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Vogels-Broeke M, Daemers D, Budé L, de Vries R, Nieuwenhuijze M. Women's Birth Beliefs During Pregnancy and Postpartum in the Netherlands: A Quantitative Cross-Sectional Study. J Midwifery Womens Health 2023; 68:210-220. [PMID: 36938758 DOI: 10.1111/jmwh.13473] [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: 02/18/2022] [Revised: 11/30/2022] [Accepted: 12/29/2022] [Indexed: 03/21/2023]
Abstract
INTRODUCTION Women and care providers increasingly regard childbirth as a medical process, resulting in high use of medical interventions, which could negatively affect a woman's childbirth experience. Women's birth beliefs may be key to understanding the decisions they make and the acceptance of medical interventions in childbirth. In this study we explore women's beliefs about birth as a natural and medical process and the factors that are associated with women's birth beliefs. METHODS Data were obtained from a cross-sectional survey of women living in the Netherlands asking them about their experiences during pregnancy and childbirth, including their beliefs about birth as a natural and medical process. RESULTS A total of 3494 women were included in this study. Mean scores of natural birth beliefs ranged between 3.73 and 4.01 points, and medical birth belief scores ranged between 2.92 and 3.12 points. There were significant but very small changes between prenatal and postnatal birth beliefs. Regression analyses showed that (previous) childbirth experiences were the most consistent predictor of women's birth beliefs. DISCUSSION Women's high scores on natural birth beliefs and lower scores on medical birth beliefs correspond with the philosophy of Dutch perinatal care that considers pregnancy and childbirth to be natural processes. Perinatal care providers must be aware of women's birth beliefs and recognize that they as professionals influence women's birth beliefs. They make an important contribution to women's perinatal experiences, which affects both women's natural and medical birth beliefs.
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Affiliation(s)
- Maaike Vogels-Broeke
- Research Centre for Midwifery Science, Zuyd University, Maastricht, The Netherlands.,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Darie Daemers
- Research Centre for Midwifery Science, Zuyd University, Maastricht, The Netherlands
| | - Luc Budé
- Research Centre for Midwifery Science, Zuyd University, Maastricht, The Netherlands
| | - Raymond de Vries
- Research Centre for Midwifery Science, Zuyd University, Maastricht, The Netherlands.,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.,Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, Michigan
| | - Marianne Nieuwenhuijze
- Research Centre for Midwifery Science, Zuyd University, Maastricht, The Netherlands.,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
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Hoffmann L, Hilger N, Banse R. The mindset of birth predicts birth outcomes: Evidence from a prospective longitudinal study. EUROPEAN JOURNAL OF SOCIAL PSYCHOLOGY 2023. [DOI: 10.1002/ejsp.2940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
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A framework for understanding how midwives perceive and provide care management for pregnancies complicated by gestational diabetes or hypertensive disorders of pregnancy. Midwifery 2022; 115:103498. [PMID: 36191384 DOI: 10.1016/j.midw.2022.103498] [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: 05/21/2021] [Revised: 06/20/2022] [Accepted: 09/25/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Both gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP) are common, and each are associated with adverse maternal and perinatal outcomes. Midwives may be the first point of care when these conditions arise. This study evaluated the experiences of midwives when providing care to women and people with pregnancies complicated by GDM or HDP. METHODS A mixed methods study was completed in Ontario, Canada, using a sequential, explanatory approach. A total of 144 online surveys were completed by midwives, followed by 20 semi-structured interviews that were audio recorded and transcribed verbatim. Survey data were analysed using descriptive statistics. Thematic analysis was used to generate codes from the interview data, which were mapped to the Theoretical Domains Framework (TDF), to elucidate factors that might influence management. RESULTS Most of the midwives' clinical behaviours relating to GDM or HDP were in keeping with guidelines and regulatory standards set by existing provincial standards. Six theoretical domains from the TDF appeared to influence midwives'care pathway: "Internal influences" included knowledge, skills and beliefs about capabilities; while "external influences" included social/professional role and identity, environmental context, and social influences. Interprofessional collaboration emerged as a significant factor on both the internal and external levels of influence. CONCLUSIONS We identified barriers and facilitators that may improve the experiences of midwives and clients when GDM or HDP newly arises in a pregnancy, necessitating further consultation or management by another health care provider.
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Miller YD, Tone J, Talukdar S, Martin E. A direct comparison of patient-reported outcomes and experiences in alternative models of maternity care in Queensland, Australia. PLoS One 2022; 17:e0271105. [PMID: 35819947 PMCID: PMC9275696 DOI: 10.1371/journal.pone.0271105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 06/24/2022] [Indexed: 11/19/2022] Open
Abstract
We aimed to directly compare women’s pregnancy to postpartum outcomes and experiences across the major maternity models of care offered in Queensland, Australia. We conducted secondary analyses of self-reported data collected in 2012 from a state-wide sample of women who had recently given birth in Queensland (response rate = 30.4%). Logistic regression was used to estimate the odds of outcomes and experiences associated with three models (GP Shared Care, Public Midwifery Continuity Care, Private Obstetric Care) compared with Standard Public Care, adjusting for relevant maternal characteristics and clinical covariates. Of 2,802 women, 18.2% received Standard Public Care, 21.7% received GP Shared Care, 12.9% received Public Midwifery Continuity Care, and 47.1% received Private Obstetric Care. There were minimal differences for women in GP Shared Care. Women in Public Midwifery Continuity Care were less likely to have a scheduled caesarean and more likely to have an unassisted vaginal birth, experience freedom of mobility during labour and informed consent processes for inducing labour, vaginal examinations, fetal monitoring and receiving Syntocinon to birth their placenta, and report highest quality interpersonal care. They had fewer vaginal examinations, lower odds of perineal trauma requiring sutures and anxiety after birth, shorter postpartum hospital stays, and higher odds of a home postpartum care visit. Women in Private Obstetric Care were more likely to have their labour induced, a scheduled caesarean birth, experience informed consent processes for caesarean, and report highest quality interpersonal care, but less likely to experience unassisted vaginal birth and informed consent for Syntocinon to birth their placenta. There is an urgent need to communicate variations between maternity models across the range of outcome and experiential measures that are important to women; build more rigorous comparative evidence for Private Midwifery Care; and prioritise experiential and out-of-pocket cost comparisons in further research to enable woman-centred informed decision-making.
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Affiliation(s)
- Yvette D. Miller
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD, Australia
- * E-mail:
| | - Jessica Tone
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Sutapa Talukdar
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Elizabeth Martin
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD, Australia
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Espinosa M, Artieta-Pinedo I, Paz-Pascual C, Bully-Garay P, García-Álvarez A. Attitudes toward medicalization in childbirth and their relationship with locus of control and coping in a Spanish population. BMC Pregnancy Childbirth 2022; 22:529. [PMID: 35764947 PMCID: PMC9241227 DOI: 10.1186/s12884-022-04748-2] [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: 02/15/2022] [Accepted: 05/06/2022] [Indexed: 12/02/2022] Open
Abstract
The dominant model of childbirth in most Western countries is medicalized childbirth. Women's beliefs about whether childbirth should be a medicalized process to a greater or lesser degree may be related, in addition to contextual factors, to internal factors. The objective of the study is to find out if women’s locus of control (LC) and stress coping strategies (CS) are related to having a more favourable or less favourable attitude towards medicalization (ATMC). A cross-sectional study was carried out with the participation of 248 women recruited in primary care centres by their midwives. All the women filled in answers on a mobile phone app with various different measurement instruments: the questionnaire created by Benyamini to evaluate their ATMC; the Spanish version of the Wallston MLC to evaluate their LC; and the Spanish adaptation of the “Revised Prenatal Coping Inventory (NuPCI)” scale for the assessment of their CS. The women presented a favourable attitude towards medicalization, with a mean ATMC score of 3.42. Both the LC and the CS of women during pregnancy are related to this attitude. Specifically, having an internal LC and using preparative CS both lower the probability of presenting a favourable attitude towards medicalization, while the lack of a paid job raises the probability. For each point in internal locus and preparatory coping, the ATMC score decreased by 0.02 and 0.23 points, respectively, while it increased by 0.18 for not having a paid job. The influence of these psychological factors must be taken into account in the development of content and interventions that promote a more natural birth.
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Affiliation(s)
- Maite Espinosa
- Osakidetza-Basque Health Service, Biocruces-Bizkaia Health Research Institute, C/ Edificio Biocruces 3, Plaza De Cruces, 48903, Barakaldo, Spain.
| | - Isabel Artieta-Pinedo
- Osakidetza-Basque Health Service, Biocruces-Bizkaia Health Research Institute, C/ Edificio Biocruces 3, Plaza De Cruces, 48903, Barakaldo, Spain.,Primary Care Midwife Zuazo Health Centre, OSI BARAKALDO-SESTAO-OSAKIDETZA, C/ Lurkizaga Kalea, s/n, 48902, Barakaldo, Spain.,Associate Professor of the School of Nursing, University of the Basque Country, C/ Barrio Sarriena S/N, 48940, Leioa, Spain
| | - Carmen Paz-Pascual
- Osakidetza-Basque Health Service, Biocruces-Bizkaia Health Research Institute, C/ Edificio Biocruces 3, Plaza De Cruces, 48903, Barakaldo, Spain.,Primary Care Midwife Markonzaga Health Centre, OSI BARAKALDO-SESTAO-OSAKIDETZA, C/ Antonio Trueba Kalea 17, 48910, Sestao, Spain.,Lecturer in the Midwifery Training Unit of the Basque Country, Hospital de Basurto-OSAKIDETZA, C/ Montevideo Etorbidea 18, 48013, Bilbao, Spain
| | - Paola Bully-Garay
- Paola Bully Methodological and Statistical Consultant, C/ Barrio La Sota, 48190, Sopuerta, Spain
| | - Arturo García-Álvarez
- Osakidetza-Basque Health Service, Biocruces-Bizkaia Health Research Institute, C/ Edificio Biocruces 3, Plaza De Cruces, 48903, Barakaldo, Spain
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Nahidi F, Hajifoghaha M, Simbar M, Nasiri M. Assessment of Prenatal Care Providers’ Competencies From the Perspective of Pregnant Women: An Iranian Study. J Patient Exp 2022; 9:23743735221092559. [PMID: 35450090 PMCID: PMC9016611 DOI: 10.1177/23743735221092559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Pregnant women have expectations from their providers;
sometimes their expectations are somewhat different from the current situation.
Objective: to assess of competencies of prenatal care providers
according to the views of pregnant women in Iran. Method: This is a
descriptive-analytical study. Sampling were 300 pregnant women. A
researcher-made questionnaire with appropriate validity and reliability was
used. These competencies were divided into 4 dimensions of professional skills,
communication skills, individual characteristics of prenatal care providers, and
the characteristics of pregnancy and childbirth centers. Results:
The percentage of the expected status of professional skills’ score of prenatal
care providers (97.17) did not significantly differ from the current status
(96.07). Nevertheless, there was a significant difference between the
percentages of scores of expected (95.61) and the current statuses (90.89) of
communication skills. The percentage of expected status (94.74) and the current
status (84.17) scores of individual characteristics of prenatal care providers.
The percentages of the expected status scores (95.24) and the status quo (89.61)
of characteristics of pregnancy and childbirth centers were a significant
difference. Conclusion: It is needed to upgrade some competencies
of prenatal care providers. So, providers should focus their efforts on
strengthening the expected skills of their pregnant women.
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Affiliation(s)
- Fatemeh Nahidi
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Mahboubeh Hajifoghaha
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoumeh Simbar
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Malihe Nasiri
- Department of Basic Sciences, Faculty of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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MacDougall C, Johnston K. Client experiences of expertise in midwifery care in New Brunswick, Canada. Midwifery 2021; 105:103227. [PMID: 34954470 DOI: 10.1016/j.midw.2021.103227] [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: 05/21/2021] [Accepted: 12/13/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study contextualizes client experiences of midwifery in New Brunswick within the broader literature on midwifery in Canada and contributes to understandings of how midwifery care fits into the landscape of reproductive healthcare in the province. DESIGN Semi structured interviews with 32 clients and supportive others of the New Brunswick midwifery program were carried out in 2019 and 2020, and transcripts were analysed using general thematic analysis. SETTING N New Brunswick, Canada PARTICIPANTS: Clients of midwifery care provided by the Fredericton Midwifery Centre, as well as their supportive others (partners and spouses, family members, friends) FINDINGS: Participants in this study reported a high degree of satisfaction with midwifery services and identified several approaches to practice that they felt contributed to high quality midwifery care. These include competence and expertise, time and access as abundance rather than scarcity, attention to the familial context, trauma informed care and attention to mental and emotional health, postpartum care, and supporting agency and autonomy. In short, participants' responses indicate that midwifery care in New Brunswick meets the criteria for respectful maternity care, as outlined by Shakibazadeh et al. (Shakibazadeh et al., 2018) and Butler et al. (Butler et al., 2020). Our findings are in line with research on midwifery care in other settings, although there is a significant emphasis on the medical expertise and training of midwives amongst our participants which is less evident in the scholarly literature. KEY CONCLUSIONS In a province where reproductive health care has been systematically underfunded, clients celebrate the expertise and competence of midwives, challenging the narrative which constructs midwifery as 'traditional' care, and hospital-based obstetrics as expert care. Instead, midwives are recognized as highly specialized evidence-based practitioners, and this is particularly prized by clients in relation to processes of information sharing.
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Hoffmann L, Banse R. Psychological aspects of childbirth: Evidence for a birth‐related mindset. EUROPEAN JOURNAL OF SOCIAL PSYCHOLOGY 2021. [DOI: 10.1002/ejsp.2719] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Lisa Hoffmann
- Department of Psychology, Social‐ and Legal Psychology University of Bonn Bonn Germany
| | - Rainer Banse
- Department of Psychology, Social‐ and Legal Psychology University of Bonn Bonn Germany
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A scoping review of evidence comparing models of maternity care in Australia. Midwifery 2021; 99:102973. [PMID: 33932707 DOI: 10.1016/j.midw.2021.102973] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 02/05/2021] [Accepted: 02/24/2021] [Indexed: 01/08/2023]
Abstract
OBJECTIVES To synthesize available evidence comparing outcomes and experiences of care received in different maternity models in Australia and identify the information gaps hindering women's decisions between alternative models. DESIGN A literature search was conducted to identify published research over the last twenty years that directly compared clinical and/or experiential outcomes of women in different maternity models of care in Australia. Outcome measures of included articles were identified and assessed to evaluate current comparative information available to women and health professionals. The quality of included studies was assessed using Joanna Briggs Institute (JBI) critical appraisal tools for randomised controlled studies (RCTs) and cohort studies. Quantitative data were extracted and synthesised for further analysis. SETTING/PARTICIPANTS Published studies comparing at least two maternity care models providing antenatal, intrapartum and postpartum care in Australia. RESULTS Eight studies (five RCTs and three observational studies) met inclusion criteria. Seven studies compared the outcomes of public midwifery continuity care and standard public care and one compared the outcomes of public midwifery continuity care, standard care and private obstetric care. There was no evidence directly comparing all broadly categorised available models in Australia. Data for clinical outcomes were collected from hospital records and experiential data were self-reported. Seven out of eight studies used data collected from single public hospital settings and one study included data from two tertiary hospitals. Women in public midwifery continuity models were more likely to have unassisted vaginal births, continuity of care and satisfaction and lower use of interventions (i.e., episiotomy, induction of labour, use of analgesia) and neonatal admission in intensive care units (ICU), compared with those in standard public models (and private obstetric care in one study). CONCLUSION This scoping review reveals lack of reliable direct comparison of clinical and experiential outcomes across the multiple available public and private maternity models of care in Australia. Quality alignment between women's needs and their maternity model of care can prevent under or over specialised care and avoidable health system costs. Comprehensive information comparing all available maternity care models can guide gatekeeper health professionals and women to choose the best model according to women's needs and preferences. There is a need for research providing more comprehensive and ecological comparisons between available models of maternity care to inform such decision making support. Moreover, women's experiential data across maternity model of care comparisons could be used more consistently to better represent the relative outcomes of alternative models from a consumer-centred perspective.
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Chan MH, Hauck Y, Kuliukas L, Lewis L. Women's experiences of their involvement around care decisions during a subsequent pregnancy after a previous caesarean birth in Western Australia. Women Birth 2020; 34:e442-e450. [PMID: 33004288 DOI: 10.1016/j.wombi.2020.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 08/14/2020] [Accepted: 09/08/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Women who have a caesarean birth can have an experience that may impact decision-making for subsequent births. For some women this decision-making can be associated with anxiety. AIM To provide rich, surface level descriptions by exploring women's experiences of their involvement in decision-making during a subsequent pregnancy after a previous caesarean birth. METHODS A descriptive qualitative study was performed between May 2018 and February 2019 using Braun and Clarke's six steps guided analysis. Pregnant women with a previous caesarean birth, receiving antenatal care at a tertiary maternity hospital in Western Australia, and self-reported low to moderate levels of anxiety were invited to participate in a telephone interview. FINDINGS Women's (n = 17) experiences revealed four themes: 1) Learning from past experiences (two sub-themes loss of control and coming to terms), 2) Claiming ownership in decisions (two sub-themes challenging professional judgement and prioritising her needs, wishes and preferences), 3) Being empowered (three sub-themes getting a full picture, speaking out, and not just the baby or a number), 4) Moving forward (two sub-themes building trust in health professionals and establishing guardrails to minimise loss of control). DISCUSSION Women's experiences around decision-making in a subsequent pregnancy can vary according to whether their fears and anxieties are acknowledged and addressed. Women who are informed, and receive support and respect are empowered to move forward. CONCLUSION Continuity of care may provide women with more opportunities to build trusting relationships with clinicians and be truly known as an individual with unique preferences and desires.
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Affiliation(s)
- Maria Hakyung Chan
- School of Nursing, Midwifery and Paramedicine, Curtin University, Kent Street, Bentley WA 6102, Australia.
| | - Yvonne Hauck
- School of Nursing, Midwifery and Paramedicine, Curtin University, Kent Street, Bentley WA 6102, Australia.
| | - Lesley Kuliukas
- School of Nursing, Midwifery and Paramedicine, Curtin University, Kent Street, Bentley WA 6102, Australia.
| | - Lucy Lewis
- School of Nursing, Midwifery and Paramedicine, Curtin University, Kent Street, Bentley WA 6102, Australia.
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Durgun Ozan Y, Alp Yilmaz F. Is there a relationship between basic birth beliefs and pregnancy-related anxiety in Turkey. J Obstet Gynaecol Res 2020; 46:2036-2042. [PMID: 32643257 DOI: 10.1111/jog.14375] [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: 12/29/2019] [Revised: 06/02/2020] [Accepted: 06/12/2020] [Indexed: 11/26/2022]
Abstract
AIM It is important to investigate the relationship between the beliefs about birth as a natural or medical process and the pregnancy-related anxiety that has a powerful impact on the negative outcomes of labor. This study was aimed at investigating the relationship between basic birth beliefs and pregnancy-related anxiety in Turkey. METHODS This descriptive, cross-sectional and correlational study was conducted in a University hospital located in eastern Turkey. The study sample included 473 primiparae having completed 14 weeks of pregnancy. The Birth Belief Scale and Pregnancy-Related Anxiety Questionnaire/PRAQ-R2 were used to collect the data. RESULTS A relationship was found between birth beliefs and pregnancy-related anxiety. Strong beliefs about birth as a medical process or weak beliefs about birth as a natural process were found to be related with fear of giving birth and worries about bearing a handicapped child. CONCLUSION A relationship was detected between beliefs of pregnant women about birth as a medical and natural process and fear of giving birth, worries about bearing a handicapped child., concern about own appearance. It is highly important to detect the birth beliefs in order to help women have a healthy pregnancy period and to decrease their anxiety levels. Pregnancy-related anxieties of women must be detected, and their birth beliefs that result in anxiety must not be overlooked during the provision of prenatal healthcare services.
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Affiliation(s)
- Yeter Durgun Ozan
- Nursing Department, Atatürk School of Health, Dıcle University, Dıyarbakır, Turkey
| | - Figen Alp Yilmaz
- Health Sciences Faculty, Yozgat Bozok University, Yozgat, Turkey
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Alp Yilmaz F, Durgun Ozan Y. Women's birth beliefs and associated factors in an obstetrics clinic in the Southeastern Anatolian Region of Turkey. JOURNAL OF HEALTH RESEARCH 2020. [DOI: 10.1108/jhr-07-2019-0166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
PurposeThe impact of birth beliefs on pregnancy and delivery are universally recognized, but the factors that affect birth beliefs vary across regions depending on individual and cultural characteristics. This study aimed to determine women's birth beliefs and examine their associated factors.Design/methodology/approachThis cross-sectional study was conducted with 548 primiparas in the obstetrics clinic of a university hospital located in the Southeastern Anatolian Region of Turkey from February to June 2019. Descriptive characteristics, form and the Birth Beliefs Scale were used in data collection. To analyze the data, descriptive statistics, T-tests and ANOVA analyses were used.FindingsIt was determined that factors such as age group, income level, any problems during pregnancy and preferred delivery mode statistically affected women's birth beliefs.Originality/valueBased on the findings from this study, healthcare personnel should provide training and consultation services to pregnant women starting from the prenatal period to help ensure a positive labor experience.
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Darling EK, Grenier L, Nussey L, Murray-Davis B, Hutton EK, Vanstone M. Access to midwifery care for people of low socio-economic status: a qualitative descriptive study. BMC Pregnancy Childbirth 2019; 19:416. [PMID: 31718569 PMCID: PMC6849230 DOI: 10.1186/s12884-019-2577-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 10/31/2019] [Indexed: 11/25/2022] Open
Abstract
Background Despite public funding of midwifery care, people of low-socioeconomic status are less likely to access midwifery care in Ontario, Canada, but little is known about barriers that they experience in accessing midwifery care. The purpose of this study was to examine the barriers and facilitators to accessing midwifery care experienced by people of low-socioeconomic status. Methods A qualitative descriptive study design was used. Semi-structured interviews were conducted with 30 pregnant and post-partum people of low-socioeconomic status in Hamilton, Ontario from January to May 2018. Transcribed interviews were coded using open coding techniques and thematically analyzed. Results We interviewed 13 midwifery care recipients and 17 participants who had never received care from midwives. Four themes arose from the interviews: “I had no idea…”, “Babies are born in hospitals”, “Physicians as gateways into prenatal care”, and “Why change a good thing?”. Participants who had not experienced midwifery care had minimal knowledge of midwifery and often had misconceptions about midwives’ scope of practice and education. Prevailing beliefs about pregnancy and birth, particularly concerns about safety, drove participants to seek care from a physician. Physicians are the entry point into the health care system for many, yet few participants received information about midwifery care from physicians. Participants who had experienced midwifery care found it to be an appropriate match for the needs of people of low socioeconomic status. Word of mouth was a primary source of information about midwifery and the most common reason for people unfamiliar with midwifery to seek midwifery care. Conclusions Access to midwifery care is constrained for people of low-socioeconomic status because lack of awareness about midwifery limits the approachability of these services, and because information about midwifery care is often not provided by physicians when pregnant people first contact the health care system. For people of low-socioeconomic status, inequitable access to midwifery care may be exacerbated by lack of knowledge about midwifery within social networks and a tendency to move passively through the health care system which traditionally favours physician care. Targeted efforts to address this issue are necessary to reduce disparities in access to midwifery care.
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Affiliation(s)
- Elizabeth K Darling
- McMaster Midwifery Research Centre, McMaster University, HSC 4H24, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada.
| | - Lindsay Grenier
- McMaster Midwifery Research Centre, McMaster University, HSC 4H24, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada
| | - Lisa Nussey
- McMaster Midwifery Research Centre, McMaster University, HSC 4H24, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada
| | - Beth Murray-Davis
- McMaster Midwifery Research Centre, McMaster University, HSC 4H24, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada
| | - Eileen K Hutton
- McMaster Midwifery Research Centre, McMaster University, HSC 4H24, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada
| | - Meredith Vanstone
- Department of Family Medicine, Centre for Health Economics and Policy Analysis McMaster FHS Education Research, Innovation & Theory (MERIT) program, McMaster University, 100 Main St. W, Hamilton, ON, L8P 1H6, Canada
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Preis H, Pardo J, Peled Y, Benyamini Y. Changes in the basic birth beliefs following the first birth experience: Self-fulfilling prophecies? PLoS One 2018; 13:e0208090. [PMID: 30475898 PMCID: PMC6258230 DOI: 10.1371/journal.pone.0208090] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 11/12/2018] [Indexed: 12/30/2022] Open
Abstract
Women's basic beliefs about birth as a natural and as a medical process are associated with childbirth choices and experience. These beliefs have only recently been quantified and not much is known about their development. In the current study, we assessed the differential effects of the objective and the subjective birth experience on changes in these beliefs. Using self-report questionnaires, we evaluated prenatal to postpartum changes among 342 Israeli first-time mothers. Participants were recruited during pregnancy, between February 2016 and January 2017, mostly in clinical settings, and followed-up two months postpartum. On average, women's beliefs about birth being natural weakened following childbirth and their belief about birth being medical strengthened. In regression models, it was either the objective or the subjective experience that was related to change in the basic birth beliefs: A more medicalized birth was associated with strengthening of the medical belief while greater birth satisfaction was related to strengthening of the natural belief. A mediation effect was observed, which indicated that the beliefs are strengthened when the lived experience fulfilled women's expectation about birth being satisfying, natural or medical. This study adds to the growing body of knowledge regarding the development and evolution of the birth beliefs. It highlights the need to view the beliefs separately and to distinctively assess the objective and subjective birth experience. It supports the need to empower mothers, especially those who had more medicalized births or unsatisfactory ones, which would help conserve their belief in their body and in the normal physiological course of birth.
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Affiliation(s)
- Heidi Preis
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
- * E-mail:
| | - Joseph Pardo
- Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center–Beilinson Hospital; affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yoav Peled
- Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center–Beilinson Hospital; affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yael Benyamini
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
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Clesse C, Lighezzolo-Alnot J, de Lavergne S, Hamlin S, Scheffler M. The evolution of birth medicalisation: A systematic review. Midwifery 2018; 66:161-167. [PMID: 30176390 DOI: 10.1016/j.midw.2018.08.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 07/01/2018] [Accepted: 08/12/2018] [Indexed: 02/04/2023]
Abstract
First described at the beginning of the 1970s, the concept of birth medicalisation has experienced a theoretical and ideological evolution influenced by the lines of research that have been associated with it. This evolution has given rise to different schools of thought concerning medicalisation, but also various methodologies used in different scientific fields. It seems relevant to propose a global synthesis of the various lines of thought related to birth medicalisation. To do this, the authors conducted a systematic literature review based on the PRISMA method. With a total of 38 occurrences in French and English, the authors scrutinised 17 databases with a publication period between 1995 and 2018. A total of 112 documents (107 articles, 3 book chapters, 2 books) has been identified, grouped and categorised into five main themes in the results section (1) the theoretical evolution of the concept of medicalisation, (2) factors related to the birth medicalisation, (3) the impact of the birth medicalisation, (4) the humanisation of birth and (5) experiences related to childbirth. A reasoned synthesis of the literature is therefore carried out in each part and then discussed according to the selected lines of research that require development in order to guarantee the best possible accompaniment to women who give birth.
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Affiliation(s)
- Christophe Clesse
- Interpsy Laboratory (EA4432) Université de Lorraine - Nancy 2. 3 Place Godeffroy de Bouillon, 54000 Nancy, France; Hospital Centre of Jury-les-Metz - Route d'Ars Laquenexy BP75088, 57073, JURY-LESMETZ Cedex 03, France; Polyclinic Majorelle. 1240 avenue Raymond Pinchard 54100 Nancy, France.
| | - Joëlle Lighezzolo-Alnot
- Interpsy Laboratory (EA4432) Université de Lorraine - Nancy 2. 3 Place Godeffroy de Bouillon, 54000 Nancy, France.
| | | | - Sandrine Hamlin
- Polyclinic Majorelle. 1240 avenue Raymond Pinchard 54100 Nancy, France.
| | - Michèle Scheffler
- Polyclinic Majorelle. 1240 avenue Raymond Pinchard 54100 Nancy, France; Cabinet de Gynécologie Médicale et Obstétrique. 21 avenue Foch 54000 Nancy, France.
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Preis H, Gozlan M, Dan U, Benyamini Y. A quantitative investigation into women's basic beliefs about birth and planned birth choices. Midwifery 2018; 63:46-51. [PMID: 29803012 DOI: 10.1016/j.midw.2018.05.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 03/07/2018] [Accepted: 05/01/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Perceptions about the nature of the birth process are important in determining women's birth choices regarding labour and delivery but are scarcely the subject of empirical research. The aim of the current study was to assess women's beliefs about birth as a natural and safe or medical and risky process and study the associations of these beliefs with fear of childbirth and planned birth choices. DESIGN An observational study using self-administered questionnaires during pregnancy. SETTING 1. Community women's health centres in a metropolitan area in Israel; 2. Purposeful sampling of women who plan to birth naturally, through home midwives and targeted internet forums. PARTICIPANTS 746 women with a singleton pregnancy in their second and third trimester. MEASUREMENTS Beliefs about birth as a natural and a medical process, fear of childbirth, and a range of natural birth choices. FINDINGS The birth beliefs were associated with women's birth intentions. The more women believed birth to be natural and the less they believed it to be medical, the more likely they were to make more natural birth-related choices. In the presence of the birth beliefs, fear of childbirth no longer had an independent association with birth choices. The beliefs interacted with each other, revealing a stronger association of viewing birth as natural with planning more natural choices among women who did not view birth as very medical. KEY CONCLUSION It is important to recognize women's beliefs about birth and how they may affect their fear of childbirth and birth intentions. Further studies on the origin of such beliefs and their development are needed. IMPLICATIONS FOR PRACTICE Women should be allowed to choose how they would like to birth in accordance with their beliefs. At the same time, strengthening women's belief in the natural birth process and their body's ability to perform it, could help lower fear of childbirth and medical intervention rates.
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Affiliation(s)
- Heidi Preis
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv 69978, Israel.
| | - Miri Gozlan
- Women's Health Center, Maccabi Health Services, 1 Lishansky Street, Rishon LeZion, Israel.
| | - Uzi Dan
- Women's Health Center, Maccabi Health Services, 1 Lishansky Street, Rishon LeZion, Israel.
| | - Yael Benyamini
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv 69978, Israel.
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Preis H, Eisner M, Chen R, Benyamini Y. First-time mothers' birth beliefs, preferences, and actual birth: A longitudinal observational study. Women Birth 2018; 32:e110-e117. [PMID: 29753684 DOI: 10.1016/j.wombi.2018.04.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 04/13/2018] [Accepted: 04/24/2018] [Indexed: 10/16/2022]
Abstract
PROBLEM Birth preferences, such as mode and place of birth and other birth options, have important individual and societal implications, yet few studies have investigated the mechanism which predicts a wide range of childbirth options simultaneously. BACKGROUND Basic beliefs about birth as a natural and as a medical process are both predictive factors for childbirth preferences. Studies investigating birth beliefs, preferences, and actual birth are rare. AIM To test a predictive model of how these beliefs translate into birth preferences and into actual birth related-options. METHODS Longitudinal observational study including 342 first-time expectant mothers recruited at women's health centres and natural birth communities in Israel. All women filled out questionnaires including basic birth beliefs and preferred birth options. Two months postpartum, they filled out a questionnaire including detailed questions regarding actual birth. FINDINGS Stronger beliefs about birth being natural were related to preferring a more natural place and mode of birth and preferring more natural birth-related options. Stronger beliefs about birth being medical were associated with opposite options. The preferences mediated the association between the birth beliefs and actual birth. The beliefs predicted the preferences better than they predicted actual birth. DISCUSSION Birth beliefs are pivotal in the decision-making process regarding preferred and actual birth options. In a medicalized obstetric system, where natural birth is something women need to actively seek out and insist on, the predictive powers of beliefs and of preferences decrease. CONCLUSION Women's beliefs should be recognized and birth preferences respected.
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Affiliation(s)
- Heidi Preis
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, 6997801, Israel.
| | - Michal Eisner
- Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center - Beilinson Hospital, Affiliated with Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Rony Chen
- Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center - Beilinson Hospital, Affiliated with Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Yael Benyamini
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, 6997801, Israel
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Preis H, Chen R, Eisner M, Pardo J, Peled Y, Wiznitzer A, Benyamini Y. Testing a biopsychosocial model of the basic birth beliefs. Birth 2018; 45:79-87. [PMID: 28914459 DOI: 10.1111/birt.12313] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Revised: 08/11/2017] [Accepted: 08/13/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND Women perceive what birth is even before they are pregnant for the first time. Part of this conceptualization is the basic belief about birth as a medical and natural process. These two separate beliefs are pivotal in the decision-making process about labor and birth. Adapting Engel's biopsychosocial framework, we explored the importance of a wide range of factors which may contribute to these beliefs among first-time mothers. METHOD This observational study included 413 primiparae ≥24 weeks' gestation, recruited in medical centers and in natural birth communities in Israel. The women completed a questionnaire which included the Birth Beliefs Scale and a variety of biopsychosocial characteristics such as obstetric history, birth environment, optimism, health-related anxiety, and maternal expectations. RESULTS Psychological dispositions were more related to the birth beliefs than the social or biomedical factors. Sociodemographic characteristics and birth environment were only marginally related to the birth beliefs. The basic belief that birth is a natural process was positively related to optimism and to conceiving spontaneously. Beliefs that birth is a medical process were related to pessimism, health-related anxiety, and to expectations that an infant's behavior reflects mothering. Expectations about motherhood as being naturally fulfilling were positively related to both beliefs. CONCLUSION Psychological factors seem to be most influential in the conceptualization of the beliefs. It is important to recognize how women interpret the messages they receive about birth which, together with their obstetric experience, shape their beliefs. Future studies are recommended to understand the evolution of these beliefs, especially within diverse cultures.
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Affiliation(s)
- Heidi Preis
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - Rony Chen
- Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center-Beilinson Hospital (affiliated with Sackler Faculty of Medicine), Tel Aviv University, Tel Aviv, Israel
| | - Michal Eisner
- Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center-Beilinson Hospital (affiliated with Sackler Faculty of Medicine), Tel Aviv University, Tel Aviv, Israel
| | - Joseph Pardo
- Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center-Beilinson Hospital (affiliated with Sackler Faculty of Medicine), Tel Aviv University, Tel Aviv, Israel
| | - Yoav Peled
- Department of Obstetrics and Gynecology, Helen Schneider Hospital for Women, Rabin Medical Center-Beilinson Hospital (affiliated with Sackler Faculty of Medicine), Tel Aviv University, Tel Aviv, Israel
| | - Arnon Wiznitzer
- Helen Schneider Hospital for Women, Rabin Medical Center-Beilinson Hospital (affiliated with Sackler Faculty of Medicine), Tel Aviv University, Tel Aviv, Israel
| | - Yael Benyamini
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
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Lewis M. An International Comparison of Midwifery Models of Care in the United Kingdom and New Zealand That Promote Relationship Building With Women and Its Influence on Women's Decision Making for Birth. INTERNATIONAL JOURNAL OF CHILDBIRTH 2018. [DOI: 10.1891/2156-5287.8.3.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Following a successful application for a Florence Nightingale Foundation travel scholarship, I completed an observation visit to New Zealand to explore its model of midwifery care. My focus consisted of three main elements: exploration at a clinical level and lessons we can learn to improve our clinical model of continuity; exploration at a strategic level to learn lessons about sustainability of continuity models, monitoring, and regulation; and exploration at the researcher level to explore research priorities and interests and to consider topics for further research and potential collaboration. The purpose of this article is to share my personal reflections on this experience.The New Zealand model is based on a philosophy of trust in both women as consumers and midwives as skilled professionals. At all levels there is a commitment to the value of autonomy and a feeling of safety in people holding the responsibility for their decisions. In New Zealand, despite a full commitment to continuity and partnership when working with women, the decisions women were making were not necessarily reflective of an increase in normality. To maximize benefit from lessons learned in practice, it seems prudent to work together internationally on improvement, innovation, and research.
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Vermeulen J, Peersman W, Quadvlieg L, Fobelets M, De Clercq G, Swinnen E, Beeckman K. Development and validation of the Midwife Profiling Questionnaire assessing women's preferred perinatal care professional and knowledge of midwives' legal competences. SEXUAL & REPRODUCTIVE HEALTHCARE 2018; 16:23-32. [PMID: 29804771 DOI: 10.1016/j.srhc.2018.01.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 12/19/2017] [Accepted: 01/14/2018] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Currently maternity care organisation is developing worldwide. Therefore insight in the position of the midwife is important. The 'Midwife Profiling Questionnaire' (MidProQ) measures women's preferred perinatal care professional and their knowledge of midwives' legal competences. MidProQ is based on the European legal framework and was tested in a pilot study. This study aims to determine its content and face validity. STUDY DESIGN A two-phase validation study with a Delphi method questioning content experts (n = 10) on items relevance and clarity as well as its scale and face validity. Further semi-structured interviews were performed with lay experts (n = 10) to evaluate the questionnaire's clarity, layout, phrasing and wording. RESULTS After round one, most questions (42/47) were considered content valid for relevance and clarity (Item Content Validity Index 0.80-1.00). Scale (Scale Content Validity Index 0.92) and face validity (Face Validity Index 0.89) of the entire instrument was obtained. Five questions were revised until item content (0.83-1.00), scale content (0.92) and face validity (1.00) were appropriate. Lay experts' suggestions for improving the readability and usability were taken into account. CONCLUSIONS We developed a valid instrument to elicit women's preferred health professional for uncomplicated pregnancy, labour and childbirth and to determine their knowledge about midwives' legal competences. Our instrument can be valuable in identifying knowledge gaps and improving the knowledge of the general population about the midwifery profession and maternity care. Finally, the MidProQ may improve research in the domain of maternity care culture, scale up midwifery and facilitate a more women-centred care.
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Affiliation(s)
- Joeri Vermeulen
- Department Health Care, Midwifery Department, Knowledge Centre Brussels Integrated Care, Erasmus University College Brussels, Laarbeeklaan 121, 1090 Brussels, Belgium.
| | - Wim Peersman
- Faculty of Medicine and Health Sciences, Department of Family Medicine and Primary Health Care, Ghent University, De Pintelaan 185, 9000 Ghent, Belgium
| | - Linda Quadvlieg
- Verloskundepraktijk De Tantes, Franeker, Hertog van Saxenlaan 36C, 8801 ES Franeker, The Netherlands
| | - Maaike Fobelets
- Department Health Care, Midwifery Department, Knowledge Centre Brussels Integrated Care, Erasmus University College Brussels, Laarbeeklaan 121, 1090 Brussels, Belgium; Faculty of Medicine and Pharmacy, I-CHER (Interuniversity Centre for Health Economics Research), Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Gerlinde De Clercq
- Department Health Care, Midwifery Department, Knowledge Centre Brussels Integrated Care, Erasmus University College Brussels, Laarbeeklaan 121, 1090 Brussels, Belgium
| | - Eva Swinnen
- Faculty of Physical Education and Physiotherapy, Rehabilitation Research, Vrije Universiteit Brussel (VUB), Pleinlaan 2, 1050 Brussels, Belgium
| | - Katrien Beeckman
- Department Health Care, Midwifery Department, Knowledge Centre Brussels Integrated Care, Erasmus University College Brussels, Laarbeeklaan 121, 1090 Brussels, Belgium; Faculty of Medicine and Pharmacy, Department Medical Sociology, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels, Belgium; Nursing and Midwifery Research Unit, University Hospital Brussels, Laarbeeklaan 101, 1090 Brussels, Belgium
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Preis H, Benyamini Y. The birth beliefs scale - a new measure to assess basic beliefs about birth. J Psychosom Obstet Gynaecol 2017; 38:73-80. [PMID: 27766924 DOI: 10.1080/0167482x.2016.1244180] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
INTRODUCTION Basic beliefs about birth as a natural and safe or a medical and risky process are central in the decisions on where and how to birth. Despite their importance, they have not been studied separately from other childbirth-related constructs. Our aim was to develop a measure to assess these beliefs. METHOD Pregnant Israeli women (N = 850, gestational week ≥14) were recruited in women's health centers, in online natural birth forums, and through home midwives. Participants filled in questionnaires including sociodemographic and obstetric background, the Birth Beliefs Scale (BBS), dispositional desire for control (DC) and planned mode of delivery. RESULTS Factor analyses revealed that the BBS is composed of two factors: beliefs about birth as a natural process and beliefs about birth as a medical process. Both subscales showed good internal and test-retest reliability. They had good construct validity, predicted birth choices, and were weakly correlated with DC. Women's medical obstetric history was associated with the BBS, further supporting the validity of the scale. DISCUSSION Beliefs about birth may be the building blocks that make up perceptions of birth and drive women's preferences. The new scale provides an easy way to distinctly assess them so they can be used to further understand planned birth behaviors. Additional studies are needed to comprehend how these beliefs form in different cultural contexts and how they evolve over time.
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Affiliation(s)
- Heidi Preis
- a Bob Shapell School of Social Work , Tel Aviv University , Tel Aviv , Israel
| | - Yael Benyamini
- a Bob Shapell School of Social Work , Tel Aviv University , Tel Aviv , Israel
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A systematic review of the relationship factor between women and health professionals within the multivariant analysis of maternal satisfaction. Midwifery 2016; 41:68-78. [PMID: 27551856 DOI: 10.1016/j.midw.2016.08.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Revised: 07/17/2016] [Accepted: 08/05/2016] [Indexed: 11/23/2022]
Abstract
INTRODUCTION personalised support provided to women by health professionals is one of the prime factors attaining women's satisfaction during pregnancy and childbirth. However the multifactorial nature of 'satisfaction' makes difficult to assess it. Statistical multivariate analysis may be an effective technique to obtain in depth quantitative evidence of the importance of this factor and its interaction with the other factors involved. This technique allows us to estimate the importance of overall satisfaction in its context and suggest actions for healthcare services. METHODS systematic review of studies that quantitatively measure the personal relationship between women and healthcare professionals (gynecologists, obstetricians, nurse, midwifes, etc.) regarding maternity care satisfaction. The literature search focused on studies carried out between 1970 and 2014 that used multivariate analyses and included the woman-caregiver relationship as a factor of their analysis. RESULTS twenty-four studies which applied various multivariate analysis tools to different periods of maternity care (antenatal, perinatal, post partum) were selected. The studies included discrete scale scores and questionnaires from women with low-risk pregnancies. The "personal relationship" factor appeared under various names: care received, personalised treatment, professional support, amongst others. The most common multivariate techniques used to assess the percentage of variance explained and the odds ratio of each factor were principal component analysis and logistic regression. DISCUSSION the data, variables and factor analysis suggest that continuous, personalised care provided by the usual midwife and delivered within a family or a specialised setting, generates the highest level of satisfaction. In addition, these factors foster the woman's psychological and physiological recovery, often surpassing clinical action (e.g. medicalization and hospital organization) and/or physiological determinants (e.g. pain, pathologies, etc.).
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Women's preferences and knowledge about the legal competences of midwives in Brussels, Belgium. A descriptive observational study. Midwifery 2016; 40:177-86. [PMID: 27450589 DOI: 10.1016/j.midw.2016.07.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 06/17/2016] [Accepted: 07/03/2016] [Indexed: 11/21/2022]
Abstract
OBJECTIVE to explore women's preferences with regard to their preferred health professional during labour and childbirth in case of an uncomplicated pregnancy, and to gain insight into women's knowledge of the legal competences of midwives. DESIGN a descriptive observational study. SETTING Brussels metropolitan region, Belgium. PARTICIPANTS women in their reproductive age, living in the Brussels metropolitan region, with Dutch or French as their first language (n=830). MEASUREMENTS a ten-item standardized questionnaire'Midwife Profiling Questionnaire' (MidProQ) was developed to determine which health professional respondents would prefer to assist them during labour and childbirth if there were no complications and to assess their knowledge about midwives' legal competences during pregnancy, labour and childbirth. Descriptive statistics were used to report the findings. To identify relationships between the socio-demographic variables of the women and her preferences, knowledge and opinion Chi² analysis were used. FINDINGS For 68.0% of the participants in an uncomplicated labour (n=564) and 66.3% of the participants with an uncomplicated childbirth (n=550), a midwife is the preferred health professional. Brussels women prefer an obstetrician in an uncomplicated labour (n=730, 88%) and for uncomplicated childbirth (n=756, 91.1%). Only 20.2% of the respondents (n=168) consider midwives to play a central role in an uncomplicated pregnancy. The knowledge of Brussels women about midwives' legal competences during pregnancy, labour and childbirth is rather poor, especially in youngsters and women who have never given birth. KEY CONCLUSIONS In general, for Brussels women, midwives are not the first preferred health professional for an uncomplicated labour or for childbirth, and they do not consider midwives to play a central role in an uncomplicated pregnancy. The legal competences of midwives are not known very well, especially by youngsters and women who have never given birth. The Belgian medical model of maternity care and women's experiences affect their preferences and knowledge about the legal competences of midwives and their opinion about the central health professional in an uncomplicated pregnancy. IMPLICATIONS FOR PRACTICE To enhance more women-centred care and initiate change in the current maternity care culture in Belgium, public education, structural changes in maternity services and strategies to inspire public opinion to initiate cultural change are suggested. Involvement of midwifery organisations, other health professionals in maternity services and policy-makers with women's groups and potential service users is key.
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Soliday E, Strahm A, Mammenga S. Fetal health locus of control: Scale properties and applications in preconception health programs. EVALUATION AND PROGRAM PLANNING 2016; 55:85-90. [PMID: 26766546 DOI: 10.1016/j.evalprogplan.2015.12.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 11/05/2015] [Accepted: 12/16/2015] [Indexed: 06/05/2023]
Abstract
Preconception health programs have resulted in improved health behaviors among participants and have shown promise in reducing adverse birth outcomes. However, the role of health beliefs in preconception health program outcomes has been overlooked but warrants attention due to reported positive associations between women's views of control over fetal health and health behavior in pregnancy. Towards an ultimate aim of improving preconception health program reach and effectiveness, we examined properties of a fetal health locus of control (FHLC; Labs & Wurtele, 1986) measure in nulliparous, childbearing aged university women and men. Students (n=1467) completed an online survey that included the FHLC subscales maternal, powerful others', and chance control over fetal health. Factor analyses and correlations with related scales supported the soundness of FHLC constructs in both women and men. All participants rated maternal control in fetal health nearly twice as highly as powerful others' and chance. We therefore recommend that FHLC be integrated into preconception health program evaluation as personal agency in fetal health likely has an important role in women's and men's preconception health behavior and health behavior change.
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Affiliation(s)
- Elizabeth Soliday
- Human Development, Washington State University Vancouver, WSU Vancouver, 14204 NE Salmon Creek Ave., Vancouver, WA 98686, United States.
| | - Anna Strahm
- Psychology Department, Washington State University Vancouver, Vancouver, WA, United States
| | - Stefani Mammenga
- Prevention Science Program, Washington State University Vancouver, Vancouver, WA, United States
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Happel-Parkins A, Azim KA. At pains to consent: A narrative inquiry into women's attempts of natural childbirth. Women Birth 2015; 29:310-20. [PMID: 26639037 DOI: 10.1016/j.wombi.2015.11.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 11/06/2015] [Accepted: 11/09/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND With only 1.2% of all annual U.S. births registered as out-of-hospital births, national trends show an increase in medicalised hospital births. Caesarean sections have become the most common surgical procedure in the U.S.; Caesarean section rates have increased from 20.6% in 1997 to 31.5% in 2009. Furthermore, in 2009, 67% of hospital births utilised epidural analgesia and 26% used oxytocin augmentation. In response to the increased medicalisation of childbirth within the U.S., some women resist standardised medical procedures and instead choose to labour and birth without medical intervention. AIM The purpose of this study was to understand and contextualise the childbirth experiences of first-time mothers who planned to have a natural childbirth (without medical intervention) in the Midsouthern United States. METHODS Using narrative inquiry, we collected data from six participants through semi-structured life-story interviews. FINDINGS Utilising thematic analysis, four recurring themes emerged: (1) benefits and limitations of pre-labour self-education; (2) labouring women's experiences of relationality; (3) the importance of birth stories and expectations; and (4) the creation of false dilemmas and complexities of "informed choice." DISCUSSION AND CONCLUSION The women's stories suggest that U.S. medical establishments, the media, and society need to empower pregnant and birthing women by creating new narratives of labour and positive spaces of relationality. Furthermore, health care professionals need to critically examine their usage of the medical model of care while respecting women's choices and agency.
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Young K, Miller YD. Keeping it Natural: Does Persuasive Magazine Content Have an Effect on Young Women’s Intentions for Birth? Women Health 2015; 55:447-66. [DOI: 10.1080/03630242.2015.1022690] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Fenwick J, Toohill J, Creedy D, Smith J, Gamble J. Sources, responses and moderators of childbirth fear in Australian women: A qualitative investigation. Midwifery 2015; 31:239-46. [DOI: 10.1016/j.midw.2014.09.003] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 08/29/2014] [Accepted: 09/04/2014] [Indexed: 11/29/2022]
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Abstract
The objective of this study was to describe nulliparas' reasons for the type of provider (i.e., midwife, physician) and childbirth setting (i.e., home, hospital, hospital-based birth center) that respondents expected for their births. Data were collected via a cross-sectional, descriptive, self-administered, Web-based survey including both close- and open-ended questions and were analyzed using conventional content analysis. Respondents were 220 nulliparous women aged 18-40 years, living in the United States, and pregnant at 20 or fewer weeks' gestation. Women's reasons were categorized broadly as relating to provider/setting attributes, relationship with provider/setting, normative choices, respondent attributes, and practical considerations. Respondents' reasons highlight misconceptions about childbirth care options, especially regarding midwifery and nonhospital settings, which may be addressed by childbirth education.
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McArdle A, Flenady V, Toohill J, Gamble J, Creedy D. How pregnant women learn about foetal movements: sources and preferences for information. Women Birth 2014; 28:54-9. [PMID: 25457375 DOI: 10.1016/j.wombi.2014.10.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Revised: 10/03/2014] [Accepted: 10/07/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Unexplained late gestation stillbirth is a significant health issue. Antenatal information about foetal movements has been demonstrated to reduce the stillbirth rate in women with decreased foetal movements. Midwives are ideally placed to provide this information to women. AIM To investigate pregnant women's perceptions of information about foetal movements and preferences for receiving information. METHODS This prospective, descriptive study was conducted in the antenatal clinic of a large metropolitan maternity hospital. FINDINGS Pregnant women (n=526) at 34 weeks gestation or later were recruited. Only 67% of women reported receiving information about foetal movements. Women reported that midwives (80%), family (57%), friends (48%) and own mother (48%) provided this information. Midwives were the most preferred source of information. Around half (52%) of the women used the internet for information but only 11% nominated the web as their preferred information source. CONCLUSION Women prefer to be given as much information about foetal movements as possible. Women favour information from health professionals, mainly from a midwife. Midwives are well-placed to partner with pregnant women and give them unbiased and evidenced based information enabling them to make decisions and choices regarding their health and well-being. While the internet is a prevalent information source, women want to be reassured that it is trustworthy and want direction to reliable pregnancy related websites.
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Affiliation(s)
- Annie McArdle
- Griffith Health Institute, School of Nursing & Midwifery, Griffith University, University Drive, Meadowbank, Queensland 4131, Australia; Mater Research Institute, University of Queensland, Aubigny Place, Mater Health Services, Raymond Tce, South Brisbane, Queensland 4101, Australia.
| | - Vicki Flenady
- Mater Research Institute, University of Queensland, Aubigny Place, Mater Health Services, Raymond Tce, South Brisbane, Queensland 4101, Australia.
| | - Jocelyn Toohill
- Griffith Health Institute, School of Nursing & Midwifery, Griffith University, University Drive, Meadowbank, Queensland 4131, Australia.
| | - Jenny Gamble
- Griffith Health Institute, School of Nursing & Midwifery, Griffith University, University Drive, Meadowbank, Queensland 4131, Australia.
| | - Debra Creedy
- Griffith Health Institute, School of Nursing & Midwifery, Griffith University, University Drive, Meadowbank, Queensland 4131, Australia.
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30
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Stevens G, Thompson R, Kruske S, Watson B, Miller YD. What are pregnant women told about models of maternity care in Australia? A retrospective study of women's reports. PATIENT EDUCATION AND COUNSELING 2014; 97:114-121. [PMID: 25085552 DOI: 10.1016/j.pec.2014.07.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Revised: 06/30/2014] [Accepted: 07/06/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To describe women's reports of the model of care options General Practitioners (GPs) discussed with them at the first pregnancy consultation and women's self-reported role in decision-making about model of care. METHODS Women who had recently given birth responded to survey items about the models of care GPs discussed, their role in final decision-making, and socio-demographic, obstetric history, and early pregnancy characteristics. RESULTS The proportion of women with whom each model of care was discussed varied between 8.2% (for private midwifery care with home birth) and 64.4% (GP shared care). Only 7.7% of women reported that all seven models were discussed. Exclusive discussion about private obstetric care and about all public models was common, and women's health insurance status was the strongest predictor of the presence of discussions about each model. Most women (82.6%) reported active involvement in final decision-making about model of care. CONCLUSION Although most women report involvement in maternity model of care decisions, they remain largely uninformed about the breadth of available model of care options. PRACTICAL IMPLICATIONS Strategies that facilitate women's access to information on the differentiating features and outcomes for all models of care should be prioritized to better ensure equitable and quality decisions.
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Affiliation(s)
- Gabrielle Stevens
- School of Psychology, The University of Queensland, Brisbane, Australia.
| | - Rachel Thompson
- School of Psychology, The University of Queensland, Brisbane, Australia; The Dartmouth Center for Health Care Delivery Science, Dartmouth College, Hanover, USA
| | - Sue Kruske
- School of Psychology, The University of Queensland, Brisbane, Australia
| | - Bernadette Watson
- School of Psychology, The University of Queensland, Brisbane, Australia
| | - Yvette D Miller
- School of Psychology, The University of Queensland, Brisbane, Australia; School of Public Health & Social Work, Queensland University of Technology, Brisbane, Australia
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31
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D’Cruz L, Lee C. Childbirth expectations: an Australian study of young childless women. J Reprod Infant Psychol 2014. [DOI: 10.1080/02646838.2013.875134] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Haines HM, Hildingsson I, Pallant JF, Rubertsson C. The role of women's attitudinal profiles in satisfaction with the quality of their antenatal and intrapartum care. J Obstet Gynecol Neonatal Nurs 2013; 42:428-41. [PMID: 23773005 DOI: 10.1111/1552-6909.12221] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE To compare perceptions of antenatal and intrapartum care in women categorized into three profiles based on attitudes and fear. DESIGN Prospective longitudinal cohort study using self-report questionnaires. Profiles were constructed from responses to the Birth Attitudes Profile Scale and the Fear of Birth Scale at pregnancy weeks 18 to 20. Perception of the quality of care was measured using the Quality from Patient's Perspective index at 34 to 36 weeks pregnancy and 2 months after birth. SETTING Two hospitals in Sweden and Australia. PARTICIPANTS Five hundred and five (505) pregnant women from one hospital in Västernorrland, Sweden (n = 386) and one in northeast Victoria, Australia (n = 123). RESULTS Women were categorized into three profiles: self-determiners, take it as it comes, and fearful. The self-determiners reported the best outcomes, whereas the fearful were most likely to perceive deficient care. Antenatally the fearful were more likely to indicate deficiencies in medical care, emotional care, support received from nurse-midwives or doctors and nurse-midwives'/doctors' understanding of the woman's situation. They also reported deficiencies in two aspects of intrapartum care: support during birth and control during birth. CONCLUSIONS Attitudinal profiling of women during pregnancy may assist clinicians to deliver the style and content of antenatal and intrapartum care to match what women value and need. An awareness of a woman's fear of birth provides an opportunity to offer comprehensive emotional support with the aim of promoting a positive birth experience.
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Affiliation(s)
- Helen M Haines
- Department of Women's and Children's Health, Obstetrics and Gynaecology, Uppsala University, Akademiskasjukhuset, Uppsala, Sweden.
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