The Landscape of Caring for Women: A Narrative Study of Midwifery Practice

Nurse practitioners' and certified nurse midwives' experiences providing comprehensive early abortion care in New England, USA

Access to abortion is linked to better maternal health and is essential to advancing women's economic and social equality. Globally, nurses and midwives have been identified as key for increasing access to this service. In this qualitative study we describe the experiences of nurse practitioners and nurse midwives who provide comprehensive early abortion care in the New England region of the United States. In contrast to much of the existing literature from around the world on nurses who deliver abortion care, we found participants' experiences providing comprehensive early abortion was generally positive. The study has implications for theory development, research, and policy.

Place and space in relation to childbirth: a critical interpretive synthesis

Background: In nursing and midwifery, the concept of environment is considered a meta-concept. Research findings suggest that the location is not the only important factor, as both place and space influence the practices of midwives. Moreover, research on the geography of health suggests a connection between place and health that could be extended to reproductive health. Therefore, to move beyond and expand traditional research expressions, it is beneficial to illuminate the concepts of place and space in relation to childbirth.

Purpose: This study was undertaken to produce a synthesis of previous qualitative research of issues in childbirth in relation to the concepts of place and space.

Method: In this Critical Interpretive Synthesis (CIS), four electronic databases; CINAHL, Medline, PsycINFO and Sociological abstracts, were used for the literature search. In total 734 papers were screened, and 27 papers met the final inclusion criteria after assessment.

Results: The synthesis reveals a need to create a space for childbirth underpinned by four aspects; a homely space, a spiritual space, a safe space, and a territorial space.

Conclusion: Findings from this review will provide a basis for useful dialogue in midwifery education and in clinical settings.

Relational Decision-Making in the Context of Life-Limiting Fetal Anomalies: Two Cases of Anencephaly Diagnosis

Life-limiting fetal diagnoses such as anencephaly require families to make decisions in which no options offered will lead to the desired outcome of a healthy newborn. Although informed choice and shared decision-making are important aspects of ethics regarding care choices, they have limitations. In this article, 2 cases of anencephaly diagnosis are presented, and a relational decision-making model of care is proposed as an alternative for aiding pregnant people and their families in making challenging choices in the context of perinatal care.

Journey to confidence: women's experiences of pain in labour and relational continuity of care

INTRODUCTION

An evaluation carried out at King's College Hospital Foundation National Health Service Trust in London identified that women who received continuity of carer from the Albany Midwifery Practice were significantly less likely to use pharmacological pain relief when comparisons were made with eight other midwifery group practices and the local maternity service as a whole. This study was designed to explore women's views of this phenomenon.

METHODS

We conducted a thematic analysis of semistructured, audiotaped, in-depth interviews with 10 women who reflected on their experiences of preparation and support for pain in labour and midwifery continuity of carer with Albany midwives, using a qualitative descriptive methodological approach.

RESULTS

Women reflected positively on how, throughout pregnancy and labour, their midwives promoted a sense of their ability to cope with the challenge of labour pain. This building of confidence was enabled through a relationship of trust that developed with their midwives and the value of hearing other women's stories during antenatal groups. These experiences enhanced women's ability to overcome fears and self-doubt about coping with pain and led to feelings of pride, elation, and empowerment after birth.

DISCUSSION

Women valued being encouraged and supported to labour without using pharmacological pain relief by midwives with whom they developed a trusting relationship throughout pregnancy. Features of midwifery approaches to pain in labour and relational continuity of care have important implications for promoting normal birth and a positive experience of pregnancy, labour, and birth for women.

Entre la sage-femme et le père, des espaces coconstruits : étude exploratoire

Nous disposons actuellement de peu de descriptions formelles de la pratique québécoise des sages-femmes et peu d’études dans ce champ de pratique se sont intéressées à porter un regard sur l’expérience des pères. Celui-ci peut être examiné sous trois angles : l’homme, le conjoint de la mère et le père de leur enfant. Quelle place l’homme, le père, a-t-il dans la pratique et dans le discours des sages-femmes québécoises? Sur la base d’entretiens en profondeur avec 23 sages-femmes pratiquant en maison de naissance, l’étude analyse les représentations qui émergent de leur discours à propos des pères et de leur pratique auprès de ces derniers. Les résultats montrent que les sages-femmes organisent leur rapport au père en termes d’espaces qui se dessinent autour de lui et avec lui. Il y a coconstruction d’espace mettant en action et en réflexion la mère, le père et la sage-femme. La discussion aborde les retombées de l’étude en termes de conceptualisation des aspects psychosociaux de l’approche québécoise de la pratique des sages-femmes.