings. Significant differences in newborn outcomes accounted for by MISS scores persisted after controlling for proportion of African American births in each state. CONCLUSION The MISS scoring system assesses the level of integration of midwives and evaluates regional access to high quality maternity care. In the United States, higher MISS Scores were associated with significantly higher rates of physiologic birth, less obstetric interventions, and fewer adverse neonatal outcomes.
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Affiliation(s)
- Saraswathi Vedam
- Birth Place Lab, Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- University of Sydney, School of Medicine, Sydney, Australia
| | - Kathrin Stoll
- Birth Place Lab, Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Marian MacDorman
- Maryland Population Research Center, University of Maryland, College Park, Maryland, United States of America
| | - Eugene Declercq
- School of Public Health, Boston University, Boston, Massachusetts, United States of America
| | - Renee Cramer
- Law, Politics and Society, Drake University, Des Moines, Iowa, United States of America
| | - Melissa Cheyney
- Department of Anthropology, Oregon State University College of Liberal Arts, Corvallis, Oregon, United States of America
| | - Timothy Fisher
- Department of Obstetrics and Gynecology, Geisel School of Medicine, Dartmouth University, Lebanon, New Hampshire, United States of America
| | - Emma Butt
- Birth Place Lab, Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Y. Tony Yang
- Health Administration and Policy, George Mason University, Fairfax, Virginia, United States of America
| | - Holly Powell Kennedy
- Department of Midwifery, Yale School of Nursing, Orange, Connecticut, United States of America
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McCabe K. Mothercraft: Birth work and the making of neoliberal mothers. Soc Sci Med 2016; 162:177-84. [DOI: 10.1016/j.socscimed.2016.06.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 06/10/2016] [Accepted: 06/13/2016] [Indexed: 10/21/2022]
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Guerra-Reyes L, Hamilton LJ. Racial disparities in birth care: Exploring the perceived role of African-American women providing midwifery care and birth support in the United States. Women Birth 2016; 30:e9-e16. [PMID: 27364419 DOI: 10.1016/j.wombi.2016.06.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 05/08/2016] [Accepted: 06/10/2016] [Indexed: 11/25/2022]
Abstract
BACKGROUND Midwifery care has been linked to positive birth outcomes. Despite the broad racial disparities in maternal and infant outcomes in the United States (US), little is known about the role of minority women in either providing or receiving this type of care. A vibrant community of minority women, who self-identify as providing these services, exists online. In this exploratory study we ask how they describe their role; view their practice; and position themselves in the broader discussions of racial health disparities in the US. METHODS Using an internet mediated qualitative design we analyse online narratives from self-described African-American nurse-midwives, lay midwives and birth assistants; we found 28 unique websites. We collected and analysed narrative material from each site. We used a thematic analysis approach to identify recurrent and emergent themes in relation to the study question. RESULTS Narratives identified a strong link to the past, as providers viewed their practice in a historical perspective linking African roots, to the diaspora, and to current African-American struggles. Providers engaged both in direct clinical work, and in activist roles. Advocacy efforts sought to expand numbers of minority birth care workers and to extend the benefits of woman-centred birth care to underserved communities. CONCLUSION Results demonstrate the continued existence and important role of diverse types of African-American birth care providers in minority communities in the US. Recognition, support, and increasing the number of midwives of colour is important in tackling racial inequalities in health. Further research should explore minority access to woman-centred care.
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Affiliation(s)
- Lucia Guerra-Reyes
- Department of Applied Health Science, School of Public Health - Indiana University Bloomington, 1025 East 7th Street, Suite 116, Bloomington 47405, USA.
| | - Lydia J Hamilton
- Department of Applied Health Science, School of Public Health - Indiana University Bloomington, 1025 East 7th Street, Suite 116, Bloomington 47405, USA
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Atchan M, Davis D, Foureur M. A methodological review of qualitative case study methodology in midwifery research. J Adv Nurs 2016; 72:2259-71. [PMID: 26909766 DOI: 10.1111/jan.12946] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2015] [Indexed: 11/29/2022]
Abstract
AIM To explore the use and application of case study research in midwifery. BACKGROUND Case study research provides rich data for the analysis of complex issues and interventions in the healthcare disciplines; however, a gap in the midwifery research literature was identified. DESIGN A methodological review of midwifery case study research using recognized templates, frameworks and reporting guidelines facilitated comprehensive analysis. DATA SOURCES An electronic database search using the date range January 2005-December 2014: Maternal and Infant Care, CINAHL Plus, Academic Search Complete, Web of Knowledge, SCOPUS, Medline, Health Collection (Informit), Cochrane Library Health Source: Nursing/Academic Edition, Wiley online and ProQuest Central. REVIEW METHODS Narrative evaluation was undertaken. Clearly worded questions reflected the problem and purpose. The application, strengths and limitations of case study methods were identified through a quality appraisal process. RESULTS The review identified both case study research's applicability to midwifery and its low uptake, especially in clinical studies. Many papers included the necessary criteria to achieve rigour. The included measures of authenticity and methodology were varied. A high standard of authenticity was observed, suggesting authors considered these elements to be routine inclusions. Technical aspects were lacking in many papers, namely a lack of reflexivity and incomplete transparency of processes. CONCLUSION This review raises the profile of case study research in midwifery. Midwives will be encouraged to explore if case study research is suitable for their investigation. The raised profile will demonstrate further applicability; encourage support and wider adoption in the midwifery setting.
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Affiliation(s)
- Marjorie Atchan
- Centre for Midwifery, Child and Family Health, University of Technology Sydney, New South Wales, Australia
| | - Deborah Davis
- Faculty of Health, ACT Health Directorate and University of Canberra, University of Canberra, Australian Capital Territory, Australia
| | - Maralyn Foureur
- Centre for Midwifery, Child and Family Health, University of Technology Sydney, New South Wales, Australia
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Howell E, Palmer A, Benatar S, Garrett B. Potential Medicaid cost savings from maternity care based at a freestanding birth center. MEDICARE & MEDICAID RESEARCH REVIEW 2014; 4:mmrr2014-004-03-a06. [PMID: 25250198 DOI: 10.5600/mmrr.004.03.a06] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Medicaid pays for about half the births in the United States, at very high cost. Compared to usual obstetrical care, care by midwives at a birth center could reduce costs to the Medicaid program. This study draws on information from a previous study of the outcomes of birth center care to determine whether such care reduces Medicaid costs for low income women. METHODS The study uses results from a study of maternal and infant outcomes at the Family Health and Birth Center in Washington, D.C. Costs to Medicaid are derived from birth center data and from other national sources of the cost of obstetrical care. RESULTS We estimate that birth center care could save an average of $1,163 per birth (2008 constant dollars), or $11.6 million per 10,000 births per year. CONCLUSIONS Medicaid is the leading payer for maternity services. As Medicaid faces continuing cost increases and budget constraints, policy makers should consider a larger role for midwives and birth centers in maternity care for low-risk Medicaid pregnant women.
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Pope TM, Fisch D. Legal Briefing: Home Birth and Midwifery. THE JOURNAL OF CLINICAL ETHICS 2013. [DOI: 10.1086/jce201324317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Sharma B, Johansson E, Prakasamma M, Mavalankar D, Christensson K. Midwifery scope of practice among staff nurses: A grounded theory study in Gujarat, India. Midwifery 2013; 29:628-36. [DOI: 10.1016/j.midw.2012.05.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Revised: 05/11/2012] [Accepted: 05/12/2012] [Indexed: 11/16/2022]
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Abstract
BACKGROUND The media both creates and reflects public opinion. The way in which health professionals are depicted in the media is likely to influence views held by and about different health professions. The aim of this study was to examine how midwives and obstetricians are reported in English language web-based news reports from around the world. METHODS News alerts from the Internet search engine Google were created to search for the terms "midwife,""midwives,""midwifery,""obstetrics," and "obstetricians." These alerts were received over a 12-month period (May 1, 2006-April 31, 2007), downloaded, and analyzed using quantitative content analysis. RESULTS A total of 522 web-based news reports for midwifery and 564 for obstetrics (n = 1,086) were found. Dominant categories for midwives were: "mainstreaming midwives" (models of care/rise of midwifery) (28%); "the Cinderella of the maternity care" (workforce/industrial) (27%); "delivering the baby with your hands tied" (funding, insurance, and legislation) (21%); "ask the expert" (education, research, and health advice) (8%), "recognizing midwives" (awards and announcements) (7%), "unsafe midwives" (litigation) (6%); and "the art of birth" (books, film, and photographs) (2%). Dominant categories for obstetricians were: "ask the expert" (research and advice) (26%); "doctors are heroes amongst us" (awards and announcements) (19%); "obstetric workforce woes" (workforce/industrial) (19%); "new frontiers" (trends in care and new technology) (17%); "the disappearing obstetrician" (insurance and litigation) (10%); and "human-interest news reports" (9%). Obstetricians were more likely to be recognized as experts on pregnancy and birth and receive public recognition compared with midwives. Midwives were more likely to be depicted as struggling to be a mainstream option while being hampered by lack of funding, insurance, and legislative barriers. CONCLUSIONS Although midwives have rising acceptance, they still struggle with recognition. Obstetricians have both acceptance and recognition. Countries where midwifery is a mainstream option have more news reports related to midwifery than obstetrics. Different issues appear more dominant in some countries, such as work force in the United Kingdom and funding, insurance, and legislation in the United States.
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Affiliation(s)
- Hannah G Dahlen
- Hannah Dahlen is an Associate Professor of Midwifery at School of Nursing and Midwifery, University of Western Sydney, Australia
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Hans JD, Kimberly C. An Educational Intervention to Change Planned Behavior Concerning Midwife‐Assisted Out‐of‐Hospital Childbirth. J Midwifery Womens Health 2011; 56:371-375. [DOI: 10.1111/j.1542-2011.2011.00036.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Peterson C. Midwifery and the Crowning of Health Care Reform. J Midwifery Womens Health 2010; 55:5-8. [DOI: 10.1016/j.jmwh.2009.10.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2009] [Revised: 10/18/2009] [Accepted: 10/18/2009] [Indexed: 11/16/2022]
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Gilliland AL. After praise and encouragement: emotional support strategies used by birth doulas in the USA and Canada. Midwifery 2010; 27:525-31. [PMID: 20850916 DOI: 10.1016/j.midw.2010.04.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2010] [Revised: 04/13/2010] [Accepted: 04/21/2010] [Indexed: 11/30/2022]
Abstract
OBJECTIVE to describe in detail the emotional support techniques employed by birth doulas during labour. DESIGN grounded theory methodology was utilised in collecting and analysing interviews given by doulas and mothers who had doula care. By using both informants, a clearer picture of what constitutes emotional support by doulas emerged. PARTICIPANTS 10 mothers from three different states in the Midwestern USA and 30 doulas from 10 different states and two Canadian provinces were interviewed. Two doulas worked in hospital-based programmes whereas the others had independent practices. Doulas usually attended births in hospitals where medical attendants spent little focused time with the mother. FINDINGS nine different strategies were distinguished. Four strategies (reassurance, encouragement, praise, explaining) were similar to those attributed to nurses in published research. Five were original and described as only being used by doulas (mirroring, acceptance, reinforcing, reframing, debriefing). CONCLUSIONS emotional support by professional birth doulas is more complex and sophisticated than previously surmised. Mothers experienced these strategies as extremely meaningful and significant with their ability to cope and influencing the course of their labour. IMPLICATIONS FOR PRACTICE the doula's role in providing emotional support is distinct from the obstetric nurse and midwife. Professional doulas utilise intricate and complex emotional support skills when providing continuous support for women in labour. Application of these skills may provide an explanation for the positive 'doula effect' on obstetric and neonatal outcomes in certain settings.
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Affiliation(s)
- Amy L Gilliland
- Department of Human Development and Family Studies, University of Wisconsin-Madison, 1526 Vilas Avenue, Madison, WI 53711-2228, USA.
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Wilson KL, Sirois FM. Birth attendant choice and satisfaction with antenatal care: the role of birth philosophy, relational style, and health self‐efficacy. J Reprod Infant Psychol 2009. [DOI: 10.1080/02646830903190946] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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