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Hrešanová E. Women who desire 'natural childbirth' in hospitals in a highly medicalized birth care system. Health Care Women Int 2024:1-21. [PMID: 39255416 DOI: 10.1080/07399332.2024.2397457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/22/2024] [Accepted: 08/23/2024] [Indexed: 09/12/2024]
Abstract
'Natural childbirth' continues to matter to women in today's world. Building on qualitative research informed by constructivist grounded theory, I aim to bring insight into the birth experiences of women who demanded 'natural childbirth' in Czech hospitals in the context of a highly medicalized birth care system. I explore four themes: (1) the requirements of birth care, (2) strategies to achieve 'natural childbirth', (3) women's views of the hospital environment, (4) that of healthcare providers. These themes address prospective and retrospective aspects of the core process of negotiating good and respectful care.
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Affiliation(s)
- Ema Hrešanová
- Department of Sociology, Faculty of Social Sciences, Charles University in Prague, Prague, Czech Republic
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Deliktas Demirci A, Ahmedova P, Kabukcuoglu K. Maternal experiences of women who had received salutary childbirth education: A descriptive qualitative study. J Adv Nurs 2024. [PMID: 39101537 DOI: 10.1111/jan.16359] [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: 03/18/2024] [Revised: 07/09/2024] [Accepted: 07/19/2024] [Indexed: 08/06/2024]
Abstract
BACKGROUND Childbirth education, underpinned by Salutogenesis, presents a paradigm shift in maternal care. There was no present information about the maternal experiences of women who had received Salutary childbirth education. OBJECTIVE The present study aimed to deeply explore women's pregnancy, birth and postnatal experiences who attended the 'Salutary Childbirth Education Program' and shed light on the mechanisms of Salutogenesis on maternal health promotion. METHODS A descriptive qualitative study was conducted with 15 mothers. The study was conducted during April-October 2023. Data were obtained through semi-structured, in-depth individual longitudinal interviews to cover all maternal periods. A thematic analysis was performed. RESULTS Women stated that they 'acquired normality oriented perspective' which provides 'attribution of positive meanings to the period' and 'freedom from their risk focus concerns'. Women experienced the naturality of the process and were in the flow. They described that they became 'aware of their internal resources', and gained 'skills for the construction of resources' and 'ability to manage the period'. The 'emotional strength' and 'Investment ability for themselves' in addition to obtained autonomy provided them a feeling of strength to actively engage in their experience. PRACTICE IMPLICATIONS This study explores the experiences of women who participated in the Salutary Childbirth Education Program and describes the mechanisms of the program's components on their experiences. By doing so, it aims to enhance understanding of how healthcare professionals can present effective childbirth education through the use of the Salutogenesis Model. PATIENT OR PUBLIC CONTRIBUTION The authors would like to acknowledge and thank the women who attended the education program and were willing to interview.
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Affiliation(s)
- Ayse Deliktas Demirci
- Department of Obstetrics & Gynaecological Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
| | - Pervin Ahmedova
- Department of Women's Studies and Gender, Research and Application Center of Women's Study and Gender Research, Akdeniz University, Antalya, Turkey
| | - Kamile Kabukcuoglu
- Department of Obstetrics & Gynaecological Nursing, Faculty of Nursing, Akdeniz University, Antalya, Turkey
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Daly D, Sedlicka N, Švanderlíková K, Kovařčíková PA, Wilhelmová R, Begley C. An online survey of women's views of respectful and disrespectful pregnancy and early labour care in the Czech Republic. BMC Pregnancy Childbirth 2024; 24:370. [PMID: 38750412 PMCID: PMC11097455 DOI: 10.1186/s12884-024-06448-5] [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: 01/06/2023] [Accepted: 03/26/2024] [Indexed: 05/18/2024] Open
Abstract
OBJECTIVE To ascertain and explore the views of women and their partners, giving birth in the Czech Republic, of the level of respectful or disrespectful care provided during pregnancy and early labour. DESIGN Ethical approval was granted for a descriptive, online anonymous survey of 65 questions, with quantitative and qualitative responses. SETTING The Czech Republic.The survey was completed by 8,767 women and 69 partners in 2018. MEASUREMENTS AND FINDINGS Descriptive statistics and thematic analysis were used to present results. The majority of women were aged 26-35 years. Most had birthed in one of 93 hospitals, with 1.5% home births. Almost 40% never had an abdominal examination.in pregnancy. Quantitative data analysis revealed that less than half were given information on place of birth, or how to keep labour normal or non-interventionist. Almost 60% did not get information on positions for birth. Most (68%) commenced labour naturally, 25% had labour induced, 40% of them before term, and 7% had an elective caesarean section; 55% stated they had not been given any choice in the decision. Over half of those who had a membrane sweep said permission had not been sought. Half (54%) only had 'checking' visits from the midwife in labour. KEY CONCLUSIONS Findings reveal a lack of information-giving, discussion and shared decision-making from healthcare professionals during pregnancy and early labour. Some practices were non-evidenced-based, and interventions were sometimes made without consent. IMPLICATIONS FOR PRACTICE The examples of disrespectful care described in this study caused women distress during childbirth, which may result in an increased fear of childbirth or an increase in free-birthing.
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Affiliation(s)
- Deirdre Daly
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin, DO2 T283, Ireland.
| | - Natalie Sedlicka
- Association for Birth Houses & Centers (APODAC), Týnská ulička 1064/6, , Prague 1, 11000, Czech Republic
| | - Kateřina Švanderlíková
- Association for Birth Houses & Centers (APODAC), Týnská ulička 1064/6, , Prague 1, 11000, Czech Republic
| | - PetraAnn Ann Kovařčíková
- Association for Birth Houses & Centers (APODAC), Týnská ulička 1064/6, , Prague 1, 11000, Czech Republic
| | - Radka Wilhelmová
- Faculty of Medicine, Department of Health Sciences, Masaryk University, Brno, Czech Republic
| | - Cecily Begley
- School of Nursing and Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin, DO2 T283, Ireland
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Abdolalipour S, Abbasalizadeh S, Mohammad-Alizadeh-Charandabi S, Abbasalizadeh F, Jahanfar S, Raphi F, Mirghafourvand M. Effect of implementation of the WHO intrapartum care model on maternal and neonatal outcomes: a randomized control trial. BMC Pregnancy Childbirth 2024; 24:283. [PMID: 38632530 PMCID: PMC11022439 DOI: 10.1186/s12884-024-06449-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 03/26/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND In 2018, the World Health Organization published a set of recommendations for further emphasis on the quality of intrapartum care to improve the childbirth experience. This study aimed to determine the effects of the WHO intrapartum care model on the childbirth experience, fear of childbirth, the quality of intrapartum care (primary outcomes), as well as post-traumatic stress disorder symptoms, postpartum depression, the duration of childbirth stages, the frequency of vaginal childbirth, Apgar score less than 7, desire for subsequent childbearing, and exclusive breastfeeding in the 4 to 6 weeks postpartum period (secondary outcomes). METHODS This study was a randomized controlled trial involving 108 pregnant women admitted to the maternity units of Al-Zahra and Taleghani hospitals in Tabriz-Iran. Participants were allocated to either the intervention group, which received care according to the ' 'intrapartum care model, or the control group, which received the' 'hospital's routine care, using the blocked randomization method. A Partograph chart was drawn for each participant during pregnancy. A delivery fear scale was completed by all participants both before the beginning of the active phase (pre-intervention) and during 7 to 8 cm dilation (post-intervention). Participants in both groups were followed up for 4 to 6 weeks after childbirth and were asked to complete questionnaires on childbirth experience, postpartum depression, and post-traumatic stress disorder symptoms, as well as the pregnancy and childbirth questionnaire and checklists on the desire to have children again and exclusive breastfeeding. The data were analyzed using independent T and Mann-Whitney U tests and analysis of covariance ANCOVA with adjustments for the parity variable and the baseline scores or childbirth fear. RESULTS The average score for the childbirth experience total was notably higher in the intervention group (Adjusted Mean Difference (AMD) (95% Confidence Interval (CI)): 7.0 (0.6 to 0.8), p < 0.001). Similarly, the intrapartum care quality score exhibited a significant increase in the intervention group (AMD (95% CI): 7.0 (4.0 to 10), p < 0.001). Furthermore, the post-intervention fear of childbirth score demonstrated a substantial decrease in the intervention group (AMD (95% CI): -16.0 (-22.0 to -10.0), p < 0.001). No statistically significant differences were observed between the two groups in terms of mean scores for depression, PTSD symptoms, duration of childbirth stages, frequency of vaginal childbirth, Apgar score less than 7, and exclusive breastfeeding in the 4 to 6 weeks postpartum (p > 0.05). CONCLUSION The intrapartum care model endorsed by the World Health Organization (WHO) has demonstrated effectiveness in enhancing childbirth experiences and increasing maternal satisfaction with the quality of obstetric care. Additionally, it contributes to the reduction of fear associated with labor and childbirth. Future research endeavors should explore strategies to prioritize and integrate respectful, high-quality care during labor and childbirth alongside clinical measures.
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Affiliation(s)
- Somayeh Abdolalipour
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, IR, Iran
| | - Shamsi Abbasalizadeh
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Fatemeh Abbasalizadeh
- Women's Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shayesteh Jahanfar
- Tufts School of Medicine, Department of Public Health and Community Medicine, Boston, USA
| | - Fatemeh Raphi
- Master of Midwifery, Clinical Research Development Unit, Taleghani Hospital, Tabriz University of Medical Sciences, Tabriz, IR, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, IR, Iran.
- Social Determinants of Health Research Center, Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
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Deliktas Demirci A, Oruc M, Kabukcuoglu K. "I need to make sense of my birth experience": A descriptive qualitative study of postnatal women's opinions, and expectations about postnatal debriefing. Midwifery 2024; 131:103955. [PMID: 38368848 DOI: 10.1016/j.midw.2024.103955] [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: 08/29/2023] [Revised: 02/09/2024] [Accepted: 02/10/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND Evidence shows that women feel valued and satisfied after discussing their birth experiences. However, uncertainties persist surrounding the concept of postnatal debriefing practice. AIM To explore the opinions and expectations of women relating to postnatal debriefing and their experiences when the postnatal debriefing is not presented. METHOD A descriptive qualitative study of 20 postnatal women was conducted using in-depth semi-structured interviews from April-May 2023. Thematic analysis was applied to the data collected in interviews. RESULTS Analysis of interview data generated three main themes and nine sub-themes. Women wanted to make sense of their birth experience They expressed their opinions on the components of postnatal debriefing They advocated for all women to be offered this practice by known healthcare professionals who interact with them They do not want to only talk about their birth experience but also meet their needs Women agree that expectations related to birth determine the need for the practice. They hoped for psychological adaptation by relieving their distress and gaining a sense of closure. The discussion process was expected to prevent reflection of trauma to the future and provide transition to the postnatal period. CONCLUSION The present study explored women perceptions and expectations of postnatal debriefing. Healthcare professionals should behave sensitively to women's expectations and needs in relation to their birth experience. Further research is warranted to clarify the components and effects of postnatal debriefing practice to develop consolidated guidance.
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Affiliation(s)
- Ayse Deliktas Demirci
- Akdeniz University, Faculty of Nursing, Department of Obstetrics & Gynaecological Nursing, Dumlupınar Bulvarı, Antalya 07058, Turkey.
| | - Mine Oruc
- Antalya Science University, Faculty of Nursing, Department of Obstetrics & Gynaecological Nursing, Antalya, Turkey
| | - Kamile Kabukcuoglu
- Akdeniz University, Faculty of Nursing, Department of Obstetrics & Gynaecological Nursing, Dumlupınar Bulvarı, Antalya 07058, Turkey
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Hadjigeorgiou E, Andreaki M, Koliandri I, Spyridou A, Balaam MC, Christoforou A. Exploring mothers' experiences of perinatal care in Cyprus: Babies Born Better survey. BMC Pregnancy Childbirth 2023; 23:487. [PMID: 37393248 PMCID: PMC10314612 DOI: 10.1186/s12884-023-05800-5] [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: 01/26/2023] [Accepted: 06/19/2023] [Indexed: 07/03/2023] Open
Abstract
INTRODUCTION A positive perinatal experience facilitates a smooth transition to motherhood and enhances the development of a strong bond between mother and newborn, contributing to maternal and societal wellbeing. Given the medicalization of childbirth in Cyprus, the examination of mothers' experiences of perinatal care becomes imperative. AIM To investigate mothers' experiences of care during the perinatal period and to identify factors related to the provision of maternal care that contribute to the interpretation of these experiences. METHODS The study draws on data from the European survey "Babies Born Better", an online survey utilizing a mixed-methods approach to explore women's experiences of maternity care across Europe. The study population were women who had given birth in Cyprus over a 5-year period (2013-2018). Quantitative data were analyzed using SPSS v22, while qualitative data were analyzed through inductive content analysis. FINDINGS A total of 360 mothers participated in the study. In rating their overall experience, 24.2% stated that they had a "bad experience", 11.1% a "good experience",13.9% a "very good experience", and 13,3% a "very bad experience". The top three sub-factors of the overall experience which received positive evaluation were "Relationship with health care professionals" (33.6%), "Birth environment and care" (11.4%), and "Breastfeeding guidance" (10.8%). The qualitative analysis yielded five themes: "Relationship with health care professionals", "Breastfeeding establishment", "Childbirth rights", "Birth environment and services" and "Choice of mode of birth". CONCLUSION Mothers in Cyprus wish to have respectful maternity care. They need maternity health care professionals to respect their dignity and ask for evidence-based information with shared decision making. Mothers in Cyprus expect to have their childbirth rights safeguarded, to have better support from HCP, and to receive humanized care. The perinatal care provided in Cyprus needs significant improvements based on mothers' needs and expectations.
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Affiliation(s)
- E Hadjigeorgiou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus.
| | - M Andreaki
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - I Koliandri
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - A Spyridou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - M C Balaam
- School of Community Health and Midwifery, University of Central Lancashire, Preston, UK
| | - A Christoforou
- Department of Social & Behavioral Sciences and Health Science, European University Cyprus, Nicosia, Cyprus
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Buchanan K, Geraghty S, Whitehead L, Newnham E. Woman-centred ethics: A feminist participatory action research. Midwifery 2023; 117:103577. [PMID: 36563440 DOI: 10.1016/j.midw.2022.103577] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/15/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Contemporary ethical issues in the maternity system are nuanced, complex and layered. Medicalisation and the reported rise in incidence of mistreatment and birth trauma, has been described as unethical. Some authors suggest bioethical principles are limited in terms of guiding everyday care of pregnancy and birth. There is currently no known published research which explores what birthing people say is ethical. AIMS This study sought to explore women's experience of maternity care from an ethical perspective. METHOD A Feminist Participatory Action Research (FPAR) was conducted over three years, in two phases. A Community Action Research Group (CARG) was formed of nine participants, and data were captured from five focus groups. A further ten participants were recruited for individual in-depth interviews, the data corpus was combined, and thematic analysis was applied. All 19 participants had experienced a midwifery model of care in Western Australia. RESULTS A unique ethical perspective was described by the participants. The central theme: 'Radical desires: Individuals values and context' placed the woman at the centre of the care, in determining what is ethical. Two categories captured the care experienced: Woman-centred ethics or Authoritarian ethics. A conceptual model Woman-centred ethics is offered to enhance everyday ethical midwifery care. DISCUSSION The participants in this study perceived care as either ethical or unethical based on the quality of the relationship, the knowledge that was shared and the manner of the care given. The Woman-centred ethics model may be a starting point for moving the field forward in ethical discussion.
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Affiliation(s)
- Kate Buchanan
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA 6027, Australia; The University of Notre Dame Australia, 19 Mouat Street Fremantle 6959, WA, Australia.
| | - Sadie Geraghty
- The University of Notre Dame Australia, 19 Mouat Street Fremantle 6959, WA, Australia
| | - Lisa Whitehead
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA 6027, Australia
| | - Elizabeth Newnham
- School of Nursing and Midwifery, University of Newcastle, University Dve, NSW 2308, Australia
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Backes MTS, Carvalho KMD, Ribeiro LN, Amorim TS, Santos EKAD, Backes DS. The prevalence of the technocratic model in obstetric care from the perspective of health professionals. Rev Bras Enferm 2021; 74:e20200689. [PMID: 34406273 DOI: 10.1590/0034-7167-2020-0689] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 11/01/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES to identify the reasons for the prevalence of the technocratic model in obstetric care from the perspective of health professionals. METHODS Grounded Theory. Study approved by two Research Ethics Committees and conducted by theoretical sampling, from July 2015 to June 2017. Twenty-nine interviews were conducted with health professionals from two maternity hospitals in the Southern Region of Brazil. Data collection and analysis was performed alternately; and analysis by open, axial, and selective coding/integration. RESULTS the technocratic model still persists because the assistance is performed in a mechanized way, centered on the professionals. There is a lack of systematization of care, and under-dimensioning of the nursing staff. FINAL CONSIDERATIONS obstetric nurses need to review their performance in obstetric centers, the internal organization, the dimensioning of nursing professionals, and become protagonists of care. Investment in academic training/updating the knowledge of midwifery professionals, based on scientific evidence and user-centered care is necessary.
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Affiliation(s)
| | | | | | - Tamiris Scoz Amorim
- Universidade Federal de Santa Catarina. Florianópolis, Santa Catarina, Brazil
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Deliktas Demirci A, Kabukcuoglu K, Haugan G, Aune I. Turkish midwives' experiences and opinions in promoting normal births: A grounded theory study. Midwifery 2021; 99:103006. [PMID: 33910158 DOI: 10.1016/j.midw.2021.103006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 02/05/2021] [Accepted: 04/06/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Worldwide, the biomedical model of maternity care has been dominant, with the overuse of interventions. AIM This study aimed to gain a deeper understanding of the experiences and opinions of Turkish midwives regarding the promotion of normal births. METHODS In-depth interviews were conducted with 12 midwives; data were analysed using grounded theory. The data were analysed according to the constant comparative method. FINDINGS The study generated a core category (We want to promote normal births, but have no power to do it), which means all participants wanted to promote normal births. However, they have been disempowered by the medicalised systems of care. There were also three main categories (different ideologies in the labour ward, the midwives have no power, unempowered women). The participants reported that different ideologies in the labour ward were a challenge to promoting normal births. Their working conditions and education level were not enough to support normal birth. The pregnant women were described as unempowered due to a lack of antenatal education and having a fear of childbirth. CONCLUSION AND IMPLICATIONS FOR PRACTICE Normal birth could be promoted by enhancing the power and responsibilities of midwives. The women need antenatal education to have a normal birth. The normal birth may promote the enhanced readiness of women and midwives.
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Affiliation(s)
- Ayse Deliktas Demirci
- Akdeniz University, Faculty of Nursing, Department of Obstetrics & Gynaecological Nursing, Antalya, Turkey.
| | - Kamile Kabukcuoglu
- Akdeniz University, Faculty of Nursing, Department of Obstetrics & Gynaecological Nursing, Antalya, Turkey
| | - Gorill Haugan
- Norwegian University of Science and Technology (NTNU), Faculty of Medicine and Health Sciences, Department of Public Health and Nursing, Trondheim, Norway; Nord University, Faculty of Nursing and Health Science
| | - Ingvild Aune
- Norwegian University of Science and Technology (NTNU), Faculty of Medicine and Health Sciences, Faculty of Medicine and Health Sciences, Department of Clinical and Molecular Medicine, Midwifery Education, Trondheim, Norway
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Anderson G, Zega M, D'Agostino F, Rega ML, Colaceci S, Damiani G, Alvaro R, Cocchieri A. Meta-Synthesis of the Needs of Women Cared for by Midwives During Childbirth in Hospitals. J Obstet Gynecol Neonatal Nurs 2020; 50:6-19. [PMID: 33217368 DOI: 10.1016/j.jogn.2020.10.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2020] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE To identify and meta-synthesize results of qualitative studies on the needs of women cared for by midwives during childbirth in hospitals. DATA SOURCES MEDLINE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, and the Cochrane Library. STUDY SELECTION We restricted the bibliographic search to articles published in English to July 31, 2020. The initial search yielded 6,407 articles, and after 2,504 duplicates were removed, we screened the titles and abstracts of 3,903 articles. We conducted a full-text review of 89 articles and included 13 qualitative studies about the needs of women who were hospitalized during childbirth and had midwives as their primary maternity care providers. DATA EXTRACTION We extracted data (e.g., authors, publication date, type of study, sample size, results, and quotes) from the full text of each article into a standardized table. Two authors reviewed all articles using the Critical Appraisal Skills Programme tool to assess study quality and to independently score each study. DATA SYNTHESIS We analyzed the findings of each study and synthesized them to develop themes. We found 14 major themes that reflected the needs of women during hospitalization for childbirth: Nutrition, Hygiene, Privacy, Information, Bodily Respect, Respect for Social Role, Family Intimacy, Shelter, Pain Management, Partnership, Movement, Reassurance, Support, and Empowerment. We categorized these themes in Maslow's hierarchy of needs to better understand the phenomenon. CONCLUSION We identified 14 needs that midwives and nurses can meet when they care for women in hospitals during childbirth. Standardized methods to assess these needs and to link them to specific interventions can be used by midwives and nurses, which will likely affect women's satisfaction with their experience and overall quality of care.
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Consensus on priorities in maternal education: results of Delphi and nominal group technique approaches. BMC Pregnancy Childbirth 2019; 19:264. [PMID: 31340770 PMCID: PMC6657030 DOI: 10.1186/s12884-019-2382-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Accepted: 06/26/2019] [Indexed: 02/04/2023] Open
Abstract
Background Maternal education is wide-ranging and covers many areas from pregnancy to the immediate postpartum period and childrearing. However, for it to be effective, more resources need to be assigned to key topics. The goal of this study was to identify and prioritize the most important issues in maternal education, so that specific objectives could subsequently be set and learning outcomes evaluated. Methods We drew up a comprehensive list of topics addressed in existing maternal education programs, based on a systematic review of information obtained from the Internet and the experience of the research team. The topics were presented to a multidisciplinary panel whose members were asked to rate them from 1 to 9, and consensus of opinion was reached using a two-round Delphi survey, with consensus defined beforehand as 80% agreement among panelists in awarding a score of 7, 8 or 9. The most highly-rated topics were then discussed and again prioritized by a multidisciplinary team of healthcare and non-healthcare experts, using a nominal group technique. Results Initially, 650 topics were identified and grouped into 80 categories which were then prioritized by 54 healthcare and non-healthcare experts using a Delphi survey with a study participation rate of around 20%. 63 topics were considered very important, so criteria were restricted and only the 24 highest-scoring selected (95% of agreement on scores ≥7 or 80% of agreement on scores ≥8). Using the nominal group technique, a group of 12 experts identified the following priorities: initiation and establishment of breastfeeding, development of a birth plan, identification of problems and self-care postpartum, nutrition and a healthy lifestyle, options for pain management in labor and birth and characteristics of a normal newborn/looking after a newborn baby. Conclusion This study, with a Delphi study and the Consensus among Experts: the nominal group technique, has succeeded in identifying priority topics in maternal education. We need to assess women’s needs in relation to these topics, design an intervention to respond to these needs and evaluate its effectiveness.
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