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Nahaee J, Rezaie M, Abdoli E, Mirghafourvand M, Ghanbari-Homaie S, Jafarzadeh M. Association of childbirth experience with long-term psychological outcomes: a prospective cohort study. Reprod Health 2024; 21:71. [PMID: 38816741 PMCID: PMC11137992 DOI: 10.1186/s12978-024-01819-9] [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: 06/02/2023] [Accepted: 05/22/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND There has been limited research on the lasting impact of giving birth on both mothers and infants. This study aimed to investigate women's memories of their childbirth experience 4 months and 4 years after giving birth. Additionally, it aimed to examine how the childbirth experience is linked to women's mental health, sexual satisfaction, exclusive breastfeeding, and the type of subsequent birth. METHODS In this prospective cohort study, a total of 580 women giving birth in Tabriz hospitals in 2018 were followed up for 4 years. The data were collected using a childbirth experience questionnaire, a mental health inventory, and a sexual satisfaction scale for women, and were analyzed by a Pearson correlation test, an independent samples t-test, and a general linear model. RESULTS The total scores of the childbirth experience in two short-term (4 months) and long-term (4 years) time points following the birth had a significant and strong correlation with each other (r = .51; p < .001). After adjusting for the effects of socio-demographic and obstetric characteristics, sexual satisfaction had significant relationships with childbirth experience (p < .001) and postpartum complications (p < .001). In addition, mental health had significant relationships with childbirth experience (p < .001), postpartum complications (p < .001), and low income (p = .004). CONCLUSIONS Even 4 years after giving birth, women have a clear recall of their childbirth experience. This experience has a significant association with long-term outcomes such as sexual satisfaction, mental health, exclusive breastfeeding, and subsequent birth type.
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Affiliation(s)
- Jila Nahaee
- Department of Midwifery, Faculty of Nursing and Midwifery, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Mansour Rezaie
- Department of Anesthesiology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elham Abdoli
- 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
| | - Solmaz Ghanbari-Homaie
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mina Jafarzadeh
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
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Kuipers Y, De Bock V, Van de Craen N, Bosmans V. 'Naming and faming' maternity care providers: A mixed-methods study. Midwifery 2024; 130:103912. [PMID: 38154428 DOI: 10.1016/j.midw.2023.103912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 10/21/2023] [Accepted: 12/20/2023] [Indexed: 12/30/2023]
Abstract
BACKGROUND Positive benchmarking can serve as a catalyst for maternity care improvement. AIM To retrospectively benchmark Flemish maternity care providers' qualities, based on women's positive care experiences, and to explore which attributes of the different care providers contribute to these experiences. METHODS A sequential, two-phased mixed-methods study benchmarking the qualities of the community midwife, the hospital midwife, and the obstetrician. An online questionnaire was used to collect the data among pregnant and postpartum women, who rated their care experiences with the various care providers using the Net Promoter Score. Non-parametric and post hoc tests established the differences between types of clinicians and between antenatal, intrapartum, and postpartum Net Promoter Score mean scores. Content analysis was used to construct a final pool of keywords representing attributes of care professionals, accumulated from the promoters' free text responses. Ranks were assigned to each keyword based on its frequency. FINDINGS A total of 2385 Net Promoter Scale scores and 1856 free-text responses of 1587 responders were included. The community midwife received the overall highest NPS scores (p < .001). The promoters (n = 1015) assigned community midwives the highest NPS scores (9.67), followed by obstetricians (9.57) and hospital-based midwives (9.51). The distinct benchmarking attributes of community midwives were availability (p < .001), supportiveness (p = .04) and personalised care (p < .001). Being honest (p < .001), empathic (p < .001) and inexhaustible (p = .04) benchmarked hospital midwives. Calmness (p < .001), a no-nonsense approach (p < .001), being humane (p = .01) and comforting (p = .02) benchmarked obstetricians. DISCUSSION/CONCLUSION The findings indicate that all care providers are highly valued, but community midwives are ranked the highest. The distinct differences between the care professionals can serve as exemplary performance for professional development and shape the profiles of maternity care professionals.
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Affiliation(s)
- Yvonne Kuipers
- Department of Health and Social Care, School of Midwifery, AP University of Applied Sciences, Noorderplaats 2, 2000 Antwerp, Belgium; School of Health and Social Care, Edinburgh Napier University, Sighthill Campus, EH11 4BN Edinburgh, United Kingdom.
| | - Vanessa De Bock
- Department of Health and Social Care, School of Midwifery, AP University of Applied Sciences, Noorderplaats 2, 2000 Antwerp, Belgium
| | - Natacha Van de Craen
- Department of Health and Social Care, School of Midwifery, AP University of Applied Sciences, Noorderplaats 2, 2000 Antwerp, Belgium
| | - Valerie Bosmans
- Department of Health and Social Care, School of Midwifery, AP University of Applied Sciences, Noorderplaats 2, 2000 Antwerp, Belgium
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Leijerzapf DR, van der Pijl MSG, Hollander MH, Kingma E, de Jonge A, Verhoeven CJM. Experienced disrespect & abuse during childbirth and associated birth characteristics: a cross-sectional survey in the Netherlands. BMC Pregnancy Childbirth 2024; 24:170. [PMID: 38424515 PMCID: PMC10905902 DOI: 10.1186/s12884-024-06360-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/20/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Experiencing upsetting disrespect and abuse (D&A) during labour and birth negatively affects women's birth experiences. Knowing in what circumstances of birth women experience upsetting situations of D&A can create general awareness and help healthcare providers judge the need for extra attention in their care to help reduce these experiences. However, little is known about how different birth characteristics relate to the experience of D&A. Previous studies showed differences in birth experiences and experienced D&A between primiparous and multiparous women. This study explores, stratified for parity, (1) how often D&A are experienced in the Netherlands and are considered upsetting, and (2) which birth characteristics are associated with these upsetting experiences of D&A. METHODS For this cross-sectional study, an online questionnaire was set up and disseminated among women over 16 years of age who gave birth in the Netherlands between 2015 and 2020. D&A was divided into seven categories: emotional pressure, unfriendly behaviour/verbal abuse, use of force/physical violence, communication issues, lack of support, lack of consent and discrimination. Stratified for parity, univariable and multivariable logistic regression analyses were performed to examine which birth characteristics were associated with the upsetting experiences of different categories of D&A. RESULTS Of all 11,520 women included in this study, 45.1% of primiparous and 27.0% of multiparous women reported at least one upsetting experience of D&A. Lack of consent was reported most frequently, followed by communication issues. For both primiparous and multiparous women, especially transfer from midwife-led to obstetrician-led care, giving birth in a hospital, assisted vaginal birth, and unplanned cesarean section were important factors that increased the odds of experiencing upsetting situations of D&A. Among primiparous women, the use of medical pain relief was also associated with upsetting experiences of D&A. CONCLUSION A significant number of women experience upsetting disrespectful and abusive care during birth, particularly when medical interventions are needed after the onset of labour, when care is transferred during birth, and when birth takes place in a hospital. This study emphasizes the need for improving quality of verbal and non-verbal communication, support and adequate decision-making and consent procedures, especially before, during, and after the situations of birth that are associated with D&A.
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Affiliation(s)
- Denise R Leijerzapf
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Midwifery Science, Amsterdam, Netherlands.
- Midwifery Academy Amsterdam Groningen, InHolland, Amsterdam, Netherlands.
- Amsterdam Public Health, Quality of Care, Amsterdam, the Netherlands.
- Department of Primary and Long-Term Care, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
| | - Marit S G van der Pijl
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Midwifery Science, Amsterdam, Netherlands
- Midwifery Academy Amsterdam Groningen, InHolland, Amsterdam, Netherlands
- Amsterdam Public Health, Quality of Care, Amsterdam, the Netherlands
- Department of Primary and Long-Term Care, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Martine H Hollander
- Amalia Children's Hospital, Department of Obstetrics, Radboud University Medical Center, Nijmegen, the Netherlands
| | | | - Ank de Jonge
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Midwifery Science, Amsterdam, Netherlands
- Midwifery Academy Amsterdam Groningen, InHolland, Amsterdam, Netherlands
- Department of Primary and Long-Term Care, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Amsterdam Reproduction & Development Research Institute, Amsterdam, the Netherlands
| | - Corine J M Verhoeven
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Midwifery Science, Amsterdam, Netherlands
- Midwifery Academy Amsterdam Groningen, InHolland, Amsterdam, Netherlands
- Amsterdam Public Health, Quality of Care, Amsterdam, the Netherlands
- Department of Primary and Long-Term Care, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Division of Midwifery, School of Health Sciences, University of Nottingham, Nottingham, UK
- Department of Obstetrics and Gynaecology, Maxima Medical Centre, Veldhoven, the Netherlands
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Ängeby K, Ternström E. Women's experiences and needs concerning care and support during the various phases of childbirth and the postnatal period: Analysis of free-text comments based on Quality from the Patient's Perspective in Sweden. Eur J Midwifery 2024; 8:EJM-8-08. [PMID: 38375418 PMCID: PMC10875707 DOI: 10.18332/ejm/176698] [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: 08/18/2023] [Revised: 12/07/2023] [Accepted: 01/18/2024] [Indexed: 02/21/2024] Open
Abstract
INTRODUCTION Positive birth experiences can be a decisive factor in the well-being and future health of both women and their newborns. The quality of care is a multidimensional concept influenced by the external structure of the organization, the administrative qualities of the environment, and the individual patient's preferences about care. The aim was to describe women's preferences and experiences concerning support and treatment, and their perception of quality of care during all phases of labor and the postnatal period. METHODS Free-text comments of 635 women from four different open comment questions were analyzed. A qualitative content analysis was conducted in two steps: an inductive phase followed by a deductive phase using the Quality of care from a Patient's Perspective framework (QPP). RESULTS A total of 1148 free-text comments were coded; and 10 sub-categories were created and inserted under the QPP framework covering the latent meaning of the sub-category. Five of the sub-categories were sorted under the identity-oriented approach, four under physical-technical conditions, and one under the sociocultural atmosphere and reflected the women's experiences and needs regarding support and treatment during early labor, the active phase of labor, and the postnatal period. CONCLUSIONS High-quality care and support are important aspects for women during childbirth, irrespective of the phase of labor or postnatal period. The need for individualized care, active participation in one's own birth and using a family centered approach were also emphasized. Organizational factors influenced the quality of care and were particularly noticeable during birth.
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Affiliation(s)
- Karin Ängeby
- Women's Department and Centre for Clinical Research Education, County Council of Värmland, Karlstad, Sweden
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Elin Ternström
- School of Health and Welfare, Dalarna University, Falun, Sweden
- Department of Women’s and Children’s Health, Uppsala University, Akademiska Sjukhuset, Uppsala, Sweden
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Thijssen KMJ, Kierkels JJM, van Meurs A, Verhoeven CJ, van der Hout-van der Jagt MB, Oei SG. Visualization of contractions: Evaluation of a new experience design concept to enhance the childbirth experience. Birth 2023; 50:1025-1033. [PMID: 37550881 DOI: 10.1111/birt.12754] [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: 09/24/2021] [Revised: 07/12/2023] [Accepted: 07/17/2023] [Indexed: 08/09/2023]
Abstract
BACKGROUND The purpose of this study was to develop and evaluate an innovative design proposition intended to help enhance the childbirth experience. The innovation consists of a smartphone application for birth preparation during pregnancy with information and coaching, in addition to a wall projection at the labor ward that visualizes the progress of labor based on uterine monitoring data. METHODS We conducted a randomized controlled clinical pilot study. Singleton pregnant people pursuing a vaginal birth were recruited between 28 and 32 weeks of gestation and allocated to the intervention group (mobile application during the third trimester and wall projection at the labor ward) or to care as usual. Childbirth expectations and experiences were measured with validated questionnaires, which were completed at 32 and 36 weeks of gestation, immediately after birth, and at 4 weeks postpartum. Quantitative outcomes were analyzed and feedback about the proposition was evaluated using qualitative methods. RESULTS The qualitative feedback from patients was largely positive; however, we could not detect any significant differences between the intervention and control groups about fear of childbirth and other outcome measures. CONCLUSION In this pilot study, we evaluated a new experience design proposition for pregnancy and childbirth. This study generated data that will help to further improve and evaluate similar innovations in the future. This application may facilitate participatory care, promoting active involvement of parents in the healthcare processes of pregnancy and childbirth.
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Affiliation(s)
- Kirsten M J Thijssen
- Department of Obstetrics & Gynecology, Máxima Medical Centre, Veldhoven, The Netherlands
- Faculty of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Eindhoven MedTech Innovation Center (e/MTIC), Eindhoven, The Netherlands
- University Medical Centre Utrecht, Utrecht, The Netherlands
| | | | | | - Corine J Verhoeven
- Department of Obstetrics & Gynecology, Máxima Medical Centre, Veldhoven, The Netherlands
- Department of Midwifery Science, AVAG, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Department of Midwifery, University of Nottingham, Nottingham, UK
| | - M Beatrijs van der Hout-van der Jagt
- Department of Obstetrics & Gynecology, Máxima Medical Centre, Veldhoven, The Netherlands
- Faculty of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Eindhoven MedTech Innovation Center (e/MTIC), Eindhoven, The Netherlands
- Faculty of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - S Guid Oei
- Department of Obstetrics & Gynecology, Máxima Medical Centre, Veldhoven, The Netherlands
- Faculty of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
- Eindhoven MedTech Innovation Center (e/MTIC), Eindhoven, The Netherlands
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Thaels E, Meermans H, Beeckman K. What influences women's experiences of childbirth in Flanders? - A quantitative cross-sectional analysis of the Babies Born Better survey. Midwifery 2023; 126:103810. [PMID: 37690313 DOI: 10.1016/j.midw.2023.103810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 07/06/2023] [Accepted: 08/29/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVE Labour and birth experiences are of great importance since these can have positive, but also negative effects on women's health and wellbeing. This is the first study, which investigated the factors that influence women's experiences of childbirth in Flanders, Belgium. DESIGN A cross-sectional quantitative analysis was used to examine primary data obtained by the Babies Born Better project. Data collection took place via an online survey from April 2018 until August 2018 in Flanders. PARTICIPANTS 1414 women that gave birth across all birth settings between 2013 and 2018, who speak Flemish/Dutch were included. Participants were self-selected by filling out the Babies Born Better survey in 2018. FINDINGS The majority of the Flemish women included in this study reported a positive labour and birth experience. Analysis of the demographic variables showed that women who were single or not co-habiting reported a worse experience of labour and birth (P = 0.012). All obstetric factors included showed significant differences (P<0.01). Lastly, women were more likely to report a better experience when birth took place at home or in a midwifery unit and when the main care provider was a midwife (P<0.01). When controlled for significant variables from the univariate analysis, an impact on the birth experience was only found with the obstetric factors. A preterm (OR 0.544, 95%CI 0.362-0.817) and post term birth (OR 0.664, 95% CI 0.462-0.953) were found to reduce the chance of a good experience compared to a birth at term. In case of complications during pregnancy, women were less likely to report having had a good experience (OR 0.632, 95% CI 0.470 - 0.849). Medical interventions such as induction- (OR 0.346, 95% CI 0.241 - 0.497) and augmentation of labour (OR 0.318, 95% CI 0.218-0.463), an instrumental birth (OR 0.318, 95% CI 0.218-0.463) or a planned- (OR 0.349, 95% CI 0.205-0.596) or emergency caesarean section (OR 0.190, 95% CI 0.109-0.329) reduced the chances of women reporting to have had a good experience with care around labour and birth. KEY CONCLUSIONS The majority of women included in this study reported a good experience of care during labour and at birth. Certain obstetric factors such as having a straightforward pregnancy without complications, a physiological onset of labour at term without the need for augmentation and to give birth vaginally (without instrument) have shown a positive impact on women's reported birth experiences. IMPLICATIONS FOR PRACTICE Women's involvement in decision-making, especially when medical interventions are wanted or needed can improve positive birth experiences. More research is needed on how to support women and empower them, even more so in case of complications to ensure a sense of control and achievement.
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Affiliation(s)
- Ellen Thaels
- Faculty of Health & Wellbeing, School of Community Health & Midwifery, University of Central Lancashire, Fylde Rd, Preston, England PR1 2HE, UK.
| | - Hanne Meermans
- Verpleeg- en Vroedkunde, Centre for Research and Innovation in Care, Midwifery Research Education and Policymaking (MIDREP), Universiteit Antwerpen, Prinsstraat 13, Antwerp 2000, Belgium
| | - Katrien Beeckman
- Verpleeg- en Vroedkunde, Centre for Research and Innovation in Care, Midwifery Research Education and Policymaking (MIDREP), Universiteit Antwerpen, Prinsstraat 13, Antwerp 2000, Belgium; Faculty of Medicine and Pharmacy, Public Health, Nursing and Midwifery Research Unit, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, Brussels 1090, Belgium
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Opondo C, Harrison S, Sanders J, Quigley MA, Alderdice F. The relationship between perineal trauma and postpartum psychological outcomes: a secondary analysis of a population-based survey. BMC Pregnancy Childbirth 2023; 23:639. [PMID: 37674105 PMCID: PMC10481495 DOI: 10.1186/s12884-023-05950-6] [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: 04/05/2023] [Accepted: 08/24/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Perineal trauma, involving either naturally occurring tears or episiotomy, is common during childbirth but little is known about its psychological impact. This study aimed to determine the associations between childbirth related perineal trauma and psychological outcomes reported by women three months after giving birth and to explore factors that could mediate relationships between perineal trauma and maternal psychological outcomes. METHODS This study was a secondary analysis of data from a cross-sectional population-based survey of maternal and infant health. A total of 4,578 women responded to the survey, of which 3,307 had a vaginal birth and were eligible for inclusion into the analysis. Symptoms of depression, anxiety, and post-traumatic stress (PTS) symptoms were assessed using validated self- report measures. Physical symptoms were derived from a checklist and combined to produce a composite physical symptoms score. Regression models were fitted to explore the associations. RESULTS Nearly three quarters of women experienced some degree of perineal trauma. Women who experienced perineal trauma reported having more postnatal physical symptoms (adjusted proportional odds ratio 1.47, 95%CI 1.38 to 1.57, p-value < 0.001), were more likely to report PTS symptoms (adjusted OR 1.19, 95%CI 1.04 to 1.36, p-value 0.010), and there was strong evidence that each unit increase in the physical symptoms score was associated with between 38 and 90% increased adjusted odds of adverse psychological symptoms. There was no evidence of association between perineal trauma and satisfaction with postnatal care, although there was strong evidence that satisfaction with labour and birth was associated with 16% reduced adjusted odds of depression and 30% reduced adjusted odds of PTS symptoms. CONCLUSIONS Women who experienced perineal trauma were more likely to experience physical symptoms, and the more physical symptoms a woman experienced the more likely she was to report having postnatal depression, anxiety and PTS symptoms. There was some evidence of a direct association between perineal trauma and PTS symptoms but no evidence of a direct association between perineal trauma and depression or anxiety. Assessment and management of physical symptoms in the postnatal period may play an important role in reducing both physical and psychological postnatal morbidity.
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Affiliation(s)
- Charles Opondo
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, OX3 7LF, Oxford, UK
| | - Siân Harrison
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, OX3 7LF, Oxford, UK
| | - Julia Sanders
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Ty Dewi Sant Health Park, Cardiff, CF14 4XN, UK
| | - Maria A Quigley
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, OX3 7LF, Oxford, UK
| | - Fiona Alderdice
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, OX3 7LF, Oxford, UK.
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Offerhaus P, van Haaren-Ten Haken TM, Keulen JKJ, de Jong JD, Brabers AEM, Verhoeven CJM, Scheepers HCJ, Nieuwenhuijze M. Regional practice variation in induction of labor in the Netherlands: Does it matter? A multilevel analysis of the association between induction rates and perinatal and maternal outcomes. PLoS One 2023; 18:e0286863. [PMID: 37289749 PMCID: PMC10249899 DOI: 10.1371/journal.pone.0286863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 05/25/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND Practice variation in healthcare is a complex issue. We focused on practice variation in induction of labor between maternity care networks in the Netherlands. These collaborations of hospitals and midwifery practices are jointly responsible for providing high-quality maternity care. We explored the association between induction rates and maternal and perinatal outcomes. METHODS In a retrospective population-based cohort study, we included records of 184,422 women who had a singleton, vertex birth of their first child after a gestation of at least 37 weeks in the years 2016-2018. We calculated induction rates for each maternity care network. We divided networks in induction rate categories: lowest (Q1), moderate (Q2-3) and highest quartile (Q4). We explored the association of these categories with unplanned caesarean sections, unfavorable maternal outcomes and adverse perinatal outcomes using descriptive statistics and multilevel logistic regression analysis corrected for population characteristics. FINDINGS The induction rate ranged from 14.3% to 41.1% (mean 24.4%, SD 5.3). Women in Q1 had fewer unplanned caesarean sections (Q1: 10.2%, Q2-3: 12.1%; Q4: 12.8%), less unfavorable maternal outcomes (Q1: 33.8%; Q2-3: 35.7%; Q4: 36.3%) and less adverse perinatal outcomes (Q1: 1.0%; Q2-3: 1.1%; Q4: 1.3%). The multilevel analysis showed a lower unplanned caesarean section rate in Q1 in comparison with reference category Q2-3 (OR 0.83; p = .009). The unplanned caesarean section rate in Q4 was similar to the reference category. No significant associations with unfavorable maternal or adverse perinatal outcomes were observed. CONCLUSION Practice variation in labor induction is high in Dutch maternity care networks, with limited association with maternal outcomes and no association with perinatal outcomes. Networks with low induction rates had lower unplanned caesarean section rates compared to networks with moderate rates. Further in-depth research is necessary to understand the mechanisms that contribute to practice variation and the observed association with unplanned caesarean sections.
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Affiliation(s)
- Pien Offerhaus
- Research Centre for Midwifery Science, Zuyd University, Maastricht, the Netherlands
| | | | - Judit K. J. Keulen
- Research Centre for Midwifery Science, Zuyd University, Maastricht, the Netherlands
| | - Judith D. de Jong
- Nivel–Netherlands Institute for Health Services Research, Utrecht, The Netherlands
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Anne E. M. Brabers
- Nivel–Netherlands Institute for Health Services Research, Utrecht, The Netherlands
| | - Corine J. M. Verhoeven
- Department of Midwifery Science, Amsterdam University Medical Centre (UMC), Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Midwifery Academy Amsterdam Groningen, Inholland, Amsterdam, the Netherlands
- Amsterdam Public Health, Quality of Care, Amsterdam, the Netherlands
- Department of General Practice & Elderly Care Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- Division of Midwifery, School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
- Department of Obstetrics and Gynaecology, Maxima Medical Centre, Veldhoven, the Netherlands
| | - Hubertina C. J. Scheepers
- Department of Obstetrics and Gynecology, GROW School for Oncology and Reproduction, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Marianne Nieuwenhuijze
- Research Centre for Midwifery Science, Zuyd University, Maastricht, the Netherlands
- Maastricht University, Care and Public Health Research Institute, Maastricht, the Netherlands
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Place K, Rahkonen L, Adler K, Kruit H. Women's subjective perceptions and background factors associated with poor maternal childbirth experience among induced and spontaneous onset of labour: a two-year tertiary hospital cohort study. BMC Pregnancy Childbirth 2023; 23:349. [PMID: 37179323 PMCID: PMC10182675 DOI: 10.1186/s12884-023-05665-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 04/30/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Women undergoing induction of labour (IOL) more often have poor childbirth experience compared to women with spontaneous onset of labour (SOL). For understanding and optimizing childbirth experience in IOL, we investigated the subjective maternal reasons and perceptions leading to poor childbirth experience in IOL compared to SOL, as well as the background factors and delivery outcomes associated with the poor experience. METHODS Two-year retrospective cohort study included 836/19442 deliveries (4.3%) with poor childbirth experience in induced or spontaneous onset at term in Helsinki University Hospital. Poor childbirth experience occurred in 389/5290 (7.4%) cases of IOL and in 447/14152 (3.2%) of SOL. Childbirth experience was measured after delivery using Visual Analog Scale (VAS) score, with poor experience defined as VAS < 5. The primary outcome of the study were the maternal reasons for poor childbirth experience. The parameters were collected in the hospital database and statistical analyses were performed by using Mann-Whitney U-test and t-test. RESULTS The subjective maternal reasons for poor childbirth experience were pain (n = 529, 63.3%), long labour (n = 209, 25.0%), lack of support by care givers (n = 108, 12.9%), and unplanned caesarean section (CS) (n = 104, 12.4%). The methods of labour analgesia were similar among the women who expressed pain as the main reason compared with those who didn't. When comparing the reasons according to the onset of labour, IOL group more often reported unplanned CS (17.2% vs. 8.3%; p < 0.001) and lack of support by the care givers (15.4% vs. 10.7%; p = 0.04), while SOL group more often named pain (68.7% vs. 57.1%; p = 0.001) and rapid labour (6.9% vs. 2.8%; p = 0.007). In multivariable logistic regression model, IOL was associated with lower risk for pain compared to SOL (adjusted OR 0.6, 95%CI 0.5-0.8; p < 0.01). Primiparas more often reported long labour (29.3% vs. 14.3%; p < 0.001) and concern over own or baby's wellbeing (5.7% vs. 2.1%; p = 0.03) compared to multiparas. Women who feared childbirth more often reported lack of support compared to women with no fear (22.6% vs. 10.7%; p < 0.001). CONCLUSION The main reasons for poor childbirth experience were pain, long labour, unplanned CS and the lack of support by care givers. The childbirth experience is complex and could be optimized by information, support and presence of care givers especially in induced labour.
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Affiliation(s)
- Katariina Place
- Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, HUS, Haartmaninkatu 2, 00029, Helsinki, Finland
| | - Leena Rahkonen
- Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, HUS, Haartmaninkatu 2, 00029, Helsinki, Finland
| | - Katti Adler
- Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, HUS, Haartmaninkatu 2, 00029, Helsinki, Finland
| | - Heidi Kruit
- Department of Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, HUS, Haartmaninkatu 2, 00029, Helsinki, Finland.
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10
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Hall H, Fooladi E, Kloester J, Ulnang A, Sinni S, White C, McLaren M, Yeganeh L. Factors that Promote a Positive Childbearing Experience: A Qualitative Study. J Midwifery Womens Health 2023; 68:44-51. [PMID: 36083856 PMCID: PMC10087184 DOI: 10.1111/jmwh.13402] [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: 01/24/2022] [Revised: 06/22/2022] [Accepted: 06/28/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Experiences of pregnancy and birth are important and have long-term impacts on the well-being of women and their families. Perinatal services should aim for care that promotes a positive childbearing experience, as well as optimizing health outcomes for the woman and newborn. This study aimed to understand the health system factors that promote a positive childbearing experience. METHODS Women who had a positive experience and had given birth in Australia in the previous 12 months were recruited for individual semistructured interviews. The interview guide focused on health system factors that participants credited with contributing to their positive experience of perinatal care. Interviews were conducted until data saturation was reached. Qualitative data were transcribed verbatim and analyzed using inductive thematic analysis. RESULTS Data from 36 interviews were thematically analyzed, and 4 major themes were generated: health care provider attributes, health system attributes, communication and decision-making, and experience of care. The salient factors that promoted positive experiences included care that was respectful and individualized with effective communication, access to midwifery continuity of care models, and good integration between services. Competent and professional health care providers who facilitated shared decision-making were also essential. DISCUSSION Although women often sought out care that promoted physiologic birth, they emphasized that the way they were cared for was more important than fulfilling specific birth aspirations. Quality maternity care has the capacity to support a woman's confidence in her own abilities and promote a positive, and sometimes transformative, childbearing experience.
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Affiliation(s)
- Helen Hall
- School of Health, Federation University, Australia
| | - Ensieh Fooladi
- School of Nursing and Midwifery, Monash University, Australia
| | - Joy Kloester
- School of Nursing and Midwifery, Monash University, Australia
| | | | | | | | | | - Ladan Yeganeh
- School of Nursing and Midwifery, Monash University, Australia
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11
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Trends in facility-based childbirth and barriers to care at a birth center and community hospital in rural Chiapas, Mexico: A mixed-methods study. Midwifery 2023; 116:103507. [PMID: 36288677 DOI: 10.1016/j.midw.2022.103507] [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: 10/18/2021] [Revised: 07/09/2022] [Accepted: 09/28/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To assess trends in childbirth at a hospital-birth center among women living in Compañeros En Salud (CES)-affiliated communities in Chiapas, Mexico and explore barriers to childbirth care. Our hypothesis was that despite interventions to support and incentivize childbirth at the hospital-birth center, the proportion of births at the hospital-birth center among women from Compañeros En Salud-affiliated communities has not significantly changed after two years. We suspected that this may be due to structural factors impacting access to care and/or perceptions of care impacting desire to deliver at the birth center. DESIGN This explanatory mixed-methods study included a retrospective Compañeros En Salud maternal health census review followed by quantitative surveys and semi-structured qualitative interviews. PARTICIPANTS AND SETTING Participants were women living in municipalities in the mountainous Sierra Madre region of Chiapas, Mexico who received prenatal care in one of 10 community clinics served by Compañeros En Salud. Participants were recruited if they gave birth anywhere other than the primary-level rural hospital and adjacent birth center supported by Compañeros En Salud, either at home or at other facilities. MEASUREMENTS We compared rates of birth at the hospital-birth center, other health facilities, and at home from 2017-2018. We conducted surveys and interviews with women who gave birth between January 2017-July 2018 at home or at facilities other than the hospital-birth center to understand perceptions of care and decision-making surrounding childbirth location. FINDINGS We found no significant difference in rates of overall number of women birthing at the hospital-birth center from Compañeros En Salud-affiliated communities between 2017 and 2018 (p=0.36). Analysis of 158 surveys revealed distance (30.4%), time (27.8%), and costs (25.9%) as reasons for not birthing at the hospital-birth center. From 27 interviews, negative perceptions and experiences of the hospital included low-quality and disrespectful care, low threshold for medical interventions, and harm and suffering. Partners or family members influenced most decisions about childbirth location. KEY CONCLUSIONS Interventions to minimize logistical barriers may not be sufficient to overcome distance and perceptions of low-quality, disrespectful care. IMPLICATIONS FOR PRACTICE Better understanding of complex decision-making around childbirth will guide Compañeros En Salud in developing interventions to further meet the needs and preferences of birthing women in rural Chiapas.
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12
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Reviewing birth experience following a high-risk pregnancy: A feasibility study. Midwifery 2023; 116:103508. [PMID: 36223663 DOI: 10.1016/j.midw.2022.103508] [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: 06/03/2020] [Revised: 04/07/2022] [Accepted: 09/30/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Complications during pregnancy and birth are known risk factors for negative birth experience. Women value the opportunity to review their birth experiences, but limited knowledge exists about appropriate interventions and the feasibility of providing this care for women following high-risk pregnancies. OBJECTIVE To describe the construction and evaluate the feasibility and acceptability of a postpartum midwifery counselling intervention for women following high-risk pregnancies. DESIGN A mixed-method study. SETTING A high-risk antenatal outpatient clinic at Landspítali University Hospital in Reykjavík, Iceland. SAMPLE, RECRUITMENT AND DATA COLLECTION Thirty women who experienced high-risk pregnancies were invited to write about and review their birth experience with a known midwife 4-6 weeks postpartum. Eight midwives working in a high-risk antenatal clinic provided the intervention after a special training. Data including birth outcomes, birth experience and experience of the intervention were collected by questionnaires from women at two time points before and after the counselling intervention. Midwives providing the intervention completed diaries and participated in focus group interview to explore their experiences of the process. DATA ANALYSIS Descriptive and content analysis. FINDINGS Women and midwives perceived the intervention positively and feasible in this context. Midwives evaluated the pre-training program as helpful. Most women would like to review their birth experience with a midwife they know, 4-6 weeks postpartum. Almost half of the women wrote about their birth experiences. KEY CONCLUSIONS The findings indicate that women experiencing high-risk pregnancies might benefit from a follow up by a midwife they know. Women and midwives perceived the counselling intervention as an acceptable and feasible option in maternity care. The training program sufficiently prepared the midwives to provide the counselling intervention. IMPLICATIONS FOR PRACTICE The findings provide an opportunity to offer the intervention on a larger scale to explore the effects further and subsequently implement into routine care after birth for high-risk women.
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13
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Leinweber J, Fontein-Kuipers Y, Thomson G, Karlsdottir SI, Nilsson C, Ekström-Bergström A, Olza I, Hadjigeorgiou E, Stramrood C. Developing a woman-centered, inclusive definition of traumatic childbirth experiences: A discussion paper. Birth 2022; 49:687-696. [PMID: 35403241 DOI: 10.1111/birt.12634] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 02/18/2022] [Accepted: 03/08/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Many women experience giving birth as traumatic. Although women's subjective experiences of trauma are considered the most important, currently there is no clear inclusive definition of a traumatic birth to help guide practice, education, and research. AIM To formulate a woman-centered, inclusive definition of a traumatic childbirth experience. METHODS After a rapid literature review, a five-step process was undertaken. First, a draft definition was created based on interdisciplinary experts' views. The definition was then discussed and reformulated with input from over 60 multidisciplinary clinicians and researchers during a perinatal mental health and birth trauma research meeting in Europe. A revised definition was then shared with consumer groups in eight countries to confirm its face validity and adjusted based on their feedback. RESULTS The stepwise process confirmed that a woman-centered and inclusive definition was important. The final definition was: "A traumatic childbirth experience refers to a woman's experience of interactions and/or events directly related to childbirth that caused overwhelming distressing emotions and reactions; leading to short and/ or long-term negative impacts on a woman's health and wellbeing." CONCLUSIONS This definition of a traumatic childbirth experience was developed through consultations with experts and consumer groups. The definition acknowledges that low-quality provider interactions and obstetric violence can traumatize individuals during childbirth. The women-centered and inclusive focus could help women to identify and validate their experiences of traumatic birth, offering benefits for practice, education, and research, as well as for policymaking and activism in the fields of perinatal mental health and respectful maternity care.
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Affiliation(s)
- Julia Leinweber
- Institut of Midwifery, Charité-University Medicine Berlin, Berlin, Germany
| | - Yvonne Fontein-Kuipers
- School of Midwifery, Health and Social Work, University College Antwerp, Antwerp, Belgium.,Edinburgh Napier University, School of Health and Social Care, Edinburgh, Scotland
| | - Gill Thomson
- Maternal and Infant Nutrition & Nurture Unit, School of Community Health & Midwifery, University of Central Lancashire, Preston, UK
| | | | - Christina Nilsson
- Faculty of Caring Science, Work Life and Social Welfare, University in Borås, Borås, Sweden
| | | | - Ibone Olza
- European Institute of Perinatal Mental Health, Madrid, Spain
| | - Eleni Hadjigeorgiou
- Nursing Department, Faculty of Health Science, Cyprus University of Technology, Limassol, Cyprus
| | - Claire Stramrood
- Department of Obstetrics and Gynaecology, OLVG Hospital, Amsterdam, The Netherlands
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14
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Disrespect and abuse during labour and birth amongst 12,239 women in the Netherlands: a national survey. Reprod Health 2022; 19:160. [PMID: 35804419 PMCID: PMC9266084 DOI: 10.1186/s12978-022-01460-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 06/20/2022] [Indexed: 11/20/2022] Open
Abstract
Background Women experience disrespect and abuse during labour and birth all over the world. While the gravity of many forms of disrespect and abuse is evident, some of its more subtle forms may not always be experienced as upsetting by women. This study examines (1) how often women experience disrespect and abuse during labour and birth in the Netherlands and (2) how frequently they consider such experiences upsetting. We also examine (3) which respondent characteristics (age, ethnicity, educational level and parity) are associated with those experiences of disrespect and abuse that are upsetting, and (4) the associations between upsetting experiences of disrespect and abuse, and women’s labour and birth experiences. Methods Women who gave birth up to five years ago were recruited through social media platforms to participate in an online survey. The survey consisted of 37 questions about experiences of disrespect and abuse divided into seven categories, dichotomised in (1) not experienced, or experienced but not considered upsetting (2) experienced and considered upsetting. A multivariable logistic regression analysis was performed to examine associated characteristics with upsetting experiences of disrespect and abuse. A Chi-square test was used to investigate the association between upsetting experiences of disrespect and abuse and overall birth experience.
Results 13,359 respondents started the questionnaire, of whom 12,239 met the inclusion and exclusion criteria. Disrespect and abuse in terms of ‘lack of choices’ (39.8%) was reported most, followed by ‘lack of communication’ (29.9%), ‘lack of support’ (21.3%) and ‘harsh or rough treatment/physical violence’ (21.1%). Large variation was found in how frequently certain types of disrespect and abuse were considered upsetting, with 36.3% of women experiencing at least one situation of disrespect and abuse as upsetting. Primiparity and a migrant background were risk factors for experiencing upsetting disrespect and abuse in all categories. Experiencing more categories of upsetting disrespect and abuse was found to be associated with a more negative birth experience. Conclusions Disrespectful and abusive experiences during labour and birth are reported regularly in the Netherlands, and are often (but not always) experienced as upsetting. This emphasizes an urgent need to implement respectful maternity care, even in high income countries. Supplementary Information The online version contains supplementary material available at 10.1186/s12978-022-01460-4. Disrespect and abuse during labour and birth is a globally recognized phenomenon and has been linked to traumatic birth experiences and PTSD. In our study, we investigated how often women experience disrespect and abuse during labour and birth in the Netherlands and what proportion of these experiences was found to be upsetting. We also looked at risk factors for experiencing upsetting disrespect and abuse and to what extent upsetting disrespect and abuse influences the overall labour and birth experience. We conducted an online survey, with 12,239 respondents included in the analysis. We found a large variation in how frequently certain types of disrespect and abuse were considered upsetting, with 36.3% of women experiencing at least one situation of disrespect and abuse as upsetting. More subtle forms of disrespect and abuse, such as lack of choice, communication or support, were most prevalent and often considered upsetting. Giving birth for the first time and having a migrant background were risk factors for experiencing upsetting disrespect and abuse. Upsetting disrespect and abuse was found to have a strong impact on the overall labour and birth experience; with every additional experienced category of upsetting disrespect and abuse, the number of (very) positive labour and birth experiences decreases and the number of very negative ones increases. Although disrespect and abuse is a complex issue and its measurement subjective, this study shows that there is still a long way to go before achieving optimal respectful maternity care for all women, even in high income countries.
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Lyngbye K, Melgaard D, Lindblad V, Kragholm KH, Eidhammer A, Westmark S, Maimburg RD. Do women's perceptions of their childbirth experiences change over time? A six-week follow-up study in a Danish population. Midwifery 2022; 113:103429. [PMID: 35901608 DOI: 10.1016/j.midw.2022.103429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 07/06/2022] [Accepted: 07/07/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate how women's perception of the childbirth experience developed during the postpartum period. The secondary aim was to explore how selected birth interventions were subjectively perceived as part of the birth experience. DESIGN A prospective cohort study comparing childbirth experience, assessed at one and six weeks postpartum, using the Childbirth Experience Questionnaire (CEQ). SETTING A regional hospital in the northern part of Denmark, with 1,400 childbirths annually. PARTICIPANTS A total of 201 women with low-risk births who gave birth at North Denmark Regional Hospital were included in this study. We included both nulliparous and multiparous women. MEASUREMENTS AND FINDINGS More than 50% of the women changed their perceptions about their childbirth experience after six weeks. After six weeks the overall CEQ score and the domains 'Participation' and 'Professional support' had a lower CEQ score compared to scores obtained one week postpartum, although differences were small. Induction of labor, augmentation of labor, emergency caesarean section, epidural analgesia, and use of nitrous oxide were associated with a lower CEQ score. KEY CONCLUSIONS Women assessed their overall birth experience more negatively at six weeks postpartum compared to one week postpartum. Some interventions in the labor process influenced the women's assessment of their experiences negatively. IMPLICATIONS FOR PRACTICE Paying attention to preventive initiatives to ensure the women a spontaneous birth, if possible, may be essential to create positive perceptions of the childbirth experience.
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Affiliation(s)
- Kristine Lyngbye
- Department of Gynecology and Obstetrics, North Denmark Regional Hospital, Bispensgade 37, Hjoerring 9800, Denmark.
| | - Dorte Melgaard
- Centre of Clinical Research, North Denmark Regional Hospital, Bispensgade 37, Hjoerring 9800, Denmark; Department of Clinical Medicine and Centre for Clinical Research, Aalborg University, Soendre Skovvej 15, Aalborg 9000, Denmark
| | - Victoria Lindblad
- Department of Gynecology and Obstetrics, North Denmark Regional Hospital, Bispensgade 37, Hjoerring 9800, Denmark
| | - Kristian Hay Kragholm
- Unit of Clinical Biostatistics and Epidemiology - Department of Cardiology, Aalborg University Hospital, Hobrovej 18-22, Aalborg 9000, Denmark
| | - Anya Eidhammer
- Department of Gynecology and Obstetrics, North Denmark Regional Hospital, Bispensgade 37, Hjoerring 9800, Denmark
| | - Signe Westmark
- Centre of Clinical Research, North Denmark Regional Hospital, Bispensgade 37, Hjoerring 9800, Denmark
| | - Rikke Damkjær Maimburg
- Department of Clinical Medicine, Department of Obstetrics and Gynecology, Palle Juul-Jensens Boulevard 103, Aarhus 8200, Denmark; School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith NSW, Sydney 2751, Australia
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16
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Leinweber J, Fontein-Kuipers Y, Karlsdottir SI, Ekström-Bergström A, Nilsson C, Stramrood C, Thomson G. Developing a woman-centered, inclusive definition of positive childbirth experiences: A discussion paper. Birth 2022; 50:362-383. [PMID: 35790019 DOI: 10.1111/birt.12666] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 12/01/2022]
Abstract
INTRODUCTION A positive childbirth experience promotes women's health, both during and beyond the perinatal period. Understanding what constitutes a positive childbirth experience is thus critical to providing high-quality maternity care. Currently, there is no clear, inclusive, woman-centered definition of a positive childbirth experience to guide practice, education, and research. AIM To formulate an inclusive woman-centered definition of a positive childbirth experience. METHODS A six-step process was undertaken: (a) Key concepts associated with a positive childbirth were derived from a rapid literature review; (b) The key concepts were used by interdisciplinary experts in the author group to create a draft definition; (c) The draft definition was presented to clinicians and researchers during a European research meeting on perinatal mental health; (d) The authors integrated the expert feedback to refine the working definition; (e) A revised definition was shared with women from consumer groups in six countries to confirm its face validity; and (f) A final definition was formulated based on the women's feedback (n = 42). RESULTS The following definition was formulated: "A positive childbirth experience refers to a woman's experience of interactions and events directly related to childbirth that made her feel supported, in control, safe, and respected; a positive childbirth can make women feel joy, confident, and/or accomplished and may have short and/or long-term positive impacts on a woman's psychosocial well-being." CONCLUSIONS This inclusive, woman-centered definition highlights the importance of provider interactions for facilitating a positive childbirth experience. Feeling supported and having a sense of control, safety, and respect are central tenets. This definition could help to identify and validate positive childbirth experience(s), and to inform practice, education, research, advocacy, and policy-making.
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Affiliation(s)
- Julia Leinweber
- Institute of Midwifery, Charité-University Medicine Berlin, Berlin, Germany
| | - Yvonne Fontein-Kuipers
- School of Midwifery, Health and Social Work, University College Antwerp, Antwerp, Belgium.,Edinburgh Napier University, School of Health and Social Care, Edinburgh, UK
| | | | - Anette Ekström-Bergström
- Department of Health Sciences, University West, Trollhättan, Sweden.,Department of Nursing and Reproductive, Perinatal and Sexual Health, School of Health Sciences, University of Skövde, Skövde, Sweden
| | - Christina Nilsson
- Munkebäck Antenatal Clinic, Region Västra Götaland, Gothenburg, Sweden
| | - Claire Stramrood
- Department of Obstetrics and Gynaecology, OLVG Hospital, Amsterdam, The Netherlands
| | - Gill Thomson
- Maternal and Infant Nutrition & Nurture Unit, School of Community Health & Midwifery, University of Central Lancashire, Preston, UK
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17
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Molin B, Zwedberg S, Berger AK, Sand A, Georgsson S. Disempowering women-a mixed methods study exploring informational support about pain persisting after childbirth and its consequences. BMC Pregnancy Childbirth 2022; 22:510. [PMID: 35739466 PMCID: PMC9229078 DOI: 10.1186/s12884-022-04841-6] [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: 01/18/2022] [Accepted: 06/16/2022] [Indexed: 12/03/2022] Open
Abstract
Background Access to information is essential to achieving individual empowerment; meaning the ability to exercise control, manage one’s own condition and make informed decisions. However, studies have shown that information provided to women regarding physiological changes during the postpartum period and postpartum health was inadequate, incorrect, or inconsistent. Methods The aim of this study was to explore informational support about pain persisting after childbirth and its consequences. A sequential explanatory mixed methods design was used. In the first, quantitative phase, 1,171 women, who gave birth eight months earlier, completed a self-administered questionnaire. In the second, qualitative phase, 20 women who experienced chronic pain were interviewed. Descriptive statistics and qualitative content analysis were used to analyse the data. Results The majority of the women did not receive information about pain persisting after childbirth, or the information was insufficient or incorrect. They did not know when and where to seek help and did not consult health care professionals. In addition, the lack of information had a negative impact on women’s psychological well-being. All women expressed the need to be informed by health care professionals, irrespective of the individual risk of developing chronic pain. Conclusions Health services should ensure availability of information to give the women opportunity to achieve empowerment to make good health decisions, increase control over their health and well-being as well as to enhance their self-efficacy. We propose that a booklet or leaflet with relevant information about the risk of developing chronic pain, symptoms and treatment, along with advice about appropriate health care settings should be provided as part of antenatal or postnatal care.
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Affiliation(s)
- Beata Molin
- Department of Clinical Science Intervention and Technology (CLINTEC), Division of Obstetrics and Gynaecology, Karolinska Institutet, Karolinska University Hospital, 141 86, Stockholm, Huddinge, Sweden. .,Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden.
| | - Sofia Zwedberg
- Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden.,Theme Children's & Women's Health, PA Pregnancy Care and Delivery, Karolinska University Hospital, Stockholm, Sweden
| | | | - Anna Sand
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Susanne Georgsson
- Department of Clinical Science Intervention and Technology (CLINTEC), Division of Obstetrics and Gynaecology, Karolinska Institutet, Karolinska University Hospital, 141 86, Stockholm, Huddinge, Sweden.,The Swedish Red Cross University, Stockholm, Sweden
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18
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Davidsen AS, Birkmose AR, Kragstrup J, Siersma V, Ertmann RK. The association of a past childbirth experience with a variety of early physical and mental symptoms in subsequent pregnancies. Midwifery 2022; 112:103406. [PMID: 35772244 DOI: 10.1016/j.midw.2022.103406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 06/12/2022] [Accepted: 06/13/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Some women have a perceived negative experience of childbirth due to various reasons- e.g., obstetric complications or the feeling of loss of control. We do not know enough about the effects of a perceived negative experience of a childbirth on a woman's subsequent pregnancies. The aim of this study was to investigate whether a previously perceived negative childbirth experience affects a woman's physical and mental well-being in a later pregnancy. METHODS A prospective cohort study in Danish general practice, based on information about women's childbirth experiences from the Pregnancy Health Record filled in by the general practitioner (GP) and data from an electronic questionnaire completed by the women. RESULTS A total of 1288 women were included in the analysis. Women who had given birth before were found to have a significantly higher risk of experiencing nausea, varicose veins and uterine contractions, and a lower risk of pelvic cavity pain in the current pregnancy. Women having given birth before were significantly more likely to assess their physical fitness as poor and to experience poor well-being. Women with a perceived negative experience of childbirth had more sleep problems and a higher prevalence of poor self-rated health than women with unproblematic childbirth experience. CONCLUSION This study showed that women with a previously perceived negative experience of childbirth are affected according to their mental health in their subsequent pregnancy.
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Affiliation(s)
- Agnes S Davidsen
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Anna R Birkmose
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jakob Kragstrup
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Volkert Siersma
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ruth K Ertmann
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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19
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Junge-Hoffmeister J, Bittner A, Garthus-Niegel S, Goeckenjan M, Martini J, Weidner K. Subjective Birth Experience Predicts Mother–Infant Bonding Difficulties in Women With Mental Disorders. Front Glob Womens Health 2022; 3:812055. [PMID: 35479290 PMCID: PMC9035738 DOI: 10.3389/fgwh.2022.812055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 03/01/2022] [Indexed: 11/13/2022] Open
Abstract
Background The subjective experience of giving birth to a child varies considerably depending on psychological, medical, situational, relational, and other individual characteristics. In turn, it may have an impact on postpartum maternal mental health and family relationships, such as mother–infant bonding. The objective of the study was to evaluate the relevance of the subjective birth experience (SBE) for mother–infant bonding difficulties (BD) in women with mental disorders. Methods This study used data from N = 141 mothers who were treated for postpartum mental disorders in the mother–baby day unit of the Psychosomatic University Clinic in Dresden, Germany. Patients' mental status at admission and discharge was routinely examined using a diagnostic interview (SCID I) and standard psychometric questionnaires (e.g., EPDS, BSI, PBQ). Both, the SBE (assessed by Salmon's Item List, SIL) as well as medical complications (MC) were assessed retrospectively by self-report. The predictive value of SBE, MC, as well as psychopathological symptoms for mother–infant BD were evaluated using logistic regression analyses. Results About half of this clinical sample (47.2%) reported a negative SBE; 56.8% of all mothers presented with severe mother–infant BD toward the baby. Mothers with BD showed not only significantly more depressiveness (EPDS: M = 16.6 ± 5.6 vs. 14.4 ± 6.2*), anxiety (STAI: M = 57.2 ± 10.6 vs. 51.4 ± 10.6***), and general psychopathology (BSI-GSI: M = 1.4 ± 0.7 vs. 1.1 ± 0.6**) compared to women without BD, but also a significantly more negative SBE (SIL: M = 79.3 ± 16.2 vs. 61.3 ± 22.9***). Moreover, the SBE was the most powerful predictor for BD in univariate and multiple logistic regression analyses [OR = 0.96*** (95% CI 0.94–0.98) vs. OR = 0.96** (95% CI 0.93–0.98)], even when univariate significant predictors (e.g., current psychopathology and MC during birth) were controlled. Conclusions A negative SBE is strongly associated with mother–infant bonding in patients with postpartum mental disorders. It needs to get targeted within postpartum treatment, preferably in settings including both mother and child, to improve distorted mother–infant bonding processes and prevent long-term risks for the newborn. Furthermore, the results highlight the importance of focusing on the specific needs of vulnerable women prior to and during birth (e.g., emotional safety, good communication, and support) as well as individual factors that might be predictive for a negative SBE.
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Affiliation(s)
- Juliane Junge-Hoffmeister
- Department for Psychotherapy and Psychosomatic Medicine, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Antje Bittner
- Department for Psychotherapy and Psychosomatic Medicine, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Susan Garthus-Niegel
- Institute for Systems Medicine, Faculty of Human Medicine, Medical School Hamburg, Hamburg, Germany
- Institute and Policlinic of Occupational and Social Medicine, Technische Universität Dresden, Dresden, Germany
- Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Maren Goeckenjan
- Department of Gynecology and Obstetrics, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Julia Martini
- Department for Psychiatry and Psychotherapy, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Kerstin Weidner
- Department for Psychotherapy and Psychosomatic Medicine, Carl Gustav Carus Faculty of Medicine, Technische Universität Dresden, Dresden, Germany
- *Correspondence: Kerstin Weidner
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Aydin E, Glasgow KA, Weiss SM, Khan Z, Austin T, Johnson MH, Barlow J, Lloyd-Fox S. Giving birth in a pandemic: women's birth experiences in England during COVID-19. BMC Pregnancy Childbirth 2022; 22:304. [PMID: 35399066 PMCID: PMC8994823 DOI: 10.1186/s12884-022-04637-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 03/17/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Expectant parents worldwide have experienced changes in the way they give birth as a result of COVID-19, including restrictions relating to access to birthing units and the presence of birthing partners during the birth, and changes to birth plans. This paper reports the experiences of women in England. METHODS Data were obtained from both closed- and open-ended responses collected as part of the national COVID in Context of Pregnancy, Infancy and Parenting (CoCoPIP) Study online survey (n = 477 families) between 15th July 2020 - 29th March 2021. Frequency data are presented alongside the results of a sentiment analysis; the open-ended data was analysed thematically. RESULTS Two-thirds of expectant women reported giving birth via spontaneous vaginal delivery (SVD) (66.1%) and a third via caesarean section (CS) (32.6%) or 'other' (1.3%). Just under half (49.7%) of the CS were reported to have been elective/planned, with 47.7% being emergencies. A third (37.4%) of participants reported having no changes to their birth (as set out in their birthing plan), with a further 25% reporting COVID-related changes, and 37.4% reporting non-COVID related changes (e.g., changes as a result of birthing complications). One quarter of the sample reported COVID-related changes to their birth plan, including limited birthing options and reduced feelings of control; difficulties accessing pain-relief and assistance, and feelings of distress and anxiety. Under half of the respondents reported not knowing whether there could be someone present at the birth (44.8%), with 2.3% of respondents reporting no birthing partner being present due to COVID-related restrictions. Parental experiences of communication and advice provided by the hospital prior to delivery were mixed, with significant stress and anxiety being reported in relation to both the fluctuating guidance and lack of certainty regarding the presence of birthing partners at the birth. The sentiment analysis revealed that participant experiences of giving birth during the pandemic were predominately negative (46.9%) particularly in relation to the first national lockdown, with a smaller proportion of positive (33.2%) and neutral responses (19.9%). CONCLUSION The proportion of parents reporting birthing interventions (i.e., emergency CS) was higher than previously reported, as were uncertainties related to the birth, and poor communication, leading to increased feelings of anxiety and high levels of negative emotions. The implications of these findings are discussed.
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Affiliation(s)
- Ezra Aydin
- Department of Psychology, University of Cambridge, Downing Street, Cambridge, CB2 3EB, UK.
- Department of Psychiatry, Columbia University, New York City, USA.
| | - Kevin A Glasgow
- Department of Education, University of Cambridge, Cambridge, UK
| | - Staci M Weiss
- Department of Psychology, University of Cambridge, Downing Street, Cambridge, CB2 3EB, UK
| | - Zahra Khan
- Department of Psychology, University of Cambridge, Downing Street, Cambridge, CB2 3EB, UK
| | - Topun Austin
- Neonatal Intensive Care Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- NIHR Cambridge Biomedical Research Centre, Cambridge, UK
| | - Mark H Johnson
- Department of Psychology, University of Cambridge, Downing Street, Cambridge, CB2 3EB, UK
- Centre for Brain & Cognitive Development, Birkbeck, University of London, London, UK
| | - Jane Barlow
- Centre for Evidence-Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - Sarah Lloyd-Fox
- Department of Psychology, University of Cambridge, Downing Street, Cambridge, CB2 3EB, UK
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21
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Davis AMB, Sclafani V. Birth Experiences, Breastfeeding, and the Mother-Child Relationship: Evidence from a Large Sample of Mothers. Can J Nurs Res 2022; 54:518-529. [PMID: 35389289 DOI: 10.1177/08445621221089475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND It is a priority for public health professionals to improve global breastfeeding rates, which have remained low in Western countries for more than a decade. Few researchers have addressed how maternal perceptions of birth experiences affect infant feeding methods. Furthermore, mixed results have been shown in research regarding breastfeeding and mother-child bonding, and many studies are limited by small sample sizes, representing a need for further investigation. PURPOSE We aimed to examine the relationship between subjective birth experiences and breastfeeding outcomes, and explored whether breastfeeding affected mother-infant bonding. METHODS 3,080 mothers up to three years postpartum completed a cross - sectional survey. RESULTS Mothers who had more positive birth experiences were more likely to report breastfeeding their babies. Moreover, mothers who perceived their birth as more positive were more likely to breastfeed their child for a longer period (over 9 months) than those who had more negative experiences. In line with recent research, breastfeeding behaviours were not associated with reported mother-infant bonding. CONCLUSIONS Mothers who reported better birth experiences were most likely to breastfeed, and breastfeed for longer. We find no evidence to suggest that feeding methods are associated with bonding outcomes.
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Affiliation(s)
- Abi M B Davis
- School of Psychology, 4547University of Lincoln, Lincoln, UK
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22
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Rottenstreich M, Rotem R, Hankin A, Rottenstreich A, Sela HY, Shen O, Grisaru-Granovsky S. Outcomes of attempted vaginal births after previous recurrent operative vaginal deliveries: An individual cumulative risk analysis. Birth 2022; 49:80-86. [PMID: 34254704 DOI: 10.1111/birt.12576] [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: 03/31/2020] [Revised: 06/18/2021] [Accepted: 06/28/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Data about the risk of recurrence of vacuum extraction (VE) in multiple consecutive deliveries are scarce. We aimed to evaluate the pattern and individual cumulative risk of recurrence of VE in consecutive term deliveries. STUDY DESIGN A retrospective cohort study based on a validated electronic database at a single center between 2005 and 2019. For the purpose of the study, we focused on consecutive term deliveries of all primiparas (P1) that had a record of at least one additional delivery during the study period. We identified P1 VE deliveries (reference group) and calculated the individual cumulative risk of repeated VE for three consecutive deliveries. Multivariate analysis was conducted adjusting for potential confounders. RESULTS We identified 35 113 primiparas that met inclusion criteria. The overall VE rate for P1 was 17.9% (6969 parturient). The cumulative rates of repeated VEs at the 2nd, 3rd, and 4th deliveries were 8.6%, 26.8%, and 25.0%, respectively. The risk of recurrent VE for each of the consecutive deliveries was confirmed after adjustment for confounders (aOR [95% CI]: 5.8 [4.76-7.04], 34.2 [18.59-62.81], and 113.9 [9.77-1328.69] for the 2nd, 3rd, and 4th consecutive deliveries, respectively). CONCLUSION Women with VE at the first and second deliveries have a substantially increased risk of VE in their following deliveries; this finding may influence woman's preference when choosing future mode of delivery.
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Affiliation(s)
- Misgav Rottenstreich
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Hebrew University, Jerusalem, Israel
| | - Reut Rotem
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Hebrew University, Jerusalem, Israel
| | - Aviel Hankin
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Hebrew University, Jerusalem, Israel
| | - Amihai Rottenstreich
- Department of Obstetrics and Gynecology, Hadassah Medical Center, Hebrew University, Jerusalem, Israel
| | - Hen Y Sela
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Hebrew University, Jerusalem, Israel
| | - Ori Shen
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Hebrew University, Jerusalem, Israel
| | - Sorina Grisaru-Granovsky
- Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Hebrew University, Jerusalem, Israel
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Colciago E, Brown AM, Ornaghi S, Antolini L, Nespoli A, Fumagalli S, Robinson A. The unpredictable nature of labour and birth: a qualitative investigation regarding expectations of Italian parents to-be. Midwifery 2022; 108:103286. [DOI: 10.1016/j.midw.2022.103286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 01/10/2022] [Accepted: 02/10/2022] [Indexed: 12/01/2022]
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24
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Maskálová E, Mazúchová L, Kelčíková S, Samselyová J, Kukučiarová L. Satisfaction of women with childbirth. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2021. [DOI: 10.15452/cejnm.2021.12.0031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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25
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Inversetti A, Fumagalli S, Nespoli A, Antolini L, Mussi S, Ferrari D, Locatelli A. Childbirth experience and practice changing during COVID-19 pandemic: A cross-sectional study. Nurs Open 2021; 8:3627-3634. [PMID: 34002943 PMCID: PMC8242706 DOI: 10.1002/nop2.913] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 03/01/2021] [Accepted: 03/04/2021] [Indexed: 11/30/2022] Open
Abstract
AIM To evaluate mothers' satisfaction with childbirth experience in a cohort of women who delivered during COVID pandemia and to compare them to a pre-COVID cohort. DESIGN We performed a cross-sectional study in a low-risk Maternity Unit. METHODS Women who delivered during COVID-19 pandemic were compared to a pre-COVID cohort recruited in 2018 in the same setting. Italian version of the Birth Satisfaction Scale-Revised (I-BSS-R) was used. RESULTS Three hundred and seventy-seven women were included (277 pre-COVID and 100 during COVID pandemic). No differences in terms of satisfaction at birth were reported (I-BSS-R mean 27.0, SD 5.3 versus mean 27.6, SD 6.1, p 0.34), despite an increased rate of active intrapartum interventions. Intrapartum variables that significantly reduced satisfaction were the same in the two groups: epidural analgesia (p < .0001 in both groups), prolonged active phases (p < .0001 in both), oxytocin administration (p < .0001 in both) and operative delivery (p 0.0009 versus p 0.0019).
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Affiliation(s)
- Annalisa Inversetti
- Unit for Mother and ChildCarate Brianza HospitalASST VimercateCarate BrianzaItaly
| | - Simona Fumagalli
- School of Medicine and SurgeryUniversity of Milano‐BicoccaMonzaItaly
| | - Antonella Nespoli
- School of Medicine and SurgeryUniversity of Milano‐BicoccaMonzaItaly
| | - Laura Antolini
- School of Medicine and SurgeryCenter of Biostatistics for Clinical EpidemiologyUniversity of Milano‐BicoccaMonzaItaly
| | - Serena Mussi
- Unit for Mother and ChildCarate Brianza HospitalASST VimercateCarate BrianzaItaly
| | - Debora Ferrari
- School of Medicine and SurgeryUniversity of Milano‐BicoccaMonzaItaly
| | - Anna Locatelli
- Unit for Mother and ChildCarate Brianza HospitalASST VimercateCarate BrianzaItaly
- School of Medicine and SurgeryUniversity of Milano‐BicoccaMonzaItaly
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26
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Hendrix YMGA, van Dongen KSM, de Jongh A, van Pampus MG. Postpartum Early EMDR therapy Intervention (PERCEIVE) study for women after a traumatic birth experience: study protocol for a randomized controlled trial. Trials 2021; 22:599. [PMID: 34488847 PMCID: PMC8419663 DOI: 10.1186/s13063-021-05545-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Accepted: 08/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Up to 33% of women develop symptoms of posttraumatic stress disorder (PTSD) after a traumatic birth experience. Negative and traumatic childbirth experiences can also lead to fear of childbirth, avoiding or negatively influencing a subsequent pregnancy, mother-infant bonding problems, problems with breastfeeding, depression and reduced quality of life. For PTSD in general, eye movement desensitization and reprocessing (EMDR) therapy has proven to be effective. However, little is known about the preventive effects of early intervention EMDR therapy in women after a traumatic birth experience. The purpose of this study is to determine the effectiveness of early intervention EMDR therapy in preventing PTSD and reducing PTSD symptoms in women with a traumatic birth experience. METHODS The PERCEIVE study is a randomized controlled trial. Women suffering from the consequences of a traumatic birth experience will be randomly allocated at maximum 14 days postpartum to either EMDR therapy or 'care-as-usual'. Patients in the EMDR group receive two sessions of therapy between 14 (T0) and 35 days postpartum. All participants will be assessed at T0 and at 9 weeks postpartum (T1). At T1, all participants will undergo a CAPS-5 interview about the presence and severity of PTSD symptoms. The primary outcome measure is the severity of PTSD symptoms, whereas the secondary outcomes pertain to fear of childbirth, mother-infant bonding, breastfeeding, depression and quality of life. The study will be conducted at a large city hospital and at multiple midwifery practices in Amsterdam, the Netherlands. DISCUSSION It is to be expected that the results of this study will provide more insight about the safety and effectiveness of early intervention EMDR therapy in the prevention and reduction of PTSD (symptoms) in women with a traumatic birth experience. TRIAL REGISTRATION Netherlands Trial Register NL73231.000.20 . Registered on 21 August 2020.
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Affiliation(s)
- Y M G A Hendrix
- Department of Obstetrics and Gynaecology, OLVG, Amsterdam, the Netherlands.
| | - K S M van Dongen
- Department of Obstetrics and Gynaecology, OLVG, Amsterdam, the Netherlands
| | - A de Jongh
- Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU Amsterdam, Amsterdam, the Netherlands.,Research Department, PSYTREC, Bilthoven, the Netherlands.,School of Health Sciences, Salford University, Manchester, UK.,Institute of Health and Society, University of Worcester, Worcester, UK.,School of Psychology, Queen's University, Belfast, Northern Ireland
| | - M G van Pampus
- Department of Obstetrics and Gynaecology, OLVG, Amsterdam, the Netherlands
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27
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Lemmens SMP, van Montfort P, Meertens LJE, Spaanderman MEA, Smits LJM, de Vries RG, Scheepers HCJ. Perinatal factors related to pregnancy and childbirth satisfaction: a prospective cohort study. J Psychosom Obstet Gynaecol 2021; 42:181-189. [PMID: 31913725 DOI: 10.1080/0167482x.2019.1708894] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Satisfaction of pregnancy and childbirth is an important quality measure of maternity care. Satisfaction questionnaires generally result in high scores. However, it has been argued that dissatisfaction relies on a different construct. In response to a worldwide call for obstetric care that is more woman-centered, we identified and described the contributors to suboptimal satisfaction with pregnancy and childbirth. METHODS A prospective subcohort of 739 women from a larger cohort (Expect Study I, n = 2614) received a pregnancy and childbirth satisfaction questionnaire. Scores were transformed to a binary outcome whereby a score <100 points corresponded with less satisfied women. We performed a multiple logistic regression analysis to define independent perinatal factors related to suboptimal satisfaction. RESULTS Decreased perceived personal well-being, antenatal anxiety, and obstetrician-led care during labor were all independently associated with suboptimal pregnancy and childbirth satisfaction. No difference in satisfaction was found between antenatal care led by a midwife or an obstetrician, but midwife-led antenatal care reduced the odds of suboptimal satisfaction compared to women who were transferred to an obstetrician in the antenatal period. Antenatal anxiety was experienced by 25% of all women and is associated with decreased satisfaction scores. DISCUSSION Screening and treatment of women suffering from anxiety might improve pregnancy and childbirth satisfaction, but further research is necessary. Women's birthing experience may improve by reducing unnecessary secondary obstetric care.
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Affiliation(s)
- Stéphanie M P Lemmens
- Department of Obstetrics and Gynecology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Pim van Montfort
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Linda J E Meertens
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Marc E A Spaanderman
- Department of Obstetrics and Gynecology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Luc J M Smits
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Raymond G de Vries
- Research Center for Midwifery Science Maastricht, Zuyd University, Maastricht, The Netherlands.,Center for Bioethics and Social Sciences in Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Hubertina C J Scheepers
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
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28
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Punjabi LS, Karunamary L, Tagore S, Mathur M. Preparing for caesarean delivery from the eyes of expectant mothers and their partners: A questionnaire study. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2021; 50:721-723. [PMID: 34625761 DOI: 10.47102/annals-acadmedsg.2021214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Lavisha S Punjabi
- Department of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore
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29
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Sommerlad S, Schermelleh-Engel K, La Rosa VL, Louwen F, Oddo-Sommerfeld S. Trait anxiety and unplanned delivery mode enhance the risk for childbirth-related post-traumatic stress disorder symptoms in women with and without risk of preterm birth: A multi sample path analysis. PLoS One 2021; 16:e0256681. [PMID: 34464408 PMCID: PMC8407573 DOI: 10.1371/journal.pone.0256681] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 08/12/2021] [Indexed: 11/18/2022] Open
Abstract
Childbirth-related post-traumatic stress disorder (CB-PTSD) occurs in 3-7% of all pregnancies and about 35% of women after preterm birth (PTB) meet the criteria for acute stress reaction. Known risk factors are trait anxiety and pain intensity, whereas planned delivery mode, medical support, and positive childbirth experience are protective factors. It has not yet been investigated whether the effects of anxiety and delivery mode are mediated by other factors, and whether a PTB-risk alters these relationships. 284 women were investigated antepartum and six weeks postpartum (risk-group with preterm birth (RG-PB) N = 95, risk-group with term birth (RG-TB) N = 99, and control group (CG) N = 90). CB-PTSD symptoms and anxiety were measured using standardized psychological questionnaires. Pain intensity, medical support, and childbirth experience were assessed by single items. Delivery modes were subdivided into planned vs. unplanned delivery modes. Group differences were examined using MANOVA. To examine direct and indirect effects on CB-PTSD symptoms, a multi-sample path analysis was performed. Rates of PTS were highest in the RG-PB = 11.58% (RG-TB = 7.01%, CG = 1.1%). MANOVA revealed higher values of CB-PTSD symptoms and pain intensity in RG-PB compared to RG-TB and CG. Women with planned delivery mode reported a more positive birth experience. Path modeling revealed a good model fit. Explained variance was highest in RG-PB (R2 = 44.7%). Direct enhancing effects of trait anxiety and indirect reducing effects of planned delivery mode on CB-PTSD symptoms were observed in all groups. In both risk groups, CB-PTSD symptoms were indirectly reduced via support by medical staff and positive childbirth experience, while trait anxiety indirectly enhanced CB-PTSD symptoms via pain intensity in the CG. Especially in the RG-PB, a positive birth experience serves as protective factor against CB-PTSD symptoms. Therefore, our data highlights the importance of involving patients in the decision process even under stressful birth conditions and the need for psychological support antepartum, mainly in patients with PTB-risk and anxious traits. Trial registration number: NCT01974531 (ClinicalTrials.gov identifier).
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Affiliation(s)
- Sarah Sommerlad
- Department of Gynecology and Obstetrics, University Hospital of Frankfurt, Frankfurt, Germany
| | | | | | - Frank Louwen
- Department of Gynecology and Obstetrics, University Hospital of Frankfurt, Frankfurt, Germany
| | - Silvia Oddo-Sommerfeld
- Department of Gynecology and Obstetrics, University Hospital of Frankfurt, Frankfurt, Germany
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Abstract
ABSTRACT Trauma is experienced throughout the life span, and traumatic experiences may be remote events or current and ongoing. The health care community continues to learn the many ways in which trauma affects an individual's health, relationships, utilization of the health care system, health care experience, and ability to adopt health-related recommendations. It is important for obstetrician-gynecologists and other health care practitioners to recognize the prevalence and effect of trauma on patients and the health care team and incorporate trauma-informed approaches to delivery of care. Although trauma spans all races, ages, and socioeconomic statuses, some populations are exposed to trauma at higher rates and with greater frequency of repeated victimization. A number of health effects that may be associated with trauma are seen frequently in obstetrics and gynecology, including chronic pelvic pain, sexually transmitted infections, unintended pregnancy, conflicted feelings about pregnancy and sexuality, and difficulty with infant attachment postpartum. Obstetrician-gynecologists should become familiar with the trauma-informed model of care and strive to universally implement a trauma-informed approach across all levels of their practice with close attention to avoiding stigmatization and prioritizing resilience.
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González-Mesa E, Rengel-Díaz C, Riklikiene O, Thomson G, Cazorla-Granados O, Abreu W, Morgado-Neves D, Gökçe Isbir G, Jonsdottir SS, Karlsdóttir SI, Lalor J. Assessment of the attitude towards childbirth in health sciences students - development and validation of the questionnaire Cave-St. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01892-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AbstractThe purpose of this study is to report on the validation process of a questionnaire that explores health science students’ attitudes towards women’s childbirth experiences. This questionnaire can help inform education programs to enhance the quality of woman-professional interactions, and to improve women’s experiences of childbirth. A standardized procedure for the development and validation of the questionnaire included: item development and psychometric pre-validation, Cronbach’s Alpha coefficient calculation, test–retest and item-total correlation for the reliability analysis. Content validity was undertaken by Delphi method with sixteen panelists over two rounds. We determined the factor structure and refined and validated the questionnaire according to the responses of a cohort of 560 students using principal components factor analysis with varimax rotation. Confirmatory factor analysis was undertaken. A 52-items questionnaire CAVE-st: (acronym for cuestionario de actitudes sobre vivencias y experiencias en el parto) was developed and validated. The results of the factor analysis finally revealed four latent dimensions. The questionnaire CAVE-st is a valid and reliable tool to assess health science students’ attitude towards women’s childbirth experiences. Further work to translate and adapt the instrument in other cultures and languages will be undertaken.
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González-Mesa E, Cazorla-Granados O, Blasco-Alonso M, Sabonet L, Jiménez-López JS, Rengel-Díaz C. Educating future professionals in perinatal medicine: the attitude of medical and nursing students towards childbirth. J Perinat Med 2021; 49:485-495. [PMID: 33554590 DOI: 10.1515/jpm-2020-0395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 12/02/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The main objective of the present study was to evaluate what educational needs were being neglected in current perinatal educational program in the University of Malaga. METHODS We performed a cross-sectional study using the Students' questionnaire on attitudes towards childbirth (CAVE-st) in a sample of 378 students who were finishing their undergraduate or postgraduate academic perinatal program, including medical and nursing students. RESULTS The Cronbach's alpha reliability coefficient was 0.895. The mean score of CAVE-st in the sample was 200.34 (DT 21.0). The scores were below the median value in more than 53% of the students, especially in medical students. Female students scored systematically higher in the overall scale and its subscales, even after adjusting for study groups. On the other hand, the students with children scored significantly lower in the subscale that explored their attitudes towards unexpected results. A huge margin for improvement was recognizable in those subscales related with childbirth medicalization, respect to women decisions, and health-care prioritization. CONCLUSIONS Students' attitude towards childbirth need to be improved as a means to improve women's childbirth experience and prevent birth-related trauma. The current undergraduate and postgraduate training in perinatal care lacks a comprehensive and biopsychosocial perspective that would improve the quality of clinical practice during childbirth.
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Affiliation(s)
- Ernesto González-Mesa
- Obstetrics and Gynecology Department, School of Medicine, University of Malaga, Malaga, Spain.,Obstetrics and Gynecology Department, Malaga Regional University Hospital, Malaga, Spain.,IBIMA Research Group in Maternal-Fetal Medicine, Epigenetics, Women's Diseases and Reproductive Health, Malaga, Spain
| | - Olga Cazorla-Granados
- Obstetrics and Gynecology Department, School of Medicine, University of Malaga, Malaga, Spain
| | - Marta Blasco-Alonso
- Obstetrics and Gynecology Department, School of Medicine, University of Malaga, Malaga, Spain.,Obstetrics and Gynecology Department, Malaga Regional University Hospital, Malaga, Spain.,IBIMA Research Group in Maternal-Fetal Medicine, Epigenetics, Women's Diseases and Reproductive Health, Malaga, Spain
| | - Lorena Sabonet
- Obstetrics and Gynecology Department, Malaga Regional University Hospital, Malaga, Spain.,IBIMA Research Group in Maternal-Fetal Medicine, Epigenetics, Women's Diseases and Reproductive Health, Malaga, Spain
| | - Jesús S Jiménez-López
- Obstetrics and Gynecology Department, School of Medicine, University of Malaga, Malaga, Spain.,Obstetrics and Gynecology Department, Malaga Regional University Hospital, Malaga, Spain.,IBIMA Research Group in Maternal-Fetal Medicine, Epigenetics, Women's Diseases and Reproductive Health, Malaga, Spain
| | - Cristóbal Rengel-Díaz
- IBIMA Research Group in Maternal-Fetal Medicine, Epigenetics, Women's Diseases and Reproductive Health, Malaga, Spain.,Obstetrics and Gynecology Department, Ntra Sra de la Victoria University Hospital, Malaga, Spain.,Nursing Department, School of Health Sciences, University of Malaga, Malaga, Spain
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Havizari S, Ghanbari-Homaie S, Eyvazzadeh O, Mirghafourvand M. Childbirth experience, maternal functioning and mental health: how are they related? J Reprod Infant Psychol 2021; 40:399-411. [PMID: 33843380 DOI: 10.1080/02646838.2021.1913488] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Introduction: Childbirth experience is shaped by the labor and delivery process. The aim of this study was to investigate the relationship between childbirth experience, subsequent postpartum maternal functioning and mental health.Methods: A total of 483 mothers in the first 4-16 weeks postpartum participated in this cross-sectional study. The cluster random sampling method was used to select the participants. The Questionnaire for Assessing the Childbirth Experience, Mental Health Inventory, and the Barkin Index of Maternal Functioning were completed through interviews.Results: The mean childbirth experience, mental health, and maternal functioning scores were 1.6 (0.4), 79.1 (15.0), and 97.4 (13.0), respectively. There was a significant correlation between the total mental health and maternal functioning scores and all its subscales with childbirth experience scores (P<0.001). Results from the general linear model pointed to a significant correlation between maternal functioning and childbirth experience (P<0.001), as well as between receiving support for infant care (P<0.001) and family income adequacy (P=0.006). Mental health was also significantly correlated with childbirth experience (P<0.001), complete life satisfaction (P<0.001), and receiving support for infant care (P=0.025).Conclusion: Supportive care provision services may improve mothers' birth experiences, which leads to enhanced postpartum maternal functioning and mental health.
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Affiliation(s)
- Shiva Havizari
- Midwifery Counseling, Tabriz University of Medical Sciences, Student Research Center, Tabriz, Iran
| | - Solmaz Ghanbari-Homaie
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ommlbanin Eyvazzadeh
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Midwifery Department, Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Fontein Kuipers YJ, Mestdagh E. The experiential knowledge of migrant women about vulnerability during pregnancy: A woman-centred mixed-methods study. Women Birth 2021; 35:70-79. [PMID: 33745823 DOI: 10.1016/j.wombi.2021.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 02/24/2021] [Accepted: 03/08/2021] [Indexed: 11/30/2022]
Abstract
PROBLEM Within maternity care policies and practice, pregnant migrant women are regarded as a vulnerable population. BACKGROUND Women's experiential knowledge is a key element of woman-centred care but is insufficiently addressed in midwifery practice and research that involves migrant women. AIM To examine if pregnant migrant women's experiential knowledge of vulnerability corresponds with sets of criteria of vulnerability, and to explore how migrant women make sense of vulnerability during pregnancy. METHODS A sequential two-phased mixed-methods study, conducted in the Netherlands, integrating survey data of 89 pregnant migrant women and focus group data obtained from 25 migrant mothers - living in deprived areas according to the Dutch socio-economic index. RESULTS Criteria associated with vulnerability were reported by 65.2% of the participants and 62.9% of the participants reported adverse childhood experiences. On a Visual Analogue Scale, ranging from 0 (not vulnerable) to 10 (very vulnerable), participants self-reported sense of vulnerability showed a mean score of 4.2 (±2.56). Women's experiential knowledge of vulnerability significantly correlated with the mean sum score of clinical criteria of vulnerability (r .46, p .002) and with the mean sum score of adverse childhood experiences (r .48, p<.001). Five themes emerged from the focus group discussions: "Look beyond who you think I am and see and treat me for who I really am", "Ownership of truth and knowledge", "Don't punish me for being honest", "Projection of fear" and "Coping with labelling". CONCLUSION Pregnant migrant women's experiential knowledge of vulnerability is congruent with the criteria. Calling upon experiential knowledge is an attribute of the humane woman-midwife relationship.
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Affiliation(s)
- Yvonne J Fontein Kuipers
- Rotterdam University of Applied Sciences, School of Midwifery, Rochussenstraat 198, 3015 EK Rotterdam, Netherlands; Artesis Plantijn University of Applied Sciences, Department of Health & Social Care, Noorderplaats 2, 2000 Antwerp, Belgium; Antwerp University, Universiteitsplein 1, 2610 Wilrijk, Belgium.
| | - Eveline Mestdagh
- Artesis Plantijn University of Applied Sciences, Department of Health & Social Care, Noorderplaats 2, 2000 Antwerp, Belgium; Antwerp University, Universiteitsplein 1, 2610 Wilrijk, Belgium
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van der Pijl MSG, Kasperink M, Hollander MH, Verhoeven C, Kingma E, de Jonge A. Client-care provider interaction during labour and birth as experienced by women: Respect, communication, confidentiality and autonomy. PLoS One 2021; 16:e0246697. [PMID: 33577594 PMCID: PMC7880498 DOI: 10.1371/journal.pone.0246697] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 01/23/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Respectful Maternity Care is important for achieving a positive labour and birth experience. Client-care provider interaction-specifically respect, communication, confidentiality and autonomy-is an important aspect of Respectful Maternity Care. The aim of this study was twofold: (1) to assess Dutch women's experience of respect, communication, confidentiality and autonomy during labour and birth and (2) to identify which client characteristics are associated with experiencing optimal respect, communication, confidentiality and autonomy. METHODS Pregnant women and women who recently gave birth in the Netherlands were recruited to fill out a validated web-based questionnaire (ReproQ). Mean scores per domain (scale 1-4) were calculated. Domains were dichotomised in non-optimal (score 1, 2,3) and optimal client-care provider interaction (score 4), and a multivariable logistic regression analysis was performed. RESULTS Of the 1367 recruited women, 804 respondents completed the questionnaire and 767 respondents completed enough questions to be included for analysis. Each domain had a mean score above 3.5. The domain confidentiality had the highest proportion of optimal scores (64.0%), followed by respect (53.3%), communication (45.1%) and autonomy (36.2%). In all four domains, women who gave birth at home with a community midwife had a higher proportion of optimal scores than women who gave birth in the hospital with a (resident) obstetrician or hospital-based midwife. Lower education level, being multiparous and giving birth spontaneously were also significantly associated with a higher proportion of optimal scores in (one of) the domains. DISCUSSION This study shows that on average women scored high on experienced client-care provider interaction in the domains respect, communication, confidentiality and autonomy. At the same time, client-care provider interaction in the Netherlands still fell short of being optimal for a large number of women, in particular regarding women's autonomy. These results show there is still room for improvement in client-care provider interaction during labour and birth.
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Affiliation(s)
- Marit S. G. van der Pijl
- Amsterdam University Medical Centre (UMC), Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG/Amsterdam Public Health, Amsterdam, The Netherlands
- * E-mail:
| | - Marlies Kasperink
- Amsterdam University Medical Centre (UMC), Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG/Amsterdam Public Health, Amsterdam, The Netherlands
| | - Martine H. Hollander
- Amalia Children’s Hospital, Department of Obstetrics, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Corine Verhoeven
- Amsterdam University Medical Centre (UMC), Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG/Amsterdam Public Health, Amsterdam, The Netherlands
- Division of Midwifery, School of Health Sciences, University of Nottingham, Nottingham, United Kingdom
- Department of Obstetrics and Gynaecology, Maxima Medical Centre, Veldhoven, The Netherlands
| | - Elselijn Kingma
- Department of Philosophy, University of Southampton, Southampton, United Kingdom
- Department of Industrial Engineering & Innovation Sciences, Philosophy & Ethics, Technical University Eindhoven, Eindhoven, The Netherlands
| | - Ank de Jonge
- Amsterdam University Medical Centre (UMC), Vrije Universiteit Amsterdam, Department of Midwifery Science, AVAG/Amsterdam Public Health, Amsterdam, The Netherlands
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Benet M, Escuriet R, Palomar-Ruiz L, Ruiz-Berdún D, Leon-Larios F. Women's agenda for the improvement of childbirth care: Evaluation of the Babies Born Better survey data set in Spain. Birth 2020; 47:365-377. [PMID: 32981109 DOI: 10.1111/birt.12505] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 09/01/2020] [Accepted: 09/05/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Public patient involvement (PPI) generates knowledge about the health-illness process through the incorporation of people's experiences and priorities. The Babies Born Better (BBB) survey is a pan-European online questionnaire that can be used as a PPI tool for preliminary and consultative forms of citizens' involvement. The purpose of this research was to identify which practices support positive birth experiences and which ones women want changed. METHODS The BBB survey was distributed in virtual communities of practice and through social networks. The version launched in Spain was used to collect data in 2014 and 2015 from women who had given birth in the previous 5 years. A descriptive, quantitative analysis was applied to the sociodemographic data. Two open-ended questions were analyzed by qualitative content analysis using a deductive and inductive codification process. RESULTS A total of 2841 women participated. 41.1% of the responses concerned the category "Care received and experienced," followed by "Specific interventions and procedures" (26.6%), "Involved members of care team" (14.2%), and "Environmental conditions" (9%). Best practices were related to how care is provided and received, and the main areas for improvement referred to specific interventions and procedures. CONCLUSIONS This survey proved a useful tool to map the best and poorest practices reported. The results suggest a need for improvement in some areas of childbirth care. Women's reports on negative experiences included a wide range of routine clinical interventions, avoidable procedures, and the influence exerted by professionals on their decision-making.
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Affiliation(s)
- Marta Benet
- Mar Nursing School, Pompeu Fabra University, Barcelona, Spain.,Research Group on Society, Politics and Inclusive Communities, University of Vic-Central University of Catalonia, Barcelona, Spain
| | - Ramon Escuriet
- GHenderS Research Group, School of Health Sciences, Blanquerna, University Ramon Llull, Barcelona, Spain
| | - Laura Palomar-Ruiz
- Colegio Público de Educación Especial "Pablo Picasso" de Alcalá de Henares (Spain), Madrid, Spain
| | - Dolores Ruiz-Berdún
- Department of Surgery, Medical and Social Sciences, University of Alcalá, Alcalá de Henares, Spain
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Anderson CA, Connolly JP. Measuring Adolescent Birth Trauma: Development, Adaptation, and Evaluation of the Psychometric Properties for the Childbirth Trauma Index. J Nurs Meas 2020; 28:489-502. [PMID: 32737193 DOI: 10.1891/jnm-d-19-00012] [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] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE Childbirth can have negative consequences; however, measurement tools to assess this event are limited; and none consider the adolescent's birth. This study assessed the psychometric properties of the childbirth trauma index (CTI). METHODS Construct validity and reliability of the CTI was assessed via a field test involving 160 adolescents 3 days postpartum. RESULTS A modified 8-item version of the original CTI exhibited acceptable construct validity and reliability criteria. The CTI was found to link with birth appraisal, but not subjective distress measurements. CONCLUSIONS The CTI may be a more robust means of assessing birth appraisal than use of single-item measures. Recommendations for practice suggest use of the modified CTI to assess birth appraisal, or use in combination with single-item rating scales.
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Offerhaus P, Jans S, Hukkelhoven C, de Vries R, Nieuwenhuijze M. Women's characteristics and care outcomes of caseload midwifery care in the Netherlands: a retrospective cohort study. BMC Pregnancy Childbirth 2020; 20:517. [PMID: 32894082 PMCID: PMC7487921 DOI: 10.1186/s12884-020-03204-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 08/21/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The maternity care system in the Netherlands is well known for its support of community-based midwifery. However, regular midwifery practices typically do not offer caseload midwifery care - one-to-one continuity of care throughout pregnancy and birth. Because we know very little about the outcomes for women receiving caseload care in the Netherlands, we compared caseload care with regular midwife-led care, looking at maternal and perinatal outcomes, including antenatal and intrapartum referrals to secondary (i.e., obstetrician-led) care. METHODS We selected 657 women in caseload care and 1954 matched controls (women in regular midwife-led care) from all women registered in the Dutch Perinatal Registry (Perined) who gave birth in 2015. To be eligible for selection the women had to be in midwife-led antenatal care beyond 28 gestational weeks. Each woman in caseload care was matched with three women in regular midwife-led care, using parity, maternal age, background (Dutch or non-Dutch) and region. These two cohorts were compared for referral rates, mode of birth, and other maternal and perinatal outcomes. RESULTS In caseload midwifery care, 46.9% of women were referred to obstetrician-led care (24.2% antenatally and 22.8% in the intrapartum period). In the matched cohort, 65.7% were referred (37.4% antenatally and 28.3% in the intrapartum period). In caseload care, 84.0% experienced a spontaneous vaginal birth versus 77.0% in regular midwife-led care. These patterns were observed for both nulliparous and multiparous women. Women in caseload care had fewer inductions of labour (13.2% vs 21.0%), more homebirths (39.4% vs 16.1%) and less perineal damage (intact perineum: 41.3% vs 28.2%). The incidence of perinatal mortality and a low Apgar score was low in both groups. CONCLUSIONS We found that when compared to regular midwife-led care, caseload midwifery care in the Netherlands is associated with a lower referral rate to obstetrician-led care - both antenatally and in the intrapartum period - and a higher spontaneous vaginal birth rate, with similar perinatal safety. The challenge is to include this model as part of the current effort to improve the quality of Dutch maternity care, making caseload care available and affordable for more women.
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Affiliation(s)
- Pien Offerhaus
- Research Centre for Midwifery Science, Midwifery Education and Studies Maastricht, ZUYD University, Universiteitssingel 60, 6229 ER Maastricht, the Netherlands
| | - Suze Jans
- TNO, Department of Child Health, Schipholweg 77, 2316 ZL Leiden, The Netherlands
| | | | - Raymond de Vries
- Research Centre for Midwifery Science, Midwifery Education and Studies Maastricht, ZUYD University, Universiteitssingel 60, 6229 ER Maastricht, the Netherlands
- CAPHRI (School for Public Health and Primary Care), Maastricht University, PO Box 616, 6200 MD Maastricht, the Netherlands
- Center for Bioethics and Social Sciences in Medicine, University of Michigan Medical School, 2800 Plymouth Road, Building 14, CBSSM, Ann Arbor, MI 48109-2800 USA
| | - Marianne Nieuwenhuijze
- Research Centre for Midwifery Science, Midwifery Education and Studies Maastricht, ZUYD University, Universiteitssingel 60, 6229 ER Maastricht, the Netherlands
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Feijen-de Jong E, van der Pijl M, Vedam S, Jansen D, Peters L. Measuring respect and autonomy in Dutch maternity care: Applicability of two measures. Women Birth 2020; 33:e447-e454. [DOI: 10.1016/j.wombi.2019.10.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 10/28/2019] [Accepted: 10/28/2019] [Indexed: 11/24/2022]
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Connolly JP, Anderson C. Cesarean effects on adolescents' birth experiences: counterfactual analysis. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2020; 42:318-328. [PMID: 32844980 PMCID: PMC7879090 DOI: 10.1590/2237-6089-2019-0102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 02/21/2020] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The birth experience of adolescents is understudied even though they are a particularly vulnerable population to experience a negative birth event, given that they exhibit many known risk factors. OBJECTIVE To ascertain whether a cesarean birth mediates the impact of infant complications on the birth experience of adolescent mothers. METHODS Using a secondary analysis of data collected from 303 postpartum adolescents previously evaluated for depression and post-traumatic stress, we employed counterfactual causal analysis to determine if delivery type mediated the birth experience at different levels of depression. Noted limitations pertain to methodological assumptions and computational feasibility as well as potential sample bias. RESULTS We found that the mediating effect of delivery mode depended on the adolescent's depression level as well as on the specific operationalization of the birth experience. At low levels of depression, the odds of a negative birth appraisal were reduced by around 30% when operationalized as a single item subjective rating. In contrast, at high levels of depression, the odds of a negative birth experience increased by 80% when operationalized as an Impact of Event Scale (IES) subconstruct. CONCLUSION Depression level plays a pivotal role in moderating how delivery mode mediates the birth experience. The direction of impact also depends on how the birth experience is operationalized.
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Affiliation(s)
- John P Connolly
- University of Texas at Arlington , Arlington , TX , United States of America
| | - Cheryl Anderson
- University of Texas at Arlington , Arlington , TX , United States of America
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Hajizadeh K, Vaezi M, Meedya S, Mohammad Alizadeh Charandabi S, Mirghafourvand M. Respectful maternity care and its relationship with childbirth experience in Iranian women: a prospective cohort study. BMC Pregnancy Childbirth 2020; 20:468. [PMID: 32807127 PMCID: PMC7430112 DOI: 10.1186/s12884-020-03118-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 07/16/2020] [Indexed: 11/10/2022] Open
Abstract
Background Intrapartum respectful maternity care is defined as a fundamental human right that can affect the mother’s experiences. This study aimed to determine the status of respectful maternity care and its relationship with childbirth experience among Iranian women. Methods This prospective cohort study recruited 334 postpartum women in postpartum wards of two public and four private hospitals in Tabriz, Iran. Quota sampling was used based on the number of births in each hospital. Data were collected through interviews with the use of the following tools: sociodemographic and obstetrics characteristics questionnaire, respectful maternity care scale (6 to 18 h postpartum), and childbirth experience questionnaire (30 to 45 days postpartum). The General Linear Model was used to determine the relationship between respectful maternity care and childbirth experience. Results The mean respectful maternity care score was 62.58 with a range of 15 to 75, and the total childbirth experience score was 3.29 with a range of 1 to 4. After adjusting for sociodemographic and obstetrics characteristics, a statistically significant direct correlation was found between respectful maternity care and a positive childbirth experience (P < 0.001). Conclusions The findings reveals a direct relationship between respectful maternity care and positive childbirth experience. Therefore, it is recommended that mangers and policy makers in childbirth facilities reinforce facilitating a respectful maternity care to improve women’s child birth experience and prevent potential adverse effects of negative childbirth experiences.
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Affiliation(s)
- Khadije Hajizadeh
- Midwifery Students' Research Committee, Midwifery Department, Tabriz University of Medical sciences, Tabriz, Iran
| | - Maryam Vaezi
- Fellowship of gynecology oncology, Alzahra teaching hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shahla Meedya
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | | | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
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Schaal NK, Fehm T, Helbig M, Fleisch M, Hepp P. The Influence of Personality and Anxiety Traits on Birth Experience and Epidural Use in Vaginal Deliveries - A Cohort Study. Women Health 2020; 60:1141-1150. [PMID: 32781945 DOI: 10.1080/03630242.2020.1802640] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
A positive birth experience for the mother is an important goal in obstetric health care and is influenced by several factors. For this study, 186 women filled in questionnaires between 24 and 72 hours after giving birth vaginally. We evaluated the Big-Five personality traits (extraversion, neuroticism, openness, conscientiousness and agreeableness), trait anxiety, different dimensions of childbirth experience and pain management. Correlation analysis revealed that trait anxiety and neuroticism were negatively associated with several dimensions of the birth experience. Furthermore, conscientiousness and extraversion were positively correlated with the dimension Participation. Regression analysis for the individual dimensions and overall score respectively, confirmed the independent impact of anxiety trait on Perceived Safety, Participation and Professional Support and the overall score as well as of neuroticism on Perceived Safety and conscientiousness on Participation. The significant regression models showed small R2-scores (.084-.154). The birth experience did not differ whether the women received an epidural or not. Women who did not receive an epidural displayed higher scores on the personality trait conscientiousness. The study highlights small but important associations between personality traits and birth experience in vaginal births which should sensitize the medical staff when supporting women during labor.
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Affiliation(s)
- Nora K Schaal
- Department of Experimental Psychology, Heinrich-Heine-University , Düsseldorf, Germany
| | - Tanja Fehm
- Clinic for Gynecology and Obstetrics, Heinrich-Heine-University , Düsseldorf, Germany
| | - Martina Helbig
- Clinic for Gynecology and Obstetrics, Heinrich-Heine-University , Düsseldorf, Germany
| | - Markus Fleisch
- Clinic for Gynecology and Obstetrics, HELIOS University Hospital Wuppertal, University Witten/Herdecke , Wuppertal, Germany
| | - Philip Hepp
- Clinic for Gynecology and Obstetrics, HELIOS University Hospital Wuppertal, University Witten/Herdecke , Wuppertal, Germany.,Clinic for Gynecology and Obstetrics, University Clinic Augsburg , Germany
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Deninotti J, Denis A, Berdoulat É. Emergency C-section, maternal satisfaction and emotion regulation strategies: effects on PTSD and postpartum depression symptoms. J Reprod Infant Psychol 2020; 38:421-435. [PMID: 32683885 DOI: 10.1080/02646838.2020.1793308] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This cross-sectional study aimed to investigate the relationship between a mother's current emotion regulation strategy (antecedent-focused vs. response-focused), her satisfaction with childbirth, and posttraumatic and/or depressive symptoms after unplanned C-section. BACKGROUND The mother's and baby's health is considered a priority during childbirth. As a result, situations in which an unplanned C-section is required may not allow mothers to express their needs and emotions. This may lead to feelings of dissatisfaction regarding the childbirth experience. METHODS Fifty French participants aged 18-35 (M = 27.10; S.D. = 3.99) who had a C-section were recruited on social networking groups and completed four self-report measures online, up to two years after childbirth. These measures assessed emotion regulation strategies currently used, birth satisfaction, postpartum depression symptoms and PTSD symptoms. RESULTS Main results indicate (1) Mothers who use expressive suppression, a response-focused strategy, are less satisfied with childbirth. (2) Emotion regulation, when combined with maternal satisfaction, shows a negative association with posttraumatic stress score and depression score. CONCLUSION This study provides interesting data for further research. Follow-up studies about emotion regulation, postpartum depression and posttraumatic stress symptoms should be conducted in the future in order to provide clinical recommendations.
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Goodarzi B, Walker A, Holten L, Schoonmade L, Teunissen P, Schellevis F, de Jonge A. Towards a better understanding of risk selection in maternal and newborn care: A systematic scoping review. PLoS One 2020; 15:e0234252. [PMID: 32511258 PMCID: PMC7279596 DOI: 10.1371/journal.pone.0234252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 05/21/2020] [Indexed: 01/21/2023] Open
Abstract
Globally, millions of women and their children suffer due to preventable morbidity and mortality, associated with both underuse and overuse of maternal and newborn care. An effective system of risk selection that differentiates between what care should be provided and who should provide it is a global necessity to ensure women and children receive appropriate care, at the right place and the right time. Poor conceptualization of risk selection impedes evaluation and comparison of models of risk selection across various settings, which is necessary to improve maternal and newborn care. We conducted a scoping review to enhance the understanding of risk selection in maternal and newborn care. We included 210 papers, published over the past four decades, originating from 24 countries. Using inductive thematic analysis, we identified three main dimensions of risk selection: (1) risk selection as an organisational measure to optimally align women's and children's needs and resources, (2) risk selection as a practice to detect and assess risk and to make decisions about the delivery of care, and (3) risk selection as a tool to ensure safe care. We found that these three dimensions have three themes in common: risk selection (1) is viewed as both requiring and providing regulation, (2) has a provider centred focus and (3) aims to avoid underuse of care. Due to the methodological challenges of contextual diversity, the concept of risk selection needs clear indicators that capture the complexity of care to make cross-setting evaluation and comparison of risk selection possible. Moreover, a comprehensive understanding of risk selection needs to consider access disparity, women's needs, and unnecessary medicalization.
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Affiliation(s)
- Bahareh Goodarzi
- Department of Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Annika Walker
- Department of Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lianne Holten
- Department of Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Linda Schoonmade
- Medical Library, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Pim Teunissen
- Department of Obstetrics and Gynaecology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- School of Health Professions Education, Maastricht University, Maastricht, The Netherlands
| | - François Schellevis
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands
| | - Ank de Jonge
- Department of Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Fuzy E, Clow SE, Fouché N. ‘Please treat me like a person’—respectful care during adolescent childbirth. ACTA ACUST UNITED AC 2020. [DOI: 10.12968/bjom.2020.28.6.360] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background This study explored the lived childbirth experiences of ‘middle adolescent’ mothers between 14–16 years of age. Study design A qualitative design was followed with a Husserlian phenomenological approach and Colaizzi's seven steps to unravelling information. Using semi-structured conversations, information was gathered from six middle-adolescent mothers who had normal vaginal births of healthy term infants in two public hospitals in South Africa. Findings An overarching theme of preservation of personhood was identified. Three themes emerged i) unpreparedness for childbirth, ii) an unsettled state of mind during childbirth and iii) feeling overwhelmed by the experience. Conclusion More positive birth experiences were associated with respectful, non-judgmental midwife care and having their mothers as birth companions while humiliation, victimisation and rudeness were associated with negative birth experiences. Recommendations More focus is needed on adolescent-friendly healthcare services and age-appropriate education; continuous labour support; pain management and respectful care during childbirth.
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Affiliation(s)
| | - Sheila Elizabeth Clow
- Department of health and rehabilitation sciences, division of nursing and midwifery, University of Cape Town
| | - Nicola Fouché
- Department of health and rehabilitation sciences, division of nursing and midwifery, University of Cape Town
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Crossland N, Kingdon C, Balaam MC, Betrán AP, Downe S. Women's, partners' and healthcare providers' views and experiences of assisted vaginal birth: a systematic mixed methods review. Reprod Health 2020; 17:83. [PMID: 32487226 PMCID: PMC7268509 DOI: 10.1186/s12978-020-00915-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 04/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND When certain complications arise during the second stage of labour, assisted vaginal delivery (AVD), a vaginal birth with forceps or vacuum extractor, can effectively improve outcomes by ending prolonged labour or by ensuring rapid birth in response to maternal or fetal compromise. In recent decades, the use of AVD has decreased in many settings in favour of caesarean section (CS). This review aimed to improve understanding of experiences, barriers and facilitators for AVD use. METHODS Systematic searches of eight databases using predefined search terms to identify studies reporting views and experiences of maternity service users, their partners, health care providers, policymakers, and funders in relation to AVD. Relevant studies were assessed for methodological quality. Qualitative findings were synthesised using a meta-ethnographic approach. Confidence in review findings was assessed using GRADE CERQual. Findings from quantitative studies were synthesised narratively and assessed using an adaptation of CERQual. Qualitative and quantitative review findings were triangulated using a convergence coding matrix. RESULTS Forty-two studies (published 1985-2019) were included: six qualitative, one mixed-method and 35 quantitative. Thirty-five were from high-income countries, and seven from LMIC settings. Confidence in the findings was moderate or low. Spontaneous vaginal birth was most likely to be associated with positive short and long-term outcomes, and emergency CS least likely. Views and experiences of AVD tended to fall somewhere between these two extremes. Where indicated, AVD can be an effective, acceptable alternative to caesarean section. There was agreement or partial agreement across qualitative studies and surveys that the experience of AVD is impacted by the unexpected nature of events and, particularly in high-income settings, unmet expectations. Positive relationships, good communication, involvement in decision-making, and (believing in) the reason for intervention were important mediators of birth experience. Professional attitudes and skills (development) were simultaneously barriers and facilitators of AVD in quantitative studies. CONCLUSIONS Information, positive interaction and communication with providers and respectful care are facilitators for acceptance of AVD. Barriers include lack of training and skills for decision-making and use of instruments.
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Affiliation(s)
- Nicola Crossland
- Faculty of Health and Wellbeing, University of Central Lancashire, Preston, PR1 2HE, UK.
| | - Carol Kingdon
- Research in Childbirth and Health Unit, University of Central Lancashire, Preston, PR1 2HE, UK
| | - Marie-Clare Balaam
- Research in Childbirth and Health Unit, University of Central Lancashire, Preston, PR1 2HE, UK
| | - Ana Pilar Betrán
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Soo Downe
- Research in Childbirth and Health Unit, University of Central Lancashire, Preston, PR1 2HE, UK
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Aannestad M, Herstad M, Severinsson E. A meta-ethnographic synthesis of qualitative research on women's experience of midwifery care. Nurs Health Sci 2020; 22:171-183. [PMID: 32170804 DOI: 10.1111/nhs.12714] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 03/10/2020] [Accepted: 03/10/2020] [Indexed: 12/19/2022]
Abstract
Labor and birth constitute a significant emotional event for a childbearing woman. The aim was to explore women's reflections on their experiences of labor and birth and how these were influenced by the midwifery care they received. A modified version of Noblit and Hare's meta-ethnographic approach was used to develop an inductive and interpretive synthesis of nine qualitative articles. Relevant databases were searched and qualitative articles appraised by means of the Critical Appraisal Skills Program. Two metaphors were identified: The guide-Please share your knowledge and The motherly midwife as an anchor. The comprehensive understanding of the images evoked by the metaphors resulted in an overall metaphoric representation of the women's experiences: The midwife as a birth pilot, that is, a positive labor and birth experience is dependent on the relationship with the midwife. This finding confirms previous knowledge that a trusting relationship results in confidence, while feeling secure leads to a positive birth experience. The metaphors facilitate understanding of the significance of the midwife for women's labor and birth experiences. Knowledge of labor and birth experiences helps to broaden understanding of the necessity of midwives being willing to engage, act, be aware of errors that may affect women's birth experience, and employ tools to predict unexpected adverse events.
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Affiliation(s)
| | - Marit Herstad
- Obstetric Care, Oslo University Hospital, Ullevål, Oslo, Norway
| | - Elisabeth Severinsson
- Department of Research, Nursing and Healthcare Research Group, Stavanger University Hospital, Stavanger, Norway
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Variables related to maternal satisfaction with intrapartum care in Northern Italy. Women Birth 2020; 34:154-161. [PMID: 32111557 DOI: 10.1016/j.wombi.2020.01.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 01/22/2020] [Accepted: 01/22/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND The experience of labour and birth is complex, multidimensional and subjective and has the potential to affect the women and their families physically and emotionally. However, there is a lack of research around maternal satisfaction in Italy. AIM To evaluate mothers' satisfaction with their childbirth experience in relation to socio-demographic characteristics, obstetric history and intrapartum care variables. METHODS A cross-sectional study involving 277 women who had given birth in a low risk maternity unit in Northern Italy was undertaken. Satisfaction with birth was measured using the Italian version of the Birth Satisfaction Scale-Revised (I-BSS-R). The scale comprises three Sub-Scales: quality of care provided, personal attributes of women and stress experienced during childbirth. FINDINGS No socio-demographic variables were related to maternal satisfaction. Multiparous women had a higher satisfaction score (p=0.020; CI:0.23;2.75). Antenatal class attendance was negatively associated with maternal satisfaction (p=0.038; CI:-2.58; -0.07). Intrapartum variables that significantly reduced maternal satisfaction were: epidural usage (p=0.000; CI:-4.66; -2.07), active phase >12h (p=0.000; CI:-6.01; -2.63), oxytocin administration (p=0.000; CI:-5.08; -2.29) and vacuum assisted birth (p=0.001; CI:-6.50; -1.58). Women with an intact perineum were more likely to be satisfied (p=0.008; CI:-4.60; -0.69). DISCUSSION In accordance with other research, we showed that intrapartum interventions are negatively associated with maternal outcomes and therefore also with maternal satisfaction with birth. The sub-scale that measured Quality of Care provided scored higher than the other two Sub-Scales. CONCLUSION Further studies on maternal satisfaction in Italy should be conducted, using the I-BSS-R with the aim to compare outcomes and understand what matters to women during childbirth.
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Aksoy Derya Y, Sis Çelik A, Ejder Apay S. Turkish version of the childbirth perception scale: Reliability and validity study. Perspect Psychiatr Care 2020; 56:28-36. [PMID: 30802978 DOI: 10.1111/ppc.12368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 02/04/2019] [Accepted: 02/09/2019] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This study aimed to adapt the Childbirth Perception Scale (CPS) to the Turkish language and to test its validity and reliability. DESIGN AND METHODS This methodological study was conducted with 240 puerperants. FINDINGS The confirmatory factor analysis of the index values showed a good fit. The internal consistency coefficients were 0.74 for the delivery perception, 0.65 for the first postpartum week perception and 0.70 for the total. The total correlation of the CPS items and the test-retest correlation showed high-reliability levels. PRACTICE IMPLICATIONS Based on the study results, the Turkish language version of the CPS is valid and reliable.
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Affiliation(s)
- Yeşim Aksoy Derya
- Department of Midwifery, Faculty of Health Sciences, Inonu University, Malatya, Turkey
| | - Aslı Sis Çelik
- Deparment of Birth, Women Health and Gynecology Nursing, Faculty of Nursing, Atatürk University, Erzurum, Turkey
| | - Serap Ejder Apay
- Department of Midwifery, Faculty of Health Sciences, Atatürk University, Erzurum, Turkey
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50
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Holopainen A, Verhage ML, Oosterman M. Childbirth Experience Associated With Maternal and Paternal Stress During the First Year, but Not Child Attachment. Front Psychiatry 2020; 11:562394. [PMID: 33132933 PMCID: PMC7504903 DOI: 10.3389/fpsyt.2020.562394] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 08/14/2020] [Indexed: 11/13/2022] Open
Abstract
Women, as well as their partners, can experience childbirth in many different ways. A negative childbirth experience may have adverse effects on the entire family, resulting, for instance, in parental stress symptoms and a weakened parent-child relationship. Parental stress, without sufficient resources to compensate for it, may also in and of itself negatively influence the parent-child relationship. This study contributes to the current knowledge of the psychological effects of childbirth experience by using longitudinal data collected with both self-reports and observational measures, as well as multiple informants (i.e., mothers and partners). The aim of this study was to investigate whether 1) women's retrospective birth experiences were related to maternal and paternal parenting stress, 2) birth experience was indirectly associated with child attachment via maternal stress, and 3) birth experience was directly related to child attachment. Data were collected from a mixed sample of community and at-risk primipara women (N = 1,364), as well as from their partners and children. Retrospective childbirth experience was measured 3 months postpartum with a latent factor consisting of five items asking about the feelings that women have about their childbirth. Parental stress was measured at 3 months postpartum for partners and 3 and 12 months postpartum for mothers using the adult domain of the parental stress index (PSI). Finally, parent-child attachment is observed in a subsample of 223 women and children at 12 months postpartum with the Strange Situation Procedure (SSP). Results show that women's birth experience was significantly related to both mothers' and their partners' parenting stress. However, birth experience was not related to child attachment, neither directly nor indirectly via maternal stress. These findings emphasize the long-lasting impact that childbirth may have on both parents. Future research is still needed to further investigate which protective factors may weaken the association between birth experience and parental stress.
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Affiliation(s)
- Annaleena Holopainen
- Clinical Child and Family Studies, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Amsterdam Public Health Research Institute, VU Medical Centre, Amsterdam, Netherlands
| | - Marije L Verhage
- Clinical Child and Family Studies, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Amsterdam Public Health Research Institute, VU Medical Centre, Amsterdam, Netherlands
| | - Mirjam Oosterman
- Clinical Child and Family Studies, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Amsterdam Public Health Research Institute, VU Medical Centre, Amsterdam, Netherlands
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