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Maxwell D, Leat SR, Gallegos T, Praetorius RT. Sacred space: a qualitative interpretive meta-synthesis of women's experiences of supportive birthing environments. BMC Pregnancy Childbirth 2024; 24:372. [PMID: 38750419 PMCID: PMC11097458 DOI: 10.1186/s12884-024-06544-6] [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: 11/06/2023] [Accepted: 04/25/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND In the United States there are roughly three million births a year, ranging from cesarean to natural births. A major aspect of the birthing process is related to the healing environment, and how that helps or harms healing for the mother and child. Using the theoretical framework, Theory of Supportive Care Settings (TSCS), this study aimed to explore what is necessary to have a safe and sacred healing environment for mothers. METHOD This study utilized an updated Qualitative Interpretive Meta-synthesis (QIMS) design called QIMS-DTT [deductive theory testing] to answer the research question, What are mother's experiences of environmental factors contributing to a supportive birthing environment within healthcare settings? RESULTS Key terms were run through multiple databases, which resulted in 5,688 articles. After title and abstract screening, 43 were left for full-text, 12 were excluded, leaving 31 to be included in the final QIMS. Five main themes emerged from analysis: 1) Service in the environment, 2) Recognizing oneself within the birthing space, 3) Creating connections with support systems, 4) Being welcomed into the birthing space, and 5) Feeling safe within the birthing environment. CONCLUSIONS Providing a warm and welcoming birth space is crucial for people who give birth to have positive experiences. Providing spaces where the person can feel safe and supported allows them to find empowerment in the situation where they have limited control.
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Affiliation(s)
| | | | - Toni Gallegos
- The University of Texas at Arlington, Arlington, TX, USA
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Weerasingha TK, Ratnayake C, Abeyrathne R, Tennakoon SU. Evidence-based intrapartum care during vaginal births: Direct observations in a tertiary care hospital in Central Sri Lanka. Heliyon 2024; 10:e28517. [PMID: 38571647 PMCID: PMC10988013 DOI: 10.1016/j.heliyon.2024.e28517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 03/20/2024] [Accepted: 03/20/2024] [Indexed: 04/05/2024] Open
Abstract
Background Evidence-based practice (EBP) is an effective approach to improve maternal and newborn outcomes at birth. Objective This study aimed to assess the current intrapartum practices of a tertiary care hospital in Central Province, Sri Lanka, during vaginal births. The benchmark for this assessment was the World Health Organisation's (WHO) recommendations on intrapartum care for a positive childbirth experience. Methods An observational study was conducted at the delivery room of Teaching Hospital, Peradeniya with the participation of 196 labouring women who were selected using systematic random sampling. A non-participant observation checklist covering labour room admission procedures, management of the first, second, and third stages of labour, and immediate care of the newborn and postpartum mother was used for the data collection. The care interventions implemented throughout labour and childbirth were observed and recorded. The data analysis was done using SPSS version 22. Results WHO-recommended practices such as providing privacy (33.2%), offering oral fluids (39.3%), and opioids for pain relief (48.5%) were found to be infrequent. Encouraging correct pushing techniques (77.6%), early breastfeeding (83.2%), regular assessment of vaginal bleeding (91.3%), skin-to-skin contact (93.4%), and using prophylactic uterotonics (100.0%) were found to be frequent. However, labour companionship, use of upright positions during labour, women's choice of birth position, and use of manual or relaxation techniques for pain relief were not observed in hospital intrapartum care. Conclusion The findings of the study indicate that additional attention and monitoring are required to align the current intrapartum care practices with the WHO recommendations. Moreover, the adoption of evidence-based intrapartum care should be encouraged by conveying the standard evidence-based intrapartum care guidelines to the grassroots level healthcare workers to avoid intrapartum interventions.
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Affiliation(s)
| | - Chathura Ratnayake
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Peradeniya, Sri Lanka
| | - R.M. Abeyrathne
- Department of Sociology, Faculty of Arts, University of Peradeniya, Sri Lanka
| | - Sampath U.B. Tennakoon
- Department of Community Medicine, Faculty of Medicine, University of Peradeniya, Sri Lanka
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D’Sa JL, Jahlan IO, Alsatari ES, Zamzam S, Martin CR. Psychometric properties of a Saudi Arabian version of the Birth Satisfaction Scale-Revised (BSS-R). BELITUNG NURSING JOURNAL 2024; 10:105-113. [PMID: 38425689 PMCID: PMC10900059 DOI: 10.33546/bnj.3055] [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: 10/20/2023] [Revised: 11/22/2023] [Accepted: 01/22/2024] [Indexed: 03/02/2024] Open
Abstract
Background Maternal outcomes are closely associated with birth satisfaction, and the Birth Satisfaction Scale-Revised (BSS-R), a concise, multidimensional self-report measure, has undergone translation and validation internationally. However, research on birth satisfaction in Saudi Arabia is scarce. The absence of valid Arabic-language tools for the Saudi population may impede critical research on this topic, necessitating the translation and use of psychometrically sound instruments for measuring birth satisfaction in Saudi women. Objective This study aimed to translate and evaluate the psychometric properties of the Saudi Arabian version of the BSS-R (SA-BSS-R). Methods A total of 218 Saudi women participated in the study, and psychometric analysis of the translated SA-BSS-R involved confirmatory factor analysis, divergent validity analysis, and known-group discriminant validity assessment within a cross-sectional study design. Results The three-factor BSS-R measurement model displayed poor fit, and internal consistency fell below the threshold value. Additionally, it was observed that women undergoing an episiotomy had significantly lower overall SA-BSS-R scores. Conclusion The SA-BSS-R manifested atypical measurement properties in this population. Despite insightful observations related to episiotomy, the identified measurement shortcomings highlight the need for a more robust and culturally sensitive translation to enhance measurement characteristics.
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Affiliation(s)
- Juliana Linnette D’Sa
- Maternal and Child Health Nursing Department, College of Nursing, King Saud University, Riyadh, Saudi Arabia
| | - Ibtesam Omar Jahlan
- Maternal and Child Health Nursing Department, College of Nursing, King Saud University, Riyadh, Saudi Arabia
| | - Eman S. Alsatari
- School of Nursing, University of Louisville, Louisville, KY 40202, United States
| | - Sahar Zamzam
- Maternal and Child Health Nursing Department, College of Nursing, King Saud University, Riyadh, Saudi Arabia
- Faculty of Nursing, Alexandria University, Egypt
| | - Colin R. Martin
- Institute for Health and Wellbeing, University of Suffolk, Ipswich, Neptune Quay, IP4 1QJ, United Kingdom
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Hadjigeorgiou E, Andreaki M, Koliandri I, Spyridou A, Balaam MC, Christoforou A. Exploring mothers' experiences of perinatal care in Cyprus: Babies Born Better survey. BMC Pregnancy Childbirth 2023; 23:487. [PMID: 37393248 DOI: 10.1186/s12884-023-05800-5] [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: 01/26/2023] [Accepted: 06/19/2023] [Indexed: 07/03/2023] Open
Abstract
INTRODUCTION A positive perinatal experience facilitates a smooth transition to motherhood and enhances the development of a strong bond between mother and newborn, contributing to maternal and societal wellbeing. Given the medicalization of childbirth in Cyprus, the examination of mothers' experiences of perinatal care becomes imperative. AIM To investigate mothers' experiences of care during the perinatal period and to identify factors related to the provision of maternal care that contribute to the interpretation of these experiences. METHODS The study draws on data from the European survey "Babies Born Better", an online survey utilizing a mixed-methods approach to explore women's experiences of maternity care across Europe. The study population were women who had given birth in Cyprus over a 5-year period (2013-2018). Quantitative data were analyzed using SPSS v22, while qualitative data were analyzed through inductive content analysis. FINDINGS A total of 360 mothers participated in the study. In rating their overall experience, 24.2% stated that they had a "bad experience", 11.1% a "good experience",13.9% a "very good experience", and 13,3% a "very bad experience". The top three sub-factors of the overall experience which received positive evaluation were "Relationship with health care professionals" (33.6%), "Birth environment and care" (11.4%), and "Breastfeeding guidance" (10.8%). The qualitative analysis yielded five themes: "Relationship with health care professionals", "Breastfeeding establishment", "Childbirth rights", "Birth environment and services" and "Choice of mode of birth". CONCLUSION Mothers in Cyprus wish to have respectful maternity care. They need maternity health care professionals to respect their dignity and ask for evidence-based information with shared decision making. Mothers in Cyprus expect to have their childbirth rights safeguarded, to have better support from HCP, and to receive humanized care. The perinatal care provided in Cyprus needs significant improvements based on mothers' needs and expectations.
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Affiliation(s)
- E Hadjigeorgiou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus.
| | - M Andreaki
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - I Koliandri
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - A Spyridou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - M C Balaam
- School of Community Health and Midwifery, University of Central Lancashire, Preston, UK
| | - A Christoforou
- Department of Social & Behavioral Sciences and Health Science, European University Cyprus, Nicosia, Cyprus
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Jamaluddin A, Azhary JMK, Hong JGS, Hamdan M, Tan PC. Early versus delayed amniotomy with immediate oxytocin after Foley catheter cervical ripening in multiparous women with labor induction: A randomized controlled trial. Int J Gynaecol Obstet 2023; 160:661-669. [PMID: 35869943 DOI: 10.1002/ijgo.14361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 07/02/2022] [Accepted: 07/08/2022] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To evaluate immediate oxytocin and early amniotomy compared with delayed amniotomy after Foley catheter cervical ripening in multiparous women on intervention-to-delivery interval. METHODS This randomized trial was conducted in Malaysia in 232 term multiparous women with balloon catheter-ripened cervixes (dilatation ≥3 cm), singleton fetus, cephalic presentation with intact membranes, and reassuring fetal heart rate tracing. They were randomized to immediate titrated intravenous oxytocin infusion and early amniotomy (116) or delayed amniotomy after 4 h of oxytocin (116). Primary outcome was intervention (oxytocin initiation)-to-delivery interval. RESULTS Oxytocin-to-delivery intervals were a median of 4.99 h (interquartile range [IQR], 3.21-7.82 h) versus 6.23 h (IQR, 4.50-8.45 h) (P < 0.001) for the early versus delayed amniotomy arms, respectively. Delivery rate at 4 h and 6 h after oxytocin infusion were 40 of 116 (35%) versus 22 of 116 (19%) (relative risk [RR], 1.82 [95% confidence interval (CI), 1.16-2.86], P = 0.011) and 77 of 116 (66%) versus 54 of 116 (47%) (RR, 1.43 [95% CI, 1.13-1.80], P = 0.003) for the early versus delayed amniotomy arms, respectively. Maternal satisfaction on birth process were 7 (IQR, 6-8) versus 7 (IQR, 7-8) (P = 0.006), uterine hyperstimulation rates were 10 of 116 (9%) versus 14 of 116 (12%) (RR, 0.71 [95% CI, 0.33-1.54]) (P = 0.519), and Cesarean delivery rates were 17 of 116 (15%) versus 19 of 116 (16%) (RR, 0.90 [95% CI, 0.49-1.63], P = 0.856) for the early versus delayed amniotomy arms, respectively. CONCLUSION In multiparas at term following cervical ripening by Foley catheter, immediate oxytocin and early amniotomy compared with a scheduled 4-h delay to amniotomy shortens the interval to birth and decreases uterine hyperactivity in labor but lowers maternal satisfaction. The cesarean delivery rate is not significantly reduced. CLINICAL TRIAL REGISTRATION This study was registered with the International Standard Randomised Controlled Trial Number (ISRCTN) on September 29, 2020, with trial identification number: ISRCTN87066007 (https://doi.org/10.1186/ISRCTN87066007). The first participant was recruited on September 29, 2020, after ISRCTN registry confirmation was received.
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Affiliation(s)
- Arifah Jamaluddin
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universiti Malaya, Jalan Profesor Diraja Ungku Aziz, Kuala Lumpur, Malaysia
| | - Jerilee Mariam Khong Azhary
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universiti Malaya, Jalan Profesor Diraja Ungku Aziz, Kuala Lumpur, Malaysia
| | - Jesrine Gek Shan Hong
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universiti Malaya, Jalan Profesor Diraja Ungku Aziz, Kuala Lumpur, Malaysia
| | - Mukhri Hamdan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universiti Malaya, Jalan Profesor Diraja Ungku Aziz, Kuala Lumpur, Malaysia
| | - Peng Chiong Tan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universiti Malaya, Jalan Profesor Diraja Ungku Aziz, Kuala Lumpur, Malaysia
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Kamath P, Pai M, Shenoy R, Karkada S, D’souza S, Noronha J. Effectiveness of a peanut ball device during labour on maternal and neonatal outcomes: protocol for a randomised controlled trial. F1000Res 2022; 11:717. [PMID: 36531256 PMCID: PMC9727314 DOI: 10.12688/f1000research.109537.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/14/2022] [Indexed: 11/23/2022] Open
Abstract
Frequent positional changes and movements during labour is one of the recommendations by the World Health Organization (WHO) to prevent prolonged labour, thereby avoiding cesarean sections. However, labour induction, continuous fetal monitoring in supine position and immobilising the women during labour are standard practices in most private hospitals. To combat these problems and to implement WHO recommendations, the peanut ball is an effective device through which frequent positional changes will be achieved without disrupting the labour procedures. The current study aims to evaluate the effectiveness of the peanut ball device during labour on maternal and neonatal outcomes and assess the stress response induced by labour in terms of maternal and neonatal cortisol in low-risk primigravid women. The study is a prospective, block randomised controlled trial with parallel arms. A total of 768 study participants will be randomised to the peanut-ball group (intervention) and standard care group (control). The intervention group will receive different peanut ball positions during labour at or after 4 cm of cervical dilatation. The primary outcomes of the study are maternal outcome that includes measurement of duration of the active and the second stage of labour, stress level as measured by serum cortisol level at 3-4 cm and at 10 cm of cervical dilatation, mode of delivery, perception of pain, behavioural response during the active stage of labour and neonatal outcomes, which includes the pattern of fetal heart rate, APGAR score, birth injuries, and umbilical serum and salivary cortisol level. The collected data will be compared between the intervention and control groups. Trial Registration: This research is registered under the CTRI (Clinical Trials Registry of India) ( CTRI/2019/08/020802) (21/8/2019).
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Affiliation(s)
- Pratibha Kamath
- Department of Obstetrics and Gynecological Nursing, Manipal College of Nursing, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, 576104, India
| | - Muralidhar Pai
- Sikkim Manipal Institute of Medical Sciences(SMIMS),, Sikkim Manipal University(SMU),, Gangtok, Sikkim, India,
| | - Revathi Shenoy
- Department of Biochemistry,, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal,, Karnataka, 576104, India
| | - Sushmitha Karkada
- Department of Obstetrics and Gynecological Nursing, Manipal College of Nursing, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, 576104, India
| | - Sonia D’souza
- Department of Obstetrics and Gynecological Nursing, Manipal College of Nursing, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, 576104, India
| | - Judith Noronha
- Department of Obstetrics and Gynecological Nursing, Manipal College of Nursing, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, 576104, India
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Labor Support for Intended Vaginal Birth. Nurs Womens Health 2022; 26:S1-S42. [PMID: 36117038 DOI: 10.1016/j.nwh.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Umbilical cord clamping time and maternal satisfaction. Midwifery 2022; 115:103487. [PMID: 36126369 DOI: 10.1016/j.midw.2022.103487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 08/21/2022] [Accepted: 09/11/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Clamping of the umbilical cord is part of the third stage of delivery. Delayed cord clamping (DCC) is recommended due to its contribution to prevention of anaemia. There is no evidence on the effect of DCC on maternal satisfaction. The aim of this study is to evaluate the effect of different sociodemographic and obstetric factors, including the timing of cord clamping, on maternal satisfaction with the birth experience in our healthcare system. DESIGN Pragmatic non-drug intervention study with simple random assignment of participating mothers (Clinical Trials N°: NCT03624335). SETTING A public, university-level hospital in Villarreal city, eastern Spain. PARTICIPANTS Childbearing woman, gestation week between 35 and 42 weeks, with regular medical pregnancy checks, single pregnancy and vaginal delivery (N = 198, 80% of the women recruited). INTERVENTIONS umbilical cord clamping within 60 seconds of the birth (Early cord clamping, ECC) versus umbilical cord clamping after pulsation had been ceased (Delayed cord clamping, DCC). MEASUREMENTS Birth satisfaction was measured using the Mackey Childbirth Satisfaction Rating Scale (MCSRS). Additionally, sociodemographic data, degree of knowledge about the moment of clamping and type of breastfeeding data were recorded. The Mann-Whitney and Kruskal-Wallis tests for comparison of the mean of two, three, or more groups, respectively, and Chi-square and Spearman for comparison of two qualitative and quantitative variables, respectively, were used. To determine the weight of each factor of MCSRS, an exploratory factor analysis was carried out using the maximum likelihood method for factor extraction and the varimax method for factor rotation. The adequacy of the factor analysis was checked by mean of Kaiser-Meyer-Olkin test and Bartlett sphericity test. The level of significance was set at a p-value of < 0.05. FINDINGS The average degree of satisfaction was 4.55/5 (SD: 0.37). No statistically significant difference was observed between mothers' satisfaction according to mother level of study or mother's place of birth, while it changed significantly with age (p = 0.0398). Within the obstetric variables, satisfaction was significantly associated with spontaneous amniorrhexis, the duration of the second stage of delivery, and the Apgar value of the newborn at the first minute of life, and was independent of the number of previous pregnancies and deliveries, use of intrapartum oxytocin, epidural analgesia, episiotomy, the weight of the child at birth and type of breastfeeding. Furthermore, there was no relationship between the time of clamping and satisfaction (p = 0.5178). KEY CONCLUSIONS Maternal satisfaction with the birth experience varies with the age of the childbearing woman, and some intrapartum factors and the result is not influenced by the time of clamping of the umbilical cord. Therefore, this component of the physiological management of childbirth provides additional benefits for the health of the neonate, without negative consequences on the final perception of the maternal health care received. IMPLICATIONS FOR PRACTICE If there are no reasons that justify an early umbilical cord clamping, delaying it brings benefits to the neonate, without negatively affecting the maternal assessment of the experience of childbirth.
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Molgora S, Campo E, Carones MB, Ferrazzi E, Saita E, Facchin F. Predictors of Women’s Childbirth Experience: A Prospective Longitudinal Study on Italian New Mothers. INTERNATIONAL JOURNAL OF CHILDBIRTH 2022. [DOI: 10.1891/ijc-2021-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUNDWomen’s memories of their childbirth experience tend to remain unchanged over time. This experience can be influenced by obstetric factors as well as by sociodemographic and psychological variables.OBJECTIVETo examine whether women’s perceived childbirth experience changes over time; to identify the predictors (obstetric, sociodemographic, and psychological variables) of this experience immediately after delivery and after 3 months.METHODSThis prospective longitudinal study comprised two hundred and twenty-one Italian women who completed a self-report questionnaire at two assessment points: immediately (1–3 days) after birth (Time 1) and 3 months postpartum (Time 2). At Time 1, the questionnaire included some questions on sociodemographic, psychological, and obstetric information, and the Wijma Delivery Experience Questionnaire (WDEQ(B); at Time 2 women compiled again the WDEQ(B).RESULTSRepeated measures ANOVA revealed that the childbirth experience did not change from Time 1 to Time 2. However, predictors of this experience were different between Time 1 and Time 2: at Time 1, the childbirth experience (WDEQ(B)_t1) was significantly predicted nly by type of cesarean section; at Time 2, the childbirth experience (WDEQ(B)_t2) was significantly predicted by WDEQ(B)_t1, history of psychological disorders, and type of conception.DISCUSSIONSOur findings enhance the understanding of the main predictors of a woman’s childbirth experience. Identifying areas of vulnerability is important for clinical practice, as well as for developing maternal health policies to improve women’s birth experiences, postpartum well-being, and the baby’s development.
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Nomura RMY, Galter FR, Passarelli VC. How to Improve Adolescent Mothers' Satisfaction with Childbirth? J Pediatr Adolesc Gynecol 2022; 35:467-471. [PMID: 34902561 DOI: 10.1016/j.jpag.2021.12.004] [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: 07/16/2021] [Revised: 11/08/2021] [Accepted: 12/02/2021] [Indexed: 11/18/2022]
Abstract
STUDY OBJECTIVE This study aimed to analyze factors related to adolescent mothers' satisfaction with childbirth. DESIGN Prospective and cross-sectional study PARTICIPANTS: Fifty adolescent mothers with maternal age from 14 to 19 years and delivery of a single and live newborn at term SETTING: Low-risk maternity hospital INTERVENTION: The participants were invited to answer a questionnaire (North Bristol modified version of the Mackey Childbirth Satisfaction Rating Scale [mMCSRS]) with 18 items measuring childbirth satisfaction. Each item was to be rated on a 5-point Likert scale (very dissatisfied to very satisfied). MAIN OUTCOME MEASURE The main outcome measure was the total score on the questionnaire. RESULTS The median maternal age was 18 years (95% CI, 11-25), and the median maternal satisfaction score of adolescent mothers was 88 (95% CI, 83-90). There was a significant difference in the total scores on the mMCSRS regarding the following factors: "oral fluid and food intake during labor" (yes = 84.0 vs no = 78.0, P = 0.044); "professional who attended the birth" (physician = 78.0 vs midwife = 86.0, P = 0.022); "skin-to-skin contact" (yes = 83.0 vs no = 71.0, P = 0.004); and "breastfeeding at the first hour" (yes = 84.5 vs no = 75.5, P = 0.008). Multiple regression with a stepwise procedure identified the following independent factors: "gestational age" (coefficient = 2.14, P = 0.03), "oral fluid and food intake during labor" (coefficient = 5.30, P = 0.013), and "skin-to-skin contact" (coefficient = 11.2, P < 0.001). CONCLUSION Satisfaction with childbirth in adolescent mothers is associated with measures that can be easily implemented in the health care system. They are chiefly the provision of oral fluid and food during labor and skin-to-skin contact. Specific strategies are thus needed to increase adolescents' satisfaction with childbirth.
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Affiliation(s)
- R M Y Nomura
- Department of Obstetrics, Escola Paulista de Medicina, Federal University of São Paulo UNIFESP, São Paulo, SP, Brazil.
| | - F R Galter
- Department of Obstetrics, Escola Paulista de Medicina, Federal University of São Paulo UNIFESP, São Paulo, SP, Brazil
| | - V C Passarelli
- Department of Obstetrics, Escola Paulista de Medicina, Federal University of São Paulo UNIFESP, São Paulo, SP, Brazil
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Ginter N, Takács L, Boon MJM, Verhoeven CJM, Dahlen HG, Peters LL. The Impact of Mode of Birth on Childbirth-Related Post Traumatic Stress Symptoms beyond 6 Months Postpartum: An Integrative Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148830. [PMID: 35886682 PMCID: PMC9316477 DOI: 10.3390/ijerph19148830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/08/2022] [Accepted: 07/15/2022] [Indexed: 02/05/2023]
Abstract
(1) Background: A traumatic birth can lead to the development of childbirth-related posttraumatic stress symptoms or disorder (CB-PTS/D). Literature has identified the risk factors for developing CB-PTS/D within the first six months postpartum thoroughly. However, the impact of mode of birth on CB-PTS/D beyond 6 months postpartum is scarcely studied. (2) Methods: A systematic search of the literature was conducted in the databases PubMed, Embase and CINAHL and PRISMA guidelines were followed. Studies were included if they reported the impact of mode of birth on CB-PTS/D beyond 6 months postpartum. (3) Results: In total, 26 quantitative and 2 qualitative studies were included. In the quantitative studies the percentage of women with CB-PTS/D ranged from 0.7% to 42% (between six months and five years postpartum). Compared with vaginal birth, operative vaginal birth, and emergency caesarean section were associated with CB-PTS/D beyond 6 months postpartum. Qualitative studies revealed that some women were suffering from CB-PTS/D as long as 18 years after birth. (4) Conclusions: Long- term screening of women for PTSD in the postnatal period could be beneficial. More research is needed on models of care that help prevent CB-PTS/D, identifying women at risk and factors that maintain CB-PTS/D beyond 6 months postpartum.
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Affiliation(s)
- Nicole Ginter
- Department of General Practice & Elderly Medicine, Section Midwifery Science, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands; (M.J.M.B.); (L.L.P.)
- Department of Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands;
- Correspondence:
| | - Lea Takács
- Department of Psychology, Faculty of Arts, Charles University, 116 42 Prague, Czech Republic;
| | - Martine J. M. Boon
- Department of General Practice & Elderly Medicine, Section Midwifery Science, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands; (M.J.M.B.); (L.L.P.)
- Department of Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands;
| | - Corine J. M. Verhoeven
- Department of Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands;
- Division of Midwifery, School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK
- Department of Obstetrics and Gynaecology, Maxima Medical Centre, 5504 DB Veldhoven, The Netherlands
| | - Hannah G. Dahlen
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW 2751, Australia;
| | - Lilian L. Peters
- Department of General Practice & Elderly Medicine, Section Midwifery Science, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands; (M.J.M.B.); (L.L.P.)
- Department of Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081 BT Amsterdam, The Netherlands;
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW 2751, Australia;
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Tallhage S, Årestedt K, Schildmeijer K, Oscarsson M. Prevalence of amniotomy in Sweden: a nationwide register study. BMC Pregnancy Childbirth 2022; 22:486. [PMID: 35701766 PMCID: PMC9195378 DOI: 10.1186/s12884-022-04805-w] [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: 03/09/2022] [Accepted: 06/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Amniotomy is a commonly used labor intervention with uncertain evidence, and there are complications connected to the intervention. Yet, the Swedish prevalence of amniotomy is unknown. The aim of the study was therefore to describe the prevalence of amniotomy in Sweden. METHODS This nationwide register-based study included 330,913 women giving birth in 2017-2020. Data were collected from the Swedish Pregnancy Register in which the majority of data is collected via direct transfer from medical records. Prevalence of amniotomy was described for all births, for nulliparous and multiparous women with spontaneous onset of labour, and at the hospital level. Descriptive statistics and chi-square test were used to analyse the data. RESULTS For all births, the prevalence of amniotomy was 40.6%. More amniotomies were performed in Robson group 1 compared to Robson group 3; 41.1% vs 32.3% (p < 0.001). The prevalence for all births remained the same during the study period; however, a decrease from 37.5 to 34.1%, was seen in Robson group 1 and Robson group 3 (p < 0.001). Variations in the prevalence between hospitals were reported. The hospitals with the fewest number of births annually had the highest prevalence of amniotomy (45.0%), and the lowest prevalence was reported at the University hospitals (40.4%) (p < 0.001). CONCLUSIONS Amniotomy is a common labor intervention in Sweden, given that almost half of the laboring women underwent the intervention. Our results, regarding variations in the prevalence between hospitals, could imply a potential for fewer amniotomies in Swedish childbirth care.
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Affiliation(s)
- Sofia Tallhage
- Faculty of Health and Life Sciences, Linnaeus University, 391 82, Kalmar, Sweden. .,Department of Obstetrics and Gynecology, Region Kalmar County, 392 44, Kalmar, Sweden.
| | - Kristofer Årestedt
- Faculty of Health and Life Sciences, Linnaeus University, 391 82, Kalmar, Sweden.,Department of Research, Region Kalmar County, 392 44, Kalmar, Sweden
| | | | - Marie Oscarsson
- Faculty of Health and Life Sciences, Linnaeus University, 391 82, Kalmar, Sweden
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Carvalho EMPD, Göttems LBD, Guilhem DB. The teaching of good obstetric practices from the Residency preceptors’ perspective. CIENCIA & SAUDE COLETIVA 2022. [DOI: 10.1590/1413-81232022275.23872021en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract The aim of this study was to understand how the topic of good obstetric practices is taught in residency programs according to the preceptors’ perception. This is a descriptive, exploratory study, with data triangulation, with a qualitative approach. A total of 35 professionals participated in the study, of which 21 were physicians and 14 nurses. Data were collected from March to June 2018. The analysis was supported by NVivo software. The nuclei of meanings and categories were identified in the different stages, in pedagogical projects: the structuring aspects, competence profile and guiding policies for normal childbirth; in the interviews: theoretical-practical approach and the practices present in the training and, in participant observation: aspects related to the structure of the scenarios and the use of practices. Possibilities and limits were observed in the role of preceptors in the training process, constituting an area that requires continuous attention, aimed at the strengthening of the pedagogical processes in order to expand the disruptive potential of new health professionals.
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15
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Carvalho EMPD, Göttems LBD, Guilhem DB. The teaching of good obstetric practices from the Residency preceptors' perspective. CIENCIA & SAUDE COLETIVA 2022; 27:1763-1772. [PMID: 35544806 DOI: 10.1590/1413-81232022275.23872021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 12/03/2021] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to understand how the topic of good obstetric practices is taught in residency programs according to the preceptors' perception. This is a descriptive, exploratory study, with data triangulation, with a qualitative approach. A total of 35 professionals participated in the study, of which 21 were physicians and 14 nurses. Data were collected from March to June 2018. The analysis was supported by NVivo software. The nuclei of meanings and categories were identified in the different stages, in pedagogical projects: the structuring aspects, competence profile and guiding policies for normal childbirth; in the interviews: theoretical-practical approach and the practices present in the training and, in participant observation: aspects related to the structure of the scenarios and the use of practices. Possibilities and limits were observed in the role of preceptors in the training process, constituting an area that requires continuous attention, aimed at the strengthening of the pedagogical processes in order to expand the disruptive potential of new health professionals.
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Affiliation(s)
| | | | - Dirce Bellezi Guilhem
- Departamento de Enfermagem, Faculdade de Ciências da Saúde, Universidade de Brasília. Brasília DF Brasil
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16
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Khalil M, Carasso KB, Kabakian-Khasholian T. Exposing Obstetric Violence in the Eastern Mediterranean Region: A Review of Women's Narratives of Disrespect and Abuse in Childbirth. Front Glob Womens Health 2022; 3:850796. [PMID: 35547827 PMCID: PMC9082810 DOI: 10.3389/fgwh.2022.850796] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 03/07/2022] [Indexed: 11/27/2022] Open
Abstract
Background Obstetric violence (OV) threatens the provision of dignified, rights-based, high-quality, and respectful maternal care (RMC). The dearth of evidence on OV in the Eastern Mediterranean Region poses a knowledge gap requiring research to improve rights-based and respectful health practice and policy. While efforts to improve the quality of maternal health have long-existed, women's experiences of childbirth and perceptions of dignity and respect are not adequately or systematically recorded, especially in the said region. Aim This study centered on the experiences of women's mistreatment in childbirth to provide an overview of OV and offer recommendations to improve RMC. Methods A scoping review was conducted, and a total of 38 articles met the inclusion criteria and were analyzed using Bowser and Hill's framework of the seven typologies of Disrespect and Abuse (D&A) in childbirth. D&A in childbirth (or violations to RMC) is a manifestation of OV and served as a proxy to analyze its prevalence in the EMR. Findings and Discussion This study indicated that across the EMR, women experienced every type of D&A in childbirth. This happens regardless of health systems' strength or country's income, with 6 out of 7 types of D&A found in almost two-thirds of included countries. In the EMR, the most common types of D&A in childbirth are physical abuse (especially overused routine interventions) and non-dignified care (embedded in patriarchal socio-cultural norms). The intersections of these abuses enable the objectification of women's bodies and overuse of unconsented routine interventions in a hierarchical and patriarchal system that regards the power and autonomy of doctors above birthing women. If unchecked, the implications include acceptance, continuation, and underreporting of D&A in childbirth, as well as passivity toward human-rights violations, which all further cause the continuing the cycle of OV. Conclusion In order to eliminate OV, a paradigm shift is required involving infrastructure changes, education, empowerment, advocacy, a women-centered and gender-sensitive approach to health system strengthening, and policy development. Recommendations are given at individual, community, health systems, and policy levels to ensure that every woman achieves her right to health and birth in a dignified, respectful, and empowered manner.
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Affiliation(s)
- Merette Khalil
- Your Egyptian Doula, Cairo, Egypt
- International Course for Health and Development, Health Unit, KIT Royal Tropical Institute, Amsterdam, Netherlands
- *Correspondence: Merette Khalil
| | - Kashi Barbara Carasso
- International Course for Health and Development, Health Unit, KIT Royal Tropical Institute, Amsterdam, Netherlands
| | - Tamar Kabakian-Khasholian
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
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17
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Strada JKR, Vieira LB, Gouveia HG, Betti T, Wegner W, Pedron CD. Factors associated with umbilical cord clamping in term newborns. Rev Esc Enferm USP 2022; 56:e20210423. [PMID: 35348571 PMCID: PMC10081613 DOI: 10.1590/1980-220x-reeusp-2021-0423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 02/09/2022] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To identify factors associated with umbilical cord clamping in term newborns and to compare the recording of clamping time in the medical record with what was observed. METHOD Cross-sectional study, with 300 mothers-infants, in a university hospital. Clamping time and medical records were observed, and a structured questionnaire was applied to postpartum women for sociodemographic variables. Bivariate analysis, multivariate Poisson Regression model, and Kappa concordance test were performed. RESULTS The percentage of late/optimal clamping observed was 53.7%. The associated factors were skin-to-skin contact in the delivery room (PR = 0.76; 0.61-0.95; p = 0.014), position of the newborn below the vaginal canal (PR = 2.6; CI95%: 1.66-4.07; p < 0.001), position of the newborn at the vaginal level (PR = 2.03; CI95%: 1.5-2.75; p < 0.001), and need for newborn resuscitation in the delivery room (PR = 1.42; CI95%; 1.16-1.73; p = 0.001). Kappa concordance level of the professionals, records compared to the observation was: nurse 0.47, obstetrician 0.59, and pediatrician 0.86. CONCLUSION the identification of associated factors and the comparison between recording and observing the clamping time can help in the planning and implementation of improvements for adherence to good practices at birth.
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Affiliation(s)
| | - Leticia Becker Vieira
- Universidade Federal do Rio Grande do Sul, Escola de Enfermagem, Porto Alegre, RS, Brazil
| | - Helga Geremias Gouveia
- Universidade Federal do Rio Grande do Sul, Escola de Enfermagem, Porto Alegre, RS, Brazil
| | - Thais Betti
- Universidade Federal do Rio Grande do Sul, Escola de Enfermagem, Porto Alegre, RS, Brazil
| | - Wiliam Wegner
- Universidade Federal do Rio Grande do Sul, Escola de Enfermagem, Porto Alegre, RS, Brazil
| | - Cecília Drebes Pedron
- Universidade Federal do Rio Grande do Sul, Escola de Enfermagem, Porto Alegre, RS, Brazil
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18
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Gould AJ, Recabo O, Has P, Werner EF, Clark MA, Lewkowitz AK. Association of admission unit and birth satisfaction during induction of labor. J Matern Fetal Neonatal Med 2022; 35:9578-9584. [PMID: 35260026 DOI: 10.1080/14767058.2022.2048814] [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: 10/18/2022]
Abstract
OBJECTIVE As induction of labor (IOL) becomes more common, hospitals must adjust to accommodate longer length of stays on labor and delivery. An alternative to reduce the length of time spent on labor and delivery during an IOL is to perform cervical ripening on an antepartum unit. However, this may affect patient satisfaction and knowledge about the birthing process. This study aimed to evaluate whether cervical ripening conducted in an antepartum unit, rather than on a labor and delivery unit, was associated with changes in patient satisfaction with birth experience and baseline knowledge about IOL. Additionally, the study aimed to understand how patients would prefer to receive education on the IOL process. METHODS This prospective observational study recruited English and Spanish-speaking patients at or after 39 weeks and 0 days gestation who were admitted for IOL. Consenting patients completed a preliminary survey containing sociodemographic and obstetric information as well as a previously validated survey on IOL knowledge on admission. Within 48 h of delivery, patients completed a follow-up survey including a validated birth satisfaction survey, the Birth Satisfaction Scale-Revised, and questions eliciting their preferred IOL education method. Data analyses compared patients who were admitted to antepartum for IOL to those admitted directly to labor and delivery. Multivariate analyses adjusted for sociodemographic and obstetric differences between the two groups. The primary outcomes were scores on the Birth Satisfaction Scale-Revised and on a test examining IOL knowledge. Secondary outcomes included preferred method of IOL education, obstetric outcomes, and neonatal outcomes. RESULTS A total of 277 eligible patients were approached from October 2020 to March 2021. Of the 216 (78%) that consented, 159 (74%) completed the follow-up survey and were subsequently included in this analysis. Individuals admitted directly to antepartum (n = 122) more commonly self-identified as Latina, Latin American, or Hispanic (27.9% vs. 8.1%, p = .01) and were nulliparous (68.0% vs. 21.6%, p < .001) compared to participants admitted to labor and delivery for IOL (n = 37). Patients admitted to labor and delivery were more likely to undergo elective induction (29.7% vs. 9.8%, p = .006). Admission unit was not associated with differences in birth satisfaction scores or obstetric or neonatal outcomes. However, after controlling for potential confounders, patients admitted to the antepartum unit correctly answered a greater percentage of questions assessing IOL knowledge compared to patients admitted to labor and delivery (73.9% vs. 62.3%, adjusted mean difference (aMD) 12.6 [95% CI 7.2, 18.0]). Patients in both groups indicated preference for reviewing an induction checklist with a provider during prenatal care (59.1%) or using a technology-based intervention (37.1%) over attending in-person classes (3.1%) to learn more about IOL. CONCLUSION Unit of admission for IOL is not associated with satisfaction with birth experience but is associated with patient knowledge of IOL. This suggests that IOL may be initiated in less acute units than labor and delivery without altering birth experience and may potentially allow for increased patient knowledge. Additionally, IOL checklists or technology-based education may help to further increase patient knowledge about IOL.
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Affiliation(s)
- Alexander J Gould
- Women & Infants Hospital of Rhode Island, Alpert Medical School of Brown University, Providence, RI, USA
| | - Olivia Recabo
- Women & Infants Hospital of Rhode Island, Alpert Medical School of Brown University, Providence, RI, USA
| | - Phinnara Has
- Women & Infants Hospital of Rhode Island, Alpert Medical School of Brown University, Providence, RI, USA
| | - Erika F Werner
- Women & Infants Hospital of Rhode Island, Alpert Medical School of Brown University, Providence, RI, USA
| | - Melissa A Clark
- Women & Infants Hospital of Rhode Island, Alpert Medical School of Brown University, Providence, RI, USA.,Brown University School of Public Health, Providence, RI, USA
| | - Adam K Lewkowitz
- Women & Infants Hospital of Rhode Island, Alpert Medical School of Brown University, Providence, RI, USA
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19
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Mahfouz IA, Asali F, Ziara FMI, Samara B, Qudsieh S, Al-Rshoud F. Enema Administration During Labor: Pregnant Women's Perspective and Knowledge. SAGE Open Nurs 2022; 8:23779608221139148. [DOI: 10.1177/23779608221139148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 10/02/2022] [Accepted: 10/30/2022] [Indexed: 11/22/2022] Open
Abstract
Introduction Current evidence does not support the routine use of rectal enemas (REs) because they have not been associated with reduced rates of puerperal infection, degree of perineal tear, or duration of labor. A recent literature review recognized knowledge gaps regarding the uses of RE during labor including women's perceptions, pain, and satisfaction. Objectives To report pregnant women's knowledge, attitudes, perceptions, pain, and satisfaction associated with the use of RE during labor. Methods A prospective study was conducted between 20 October 2019 and 20 October 2020. Women were included if they were 37 weeks or more pregnant, had a viable pregnancy, were admitted in labor, and had an RE. Characteristic data and data about knowledge, perceptions, attitudes, pain, and satisfaction associated with its use were recorded. Women were regrouped based on their level of knowledge into low- and high-level groups. Attitudes, perceptions, inconveniences, pain, and satisfaction were regrouped into two categories: low and high on the Likert scale. Results A total of 300 women were recruited, with means (SD) for age and gestational age of 27.8 (4.8) years, and 40 (1.1) weeks, respectively, and 45.7% were knowledgeable or very knowledgeable, 76% had a positive attitude, and 88.7% perceived enemas as important. The mean scores (SD) for pain and satisfaction as measured on visual analogue scales were 1.5 (1.8) and 5.4 (1.8), respectively. Women with high knowledge about RE were older and multiparous. Recruited women were more likely to report lower inconvenience and pain scores and higher satisfaction scores (all P<.05). Conclusion Most recruited women were knowledgeable about REs, perceived them as important, and expressed a positive attitude toward their administration. The low levels of inconvenience, pain, and complications and the high satisfaction rates may be used when counseling women about when an RE is required during labor.
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Affiliation(s)
- Ismaiel Abu Mahfouz
- Faculty of Medicine, Department of Obstetrics and Gynaecology, Al-Balqa Applied University, Al Salt, Jordan
| | - Fida Asali
- Faculty of Medicine, Department of Obstetrics and Gynaecology, The Hashemite University, Zarqa, Jordan
| | - Fedaa M. I. Ziara
- Department of Obstetrics and Gynaecology, Specialty Hospital, Amman, Jordan
| | - Batool Samara
- Department of Obstetrics and Gynaecology, Specialty Hospital, Amman, Jordan
| | - Suhair Qudsieh
- Department of Obstetrics and Gynaecology, Yarmouk University, Irbid, Jordan
| | - Firas Al-Rshoud
- Faculty of Medicine, Department of Obstetrics and Gynaecology, The Hashemite University, Zarqa, Jordan
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20
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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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21
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Preis H, Mahaffey B, Heiselman C, Lobel M. The impacts of the COVID-19 pandemic on birth satisfaction in a prospective cohort of 2,341 U.S. women. Women Birth 2021; 35:458-465. [PMID: 34736888 PMCID: PMC8501233 DOI: 10.1016/j.wombi.2021.10.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 09/15/2021] [Accepted: 10/05/2021] [Indexed: 02/03/2023]
Abstract
PROBLEM Birth satisfaction is an important health outcome that is related to postpartum mood, infant caretaking, and future pregnancy intention. BACKGROUND The COVID-19 pandemic profoundly affected antenatal care and intrapartum practices that may reduce birth satisfaction. AIM To investigate the extent to which pandemic-related factors predicted lower birth satisfaction. METHODS 2341 women who were recruited prenatally in April-May 2020 and reported a live birth between April-October 2020 were included in the current analysis. Hierarchical linear regression to predict birth satisfaction from well-established predictors of birth satisfaction (step 1) and from pandemic-related factors (step 2) was conducted. Additionally, the indirect associations of pandemic-related stress with birth satisfaction were investigated. FINDINGS The first step of the regression explained 35% of variance in birth satisfaction. In the second step, pandemic-related factors explained an additional 3% of variance in birth satisfaction. Maternal stress about feeling unprepared for birth due to the pandemic and restrictions on companions during birth independently predicted lower birth satisfaction beyond the non-pandemic variables. Pandemic-related unpreparedness stress was associated with more medicalized birth and greater incongruence with birth preference, thus also indirectly influencing birth satisfaction through a mediation process. DISCUSSION Well-established contributors to birth satisfaction remained potent during the pandemic. In addition, maternal stress and restriction on accompaniment to birth were associated with a small but significant reduction in birth satisfaction. CONCLUSION Study findings suggest that helping women set flexible and reasonable expectations for birth and allowing at least one intrapartum support person can improve birth satisfaction.
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Affiliation(s)
- Heidi Preis
- Department of Psychology, Stony Brook University, Stony Brook, NY 11794, United States.
| | - Brittain Mahaffey
- Department of Psychiatry and Behavioral Health, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, United States
| | - Cassandra Heiselman
- Department of Obstetrics and Gynecology, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, United States
| | - Marci Lobel
- Department of Psychology, Stony Brook University, Stony Brook, NY 11794, United States
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22
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The Association between Birth Satisfaction and the Risk of Postpartum Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910458. [PMID: 34639758 PMCID: PMC8508559 DOI: 10.3390/ijerph181910458] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 09/26/2021] [Accepted: 09/29/2021] [Indexed: 11/17/2022]
Abstract
Negative experiences with childbirth might have a negative impact on a woman’s overall health, including a higher risk of postpartum depression. The aim of the study was to examine the association between birth satisfaction and the risk of postpartum depression (PPD). A 30-item version of the Birth Satisfaction Scale (BSS) and the Edinburgh Postnatal Depression Scale (EPDS) were used, as well as the Perceived Stress Scale (PSS). The study included 584 women (mean age 30.6 ± 4.9), 2 to 4 days postpartum. In the regression model, the negative effect of birth satisfaction on the risk of postpartum depression was shown: a lower level of satisfaction with childbirth was a significant predictor of a higher risk of PPD (β = −0.18, 95% CI = −0.08; −0.03). The regression model was controlled for the effect of the sociodemographic factors (such as education or marital status) and clinical variables (such as parity, type of delivery, psychiatric history, levels of prenatal stress). Levels of prenatal stress (β = 0.43, 95% CI = 0.27; 0.39), psychiatric history (β = 0.08, 95% CI = 0.01; 3.09), parity (β = −0.12, 95% CI = −1.82; −0.32) and type of delivery (β = 0.11, 95% CI = 0.20; 1.94) were also significantly associated with the levels of postnatal depression. The current study confirmed the association between the level of birth satisfaction and the risk of developing PPD, i.e., a lower satisfaction with childbirth may increase the risk of developing PPD.
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23
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de Souza KCR, da Silva TPR, Damasceno AKDC, Manzo BF, Souza KVD, Filipe MML, Matozinhos FP. Coexistence and prevalence of obstetric interventions: an analysis based on the grade of membership. BMC Pregnancy Childbirth 2021; 21:618. [PMID: 34503471 PMCID: PMC8431849 DOI: 10.1186/s12884-021-04092-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 08/29/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Obstetric interventions performed during delivery do not reflect improvements in obstetric care. Several practices routinely performed during childbirth, without any scientific evidence or basis - such as Kristeller maneuver, routine episiotomy, and movement or feeding restriction - reflect a disrespectful assistance reality that, unfortunately, remains in place in Brazil. The aims of the current study are to assess the coexistence and prevalence of obstetric interventions in maternity hospitals in Belo Horizonte City, based on the Grade of Membership (GoM) method, as well as to investigate sociodemographic and obstetric factors associated with coexistence profiles generated by it. METHODS Observational study, based on a cross-sectional design, carried out with data deriving from the study "Nascer em Belo Horizonte: Inquérito sobre o Parto e Nascimento" (Born in Belo Horizonte: Survey on Childbirth and Birth). The herein investigated interventions comprised practices that are clearly useful and should be encouraged; practices that are clearly harmful or ineffective and should be eliminated; and practices that are inappropriately used, in contrast to the ones recommended by the World Health Organization. The analyzed interventions comprised: providing food to parturient women, allowing them to have freedom to move, use of partogram, adopting non-pharmacological methods for pain relief, enema, perineal shaving, lying patients down for delivery, Kristeller maneuver, amniotomy, oxytocin infusion, analgesia and episiotomy. The current study has used GoM to identify the coexistence of the adopted obstetric interventions. Variables such as age, schooling, skin color, primigravida, place-of-delivery financing, number of prenatal consultations, gestational age at delivery, presence of obstetric nurse at delivery time, paid work and presence of companion during delivery were taken into consideration at the time to build patients' profile. RESULTS Results have highlighted two antagonistic obstetric profiles, namely: profile 1 comprised parturient women who were offered diet, freedom to move, use of partogram, using non-pharmacological methods for pain relief, giving birth in lying position, patients who were not subjected to Kristeller maneuver, episiotomy or amniotomy, women did not receive oxytocin infusion, and analgesia using. Profile 2, in its turn, comprised parturient women who were not offered diet, who were not allowed to have freedom to move, as well as who did not use the partograph or who were subjected to non-pharmacological methods for pain relief. They were subjected to enema, perineal shaving, Kristeller maneuver, amniotomy and oxytocin infusion. In addition, they underwent analgesia and episiotomy. This outcome emphasizes the persistence of an obstetric care model that is not based on scientific evidence. Based on the analysis of factors that influenced the coexistence of obstetric interventions, the presence of obstetric nurses in the healthcare practice has reduced the likelihood of parturient women to belong to profile 2. In addition, childbirth events that took place in public institutions have reduced the likelihood of parturient women to belong to profile 2. CONCLUSION(S) Based on the analysis of factors that influenced the coexistence of obstetric interventions, financing the hospital for childbirth has increased the likelihood of parturient women to belong to profile 2. However, the likelihood of parturient women to belong to profile 2 has decreased when hospitals had an active obstetric nurse at the delivery room. The current study has contributed to discussions about obstetric interventions, as well as to improve childbirth assistance models. In addition, it has emphasized the need of developing strategies focused on adherence to, and implementation of, assistance models based on scientific evidence.
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Affiliation(s)
- Karina Cristina Rouwe de Souza
- Graduate Nursing Program, Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte City, Minas Gerais State, Brazil
- Health Sciences, Child and Adolescent Health, Medical School, Universidade Federal de Minas Gerais, Belo Horizonte City, Minas Gerais State, Brazil
| | - Thales Philipe Rodrigues da Silva
- Health Sciences, Child and Adolescent Health, Medical School, Universidade Federal de Minas Gerais, Belo Horizonte City, Minas Gerais State, Brazil
| | | | - Bruna Figueiredo Manzo
- Maternal and Child Nursing and Public Health Department, Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte City, Minas Gerais State, Brazil
| | - Kleyde Ventura de Souza
- Maternal and Child Nursing and Public Health Department, Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte City, Minas Gerais State, Brazil
| | | | - Fernanda Penido Matozinhos
- Maternal and Child Nursing and Public Health Department, Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte City, Minas Gerais State, Brazil.
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Martinez-Vázquez S, Rodríguez-Almagro J, Hernández-Martínez A, Delgado-Rodríguez M, Martínez-Galiano JM. Obstetric factors associated with postpartum post-traumatic stress disorder after spontaneous vaginal birth. Birth 2021; 48:406-415. [PMID: 33909303 DOI: 10.1111/birt.12550] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 04/03/2021] [Accepted: 04/05/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND This study aimed to determine whether there is an association between clinical practices carried out during spontaneous vaginal birth (SVB), or clinical situations that arise during vaginal birth, and the incidence of post-traumatic stress disorder (PTSD). METHODS A cross-sectional study with 839 puerperal women in Spain was conducted. The Perinatal Post-traumatic Stress Disorder Questionnaire (PPQ) was administered online. The relationship between the risk of postpartum PTSD and various intrapartum complications was studied in addition to practices or procedures performed during the intrapartum period. RESULTS PTSD (PPQ scores ≥19) was identified in 8.1% (68) of the women who participated. Among the risk factors for PTSD was a concerning intrapartum FHR tracing (adjusted OR: 2.24, 95% CI: 1.07-4.66). Other intrapartum practices also put women at risk of PTSD, including the administration of an enema (aOR: 7.01, 95% CI: 2.14-23.01), being required to stay lying down throughout the labor and birth (aOR: 5.75, 95% CI: 3.25-10.19), artificial amniorrhexis without consent (aOR: 2.28, 95% CI: 1.31-3.97), administration of synthetic oxytocin without consent (aOR: 2.18, 95% CI: 1.26-3.77), fundal pressure during pushing (aOR: 3.14, 95% CI: 1.72-5.73), repeated vaginal examinations performed by different people (aOR: 4.84, 95% CI: 2.77-8.47), and manual removal of the placenta without anesthesia (aOR: 3.45, 95% CI: 1.81-6.58). CONCLUSIONS Various intrapartum clinical practices, all related to dehumanized treatment, and intrapartum complications, were associated with an increased risk of PTSD. There is a need to eradicate obstetric mistreatment and to increase access to evidence-informed, respectful care in Spain. Care practitioners need to better appreciate their roles in preventing PTSD.
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Affiliation(s)
| | - Julián Rodríguez-Almagro
- Department of Nursing, Faculty of Nursing of Ciudad Real, University of Castilla-La Mancha, Ciudad Real, Spain
| | - Antonio Hernández-Martínez
- Department of Nursing, Faculty of Nursing of Ciudad Real, University of Castilla-La Mancha, Ciudad Real, Spain
| | - Miguel Delgado-Rodríguez
- Department of Health Sciences, University of Jaen, Jaén, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Juan Miguel Martínez-Galiano
- Department of Nursing, University of Jaen, Jaén, Spain.,CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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25
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General anesthesia in the parturient. Int Anesthesiol Clin 2021; 59:78-89. [PMID: 34029247 DOI: 10.1097/aia.0000000000000327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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26
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Farrington E, Connolly M, Phung L, Wilson AN, Comrie-Thomson L, Bohren MA, Homer CSE, Vogel JP. The prevalence of uterine fundal pressure during the second stage of labour for women giving birth in health facilities: a systematic review and meta-analysis. Reprod Health 2021; 18:98. [PMID: 34006288 PMCID: PMC8132352 DOI: 10.1186/s12978-021-01148-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 05/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Uterine fundal pressure involves a birth attendant pushing on the woman's uterine fundus to assist vaginal birth. It is used in some clinical settings, though guidelines recommend against it. This systematic review aimed to determine the prevalence of uterine fundal pressure during the second stage of labour for women giving birth vaginally at health facilities. METHODS The population of interest were women who experienced labour in a health facility and in whom vaginal birth was anticipated. The primary outcome was the use of fundal pressure during second stage of labour. MEDLINE, EMBASE, CINAHL and Global Index Medicus databases were searched for eligible studies published from 1 January 2000 onwards. Meta-analysis was conducted to determine a pooled prevalence, with subgroup analyses to explore heterogeneity. RESULTS Eighty data sets from 76 studies (n = 898,544 women) were included, reporting data from 22 countries. The prevalence of fundal pressure ranged from 0.6% to 69.2% between studies, with a pooled prevalence of 23.2% (95% CI 19.4-27.0, I2 = 99.97%). There were significant differences in prevalence between country income level (p < 0.001, prevalence highest in lower-middle income countries) and method of measuring use of fundal pressure (p = 0.001, prevalence highest in studies that measured fundal pressure based on women's self-report). CONCLUSIONS The use of uterine fundal pressure on women during vaginal birth in health facilities is widespread. Efforts to prevent this potentially unnecessary and harmful practice are needed.
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Affiliation(s)
- Elise Farrington
- Maternal, Child and Adolescent Health Program, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia.
- Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, 3010, Australia.
| | - Mairead Connolly
- Maternal, Child and Adolescent Health Program, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia
- Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Laura Phung
- Maternal, Child and Adolescent Health Program, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia
- Melbourne Medical School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Alyce N Wilson
- Maternal, Child and Adolescent Health Program, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Liz Comrie-Thomson
- Maternal, Child and Adolescent Health Program, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Meghan A Bohren
- Gender and Women's Health Unit, School of Population and Global Health, Centre for Health Equity, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Caroline S E Homer
- Maternal, Child and Adolescent Health Program, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Joshua P Vogel
- Maternal, Child and Adolescent Health Program, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia
- School of Population and Global Health, The University of Melbourne, Parkville, VIC, 2010, Australia
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Seijmonsbergen-Schermers A, Thompson S, Feijen-de Jong E, Smit M, Prins M, van den Akker T, de Jonge A. Understanding the perspectives and values of midwives, obstetricians and obstetric registrars regarding episiotomy: qualitative interview study. BMJ Open 2021; 11:e037536. [PMID: 33441351 PMCID: PMC7812089 DOI: 10.1136/bmjopen-2020-037536] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Insight into perspectives and values of care providers on episiotomy can be a first step towards reducing variation in its use. We aimed to gain insight into these perspectives and values. SETTING Maternity care in the Netherlands. PARTICIPANTS Midwives, obstetricians and obstetric registrars working in primary, secondary or tertiary care, purposively sampled, based on their perceived episiotomy rate and/or region of work. PRIMARY AND SECONDARY OUTCOME MEASURES Perspectives and values of care providers which were explored using semistructured in-depth interviews. RESULTS The following four themes were identified, using the evidence-based practice-model of Satterfield et al as a framework: 'Care providers' vision on childbirth', 'Discrepancy between restrictive perspective and daily practice', 'Clinical expertise versus literature-based practice' and 'Involvement of women in the decision'. Perspectives, values and practices regarding episiotomy were strongly influenced by care providers' underlying visions on childbirth. Although care providers often emphasised the importance of restrictive episiotomy policy, a discrepancy was found between this vision and the large number of varying indications for episiotomy. Although on one hand care providers cited evidence to support their practice, on the other hand, many based their decision-making to a larger extent on clinical experience. Although most care providers considered women's autonomy to be important, at the moment of deciding on episiotomy, the involvement of women in the decision was perceived as minimal, and real informed consent generally did not take place, neither during labour, nor prenatally. Many care providers belittled episiotomy in their language. CONCLUSIONS Care providers' underlying vision on episiotomy and childbirth was an important contributor to the large variations in episiotomy usage. Their clinical expertise was a more important component in decision-making on episiotomy than the literature. Women were minimally involved in the decision for performing episiotomy. More research is required to achieve consensus on indications for episiotomy.
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Affiliation(s)
- Anna Seijmonsbergen-Schermers
- Department of Midwifery Science, Amsterdam UMC, Vrije Universiteit Amsterdam, AVAG, Amsterdam Public Health, Amsterdam, The Netherlands
| | - Suzanne Thompson
- Research Centre for Midwifery Science, Zuyd University, Maastricht, The Netherlands
| | - Esther Feijen-de Jong
- Department of Midwifery Science, AVAG, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Marrit Smit
- Department of Obstetrics, Leiden University Medical Centre, Leiden, Netherlands
| | - Marianne Prins
- Academie Verloskunde Amsterdam Groningen, Amsterdam, Netherlands
| | - Thomas van den Akker
- Department of Obstetrics, Leiden University Medical Centre, Leiden, Netherlands
- Athena Institute, VU University, Amsterdam, The Netherlands
| | - Ank de Jonge
- Department of Midwifery Science, Amsterdam UMC, Vrije Universiteit Amsterdam, AVAG, Amsterdam Public Health, Amsterdam, The Netherlands
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Violência obstétrica: a abordagem da temática na formação de enfermeiros obstétricos. ACTA PAUL ENFERM 2020. [DOI: 10.37689/acta-ape/2020ao01466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Kahalon R, Preis H, Benyamini Y. Who benefits most from skin-to-skin mother-infant contact after birth? Survey findings on skin-to-skin and birth satisfaction by mode of birth. Midwifery 2020; 92:102862. [PMID: 33126046 DOI: 10.1016/j.midw.2020.102862] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 08/16/2020] [Accepted: 10/13/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Previous research has shown that skin-to-skin contact in the delivery room is associated with an increase satisfaction with childbirth. The purpose of the present study was to examine whether this association differs as a function of mode of birth, such that the positive effect of skin-to-skin contact would be especially pronounced for women who had operative births. DESIGN Survey design using self-administered questionnaires during pregnancy (Time 1) and at two months postpartum (Time 2). SETTING At Time 1, women were recruited at community and hospital medical centres in two large metropolitan areas in the centre of Israel and through home midwives and internet forums. At Time 2, women completed a second questionnaire in which they reported whether they had skin-to-skin contact with their infant immediately after birth and their birth satisfaction. PARTICIPANTS Pregnant women, gestation week ≥24, with singleton pregnancy, who took part in both T1 and T2 (N = 1371, 75% of the 1833 women recruited at T1). MEASUREMENTS Analysis of covariance (ANCOVA) was used to examine whether the association between skin-to-skin contact after birth and birth satisfaction two months post-partum, differs as a function of mode of birth. Maternal or infant complications during birth, parity, and whether the pregnancy was planned, served as covariates. Birth satisfaction was measured using the Childbirth Satisfaction Scale. All measures were self-reported. FINDINGS The frequency of skin-to-skin was high (83%) for women who had vaginal birth, but lower for women who had an instrumental birth (66%) or a caesarean section (31%). At two months postpartum, women who had operative births reported less satisfaction with their birth than women who gave birth via vaginal birth. A significant interaction between skin-to-skin and mode of birth showed that although skin-to-skin was associated with higher birth satisfaction among women across all three modes of birth, i.e., vaginal (Cohen's d = .41), instrumental (Cohen's d = .64) and caesarean (Cohen's d = .87), the effect for the difference in birth satisfaction between women with and without skin-to-skin was especially large for operative births, particularly for caesarean sections. KEY CONCLUSIONS Operative birth is related to lower satisfaction with childbirth and lower rates of skin-to-skin contact immediately after birth. Yet, the association between skin-to-skin and birth satisfaction is especially strong for women who had operative births and specifically a caesarean section, suggesting that the possible contribution of skin-to-skin to birth satisfaction should be emphasised particularly after operative births. IMPLICATIONS FOR PRACTICE It is recommended that maternity care providers, managers, policy makers and medical teams facilitate skin-to-skin contact between the woman and her infant immediately, or as soon as possible, after childbirth, in both operative and non-operative births.
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Affiliation(s)
- Rotem Kahalon
- Bob Shapell School of Social Work Tel Aviv University, Israel; The School of Psychological Sciences, Tel-Aviv University, Israel.
| | - Heidi Preis
- Bob Shapell School of Social Work Tel Aviv University, Israel; Department of Psychology, Stoney Brook University, U.S
| | - Yael Benyamini
- Bob Shapell School of Social Work Tel Aviv University, Israel
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da Silva Vieira RCM, Ferreira CHJ, de Carvalho Cavalli R, do Prado MLR, Beleza ACS, Driusso P. Cross-cultural adaptation and psychometric evaluation of the Brazilian Portuguese version of the childbirth experience questionnaire. BMC Pregnancy Childbirth 2020; 20:477. [PMID: 32819328 PMCID: PMC7441667 DOI: 10.1186/s12884-020-03163-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 08/11/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Childbirth Experience Questionnaire (CEQ) is a tool designed to assess women's perceptions about labor and delivery. The aim of this study was to perform the cross-cultural adaptation and validation of the Brazilian Portuguese version of the CEQ (CEQ-Br). METHODS The original version of the CEQ was translated into Portuguese, analyzed by a committee of experts, back translated, and finally submitted to pilot-test. Two applications of the CEQ-Br were performed along with the quality of life questionnaire Medical Outcomes Study 36 - Item Short-Form Health Survey (SF-36). The SPSS software was used for statistical analysis, the intraclass correlation coefficient was used to investigate test-retest reliability, the internal consistency was investigated with the Cronbach's Alpha, and the construct validity was investigated via the Spearman correlation test. The level of significance was set at 5%. RESULTS The study included 308 women with a mean age of 31.1 ± 8.7 years. The internal consistency results for the total CEQ-Br score was considered adequate (0.89), the test-retest showed a substantial result with an ICC of 0.90, and the construct validity was analyzed via the Spearman correlation between all SF-36 dimensions and the total CEQ-B score, the analyses were considered adequate. CONCLUSIONS The results presented in this CEQ-Br validation study showed that the instrument was reliable in measuring the established psychometric properties and was considered valid. Therefore, the CEQ-Br can be applied to the Brazilian population.
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Affiliation(s)
| | - Cristine Homsi Jorge Ferreira
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo (USP), Av. Bandeirantes, Monte Alegre, Ribeirao Preto, SP, Brazil.
| | - Ricardo de Carvalho Cavalli
- Department of Gynecology and Obstetrics, Faculty of Medicine, University of São Paulo (USP), São Carlos, Brazil
| | | | - Ana Carolina Sartorato Beleza
- Department of Physical Therapy, Women's Health Research Laboratory, Federal University of São Carlos (UFSCar), São Carlos, Brazil
| | - Patricia Driusso
- Department of Physical Therapy, Women's Health Research Laboratory, Federal University of São Carlos (UFSCar), São Carlos, Brazil
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Zanardo V, Parotto M, Manghina V, Giliberti L, Volpe F, Severino L, Straface G. Pain and stress after vaginal delivery: characteristics at hospital discharge and associations with parity. J OBSTET GYNAECOL 2020; 40:808-812. [PMID: 31814477 DOI: 10.1080/01443615.2019.1672140] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The objective of this study was to characterise pre-discharge maternal pain and stress severity after vaginal delivery and associations with parity. This is a descriptive analysis with 148 women in the early post-partum period (84 primiparae and 64 secondiparae) after vaginal delivery. Pain and stress were measured by McGill Pain Questionnaire (MGPQ) and by the Psychological Stress Measure (PSM). Vaginal delivery in primiparae women was associated with MGPQ, significantly higher pain scores. Sensorial, affective and mixed pain descriptive categories were also significantly higher. Pain location involved lower abdomen, vagina and perianal area. In addition, their PSM showed a significantly higher 'Sense of effort and confusion' subscale scores. In conclusion, this study provides important information on the quality of care implications of hospital-to-home discharge practices in puerperae after vaginal delivery, a critical time characterised by qualitatively and quantitatively high pain and stress in primiparae.Impact statementWhat is already known on this subject? Pain and fatigue are the most common problems reported by women in the early postpartum period.What the results of this study add? Primiparae who delivered vaginally presented at the time of hospital-to-home discharge significantly higher pain and stress, as compared to secondiparae. Pain involved lower abdomen, vagina and perianal area, whereas the stress was quantitatively higher in the 'sense of effort and confusion'.What the implications are of these findings for clinical practice and/or further research? Awareness of problematic pain and stress associations with parity may offer the opportunity to better support puerperae to develop maternal orientation and adjust to motherhood.
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Affiliation(s)
- Vincenzo Zanardo
- Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy.,Department of Anesthesia, University of Toronto, Toronto, Canada
| | - Matteo Parotto
- Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy.,Department of Anesthesia, University of Toronto, Toronto, Canada
| | - Valeria Manghina
- Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy.,Department of Anesthesia, University of Toronto, Toronto, Canada
| | - Lara Giliberti
- Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy.,Department of Anesthesia, University of Toronto, Toronto, Canada
| | - Francesca Volpe
- Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy.,Department of Anesthesia, University of Toronto, Toronto, Canada
| | - Lorenzo Severino
- Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy.,Department of Anesthesia, University of Toronto, Toronto, Canada
| | - Gianluca Straface
- Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy.,Department of Anesthesia, University of Toronto, Toronto, Canada
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The effects of hands on and hands off/poised techniques on maternal outcomes: A systematic review and meta-analysis. Midwifery 2020; 87:102712. [DOI: 10.1016/j.midw.2020.102712] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 03/09/2020] [Accepted: 03/27/2020] [Indexed: 11/23/2022]
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33
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Lavender T, Bernitz S. Use of the partograph - Current thinking. Best Pract Res Clin Obstet Gynaecol 2020; 67:33-43. [DOI: 10.1016/j.bpobgyn.2020.03.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 03/09/2020] [Accepted: 03/11/2020] [Indexed: 01/07/2023]
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34
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Gu C, Wang X, Zhang Z, Schwank S, Zhu C, Zhang Z, Qian X. Pregnant women's clinical characteristics, intrapartum interventions, and duration of labour in urban China: a multi-center cross-sectional study. BMC Pregnancy Childbirth 2020; 20:386. [PMID: 32616073 PMCID: PMC7330978 DOI: 10.1186/s12884-020-03072-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 06/19/2020] [Indexed: 12/19/2022] Open
Abstract
Background There is an increasing global trend towards the widespread over-medicalisation of labour and childbirth. The present study aimed to investigate pregnant women’s clinical characteristics, intrapartum interventions, duration of labour and its associated factors; and to compare the differences of these variables between nulliparas and multiparas in China. Methods A multi-center cross-sectional study was carried out in three tertiary hospitals of Fudan University in Shanghai, China. A total of 1523 participants were approched and assessed for eligibility. Data on women’s sociodemographic characteristics, intrapartum interventions, and duration of labour were measured and collected. Kaplan-Meier survival analysis was performed to present the curves of total duration of labour by parity. After z-transformation of labour duration, multivariable linear regression was used to control for confounding and to identify independent associations between potential associated factors and the primary outcome of labour duration. Results Overall, 1209 eligible women agreed to participate and were investigated. Rates of different intrapartum interventions were 27.4% in use of amniotomy, 37.9% in use of oxytocin, 53.0% in continuous electronic fetal monitoring, and 52.9% in epidural use, respectively. The curve of total duration of labour was significantly different between nulliparas and multiparas (P < .001). Of the 1209 participants, 983 (81.3%) women eventually achieved successful vaginal birth while 226 (18.7%) women ended in intrapartum caesarean section. The median duration of total stage of labour was significantly longer in the nulliparous group [9.38 (6.33,14.10) hours] than that in the multiparous group [5.08 (3.00,7.83) hours] (P < .001). The following factors were independently associated with longer duration of total stage of labour: epidural analgesia (P < .001), primiparity (P < .001), continuous electronic fetal monitoring (P = .035), and increased birth weight (P = .005). Conclusions Intrapartum medical interventions become common obstetric practices in urban China. Multifactorial variables independently associated with longer duration of labour were identified, including epidural analgesia, primiparity, continuous electronic fetal monitoring, and increased birth weight. Further research is required to validate these variables and to determine the modifiable factors for labour management. And models of care with lower intervention rates such as midwife-led models of care should be developed and implemented in China.
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Affiliation(s)
- Chunyi Gu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, China.,Department of Nursing, Obstetrics & Gynaecology Hospital of Fudan University, Shanghai, China
| | - Xiaojiao Wang
- Department of Nursing, Obstetrics & Gynaecology Hospital of Fudan University, Shanghai, China
| | - Zhijie Zhang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Simone Schwank
- Department of Women and Children's Health, Reproductive Health, Karolinska Institutet, Stockholm, Sweden
| | - Chunxiang Zhu
- Department of Nursing, Obstetrics & Gynaecology Hospital of Fudan University, Shanghai, China
| | - Zheng Zhang
- Department of Nursing, Obstetrics & Gynaecology Hospital of Fudan University, Shanghai, China
| | - Xu Qian
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, China. .,Global Health Institute, Fudan University, Shanghai, China.
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