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Collins CH, Skarparis K. The experiences of pregnancy and NHS maternity care for women who have been trafficked: A qualitative study. Midwifery 2024; 135:104040. [PMID: 38878620 DOI: 10.1016/j.midw.2024.104040] [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: 02/22/2024] [Revised: 05/23/2024] [Accepted: 05/28/2024] [Indexed: 07/07/2024]
Abstract
PROBLEM Little is known about the maternity experiences of women who have been trafficked and further investigation is needed to better inform midwifery practice and to ensure that the voices of women are heard when developing guidance. BACKGROUND People who have been trafficked experience a range of health problems that could impact on pregnancy. AIM The aim of this study was to explore the experiences of pregnancy and NHS maternity care for women who have been trafficked, as well as increasing understanding of social and health factors that may impact on pregnancy outcomes. METHODS A qualitative interview study was conducted. Participants (professionals and service users) were recruited using purposive sampling. Data were analysed using thematic analysis. FINDINGS Seventeen interviews were conducted (5 service users and 12 professionals). Five themes were identified: 'One Size Fits All', 'Loss of Control', 'Social Complexity', 'Bridging Gaps', and 'Emotional Load'. DISCUSSION Our findings identify that women are expected to fit into a standardised model of maternity care that does not always recognise their complex individual physical, emotional or social needs, or provide them with control. Support workers play a vital role in helping women navigate and make sense of their maternity care. CONCLUSION Despite the issues identified, our research highlighted the positive impact of individualised care, particularly when women received continuity of care. A joined-up, trauma-informed approach between midwives and support workers could help improve care for women who have been trafficked.
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Affiliation(s)
- Catherine H Collins
- Northumbria University, Coach Lane Campus East, Newcastle upon Tyne, NE7 7XA, United Kingdom; Department of Nursing Midwifery and Health, Faculty of Health and Life Sciences, (At the time when research was conducted), United Kingdom.
| | - Katy Skarparis
- Northumbria University, Coach Lane Campus East, Newcastle upon Tyne, NE7 7XA, United Kingdom; Department of Nursing Midwifery and Health, Faculty of Health and Life Sciences, (At the time when research was conducted), United Kingdom
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Hertle D, Wende D, zu Sayn-Wittgenstein F. [Postpartum Care by Midwives: Socioeconomic Status has a Strong Influence on the Amount of Care Received An Analysis with Routine Data from BARMER Health Insurance]. DAS GESUNDHEITSWESEN 2024; 86:354-361. [PMID: 38134914 PMCID: PMC11077544 DOI: 10.1055/a-2144-5180] [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] [Indexed: 12/24/2023]
Abstract
BACKGROUND Socio-economic situation is associated with inequalities in access to health care and health-related resources. This also applies to pregnancy, birth and the postpartum period. Compared to other European countries, Germany has very good care options for the postpartum period. It has an unique system of postpartum care, which comprises home visits by midwives for 12 weeks after birth and beyond in problem cases and thus has structurally good care options. So far, however, there are hardly any studies based on routine data that show which mothers receive homevisits in postpartum care and to what extent. METHOD The study population comprised 199,978 women insured with BARMER who gave birth to at least one child in the years 2017-2020. Some women were pregnant several times in this period of time. The services billed by freelance midwives for outreach midwifery care in the puerperium were considered for 227,088 births, taking into account the socioeconomic situation of the mothers. RESULTS According to the definition of the German Institute for Economic Research, 26% of the mothers belonged to a low income group, 46% to a medium income group and 29% to a high income group. Similar to what was shown for midwifery care during pregnancy, large differences were also found with regard to postpartum care: While 90.5% of the women with a high income received home visits, only 83.5% of women with a medium income did so, and only 67.9% of women with a low income. The groups did not differ with regard to other characteristics such as rate of caesarean section, preterm births, twins, age or concomitant diseases to an extent that could explain the differences in care. Women who had received midwifery services in pregnancy were much more likely to receive home visits by a midwife in the postpartum period. Furthermore, there was a correlation with the density of midwives in the respective region. CONCLUSIONS The results suggest that access to home-based postpartum care by freelance midwives is significantly limited for low-income women. In contrast to antenatal care, women in the postpartum period cannot switch to other service providers, as outreach postpartum care is a reserved activity of midwives. Women with low incomes thus receive less midwifery care, although they have a higher need for support (Eickhorst et al. 2016).
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Affiliation(s)
- Dagmar Hertle
- BARMER Institut für Gesundheitssystemforschung, Wuppertal,
Germany
| | - Danny Wende
- BARMER Institut für Gesundheitssystemforschung, Wuppertal,
Germany
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Hertle D, Lange U, Wende D. [Healthcare in Pregnancy and Access to Midwives according to Socio-Economic Situation: An Analysis with Routine Data from BARMER Health Insurance]. DAS GESUNDHEITSWESEN 2023; 85:364-370. [PMID: 34942665 PMCID: PMC11248034 DOI: 10.1055/a-1690-7079] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Socio-economic status is an important cause of inequality in health status and access to healthcare. This also applies to pregnancy, birth and the postpartum period. Healthcare during pregnancy plays a crucial role in the success of the life phase around birth. On the basis of routine data from BARMER health insurance, the study investigated which services pregnant women received during pregnancy depending on their socio-economic situation. METHODS The study population comprised 237,251 women insured with BARMER with 278,237 births in 2015-2019. The services billed by gynaecologists and midwives during pregnancy were considered in relation to the socio-economic situation of the women involved. RESULTS Physicians dominated the provision of preventive healthcare. For almost 98% of the pregnant women, a medical preventive healthcare flat rate was billed in at least three quarters. A regular participation of the midwife in preventive healthcare from the fourth month of pregnancy with more than four preventive services was the case in only 1.2% of women. Women from low-income backgrounds received fewer antenatal healthcare services from both gynaecologists and midwives, with 31% of women with low income having no antenatal midwife contact at all, compared to only 11% of high-income women. High-income earning women were also more likely to have had early contact with a midwife (47 vs. 37% in the first trimester). The timing of the first contact seemed to be relevant for the subsequent cooperative antenatal healthcare by both professional groups. CONCLUSION The potentials of midwifery healthcare are not being leveraged. Midwives should be significantly more involved in prenatal healthcare overall, and access to midwives must be improved, especially for socially disadvantaged women. These women could benefit in particular from midwifery healthcare, as it takes greater account of social aspects in healthcare and also provides outreach services.
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Affiliation(s)
- Dagmar Hertle
- BARMER Institut für Gesundheitssystemforschung, Wuppertal,
Deutschland
| | - Ute Lange
- Studienbereich Hebammenwissenschaft, Hochschule für Gesundheit
Bochum, Deutschland
| | - Danny Wende
- BARMER Institut für Gesundheitssystemforschung, Wuppertal,
Deutschland
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Wołejszo S, Genowska A, Motkowski R, Strukcinskiene B, Klukowski M, Konstantynowicz J. Insights into Prevention of Health Complications in Small for Gestational Age (SGA) Births in Relation to Maternal Characteristics: A Narrative Review. J Clin Med 2023; 12:jcm12020531. [PMID: 36675464 PMCID: PMC9862121 DOI: 10.3390/jcm12020531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 12/29/2022] [Accepted: 01/06/2023] [Indexed: 01/11/2023] Open
Abstract
Small for gestational age (SGA) births are a significant clinical and public health issue. The objective of this review was to summarize maternal biological and socio-demographic factors and preventive strategies used to reduce the risk of SGA births. A literature search encompassing data from the last 15 years was conducted using electronic databases MEDLINE/PubMed, Google Scholar and Scopus to review risk factors and preventive strategies for SGA. Current evidence shows that primiparity, previous stillbirths, maternal age ≤24 and ≥35 years, single motherhood, low socio-economic status, smoking and cannabis use during pregnancy confer a significant risk of SGA births. Studies on alcohol consumption during pregnancy and SGA birth weight are inconclusive. Beneficial and preventive factors include the "Mediterranean diet" and dietary intake of vegetables. Periconceptional folic acid supplementation, maternal 25-hydroxyvitamin D, zinc and iron levels are partly associated with birth weight. No significant associations between COVID-19 vaccinations and birthweight are reported. A midwifery-led model based on early and extensive prenatal care reduces the risk of SGA births in women with low socio-economic status. Major preventive measures relate to the awareness of modifiable and non-modifiable risk factors of SGA, leading to changes in parents' lifestyles. These data support that education, monitoring during pregnancy, and implementing preventive strategies are as important as biological determinants in risk reduction of SGA births.
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Affiliation(s)
- Sebastian Wołejszo
- Department of Pediatrics, Rheumatology, Immunology and Metabolic Bone Diseases, Medical University of Bialystok, University Children′s Hospital, 15-274 Bialystok, Poland
- Correspondence: (S.W.); (A.G.)
| | - Agnieszka Genowska
- Department of Public Health, Medical University of Bialystok, 15-295 Bialystok, Poland
- Correspondence: (S.W.); (A.G.)
| | - Radosław Motkowski
- Department of Pediatrics, Rheumatology, Immunology and Metabolic Bone Diseases, Medical University of Bialystok, University Children′s Hospital, 15-274 Bialystok, Poland
| | | | - Mark Klukowski
- Department of Pediatrics, Rheumatology, Immunology and Metabolic Bone Diseases, Medical University of Bialystok, University Children′s Hospital, 15-274 Bialystok, Poland
| | - Jerzy Konstantynowicz
- Department of Pediatrics, Rheumatology, Immunology and Metabolic Bone Diseases, Medical University of Bialystok, University Children′s Hospital, 15-274 Bialystok, Poland
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Stoll K, Titoria R, Johnston C, Butska L. Beyond Medically Complex Pregnancy: A Scoping Review to Understand How Complexity in Pregnancy is Conceptualized. J Midwifery Womens Health 2023; 68:71-83. [PMID: 36269023 DOI: 10.1111/jmwh.13416] [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: 01/14/2022] [Revised: 08/18/2022] [Accepted: 08/30/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND The goal of this scoping review was to better understand how complexity in pregnancy is conceptualized. Specific objectives were to (1) identify factors that are conceptualized in the literature as complicating or impacting pregnancy; and (2) summarize tools and programs that have been implemented to support pregnant people with complex care needs. METHODS Electronic databases were searched from January 2000 to July 2020 and supplemented by bibliographic searches and citation chaining, to identify articles that described at least one nonmedical and one medical risk factor during pregnancy. We focused on complexity prior to the onset of labor and only included primary studies conducted in middle- or high-income countries. More than 6000 records were screened independently by 3 reviewers at the abstract and title level. RESULTS Fourteen articles met inclusion criteria. Eight studies described antenatal risk scoring systems, including the Florida Healthy Start Prenatal Risk Screen, the Kindex risk screening tool, the prenatal event history calendar, and the Rotterdam Reproductive Risk Reduction score card. We abstracted 85 medical factors and 25 nonmedical factors from the literature. Nonmedical factors that were conceptualized as complicating pregnancy or birth could be grouped into 4 domains: characteristics of the childbearing person (7 factors), socioeconomic conditions (7 factors), family and social life (5 factors), and psychoemotional health (6 factors). DISCUSSION We found limited scholarly research and few assessment tools that broaden the discussion of complexity in pregnancy beyond medical multimorbidity. Multiple dimensions of health should be integrated into a complexity framework for pregnancy that account for the diverse contexts and needs of pregnant people. An important part of this process is the development of a shared language to describe complexity that is strength based and acknowledges how environments, health care encounters, and the larger sociocultural context can affect pregnant people's medical status in pregnancy.
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Affiliation(s)
- Kathrin Stoll
- Department of Family Practice, University of British Columbia, Vancouver, Canada
| | - Reena Titoria
- Provincial Services Health Authority, Vancouver, Canada
| | - Carly Johnston
- Medical Education Program, University of British Columbia, Vancouver, Canada
| | - Luba Butska
- Midwifery Program, Department of Family Practice, University of British Columbia, Vancouver, Canada
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Simoncic V, Deguen S, Enaux C, Vandentorren S, Kihal-Talantikite W. A Comprehensive Review on Social Inequalities and Pregnancy Outcome-Identification of Relevant Pathways and Mechanisms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192416592. [PMID: 36554473 PMCID: PMC9779203 DOI: 10.3390/ijerph192416592] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/06/2022] [Accepted: 12/08/2022] [Indexed: 05/12/2023]
Abstract
Scientific literature tends to support the idea that the pregnancy and health status of fetuses and newborns can be affected by maternal, parental, and contextual characteristics. In addition, a growing body of evidence reports that social determinants, measured at individual and/or aggregated level(s), play a crucial role in fetal and newborn health. Numerous studies have found social factors (including maternal age and education, marital status, pregnancy intention, and socioeconomic status) to be linked to poor birth outcomes. Several have also suggested that beyond individual and contextual social characteristics, living environment and conditions (or "neighborhood") emerge as important determinants in health inequalities, particularly for pregnant women. Using a comprehensive review, we present a conceptual framework based on the work of both the Commission on Social Determinants of Health and the World Health Organization (WHO), aimed at describing the various pathways through which social characteristics can affect both pregnancy and fetal health, with a focus on the structural social determinants (such as socioeconomic and political context) that influence social position, as well as on intermediary determinants. We also suggest that social position may influence more specific intermediary health determinants; individuals may, on the basis of their social position, experience differences in environmental exposure and vulnerability to health-compromising living conditions. Our model highlights the fact that adverse birth outcomes, which inevitably lead to health inequity, may, in turn, affect the individual social position. In order to address both the inequalities that begin in utero and the disparities observed at birth, it is important for interventions to target various unhealthy behaviors and psychosocial conditions in early pregnancy. Health policy must, then, support: (i) midwifery availability and accessibility and (ii) enhanced multidisciplinary support for deprived pregnant women.
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Affiliation(s)
- Valentin Simoncic
- LIVE UMR 7362 CNRS (Laboratoire Image Ville Environnement), University of Strasbourg, 67100 Strasbourg, France
- Correspondence:
| | - Séverine Deguen
- Equipe PHARes Population Health Translational Research, Inserm CIC 1401, Bordeaux Population Health Research Center, University of Bordeaux, 33076 Boedeaux, France
| | - Christophe Enaux
- LIVE UMR 7362 CNRS (Laboratoire Image Ville Environnement), University of Strasbourg, 67100 Strasbourg, France
| | - Stéphanie Vandentorren
- Equipe PHARes Population Health Translational Research, Inserm CIC 1401, Bordeaux Population Health Research Center, University of Bordeaux, 33076 Boedeaux, France
- Santé Publique France, French National Public Health Agency, 94410 Saint-Maurice, France
| | - Wahida Kihal-Talantikite
- LIVE UMR 7362 CNRS (Laboratoire Image Ville Environnement), University of Strasbourg, 67100 Strasbourg, France
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Inequities in Availability of Evidence-Based Birth Supports to Improve Perinatal Health for Socially Vulnerable Rural Residents. CHILDREN 2022; 9:children9071077. [PMID: 35884061 PMCID: PMC9324486 DOI: 10.3390/children9071077] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/13/2022] [Accepted: 07/16/2022] [Indexed: 11/17/2022]
Abstract
Rural residents in the United States (US) have disproportionately high rates of maternal and infant mortality. Rural residents who are Black, Indigenous, and People of Color (BIPOC) face multiple social risk factors and have some of the worst maternal and infant health outcomes in the U.S. The purpose of this study was to determine the rural availability of evidence-based supports and services that promote maternal and infant health. We developed and conducted a national survey of a sample of rural hospitals. We determined for each responding hospital the county-level scores on the 2018 CDC Social Vulnerability Index (SVI). The sample’s (n = 93) median SVI score [IQR] was 0.55 [0.25–0.88]; for majority-BIPOC counties (n = 29) the median SVI score was 0.93 [0.88–0.98] compared with 0.38 [0.19–0.64] for majority-White counties (n = 64). Among counties where responding hospitals were located, 86.2% located in majority-BIPOC counties ranked in the most socially vulnerable quartile of counties nationally (SVI ≥ 0.75), compared with 14.1% of majority-White counties. In analyses adjusted for geography and hospital size, certified lactation support (aOR 0.36, 95% CI 0.13–0.97), midwifery care (aOR 0.35, 95% CI 0.12–0.99), doula support (aOR 0.30, 95% CI 0.11–0.84), postpartum support groups (aOR 0.25, 95% CI 0.09–0.68), and childbirth education classes (aOR 0.08, 95% CI 0.01–0.69) were significantly less available in the most vulnerable counties compared with less vulnerable counties. Residents in the most socially vulnerable rural counties, many of whom are BIPOC and thus at higher risk for poor birth outcomes, are significantly less likely to have access to evidence-based supports for maternal and infant health.
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Dawson P, Auvray B, Jaye C, Gauld R, Hay-Smith J. Social determinants and inequitable maternal and perinatal outcomes in Aotearoa New Zealand. WOMEN'S HEALTH (LONDON, ENGLAND) 2022; 18:17455065221075913. [PMID: 35109729 PMCID: PMC8819758 DOI: 10.1177/17455065221075913] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: Aotearoa New Zealand has demonstrable maternal and perinatal health inequity.
We examined the relationships between adverse outcomes in a total population
sample of births and a range of social determinant variables representing
barriers to equity. Methods: Using the Statistics New Zealand Integrated Data Infrastructure suite of
linked administrative data sets, adverse maternal and perinatal outcomes
(mortality and severe morbidity) were linked to socio-economic and health
variables for 97% of births in New Zealand between 2003 and 2018 (~970,000
births). Variables included housing, economic, health, crime and family
circumstances. Logistic regression examined the relationships between
adverse outcomes and social determinants, adjusting for demographics
(socio-economic deprivation, education, parity, age, rural/urban residence
and ethnicity). Results: Māori (adjusted odds ratio = 1.21, 95% confidence interval = 1.18–1.23) and
Asian women (adjusted odds ratio 1.39, 95% confidence interval = 1.36–1.43)
had poorer maternal or perinatal outcomes compared to New Zealand
European/European women. High use of emergency department (adjusted odds
ratio = 2.68, 95% confidence interval = 2.53–2.84), disability (adjusted
odds ratio = 1.98, 95% confidence interval = 1.83–2.14) and lack of
engagement with maternity care (adjusted odds ratio = 1.89, 95% confidence
interval = 1.84–1.95) had the strongest relationship with poor outcomes. Conclusion: Maternal health inequity was strongly associated with a range of
socio-economic and health determinants. While some of these factors can be
targeted for interventions, the study highlights larger structural and
systemic issues that affect maternal and perinatal health.
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Murray-Davis B, Darling EK, Berger H, Melamed N, Li J, Guarna G, Syed M, Barrett J, Geary M, Mawjee K, McDonald SD. Midwives perceptions of managing pregnancies complicated by obesity: A mixed methods study. Midwifery 2021; 105:103225. [PMID: 34915446 DOI: 10.1016/j.midw.2021.103225] [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: 07/29/2020] [Revised: 02/05/2021] [Accepted: 12/05/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The growing prevalence of obesity is a concern for midwives. In Canada, the absence of regulatory standards, varying protocols and consultant preferences shape clinical decision making for the midwife and may lead to inconsistent practice. Our aim was to understand the barriers, enablers, and knowledge gaps that influenced experiences of midwives in Ontario, Canada when providing care to clients impacted by obesity. METHODS Mixed methods design using a sequential, explanatory approach. Surveys conducted with midwives were administered using an online platform, followed by semi-structured interviews to understand the perspectives elicited in the survey in greater detail. Interviews were audio recorded and transcribed verbatim. Survey data were analyzed using descriptive statistics, and thematic analysis was used for generating codes, categories and themes from the interview data. RESULTS 144 midwives completed the survey and 20 participated in an interview. The participants described their clinical management when caring for those with obesity which included considerations regarding additional tests/investigations, consultation and transfer of care, and place of birth. Up to 93% of surveyed midwives believed that clients with obesity were appropriate for midwifery-led care however there was less certainty about suitability as BMI increased to higher ranges such as > 45). The care management was influenced by beliefs and attitudes, knowledge, and system-level factors. Midwives experienced barriers such as inconsistent practices and role confusion, and felt ill equipped to care for pregnancies affected by obesity due to unclear guidelines. CONCLUSIONS Overall, midwives believe clients with obesity are suitable for midwifery-led care due to its individualized, non-judgmental approach to care. Additional training for midwives and other obstetric care providers would be beneficial to help overcome barriers in providing effective care to pregnancies affected by obesity.
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Affiliation(s)
- Beth Murray-Davis
- Department of Obstetrics and Gynecology, McMaster Midwifery Research Centre, McMaster University, Hamilton, Ontario, Canada.
| | - Elizabeth K Darling
- Department of Obstetrics and Gynecology, McMaster Midwifery Research Centre, McMaster University, Hamilton, Ontario, Canada.
| | - Howard Berger
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, St. Michael's Hospital, University of Toronto, Ontario, Canada.
| | - Nir Melamed
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada.
| | - Jenifer Li
- Department of Obstetrics and Gynecology, McMaster Midwifery Research Centre, McMaster University, Hamilton, Ontario, Canada.
| | - Giuliana Guarna
- Department of Obstetrics and Gynecology, McMaster Midwifery Research Centre, McMaster University, Hamilton, Ontario, Canada.
| | - Maisah Syed
- Department of Obstetrics and Gynecology, McMaster Midwifery Research Centre, McMaster University, Hamilton, Ontario, Canada.
| | - Jon Barrett
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada.
| | - Michael Geary
- Department of Obstetrics & Gynaecology, Rotunda Hospital, Dublin, Ireland.
| | - Karizma Mawjee
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, St. Michael's Hospital, University of Toronto, Ontario, Canada.
| | - Sarah D McDonald
- Division of Maternal-Fetal Medicine, Departments of Obstetrics & Gynecology, Radiology & Health Research Methods, Evidence & Impact, McMaster University, Hamilton, Ontario, Canada.
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Niles PM, Vedam S, Witkoski Stimpfel A, Squires A. Kairos care in a Chronos world: Midwifery care as model of resistance and accountability in public health settings. Birth 2021; 48:480-492. [PMID: 34137073 DOI: 10.1111/birt.12565] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 06/02/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND In the United States (US), pregnancy-related mortality is 2-4 times higher for Black and Indigenous women irrespective of income and education. The integration of midwifery as a fundamental component of standard maternity services has been shown to improve health outcomes and service user satisfaction, including among underserved and minoritized groups. Nonetheless, there remains limited uptake of this model in the United States. In this study, we examine a series of interdependent factors that shape how midwifery care operates in historically disenfranchised communities within the Unites States. METHODS Using data collected from in-depth, semi-structured interviews, the purpose of this study was to examine the ways midwives recount, describe, and understand the relationships that drive their work in a publicly funded urban health care setting serving minoritized communities. Using a qualitative exploratory research design, guided by critical feminist theory, twenty full-scope midwives working in a large public health care network participated. Data were thematically analyzed using Braun & Clarke's inductive thematic analysis to interpret data and inductively identify patterns in participants' experiences. FINDINGS The overarching theme "Kairos care in a Chronos World" captures the process of providing health-promoting, individualized care in a system that centers measurement, efficiency, and pathology. Five subthemes support the central theme: (1) the politics of progress, (2) normalizing pathologies, (3) cherished connections, (4) protecting the experience, and (5) caring for the social body. Midwives used relationships to sustain their unique care model, despite the conflicting demands of dominant (and dominating) medical models. CONCLUSION This study offers important insight into how midwives use a Kairos approach to maternity care to enhance quality and safety. In order to realize equitable access to optimal outcomes, health systems seeking to provide robust services to historically disenfranchised communities should consider integration of relationship-based strategies, including midwifery care.
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Affiliation(s)
| | - Saraswathi Vedam
- Birth Place Lab, University of British Columbia, Vancouver, BC, Canada
| | | | - Allison Squires
- Rory Meyers College of Nursing, New York University, New York, NY, USA
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Hadebe R, Seed PT, Essien D, Headen K, Mahmud S, Owasil S, Fernandez Turienzo C, Stanke C, Sandall J, Bruno M, Khazaezadeh N, Oteng-Ntim E. Can birth outcome inequality be reduced using targeted caseload midwifery in a deprived diverse inner city population? A retrospective cohort study, London, UK. BMJ Open 2021; 11:e049991. [PMID: 34725078 PMCID: PMC8562498 DOI: 10.1136/bmjopen-2021-049991] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES (1) To report maternal and newborn outcomes of pregnant women in areas of social deprivation in inner city London. (2) To compare the effect of caseload midwifery with standard care on maternal and newborn outcomes in this cohort of women. DESIGN Retrospective observational cohort study. SETTING Four council wards (electoral districts) in inner city London, where over 90% of residents are in the two most deprived quintiles of the English Index of Multiple Deprivation (IMD) (2019) and the population is ethnically diverse. PARTICIPANTS All women booked for antenatal care under Guys and St Thomas' National Health Service Foundation Trust after 11 July 2018 (when the Lambeth Early Action Partnership (LEAP*) caseload midwifery team was implemented) until data collection 18 June 2020. This included 523 pregnancies in the LEAP area, of which 230 were allocated to caseload midwifery, and 8430 pregnancies from other areas. MAIN OUTCOME MEASURES To explore if targeted caseload midwifery (known to reduce preterm birth) will improve important measurable outcomes (preterm birth, mode of birth and newborn outcomes). RESULTS There was a significant reduction in preterm birth rate in women allocated to caseload midwifery, when compared with those who received traditional midwifery care (5.1% vs 11.2%; risk ratio: 0.41; p=0.02; 95% CI 0.18 to 0.86; number needed to treat: 11.9). Caesarean section births were significantly reduced in women allocated to caseload midwifery care, when compared with traditional midwifery care (24.3% vs 38.0%; risk ratio: 0.64: p=0.01; 95% CI 0.47 to 0.90; number needed to treat: 7.4) including emergency caesarean deliveries (15.2% vs 22.5%; risk ratio: 0.59; p=0.03; 95% CI 0.38 to 0.94; number needed to treat: 10) without increase in neonatal unit admission or stillbirth. CONCLUSION This study shows that a model of caseload midwifery care implemented in an inner city deprived community improves outcome by significantly reducing preterm birth and birth by caesarean section when compared with traditional care. This data trend suggests that when applied to targeted groups (women in higher IMD quintile and women of diverse ethnicity) that the impact of intervention is greater.
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Affiliation(s)
- Ruth Hadebe
- Department of Women's Health, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Paul T Seed
- Department of Women and Children's Health, King's College London, London, UK
| | - Diana Essien
- Department of Women's Health, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Kyle Headen
- Department of Women's Health, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Saheel Mahmud
- King's College London School of Medicine, London, UK
| | - Salwa Owasil
- King's College London School of Medicine, London, UK
| | | | - Carla Stanke
- Public Health, National Childrens Bureau, London, UK
- Lambeth Early Action Partnership, London, UK
| | - Jane Sandall
- Department of Women and Children's Health, King's College London, London, UK
| | - Mara Bruno
- Department of Women's Health, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Nina Khazaezadeh
- Department of Women's Health, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Eugene Oteng-Ntim
- Department of Women's Health, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Department of Women and Children's Health, King's College London, London, UK
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Merrer J, Le Ray C, Bonnet C, Coulm B, Blondel B. Overuse of antenatal visits and ultrasounds in low-risk women: A national population-based study. Paediatr Perinat Epidemiol 2021; 35:674-685. [PMID: 34160099 DOI: 10.1111/ppe.12782] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 04/28/2021] [Accepted: 05/08/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND A better understanding of the overuse of antenatal care is needed to improve its organisation to deal with limited medical resources and doctor shortages. OBJECTIVES To assess the proportion of women who overuse antenatal care and the associations of overuse with maternal characteristics and the qualifications of healthcare providers. METHODS We used the 2016 National Perinatal Survey, a cross-sectional population-based survey, performed in all maternity units in France, including 13,132 women. Based on the French national guidelines, 6-8 antenatal visits were defined as adequate, 9-11 as high use, and ≥12 as overuse, while 3 ultrasounds were considered adequate, 4-5 as high use, and ≥6 as overuse. We performed binary modified Poisson regressions-with adequate care as the reference-including maternal social and medical characteristics and the healthcare professionals' qualifications. RESULTS After women with inadequate care were excluded, 19.2% of low-risk women had at least 12 visits and 30.5% at least 6 ultrasounds. Overuse of visits was associated with primiparity, average to high income, less than good psychological well-being, and care by an obstetrician. The risks of overuse of ultrasounds were higher among primiparous, women with average to high income and those receiving care from a public-sector obstetrician (adjusted relative risk 1.17, 95% CI, 1.13, 1.21) or private obstetrician (adjusted relative risk 1.12, 95% CI, 1.07, 1.16), compared with a public-sector midwife. CONCLUSIONS Antenatal care overuse is very common in France and associated with some maternal characteristics and also the qualification of care provider. Antenatal care should be customised according to women's needs, in particular for primiparae and those with poor well-being, and available medical resources.
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Affiliation(s)
- Jade Merrer
- Université de Paris/ Center of Research in Epidemiology and StatisticS(CRESS)/ Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé)/ INSERM/ INRA, Paris, France
| | - Camille Le Ray
- Université de Paris/ Center of Research in Epidemiology and StatisticS(CRESS)/ Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé)/ INSERM/ INRA, Paris, France.,Port-Royal Maternity Unit, Assistance Publique-Hôpitaux de Paris - Centre, Université de Paris, Paris, France
| | - Camille Bonnet
- Université de Paris/ Center of Research in Epidemiology and StatisticS(CRESS)/ Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé)/ INSERM/ INRA, Paris, France
| | - Bénédicte Coulm
- Université de Paris/ Center of Research in Epidemiology and StatisticS(CRESS)/ Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé)/ INSERM/ INRA, Paris, France
| | - Béatrice Blondel
- Université de Paris/ Center of Research in Epidemiology and StatisticS(CRESS)/ Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé)/ INSERM/ INRA, Paris, France
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13
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Nolan SJ, Hendricks J, Williamson M, Ferguson SL. Social networking sites: Can midwives and nurses working with adolescent mothers harness their potential value? Int J Nurs Pract 2020; 27:e12895. [PMID: 33047440 DOI: 10.1111/ijn.12895] [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: 04/10/2019] [Revised: 12/01/2019] [Accepted: 09/16/2020] [Indexed: 11/28/2022]
Abstract
AIM This paper aims to discuss social networking sites as potentially salutogenic, culturally relevant extensions to maternity care provision for adolescent mothers. BACKGROUND Studies report that online networking may enhance social capital, a concept linked to enhanced well-being, particularly for marginalized individuals. Improving outcomes for adolescent mothers is an ongoing global strategy; thus, this paper has relevance for all professionals involved in their care. DESIGN This is a discussion paper. DATA SOURCES This paper draws on the authors' research and is supported by literature and theory. Key terms and Boolean operators were used to identifiy English-language papers published in January 1995 to January 2019 in nine databases and Google Scholar databases. IMPLICATIONS FOR NURSING Despite limited evidence specific to adolescent mothers, contextual studies suggest that social networking sites may enhance well-being. Nurses and midwives need to understand adolescent mothers' use of online networks to aid development of innovative, health-enhancing care strategies using adolescent-familiar modalities. CONCLUSION This paper highlights the need for further research regarding the value of professional engagement in online networks to enhance an adolescent's transition to motherhood.
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Affiliation(s)
- Samantha J Nolan
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Burleigh Waters, Australia
| | - Joyce Hendricks
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Burleigh Waters, Australia
| | - Moira Williamson
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Burleigh Waters, Australia
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McRae DN, Muhajarine N, Janssen PA. Improving birth outcomes for women who are substance using or have mental illness: a Canadian cohort study comparing antenatal midwifery and physician models of care for women of low socioeconomic position. BMC Pregnancy Childbirth 2019; 19:279. [PMID: 31387532 PMCID: PMC6683351 DOI: 10.1186/s12884-019-2428-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 07/25/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Some observational studies have shown improved birth outcomes for women of low socioeconomic position (SEP) receiving antenatal midwifery versus physician care. To understand for whom and under what circumstances midwifery care is associated with better birth outcomes we examined whether psychosocial risk including substance use, mental illness, social assistance, residence in a neighbourhood of low/moderate SEP, and teen maternal age modified the association between model of care (midwifery versus physician) and small-for-gestational-age (SGA) or preterm birth (PTB) for women of low SEP. METHODS For this retrospective cohort study, maternity data from the British Columbia Perinatal Data Registry were linked with Medical Services Plan billing data. We report adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for SGA birth (< the 10th percentile) and PTB (< 37 weeks' completed gestation). For tests of interaction between antenatal models of care and psychosocial risk, p-values < 0.10 were considered statistically significant. Women were eligible for inclusion if they were residents of British Columbia, Canada, carried a singleton fetus, had low to moderate medical/obstetric risk, birthed between April 1, 2008 and Dec. 31, 2012, and received a health insurance subsidy (n = 33,937). RESULTS Midwifery versus obstetrician patients had lower odds of PTB. The difference was 31% larger among substance users (aOR 0.24, 95% CI: 0.11-0.54) compared to non-substance users (aOR 0.55, 95% CI: 0.45-0.68). Additionally, there was a 34% statistically significant absolute difference in odds of PTB for midwifery versus obstetrician patients with both mental illness and substance use (aOR 0.18, 95% CI: 0.06-0.55) compared to women with neither mental illness nor substance use (aOR 0.52, 95% CI: 0.41-.66). Results demonstrated a consistent association between midwifery versus physician care and lower odds of SGA, yet effects were not statistically significantly different for women with higher or lower psychosocial risk. CONCLUSION Among low SEP women in British Columbia, Canada, antenatal midwifery compared to obstetrician care was associated with reduced odds of PTB. Odds were lower among women with substance use, and mental illness and substance use, than among women without these risk factors.
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Affiliation(s)
- Daphne N. McRae
- Department of Community Health and Epidemiology, University of Saskatchewan, Box 7 Health Science Building 107 Wiggins Road, Saskatoon SK, S7N 5E5 Canada
| | - Nazeem Muhajarine
- Department of Community Health and Epidemiology, University of Saskatchewan, Box 7 Health Science Building 107 Wiggins Road, Saskatoon SK, S7N 5E5 Canada
| | - Patricia A. Janssen
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver BC, V6T 1Z3 Canada
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McRae DN, Janssen PA, Vedam S, Mayhew M, Mpofu D, Teucher U, Muhajarine N. Reduced prevalence of small-for-gestational-age and preterm birth for women of low socioeconomic position: a population-based cohort study comparing antenatal midwifery and physician models of care. BMJ Open 2018; 8:e022220. [PMID: 30282682 PMCID: PMC6169769 DOI: 10.1136/bmjopen-2018-022220] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Our aim was to investigate if antenatal midwifery care was associated with lower odds of small-for-gestational-age (SGA) birth, preterm birth (PTB) or low birth weight (LBW) compared with general practitioner (GP) or obstetrician (OB) models of care for women of low socioeconomic position. SETTING This population-level, retrospective cohort study used province-wide maternity, medical billing and demographic data from British Columbia, Canada. PARTICIPANTS Our study included 57 872 pregnant women, with low socioeconomic position, who: were residents of British Columbia, Canada, carried a singleton fetus, had low to moderate medical/obstetric risk, delivered between 2005 and 2012 and received medical insurance premium assistance. PRIMARY AND SECONDARY OUTCOME MEASURES We report rates, adjusted ORs (aOR), and 95% CIs for the primary outcome, SGA birth (<the 10th percentile), and secondary outcomes, PTB (<37 weeks' completed gestation) and LBW (<2500 g). RESULTS Our sample included 4705 midwifery patients, 45 114 GP patients and 8053 OB patients. Odds of SGA birth were reduced for patients receiving antenatal midwifery versus GP (aOR 0.71, 95% CI 0.62 to 0.82) or OB care (aOR 0.59, 95% CI 0.50 to 0.69). Odds of PTB were lower for antenatal midwifery versus GP (aOR 0.74, 95% CI 0.63 to 0.86) or OB patients (aOR 0.53, 95% CI 0.45 to 0.62). Odds of LBW were reduced for midwifery versus GP (aOR 0.66, 95% CI 0.53 to 0.82) or OB patients (aOR 0.43, 95% CI 0.34 to 0.54). CONCLUSION Antenatal midwifery care in British Columbia, Canada, was associated with lower odds of SGA birth, PTB and LBW, for women of low socioeconomic position, compared with physician models of care. Results support the development of policy to ensure antenatal midwifery care is available and accessible for women of low socioeconomic position. Future research is needed to determine the underlying mechanisms linking midwifery care to better birth outcomes for women of low socioeconomic position.
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Affiliation(s)
- Daphne N McRae
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Patricia A Janssen
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Saraswathi Vedam
- Birth Place Lab, Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada
| | - Maureen Mayhew
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Deborah Mpofu
- Saskatoon City Hospital, Saskatoon Health Region, Saskatoon, Saskatchewan, Canada
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Ulrich Teucher
- Department of Psychology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Nazeem Muhajarine
- Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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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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Vedam S, Stoll K, Rubashkin N, Martin K, Miller-Vedam Z, Hayes-Klein H, Jolicoeur G. The Mothers on Respect (MOR) index: measuring quality, safety, and human rights in childbirth. SSM Popul Health 2017; 3:201-210. [PMID: 29349217 PMCID: PMC5768993 DOI: 10.1016/j.ssmph.2017.01.005] [Citation(s) in RCA: 111] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 01/17/2017] [Accepted: 01/18/2017] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Abuse of human rights in childbirth are documented in low, middle and high resource countries. A systematic review across 34 countries by the WHO Research Group on the Treatment of Women During Childbirth concluded that there is no consensus at a global level on how disrespectful maternity care is measured. In British Columbia, a community-led participatory action research team developed a survey tool that assesses women's experiences with maternity care, including disrespect and discrimination. METHODS A cross-sectional survey was completed by women of childbearing age from diverse communities across British Columbia. Several items (31/130) assessed characteristics of their communication with care providers. We assessed the psychometric properties of two versions of a scale (7 and 14 items), among women who described experiences with a single maternity provider (n=2514 experiences among 1672 women). We also calculated the proportion and selected characteristics of women who scored in the bottom 10th percentile (those who experienced the least respectful care). RESULTS To demonstrate replicability, we report psychometric results separately for three samples of women (S1 and S2) (n=2271), (S3, n=1613). Analysis of item-to-total correlations and factor loadings indicated a single construct 14-item scale, which we named the Mothers on Respect index (MORi). Items in MORi assess the nature of respectful patient-provider interactions and their impact on a person's sense of comfort, behavior, and perceptions of racism or discrimination. The scale exhibited good internal consistency reliability. MORi- scores among these samples differed by socio-demographic profile, health status, experience with interventions and mode of birth, planned and actual place of birth, and type of provider. CONCLUSION The MOR index is a reliable, patient-informed quality and safety indicator that can be applied across jurisdictions to assess the nature of provider-patient relationships, and access to person-centered maternity care.
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Affiliation(s)
- Saraswathi Vedam
- Birth Place Research Lab, Division of Midwifery, University of British Columbia, 5950 University Boulevard, Vancouver, BC, Canada V6T 1Z3
| | - Kathrin Stoll
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, Canada V6T 1Z3
| | - Nicholas Rubashkin
- Department of Global Health Sciences, University of California San Francisco, Mission Hall Building, 550 – 16th Street, 3rd Floor, San Francisco, CA 94158, USA
- Department of Obstetrics and Gynecology, University of California San Francisco, Mission Hall Building, 550 – 16th Street, 3rd Floor, San Francisco, CA 94158, USA
| | - Kelsey Martin
- Birth Place Research Lab, Division of Midwifery, University of British Columbia, 5950 University Boulevard, Vancouver, BC, Canada V6T 1Z3
| | - Zoe Miller-Vedam
- Human Rights in Childbirth, 6312 SW Capitol Highway St, 234 Portland, OR 97239, USA
| | - Hermine Hayes-Klein
- Human Rights in Childbirth, 6312 SW Capitol Highway St, 234 Portland, OR 97239, USA
| | - Ganga Jolicoeur
- Midwives Association of British Columbia, 2-175 E. 15th Avenue, Vancouver, BC, Canada V5T 2P6
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McRae DN, Muhajarine N, Stoll K, Mayhew M, Vedam S, Mpofu D, Janssen PA. Corrigendum to "Is model of care associated with infant birth outcomes among vulnerable women? A scoping review of midwifery-led versus physician-led care" [SSM - Population Health 2 (2016) 182-193]. SSM Popul Health 2017; 3:817. [PMID: 29988861 PMCID: PMC6033258 DOI: 10.1016/j.ssmph.2017.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Daphne N McRae
- Community Health and Epidemiology, University of Saskatchewan, Health Science Building, 107 Wiggins Rd., Saskatoon, Sask., Canada S7N 5E5
| | - Nazeem Muhajarine
- Community Health and Epidemiology, University of Saskatchewan, Health Science Building, 107 Wiggins Rd., Saskatoon, Sask., Canada S7N 5E5
| | - Kathrin Stoll
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, Canada V6T 1Z3
| | - Maureen Mayhew
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, Canada V6T 1Z3
| | - Saraswathi Vedam
- UBC Midwifery, University of British Columbia, Suite 320-5950 University Boulevard, Vancouver, BC, Canada V6T 1Z3
| | - Deborah Mpofu
- Community Health and Epidemiology, University of Saskatchewan, Health Science Building, 107 Wiggins Rd., Saskatoon, Sask., Canada S7N 5E5.,Saskatoon Health Region, 701 Queen St., Saskatoon, Sask., Canada S7K 0M7
| | - Patricia A Janssen
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, Canada V6T 1Z3
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