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van Haren JS, Delbressine FLM, Schoberer M, te Pas AB, van Laar JOEH, Oei SG, van der Hout-van der Jagt MB. Transferring an extremely premature infant to an extra-uterine life support system: a prospective view on the obstetric procedure. Front Pediatr 2024; 12:1360111. [PMID: 38425664 PMCID: PMC10902175 DOI: 10.3389/fped.2024.1360111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 02/02/2024] [Indexed: 03/02/2024] Open
Abstract
To improve care for extremely premature infants, the development of an extrauterine environment for newborn development is being researched, known as Artificial Placenta and Artificial Womb (APAW) technology. APAW facilitates extended development in a liquid-filled incubator with oxygen and nutrient supply through an oxygenator connected to the umbilical vessels. This setup is intended to provide the optimal environment for further development, allowing further lung maturation by delaying gas exposure to oxygen. This innovative treatment necessitates interventions in obstetric procedures to transfer an infant from the native to an artificial womb, while preventing fetal-to-neonatal transition. In this narrative review we analyze relevant fetal physiology literature, provide an overview of insights from APAW studies, and identify considerations for the obstetric procedure from the native uterus to an APAW system. Lastly, this review provides suggestions to improve sterility, fetal and maternal well-being, and the prevention of neonatal transition.
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Affiliation(s)
- Juliette S. van Haren
- Department of Industrial Design, Eindhoven University of Technology, Eindhoven, Netherlands
- Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, Netherlands
| | | | - Mark Schoberer
- Institute for Applied Medical Engineering and Clinic for Neonatology, University Hospital Aachen, Aachen, Germany
| | - Arjan B. te Pas
- Department of Pediatrics, Leiden University Medical Center, Leiden, Netherlands
| | - Judith O. E. H. van Laar
- Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - S. Guid Oei
- Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
| | - M. Beatrijs van der Hout-van der Jagt
- Obstetrics and Gynaecology, Máxima Medical Centre, Veldhoven, Netherlands
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands
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Moniri M, Rashidi F, Mirghafourvand M, Rezaei M, Ghanbari-Homaie S. The relationship between pregnancy and birth experience with maternal-fetal attachment and mother-child bonding: a descriptive-analytical study. BMC Psychol 2023; 11:426. [PMID: 38053200 DOI: 10.1186/s40359-023-01475-x] [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: 08/03/2023] [Accepted: 11/30/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Pregnancy and childbirth experience can be important factors for a pleasant relationship between mother and baby. This study assessed the relationship between the pregnancy and birth experience with maternal-fetal attachment (MFA) and mother-child bonding. METHODS A descriptive-analytical study was conducted among 228 pregnant women in Tabriz, Iran February 2022 to March 2023. Using cluster random sampling method, we included 228 women with gestational age 28-36 weeks and followed them up until six weeks postpartum. Data were collected in two stages using the following questionnaires: Pregnancy Experience Scale (hassles and uplifts), Maternal-Fetal Attachment Questionnaire (during the third trimester of pregnancy), Postpartum Bonding Questionnaire, and Childbirth Experience Questionnaire (six weeks postpartum). Data were analyzed using Pearson's correlation test and general linear model. RESULTS The mean score of MFA was significantly higher among women with feelings of being uplifted during pregnancy [β (95% CI) = 1.14 (0.87 to 1.41); p < 0.001]. However, there was no statistically significant relationship between pregnancy hassles and MFA and mother-child bonding (p > 0.05). Also, there was no statistically significant relationship between childbirth experience and mother-child bonding (p > 0.05). CONCLUSION According to the results of this study, pregnancy uplifts have a positive role in improving MFA. Therefore, it is recommended to plan interventions to make pregnancy period a pleasant experience for mothers.
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Affiliation(s)
- Monireh Moniri
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Rashidi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mansour Rezaei
- Department of Anesthesiology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Solmaz Ghanbari-Homaie
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Shariati Street, P.O. Box: 51745-347, 513897977, Tabriz, Iran.
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Innab A, Al-Khunaizi A, Al-Otaibi A, Moafa H. Effects of mindfulness-based childbirth education on prenatal anxiety: A quasi-experimental study. Acta Psychol (Amst) 2023; 238:103978. [PMID: 37429250 DOI: 10.1016/j.actpsy.2023.103978] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 06/04/2023] [Accepted: 06/30/2023] [Indexed: 07/12/2023] Open
Abstract
Pregnancy and childbirth represent a sequence of challenging events, and adaptive coping strategies are necessary to maintain emotional wellbeing. The present study aimed to assess the effectiveness of applying a mindfulness-based intervention (MBI) for pregnant Saudi women with anxiety in the third trimester. A quasi-experimental, within- and between-subject design was used for this study. Data were collected at two points between February and August 2021 from 88 participants using the Pregnancy-Related Anxiety Questionnaire and the Five Facet Mindfulness Questionnaire. A large, statistically significant reduction was observed in the mean scores of participants' anxiety post-intervention. Furthermore, the anxiety level in the intervention group was very low post-intervention compared to that in the control group. Level of education and spontaneous or medically necessary abortion significantly influenced participants' anxiety. The MBI sessions helped nulliparous women experience less anxiety during pregnancy. Healthcare providers' awareness about the importance of incorporating mindfulness in childbirth education should be increased. Future research should examine the long-term effects of mindfulness-based techniques on maternal health.
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Affiliation(s)
- Adnan Innab
- Vice Dean of Student Affairs, Nursing Administration and Education Department, College of Nursing, King Saud University, P.O. Box 642, Riyadh 11421, Saudi Arabia.
| | - Anwar Al-Khunaizi
- Qatif Central Hospital, Ministry of Health, P.O. Box 842, Khobar 31952, Saudi Arabia.
| | - Areej Al-Otaibi
- College of Nursing, Imam Abdulrahman Bin Faisal University, P.O. Box 2837, Dahran 34256, Saudi Arabia.
| | - Hamza Moafa
- Community and Psychiatric Mental Health Nursing Department, College of Nursing, King Saud University, Riyadh, Saudi Arabia, P.O. Box 642, Riyadh 11421, Saudi Arabia.
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Ball MK, Seabrook RB, Corbitt R, Stiver C, Nardell K, Medoro AK, Beer L, Brown A, Mollica J, Bapat R, Cosgrove T, Texter KT. Safety and Feasibility of Skin-to-Skin Contact in the Delivery Room for High-Risk Cardiac Neonates. Pediatr Cardiol 2023; 44:1023-1031. [PMID: 36971793 PMCID: PMC10040310 DOI: 10.1007/s00246-023-03149-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 03/12/2023] [Indexed: 03/28/2023]
Abstract
Early skin-to-skin contact (SSC), beginning in the delivery room, provides myriad health benefits for mother and baby. Early SSC in the delivery room is the standard of care for healthy neonates following both vaginal and cesarean delivery. However, there is little published evidence on the safety of this practice in infants with congenital anomalies requiring immediate postnatal evaluation, including critical congenital heart disease (CCHD). Currently, the standard practice following delivery of infants with CCHD in many delivery centers has been immediate separation of mother and baby for neonatal stabilization and transfer to a different hospital unit or a different hospital altogether. However, most neonates with prenatally diagnosed congenital heart disease, even those with ductal-dependent lesions, are clinically stable in the immediate newborn period. Therefore, we sought to increase the percentage of newborns with prenatally diagnosed CCHD who are born in our regional level II-III delivery hospitals who receive mother-baby SSC in the delivery room. Using quality improvement methodology, through a series of Plan-Do-Study-Act cycles we successfully increased mother-baby skin-to-skin contact in the delivery room for eligible cardiac patients born across our city-wide delivery hospitals from a baseline 15% to greater than 50%.
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Affiliation(s)
- Molly K Ball
- Division of Neonatology, The Ohio State University Wexner Medical Center, 700 Children's Drive - FOB Suite 6.4A, Columbus, OH, 43205, USA.
| | - R B Seabrook
- Division of Neonatology, The Ohio State University Wexner Medical Center, 700 Children's Drive - FOB Suite 6.4A, Columbus, OH, 43205, USA
- The Fetal Center at Nationwide Children's Hospital, Columbus, OH, USA
| | - R Corbitt
- The Fetal Center at Nationwide Children's Hospital, Columbus, OH, USA
| | - C Stiver
- The Heart Center at Nationwide Children's Hospital, Columbus, OH, USA
| | - K Nardell
- The Heart Center at Nationwide Children's Hospital, Columbus, OH, USA
| | - A K Medoro
- Division of Neonatology, The Ohio State University Wexner Medical Center, 700 Children's Drive - FOB Suite 6.4A, Columbus, OH, 43205, USA
| | - L Beer
- Pediatrix Medical Group, Columbus, OH, USA
| | - A Brown
- Phoenix Children's Medical Group, Neonatology, Phoenix, AZ, USA
| | - J Mollica
- The Heart Center at Nationwide Children's Hospital, Columbus, OH, USA
| | - R Bapat
- Division of Neonatology, The Ohio State University Wexner Medical Center, 700 Children's Drive - FOB Suite 6.4A, Columbus, OH, 43205, USA
| | - T Cosgrove
- The Heart Center at Nationwide Children's Hospital, Columbus, OH, USA
| | - K T Texter
- The Fetal Center at Nationwide Children's Hospital, Columbus, OH, USA
- The Heart Center at Nationwide Children's Hospital, Columbus, OH, USA
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Akhtarkia Z, Kamrani MA, Farid M, Dana HF. Relationship among Maternal Perception of Childbirth Experience, Spiritual Health and Maternal-Infant Relationship in the Postpartum Women: A Cross-Sectional Study. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2023; 28:332-338. [PMID: 37575496 PMCID: PMC10412803 DOI: 10.4103/ijnmr.ijnmr_404_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 09/11/2021] [Accepted: 10/29/2022] [Indexed: 08/15/2023]
Abstract
Background Birth represents an influential moment in women's lives that can be a powerful or traumatic experience. Therefore, the aim of this study was to assess the relationship among maternal perception of childbirth experience, spiritual health, and maternal-infant relationship in the postpartum women. Materials and Methods This descriptive-analytical study was conducted on 305 postpartum women referred to Health Centers in Karaj. The data were collected using the Perception of Birth Scale (POBS), maternal postnatal relationship scale, and spiritual health questionnaire. Results In this study, the mean (standard deviation (SD) age of the participants was 27.50 (5.56) years. The Spearman's correlation test results showed that there was a significant positive relationship among the maternal perception of childbirth experience, the general maternal-infant relationship (r = 0.34, p < 0.001), quality of relationship (r = 0.17, p = 0.002), pleasure with interaction (r = 0.32, p < 0.001), and absence of hostility (r = 0.28, p < 0.001). In addition, a positive relationship was observed among spiritual health and general maternal-infant relationship (r = 0.21, p < 0.001), pleasure in interaction (r = 0.08, p = 0.164), absence of hostility (r = 0.15, p = 0.008), and the maternal perception of childbirth experience (r = 0.11, p = 0.039). Conclusions It seems that to promote maternal-infant relationship, health care providers should not only try to promote physical intimacy between mother and infant but also create a positive emotional state for the mother during birth.
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Affiliation(s)
- Zohreh Akhtarkia
- Student Research Committee, Medicine Faculty, Alborz University of Medical Sciences, Karaj, Iran
| | - Mahnaz Akbari Kamrani
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Maliheh Farid
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Hoorvash Faraji Dana
- Forensic Medicine and Fellowship of Clinical Toxicology, Alborz University of Medical Sciences, Karaj, Iran
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Döblin S, Seefeld L, Weise V, Kopp M, Knappe S, Asselmann E, Martini J, Garthus-Niegel S. The impact of mode of delivery on parent-infant-bonding and the mediating role of birth experience: a comparison of mothers and fathers within the longitudinal cohort study DREAM. BMC Pregnancy Childbirth 2023; 23:285. [PMID: 37098555 PMCID: PMC10127505 DOI: 10.1186/s12884-023-05611-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 04/14/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND The association between mode of delivery (MOD) and parent-infant-bonding has only been studied in mothers and findings have been inconclusive. The aim of this study was to prospectively investigate how MOD relates to postpartum parent-infant-bonding in both mothers and fathers and whether these associations are mediated by birth experience. METHODS This study is part of the prospective cohort study "Dresden Study on Parenting, Work, and Mental Health" (DREAM). Our sample comprised N = 1,780 participants who completed quantitative questionnaires during pregnancy as well as 8 weeks and 14 months postpartum. MOD was dummy coded, contrasting spontaneous vaginal delivery against vaginal delivery induced by drugs, operative vaginal delivery, planned, and unplanned cesarean section. Parent-infant bonding and birth experience were assessed using validated scales. A moderated mediation analysis based on ordinary least square (OLS) regression and bootstrapped estimates was conducted, considering relevant confounding variables. RESULTS Compared to spontaneous vaginal delivery, all categories of MOD predicted more negative birth experiences in both parents. A more positive birth experience predicted stronger parent-infant-bonding at 8 weeks, but not at 14 months postpartum. Mothers who delivered via cesarean section (planned or unplanned) reported stronger parent-infant-bonding at 8 weeks and 14 months postpartum. In fathers, only unplanned cesarean section was associated with stronger parent-infant-bonding at 8 weeks postpartum. At 8 weeks postpartum, birth experience mediated the association between a vaginal delivery induced by drugs and a planned cesarean section and mother-infant-bonding and between a vaginal delivery induced by drugs, an operative vaginal delivery, and planned cesarean section and father-infant-bonding. At 14 months postpartum, birth experience mediated the association between a vaginal delivery induced by drugs, operative vaginal delivery, and planned cesarean section and parent-infant-bonding in both parents. CONCLUSIONS The results emphasize the importance of the birth experience for parent-infant-bonding in both mothers and fathers. Further research should address the mechanisms by which parents with an unplanned cesarean section establish stronger parent-infant-bonding compared to parents whose baby was delivered via spontaneous vaginal delivery, despite their overall more negative birth experiences.
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Affiliation(s)
- Svenja Döblin
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Lara Seefeld
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine TU Dresden, Dresden, Germany
| | - Victoria Weise
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Marie Kopp
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Susanne Knappe
- Evangelische Hochschule Dresden (Ehs), University of Applied Sciences for Social Work, Education and Nursing, Dresden, Germany
| | - Eva Asselmann
- Faculty of Health, HMU Health and Medical University, Potsdam, Germany
| | - Julia Martini
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Department of Psychiatry & Psychotherapy, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| | - Susan Garthus-Niegel
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Dresden, Germany.
- Institute for Systems Medicine (ISM), Faculty of Medicine, Medical School Hamburg, Hamburg, Germany.
- Department of Childhood and Families, Norwegian Institute of Public Health, Oslo, Norway.
- Institute and Outpatient Clinics of Occupational and Social Medicine, Faculty of Medicine of the Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Germany.
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Moran C, Thomson G, Moran V, Fallon V. The content, experiences and outcomes of interventions designed to increase early skin-to-skin contact in high-income settings: A mixed-methods systematic review. Acta Paediatr 2023; 112:200-221. [PMID: 36260059 PMCID: PMC10100171 DOI: 10.1111/apa.16575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 10/18/2022] [Indexed: 01/13/2023]
Abstract
AIM To explore the content, experiences and outcomes of interventions designed to increase early skin-to-skin contact (SSC) in high-income settings. METHODS A mixed-methods systematic review was undertaken across six bibliographic databases. References of all included studies were hand-searched. All papers were quality appraised using a mixed-method appraisal tool. A narrative synthesis was used to synthesise both quantitative and qualitative findings. RESULTS Database searches generated 1221 hits, and two studies were identified via hand-searching. Ten studies were included; most (n = 7) were designed to improve SSC following a caesarean section, and half were of low/poor quality. Outcomes related to SSC prevalence and/or duration (n = 7), breastfeeding prevalence, (n = 4) and six explored mothers' and/or health professionals' experiences of the intervention. While the interventions had 'some' impact on the prevalence of SSC, the duration was often limited and not in line with WHO recommendations. Breastfeeding rates (exclusive/any) were found to improve but generally not to a significant extent. Mother and healthcare professionals were positive about the interventions, with barriers to implementation noted. Most interventions targeted healthcare professionals, rather than mothers. CONCLUSION High-quality interventions that increase SSC in line with WHO recommendations, and that target both health professionals and parents are needed.
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Affiliation(s)
- Chloe Moran
- Department of Psychology, University of Liverpool, Liverpool, UK
| | - Gill Thomson
- MAINN Research Unit, School of Community Health & Midwifery, University of Central Lancashire, Preston, UK
| | - Victoria Moran
- Reader in Maternal & Child Nutrition, MAINN Research Unit, School of Community Health & Midwifery, University of Central Lancashire, Preston, UK
| | - Victoria Fallon
- Department of Psychology, University of Liverpool, Liverpool, UK
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Hannon K, Nilsen ABV, Murphy M, Eri TS, Leahy-Warren P, Corcoran P, Downe S, Daly D. What women identify as positive aspects and areas for improvement of maternity care and services in Ireland: An online survey. Women Birth 2022:S1871-5192(22)00355-9. [DOI: 10.1016/j.wombi.2022.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 11/09/2022] [Accepted: 11/23/2022] [Indexed: 11/27/2022]
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Umbilical cord clamping time and maternal satisfaction. Midwifery 2022; 115:103487. [PMID: 36126369 DOI: 10.1016/j.midw.2022.103487] [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: 02/10/2021] [Revised: 08/21/2022] [Accepted: 09/11/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Clamping of the umbilical cord is part of the third stage of delivery. Delayed cord clamping (DCC) is recommended due to its contribution to prevention of anaemia. There is no evidence on the effect of DCC on maternal satisfaction. The aim of this study is to evaluate the effect of different sociodemographic and obstetric factors, including the timing of cord clamping, on maternal satisfaction with the birth experience in our healthcare system. DESIGN Pragmatic non-drug intervention study with simple random assignment of participating mothers (Clinical Trials N°: NCT03624335). SETTING A public, university-level hospital in Villarreal city, eastern Spain. PARTICIPANTS Childbearing woman, gestation week between 35 and 42 weeks, with regular medical pregnancy checks, single pregnancy and vaginal delivery (N = 198, 80% of the women recruited). INTERVENTIONS umbilical cord clamping within 60 seconds of the birth (Early cord clamping, ECC) versus umbilical cord clamping after pulsation had been ceased (Delayed cord clamping, DCC). MEASUREMENTS Birth satisfaction was measured using the Mackey Childbirth Satisfaction Rating Scale (MCSRS). Additionally, sociodemographic data, degree of knowledge about the moment of clamping and type of breastfeeding data were recorded. The Mann-Whitney and Kruskal-Wallis tests for comparison of the mean of two, three, or more groups, respectively, and Chi-square and Spearman for comparison of two qualitative and quantitative variables, respectively, were used. To determine the weight of each factor of MCSRS, an exploratory factor analysis was carried out using the maximum likelihood method for factor extraction and the varimax method for factor rotation. The adequacy of the factor analysis was checked by mean of Kaiser-Meyer-Olkin test and Bartlett sphericity test. The level of significance was set at a p-value of < 0.05. FINDINGS The average degree of satisfaction was 4.55/5 (SD: 0.37). No statistically significant difference was observed between mothers' satisfaction according to mother level of study or mother's place of birth, while it changed significantly with age (p = 0.0398). Within the obstetric variables, satisfaction was significantly associated with spontaneous amniorrhexis, the duration of the second stage of delivery, and the Apgar value of the newborn at the first minute of life, and was independent of the number of previous pregnancies and deliveries, use of intrapartum oxytocin, epidural analgesia, episiotomy, the weight of the child at birth and type of breastfeeding. Furthermore, there was no relationship between the time of clamping and satisfaction (p = 0.5178). KEY CONCLUSIONS Maternal satisfaction with the birth experience varies with the age of the childbearing woman, and some intrapartum factors and the result is not influenced by the time of clamping of the umbilical cord. Therefore, this component of the physiological management of childbirth provides additional benefits for the health of the neonate, without negative consequences on the final perception of the maternal health care received. IMPLICATIONS FOR PRACTICE If there are no reasons that justify an early umbilical cord clamping, delaying it brings benefits to the neonate, without negatively affecting the maternal assessment of the experience of childbirth.
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Kahalon R, Preis H, Benyamini Y. Mother-infant contact after birth can reduce postpartum post-traumatic stress symptoms through a reduction in birth-related fear and guilt. J Psychosom Res 2022; 154:110716. [PMID: 35063800 DOI: 10.1016/j.jpsychores.2022.110716] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/30/2021] [Accepted: 12/31/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Despite the well-documented negative effects of posttraumatic stress symptoms following childbirth (PTSS-FC), research on protective factors for PTSS-FC is still missing. Aiming to fill this gap, we proposed and examined a process model through which maternal-infant skin-to-skin contact after birth reduces PTSS-FC by decreasing negative emotions, especially for women who had operative births. METHOD In this longitudinal study, pregnant women (N = 1833) were recruited at community and hospital medical centres in the center of Israel and through internet forums. At Time 1, during pregnancy, they rated their prenatal depressive symptoms which served as an indicator for prenatal vulnerabilities. At Time 2, two-months postpartum (N = 1371, 75% of the sample), they reported their mode of birth, whether they had skin-to-skin contact with their newborn after birth, their emotions during birth, and rated their current PTSS-FC. A moderated mediation analysis was used to examine the proposed model. RESULTS Guilt and fear during birth mediated the association between mode of birth (instrumental or cesarean versus vaginal) and PTSS-FC. Skin-to-skin contact was related to reduced feelings of guilt and fear during birth, especially for women who had a cesarean section. CONCLUSIONS Our results recognize the specific emotions that contribute to the development of PTSS-FC following operative births and show how skin-to-skin contact can possibly reduce them. As such they emphasize the importance of the implementation of skin-to-skin contact following childbirth, and especially following a cesarean section as recommended by the Baby Friendly Health Initiative (World Health Organization & UNICEF, 2009).
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Affiliation(s)
- Rotem Kahalon
- Bob Shapell School of Social Work Tel Aviv University, Israel; Department of Psychology, Simon Fraser University, Canada.
| | - Heidi Preis
- Bob Shapell School of Social Work Tel Aviv University, Israel; Department of Psychology, Stony Brook University, USA.
| | - Yael Benyamini
- Bob Shapell School of Social Work Tel Aviv University, Israel.
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Tran HT, Murray JCS, Sobel HL, Mannava P, Huynh LT, Nguyen PTT, Giang HTN, Le TTM, Hoang TA, Nguyen VD, Li Z, Pham NTQ. Early essential newborn care is associated with improved newborn outcomes following caesarean section births in a tertiary hospital in Da Nang, Vietnam: a pre/post-intervention study. BMJ Open Qual 2021; 10:bmjoq-2020-001089. [PMID: 34301731 PMCID: PMC8728344 DOI: 10.1136/bmjoq-2020-001089] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 06/20/2021] [Indexed: 11/27/2022] Open
Abstract
Background To improve maternal and neonatal outcomes, Vietnam implemented early essential newborn care (EENC) using clinical coaching and quality improvement self-assessments in hospitals to introduce policy, practice and environmental changes. Da Nang Hospital for Women and Children began EENC with caesarean section births to inform development of national guidelines. This study compared newborn outcomes after caesarean sections pre/post-EENC introduction. Methods Maternity records of all live in-born hospital caesarean births and separate case records of the subpopulation admitted to the neonatal intensive care unit (NICU) were reviewed pre-EENC (November 2013–October 2014) and post-EENC (November 2014–October 2015) implementation. NICU admissions and adverse outcomes on NICU admission were compared using descriptive statistics. Findings A total of 16 927 newborns were delivered by caesarean section: 7928 (46.8%) pre-EENC and 8999 post-EENC (53.2%). Total NICU admissions decreased from 16.7% to 11.8% (relative risk 0.71; 95% CI 0.66 to 0.76) after introduction of EENC. Compared with the pre-EENC period, babies with hypothermia on admission to the NICU declined from 5.0% to 3.7% (relative risk 0.73; 95% CI 0.63 to 0.84) and cases of sepsis from 3.2% to 0.8% (relative risk 0.26; 95% CI 0.20 to 0.33) post-EENC implementation. While more than half of all newborns in the NICU were fed something other than breastmilk pre-EENC introduction, 85.8% were exclusively breast fed post-EENC (relative risk 1.86; 95% CI 1.75 to 1.98). Preterm newborns <2000 g receiving kangaroo mother care (KMC) increased from 50% to 67% (relative risk 1.33; 95% CI 1.12 to 1.59). Conclusion The EENC quality improvement approach with caesarean section births was associated with reduced NICU admissions, admissions with hypothermia and sepsis, and increased rates of exclusive breast feeding and KMC in the NICU.
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Affiliation(s)
- Hoang Thi Tran
- Neonatal Unit, Da Nang Hospital for Women and Children, Da Nang, Vietnam .,School of Medicine and Pharmacy, The University of Da Nang, Da Nang, Vietnam
| | - John Charles Scott Murray
- Reproductive, Maternal, Newborn, Child and Adolescent Health, WHO Regional Office for the Western Pacific, Manila, Philippines
| | - Howard Lawrence Sobel
- Reproductive, Maternal, Newborn, Child and Adolescent Health, WHO Regional Office for the Western Pacific, Manila, Philippines
| | - Priya Mannava
- Reproductive, Maternal, Newborn, Child and Adolescent Health, WHO Regional Office for the Western Pacific, Manila, Philippines
| | - Le Thi Huynh
- Neonatal Unit, Da Nang Hospital for Women and Children, Da Nang, Vietnam.,School of Medicine and Pharmacy, The University of Da Nang, Da Nang, Vietnam
| | - Phuong Thi Thu Nguyen
- Neonatal Unit, Da Nang Hospital for Women and Children, Da Nang, Vietnam.,School of Medicine and Pharmacy, The University of Da Nang, Da Nang, Vietnam
| | - Hoang Thi Nam Giang
- School of Medicine and Pharmacy, The University of Da Nang, Da Nang, Vietnam
| | - Tuyen Thi Mong Le
- General Obstetrics and Gynaecology, Da Nang Hospital for Women and Children, Da Nang, Vietnam
| | - Tuan Anh Hoang
- Maternal and Child Health Department, Ministry of Health of Vietnam, Ha Noi, Vietnam
| | - Vinh Duc Nguyen
- Maternal and Child Health Department, Ministry of Health of Vietnam, Ha Noi, Vietnam
| | - Zhao Li
- Reproductive, Maternal, Newborn, Child and Adolescent Health, WHO Regional Office for the Western Pacific, Manila, Philippines
| | - Nga Thi Quynh Pham
- Universal Health Coverage team, World Health Organization Representative Office in Vietnam, Ha Noi, Vietnam
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Deys L, Wilson PV, Meedya DS. What are women's experiences of immediate skin-to-skin contact at caesarean section birth? An integrative literature review. Midwifery 2021; 101:103063. [PMID: 34157585 DOI: 10.1016/j.midw.2021.103063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 06/02/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Skin-to-skin is a well-established practice at vaginal births promoting the health of women and babies. Facilitation of skin-to-skin at caesarean section birth is growing despite environmental and historical challenges. This is led by the expectancy of women and of health professionals increasingly understanding its importance. OBJECTIVE To synthesise original research that explores the experience of women having immediate and uninterrupted skin-to-skin contact at caesarean section when woman and baby are well. DESIGN Integrative literature review. DATA SOURCES The databases of SCOPUS, PubMed, CINAHL plus, Wiley Online, Cochrane Library, Web of Science and MIDIRS were used to identify studies from 2010-2020. Hand searching of library journals, reference and citation lists were also used. METHODS The framework of Whittemore and Knafl (2005) was used to guide the literature search, thematic analysis, and synthesis of original research. Initial screening against inclusion criteria was utilised for English-published papers of full-term, well, woman and baby dyads who experienced skin-to-skin at caesarean section birth. Papers were not limited by methodology. The validated Mixed Methods Appraisal Tool (MMAT) was used for critical quality appraisal (Bartlett et al., 2018). FINDINGS In total, 750 results were returned in the initial search and a final 13 papers were included in this review including quantitative (6), qualitative (5) and mixed method (2) designs. Immediate and uninterrupted skin-to-skin at caesarean section birth, when mother and baby are well, is safe, appropriate and desired by women, improving birth experience and satisfaction. Three main themes were identified with sub-themes - Positive birth experience (satisfaction; breastfeeding goals); Sense of control (empowered; birth, not a procedure); Natural (wanting to hold their baby; becoming a mother). CONCLUSIONS The findings of this review show that skin-to-skin improves the experience for women, and particularly empowers women having a caesarean section giving them a sense of a more natural birth. Women see skin-to-skin as an opportunity to maintain control and not be separated from their baby. Many studies have focused on the benefits of skin-to-skin but less so on the wants and choices of women. Women want to see, hold and feed their babies but are unable to achieve this of their own volition during a surgical birth. Understanding how women value this close physical contact can seek to inform further research on the impact of separation. This can inform policy and practice development in maternity care services to ensure best outcomes for both women and infants. IMPLICATIONS FOR PRACTICE The practice of skin-to-skin and keeping mother and baby together is valued by women and justified by research as best-practice for health and well-being. The findings of this paper highlight the importance of maternity settings facilitating both skin-to-skin and non-separation for all women and their newborns, even more so at caesarean section births.
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Affiliation(s)
- Linda Deys
- School of Nursing, University of Wollongong, Northfields Avenue, Wollongong, NSW 2500 Australia; Clinical Midwife Consultant/IBCLC/RN, Illawarra Shoalhaven Local Health District, Australia; Maternal & Women's Health, Locked Bag 8808, South Coast Mail Centre, NSW 2521, Australia.
| | - Professor Valerie Wilson
- University of Wollongong School of Nursing and Illawarra Shoalhaven Local Health District, Australia.
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Navas Arrebola R, Peteiro Mahía L, Blanco López S, López Castiñeira N, Seoane Pillado T, Pertega Díaz S. Women's satisfaction with childbirth and postpartum care and associated variables. Rev Esc Enferm USP 2021; 55:e03720. [PMID: 34133650 DOI: 10.1590/s1980-220x2020006603720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 11/09/2020] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To determine the level of satisfaction with childbirth and the postpartum period. METHOD This is a longitudinal, observational study. Clinical variables of the patients and delivery were collected, and a descriptive and inferential analysis was performed. The validated state-trait anxiety inventory (STAI) and the satisfaction survey Care in Obstetrics Measure For Testing Satisfaction Scale (COMFORTS) in Spanish were used. RESULTS A total of 381 women was included in the study and grouped into satisfied vs. dissatisfied (94.54% vs. 5.46%). Women having given birth by eutocic delivery (p = 0.005), as well as those who had skin-to-skin time with their newborn (p = 0.012) after delivery, report more satisfaction. Mothers who were separated from their babies reported being less satisfied (p = 0.004), as did those who did not meet the expectations raised in the birth plan (p = 0.013). All the women with minimal anxiety are satisfied (p = 0.004), the same happening for those showing postpartum anxiety (p <0.001). CONCLUSION The percentage of satisfied women is high; it is necessary to monitor childbirth and postpartum care, promoting good practices in childbirth care, as well as in women's emotional well-being.
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Affiliation(s)
| | | | | | | | | | - Sonia Pertega Díaz
- Universidad de A Coruña, Complexo Hospitalario Universitario, A Coruña, Spain
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14
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Missed Nursing Care During Labor and Birth and Exclusive Breast Milk Feeding During Hospitalization for Childbirth. MCN Am J Matern Child Nurs 2021; 45:280-288. [PMID: 32496351 DOI: 10.1097/nmc.0000000000000644] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to determine associations between missed nursing care and nurse staffing during labor and birth, and exclusive breast milk feeding at hospital discharge. STUDY DESIGN AND METHODS Labor and birth nurses in three states were surveyed about missed nursing care and their maternity units' adherence to the AWHONN (2010) nurse staffing guidelines for care during labor and birth, using the Perinatal Misscare Survey. Nursing responses were aggregated to the hospital level and estimated associations between missed nursing care, nurse staffing, and hospitals' exclusive breast milk feeding rates were measured using The Joint Commission's Perinatal Care Measure (PC-05). RESULTS Surveys from 512 labor nurses in 36 hospitals were included in the analysis. The mean exclusive breast milk feeding rate was 53% (range 13%-76%). Skin-to-skin care, breastfeeding within 1 hour of birth, and appropriate recovery care were on average occasionally missed (2.33 to 2.46 out of 4; 1 = rarely, 2 = occasionally, 3 = frequently, or 4 = always) and were associated with PC-05 [B(CI) -17.1(-29, -6.3), -17.9(-30.5, -6.2), and -15.4(-28.7, -2.1), respectively]. Adherence with overall staffing guidelines was associated with PC-05 [12.9(3.4, 24.3)]. Missed nursing care was an independent predictor of PC-05 [-14.6(-26.4, -2.7)] in a multilevel model adjusting for staffing guideline adherence, perceived quality, mean age of respondents, and nurse burnout. CLINICAL IMPLICATIONS Exclusive breast milk feeding is a national quality indicator of inpatient maternity care. Nurses have substantial responsibility for direct support of infant feeding during the childbirth hospitalization. These results support exclusive breast milk feeding (PC-05) as a nurse-sensitive quality indicator.
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Casely E, Lucas D. P.49 Time to see baby? When are mothers offered the first opportunity to hold their babies during caesarean section? Int J Obstet Anesth 2021. [DOI: 10.1016/j.ijoa.2021.103047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abdulghani N, Cooklin A, Edvardsson K, Amir LH. Mothers' perceptions and experiences of skin-to-skin contact after vaginal birth in Saudi Arabia: A cross-sectional study. Women Birth 2021; 35:e60-e67. [PMID: 33608236 DOI: 10.1016/j.wombi.2021.02.001] [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: 04/09/2020] [Revised: 11/22/2020] [Accepted: 02/01/2021] [Indexed: 12/12/2022]
Abstract
PROBLEM The World Health Organization recommends immediate skin-to-skin contact after birth, however, worldwide, separation of mothers and infant is common. BACKGROUND In Saudi Arabia, there is a lack of research exploring mothers' experiences of skin-to-skin contact after birth. AIM To estimate the rate of skin-to-skin contact and describe mothers' perceptions and experiences of immediate skin-to-skin contact after vaginal birth in two largest hospitals in Jeddah, Saudi Arabia. METHODS A cross-sectional study conducted in 2017. A total of 254 mothers completed the survey on the postnatal ward (92 % response rate). The survey consisted of 36 closed and open-ended items. Data were described using summary statistics and free text comments were analysed using content analysis. RESULTS The rate of direct skin-to-skin contact was 15%. A further 54% of mothers had the baby placed on their chest/abdomen but with a sheet/gown between them. Mothers reported favourable perceptions towards skin-to-skin contact and reported the practice as acceptable (67%). Most mothers did not express concerns about feeling exposed (85%) or that skin-to-skin contact was inconsistent with norms of modesty or culture (87%). The free text comments indicated that most mothers felt positive about their experience of skin-to-skin contact, while some mothers felt overwhelmed and unprepared. DISCUSSION AND CONCLUSIONS Skin-to-skin contact was not routinely implemented after birth and the rate was low. Mothers held positive perceptions and wanted to practice skin-to-skin contact. Policy makers and clinicians should acknowledge mothers' needs and feelings by facilitating skin-to-skin contact to achieve optimal outcomes for mothers and infants.
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Affiliation(s)
- Nawal Abdulghani
- Faculty of Nursing, Umm Al-Qura University, Makkah, Saudi Arabia; Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia.
| | - Amanda Cooklin
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | - Kristina Edvardsson
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | - Lisa H Amir
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
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17
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Kahalon R, Preis H, Benyamini Y. Who benefits most from skin-to-skin mother-infant contact after birth? Survey findings on skin-to-skin and birth satisfaction by mode of birth. Midwifery 2020; 92:102862. [PMID: 33126046 DOI: 10.1016/j.midw.2020.102862] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 08/16/2020] [Accepted: 10/13/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Previous research has shown that skin-to-skin contact in the delivery room is associated with an increase satisfaction with childbirth. The purpose of the present study was to examine whether this association differs as a function of mode of birth, such that the positive effect of skin-to-skin contact would be especially pronounced for women who had operative births. DESIGN Survey design using self-administered questionnaires during pregnancy (Time 1) and at two months postpartum (Time 2). SETTING At Time 1, women were recruited at community and hospital medical centres in two large metropolitan areas in the centre of Israel and through home midwives and internet forums. At Time 2, women completed a second questionnaire in which they reported whether they had skin-to-skin contact with their infant immediately after birth and their birth satisfaction. PARTICIPANTS Pregnant women, gestation week ≥24, with singleton pregnancy, who took part in both T1 and T2 (N = 1371, 75% of the 1833 women recruited at T1). MEASUREMENTS Analysis of covariance (ANCOVA) was used to examine whether the association between skin-to-skin contact after birth and birth satisfaction two months post-partum, differs as a function of mode of birth. Maternal or infant complications during birth, parity, and whether the pregnancy was planned, served as covariates. Birth satisfaction was measured using the Childbirth Satisfaction Scale. All measures were self-reported. FINDINGS The frequency of skin-to-skin was high (83%) for women who had vaginal birth, but lower for women who had an instrumental birth (66%) or a caesarean section (31%). At two months postpartum, women who had operative births reported less satisfaction with their birth than women who gave birth via vaginal birth. A significant interaction between skin-to-skin and mode of birth showed that although skin-to-skin was associated with higher birth satisfaction among women across all three modes of birth, i.e., vaginal (Cohen's d = .41), instrumental (Cohen's d = .64) and caesarean (Cohen's d = .87), the effect for the difference in birth satisfaction between women with and without skin-to-skin was especially large for operative births, particularly for caesarean sections. KEY CONCLUSIONS Operative birth is related to lower satisfaction with childbirth and lower rates of skin-to-skin contact immediately after birth. Yet, the association between skin-to-skin and birth satisfaction is especially strong for women who had operative births and specifically a caesarean section, suggesting that the possible contribution of skin-to-skin to birth satisfaction should be emphasised particularly after operative births. IMPLICATIONS FOR PRACTICE It is recommended that maternity care providers, managers, policy makers and medical teams facilitate skin-to-skin contact between the woman and her infant immediately, or as soon as possible, after childbirth, in both operative and non-operative births.
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Affiliation(s)
- Rotem Kahalon
- Bob Shapell School of Social Work Tel Aviv University, Israel; The School of Psychological Sciences, Tel-Aviv University, Israel.
| | - Heidi Preis
- Bob Shapell School of Social Work Tel Aviv University, Israel; Department of Psychology, Stoney Brook University, U.S
| | - Yael Benyamini
- Bob Shapell School of Social Work Tel Aviv University, Israel
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Ghanbari-Homayi S, Fardiazar Z, Mohammad-Alizadeh-Charandabi S, Meedya S, Jafarabadi MA, Mohammadi E, Mirghafourvand M. Skin-to-skin contact, early initiation of breastfeeding and childbirth experience in first time mothers: a cross sectional study. ACTA ACUST UNITED AC 2020. [DOI: 10.1016/j.jnn.2019.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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