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Stephens B, Nanka-Bruce P, Lashtew HF. "We restrict certain things": a cross-sectional study of health provider adherence to WHO's recommendation for intrapartum oral intake of fluid and food in Greater Accra, Ghana. BMC Pregnancy Childbirth 2024; 24:397. [PMID: 38816819 PMCID: PMC11138096 DOI: 10.1186/s12884-024-06581-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 05/13/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Since 2018, WHO recommends oral fluid and food intake for low-risk women during labor to enhance positive childbirth experience and respect for women's preferences. This study investigated the current practices related to intrapartum oral intake among maternity care providers and women in public health facilities in Greater Accra, Ghana, and explored barriers and opportunities for adherence to the WHO guidance. METHODS We used a mixed-method design at five public health facilities in Greater Accra, Ghana, which included structured interviews with 11 facility-level quality improvement staff and 12 maternity care providers; a knowledge, attitudes, and practices survey with the same providers; and a client survey with 56 inpatient postpartum women. We conducted descriptive and inferential statistics, including z-tests to assess independent and dependent variables, and inductive thematic analyses. RESULTS Provider adherence to the WHO recommendation varied, with many imposing restrictions on oral intake during labor. Concerns included potential complications like Mendelson's syndrome, consequently framing oral intake decisions as clinical and leading providers to limit women's involvement in their care decisions. Within our sample, 54% and 43% women reported their provider counseled them on oral fluid and food intake respectively, while 41% and 34% reported their provider asked them their preference for drinking and eating respectively. Ultimately, 73% drank fluids and 19% ate food during their labor. Counseling significantly correlated with women's intake practices (p < 0.01) and providers' inquiry to women's preferences for drinking and eating (p < 0.001) during labor. CONCLUSION Adherence to evidence-based practices for intrapartum oral intake among low-risk women was inconsistence. Maternity care providers play a vital role in involving women in their care decisions and respecting women's preferences. Strengthening national-level labor care guidelines and provider quality improvement approaches like in-service training, supportive supervision, and job aides to include the WHO recommendation will help providers adhere to the guidance and contribute to promoting a positive childbirth experience for women.
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Abrán H, Kovács K, Horvát Z, Erőss E, Hollins Martin CJ, Martin CR. Translation and validation of the Hungarian version of the Birth Satisfaction Scale-Revised (BSS-R). Midwifery 2024; 132:103983. [PMID: 38581970 DOI: 10.1016/j.midw.2024.103983] [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: 11/15/2023] [Revised: 02/27/2024] [Accepted: 03/25/2024] [Indexed: 04/08/2024]
Abstract
BACKGROUND Evidence relating maternal birth experience to a range of maternal and neonatal outcomes is increasingly compelling. Consequently valid and reliable self-report of birth experience from the mothers perspective is critical. AIM The current study sought to translate and validate a Hungarian-language version of the Birth Satisfaction Scale-Revised (BSS-R). METHOD Following forward and backwards translation into Hungarian, the Hungarian BSS-R (HU-BSS-R) was administered to women in a major Transylvanian hospital maternity unit within 72 h postpartum. Key psychometric characteristics were then examined in relation to factor structure, divergent and convergent validity, internal consistency, and known-groups discriminant validity. RESULTS Two-hundred and thirty-two women completed the HU-BSS-R. Confirmatory factor analysis revealed the HU-BSS-R to offer an excellent fit to data for the established tri-dimensional measurement model. The HU-BSS-R was also found to offer excellent convergent and divergent validity and known-groups discriminant validity. No significant differences were observed between internal consistency observations between the current study and the original UK validation study. CONCLUSIONS The HU-BSS-R is a valid and reliable translation of the original BSS-R, it has proved itself to have excellent psychometric properties and is suitable for use in the Hungarian maternity context.
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Affiliation(s)
- Hunor Abrán
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs H-7621, Hungary; Odorheiu Secuiesc Municipal Hospital, Odorheiu Secuiesc, Romania.
| | - Kálmán Kovács
- Department of Obstetrics and Gynecology, University of Pécs, Pécs H-7624, Hungary
| | - Zalán Horvát
- Doctoral School of Natural Sciences, Faculty of Natural Sciences, University of Pécs, Pécs, Hungary
| | - Edina Erőss
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs H-7621, Hungary
| | - Caroline J Hollins Martin
- School of Health and Social Care, Edinburgh Napier University (ENU), Sighthill Campus, Edinburgh, Scotland, EH11 4BN, UK
| | - Colin R Martin
- Institute of Health and Wellbeing, University of Suffolk, Ipswich, UK
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Silva-Fernandez CS, de la Calle M, Arribas SM, Garrosa E, Ramiro-Cortijo D. Factors Associated with Obstetric Violence Implicated in the Development of Postpartum Depression and Post-Traumatic Stress Disorder: A Systematic Review. NURSING REPORTS 2023; 13:1553-1576. [PMID: 37987409 PMCID: PMC10661273 DOI: 10.3390/nursrep13040130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/19/2023] [Accepted: 10/27/2023] [Indexed: 11/22/2023] Open
Abstract
Postpartum depression (PPD) and post-traumatic stress disorder (PTSD) continue to be prevalent, and disabling women with mental disorders and obstetric violence (OV) may be a trigger for them, particularly during maternity. We aimed to analyze the association between manifestations of OV with the development of PPD and PTSD during pregnancy, childbirth, and postpartum. This systematic review was based on the PRISMA 2020 statement and explored original articles published between 2012 and 2022. A total of 21 articles were included in the analysis, and bias was assessed by the Effective Public Health Practice Project's Quality Assessment Tool. The highest rate of PPD symptoms appeared in women under 20 years old, multiparous, and with low education levels. The higher PTSD ratio was present in women under 35 years, primiparous, and with secondary studies. The mode of labor (instrumental or C-section) was identified as a major risk factor of PPD, being mediator variables of the informal coercion of health professionals and dissatisfaction with newborn healthcare. Instead, partner support during labor and high satisfaction with healthcare during birth were protective factors. Regarding PTSD, the mode of labor, several perineal tears, and the Kristeller technique were risk factors, and loss of autonomy and coercion modulated PTSD symptomatology. The protective factors for PTSD were respect for the labor plan, adequate communication with health professionals, social support during labor, and the skin-to-skin procedure. This systematic review provides evidence that OV contributes to PPD and PTSD, being important in developing standardized tools to prevent it. This study recommends changes in maternal healthcare policies, such as individualized healthcare assistance, humanized pregnancy protocols, and women's mental health follow-up, and improvements in the methodological quality of future research.
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Affiliation(s)
- Claudia Susana Silva-Fernandez
- Department of Biological & Health Psychology, Faculty of Psychology, Universidad Autónoma de Madrid, C/Ivan Pavlov 6, 28049 Madrid, Spain (E.G.)
| | - Maria de la Calle
- Obstetric and Gynecology Service, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Paseo de la Castellana 261, 28046 Madrid, Spain
| | - Silvia M. Arribas
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28029 Madrid, Spain
- Instituto Universitario de Estudios de la Mujer (IUEM), Universidad Autónoma de Madrid, C/Francisco Tomás y Valiente 5, 28049 Madrid, Spain
| | - Eva Garrosa
- Department of Biological & Health Psychology, Faculty of Psychology, Universidad Autónoma de Madrid, C/Ivan Pavlov 6, 28049 Madrid, Spain (E.G.)
- Instituto Universitario de Estudios de la Mujer (IUEM), Universidad Autónoma de Madrid, C/Francisco Tomás y Valiente 5, 28049 Madrid, Spain
| | - David Ramiro-Cortijo
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28029 Madrid, Spain
- Instituto Universitario de Estudios de la Mujer (IUEM), Universidad Autónoma de Madrid, C/Francisco Tomás y Valiente 5, 28049 Madrid, Spain
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Edwards R, Way S, Hundley VA. Let's talk early labour: The L-TEL randomised controlled trial. Women Birth 2023; 36:552-560. [PMID: 37562988 DOI: 10.1016/j.wombi.2023.07.132] [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: 02/01/2023] [Revised: 07/30/2023] [Accepted: 07/30/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Women without complications have lower obstetric intervention if they remain at home in early labour but many women report dissatisfaction in doing this. Using self-efficacy theory as an underpinning framework, a web-based intervention was co-created with women who had previously used maternity services. The intervention provides early labour advice, alongside the videoed, real experiences of women. METHOD The pragmatic, randomised control trial aimed to evaluate the impact of the web-based intervention on women's self-reported experiences of early labour. Low-risk, nulliparous, pregnant women (140) were randomised. The intervention group (69) received the web-based intervention antenatally to use at their own convenience and the control group (71) received usual care. Data were collected at 7-28 days postnatally using an online version of the Early Labour Experience Questionnaire (ELEQ). The primary outcome was the ELEQ score. Secondary, clinical outcomes such as labour onset, augmentation and mode of birth were collected from the existing hospital system. RESULTS There were no statistically significant differences in the ELEQ scores between trial arms. Women in the intervention group were significantly more likely to progress spontaneously in labour without the need for labour augmentation (39.1 %) compared to the control group (21.1 %) (OR 2.41, CI 95 %; 1.14-5.11). CONCLUSION Although the L-TEL Trial found no statistically significant differences in the primary outcome, the innovative intervention to support women during latent phase labour was positively received by women. Web-based resources are a cost effective, user-friendly and accessible way to provide women with education. A larger trial is needed to detect differences in clinical outcomes.
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Affiliation(s)
- Rebecca Edwards
- Frimley Park Hospital, Portsmouth Road, Surrey GU16 7UJ, UK; Centre for Midwifery & Women's Health, Bournemouth University, Bournemouth Gateway Building, St Paul's Lane, Bournemouth BH8 8GP, UK
| | - Susan Way
- Centre for Midwifery & Women's Health, Bournemouth University, Bournemouth Gateway Building, St Paul's Lane, Bournemouth BH8 8GP, UK
| | - Vanora A Hundley
- Centre for Midwifery & Women's Health, Bournemouth University, Bournemouth Gateway Building, St Paul's Lane, Bournemouth BH8 8GP, UK.
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Harkness M, Yuill C, Cheyne H, McCourt C, Black M, Pasupathy D, Sanders J, Heera N, Wallace C, Stock SJ. Experience of induction of labour: a cross-sectional postnatal survey of women at UK maternity units. BMJ Open 2023; 13:e071703. [PMID: 37160383 PMCID: PMC10174017 DOI: 10.1136/bmjopen-2023-071703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 04/14/2023] [Indexed: 05/11/2023] Open
Abstract
OBJECTIVES This study explored women's views and experiences of key elements of the induction of labour (IOL) process, including at home or in hospital cervical ripening (CR). DESIGN A questionnaire-based postnatal survey undertaken as part of the CHOICE Study process evaluation. The questionnaire was administered online and included fixed response and free-text options. SETTING National Health Service maternity units in the UK. PARTICIPANTS 309 women who had an IOL. OUTCOME MEASURES The primary outcome measure was experience of IOL. Few women returned home during CR, meaning that statistical comparison between those who experienced home-based and hospital-based CR was not possible. Findings are reported as descriptive statistics with content analysis of women's comments providing context. RESULTS Information to support choice and understand what to expect about IOL is often inadequate or unavailable. Having IOL can create anxiety and remove options for birth that women had hoped would enhance their experience. Although it can provide a more comfortable environment, home CR is not always an acceptable solution. Women described maternity care negatively impacted by staffing shortages; delays to care sometimes led to unsafe situations. Women who had a positive experience of IOL described supportive interaction with staff as a significant contribution to that. CONCLUSIONS Women do not experience IOL as a benign and consequence free intervention. There is urgent need for research to better target IOL and optimise safety and experience for women and their babies. Relatively few women were offered CR at home and further research is needed on this experience.
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Affiliation(s)
- Mairi Harkness
- Nursing Midwifery and Allied Health Research Unit, University of Stirling, Stirling, UK
| | - Cassandra Yuill
- Centre for Maternal and Child Health Research, City University of London, London, UK
| | - Helen Cheyne
- Nursing Midwifery and Allied Health Research Unit, University of Stirling, Stirling, UK
| | - Christine McCourt
- Centre for Maternal and Child Health Research, City University of London, London, UK
| | - Mairead Black
- Aberdeen Centre for Women's Health Research, Aberdeen Maternity Hospital, Aberdeen, UK
| | - Dharmintra Pasupathy
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Julia Sanders
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | | | | | - Sarah Jane Stock
- The University of Edinburgh Usher Institute of Population Health Sciences and Informatics, Edinburgh, UK
- The University of Edinburgh MRC Centre for Reproductive Health, Edinburgh, UK
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Geremia S, Valente EP, Mariani I, Dalena P, Lazzerini M. Women's suggestions on how to improve the quality of maternal and newborn care during the COVID-19 pandemic in Italy: A co-occurrence network analysis. J Glob Health 2023; 13:06013. [PMID: 37144478 PMCID: PMC10161149 DOI: 10.7189/jogh.13.06013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
Background Recent evidence revealed significant gaps in the quality of maternal and newborn care in the World Health Organization (WHO) European Region (EUR) countries. Collecting and analyzing women's views on their needs and priorities is crucial for developing actions to improve the quality of maternal and newborn care. With this study from the IMAgiNE EURO Project, we aimed to add to previous quantitative studies by analysing emerging themes from women's suggestions on how to improve the quality of maternal and newborn care during facility-based birth in Italy during the COVID-19 pandemic. Methods We collected data from mothers giving birth during the coronavirus 2019 (COVID-19) pandemic using a validated online anonymous WHO standard-based questionnaire consisting of open-ended questions. Using a word co-occurrence network (WCON), we analysed responses in Italian from women who gave birth between March 2020 and March 2022. This approach entails a graphical representation of word pairings that frequently co-occur across sentences and compose clusters. Results The texts, produced by 2010 women participating in the study, consisted of 79 204 words and 3833 sentences. Eight clusters emerged with WCON, the three largest of which were related to companionship during childbirth, breastfeeding support, and physical resources. The term "swab", associated with other terms in the COVID-19 domain, had the highest degree of centrality, thus representing a core topic. Conclusions The key emerging themes from women's suggestions can be used to shape policies to improve the quality of care for mothers and newborns. Our WCON analysis offers a valid approach to quickly screen large textual data on quality of care, providing a first set of major themes identified by clusters. As such, it could be used to improve documentation of service users' suggestions promoting the engagement of both researchers and policymakers. Registration ClinicalTrials.gov: NCT04847336.
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Childbirth experience during the COVID-19 pandemic: A qualitative thematic analysis. Midwifery 2023; 121:103669. [PMID: 37001431 PMCID: PMC10038889 DOI: 10.1016/j.midw.2023.103669] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 02/16/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023]
Abstract
Introduction Pregnancy is a period of special vulnerability for the mental health of women. The arrival of the COVID-19 pandemic altered the routines of pregnant women, its effects on this population are thus far unknown. Therefore, the objective of this study is to understand the impact of the pandemic on the birth experience of women during the state of emergency in Andalusia, Spain. Methods A qualitative study was conducted with 14 women, using semistructured interviews via telematics. These were recorded and later transcribed using the F4transkript software. In order to analyse the data retrieved from the interviews and identify the main patterns of meaning/responses, the thematic analysis method was applied. Results The main emerging themes were 'prenatal medical care', 'hospital safety', and 'postpartum with COVID-19 restrictions'. The results indicated that the reorganization of perinatal medical care, the lack of information, and the fear of contagion were the factors that most negatively influenced the participants. Instead, the security during the birth process and the tranquillity in postpartum were the positive aspects of the birth experiences during COVID-19. Conclusion This is the first qualitative study in Andalusia that identifies the specific aspects of the COVID-19 pandemic that have affected the mental health of pregnant women. The results contribute to a broader perception of the experience of women and the creation of health protocols for emergencies akin to the COVID-19 pandemic.
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Cognitive Behavioral Training and Positive Psychology Training for Pregnant Women’s Psychological Health. PSYCHOLOGICAL STUDIES 2022. [DOI: 10.1007/s12646-022-00673-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Shorey S, Chan V, Lalor JG. Perceptions of women and partners on labor and birth positions: A meta-synthesis. Birth 2022; 49:19-29. [PMID: 34245040 DOI: 10.1111/birt.12574] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 06/28/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The risks and benefits of different birthing positions are commonly studied, but both paternal and maternal preferences and experiences of different birth positions are not examined. Therefore, this systematic review aims to explore the perceptions of women and their partners on birthing positions during the first and second stage of labor, so that maternity health care practitioners can provide better quality patient-centered care. METHODS Six databases were searched from each database's inception through November 2020. Qualitative or mixed-methods studies exploring perceptions of women and/or their partners on birthing positions were included in the review. Key information and findings of the studies were extracted; qualitative data were meta-summarized, then meta-synthesized using thematic analysis. RESULTS Seven studies were included, and four themes emerged: (a) Influences on choice and preference; (b) mixed experiences from "pain" to "more in control"; (c) impact on postpartum health; and (d) ways to empower couples in their choice. CONCLUSIONS Women's preferences for birthing positions were influenced by a myriad of personal and socio-cultural beliefs and traditions. Findings suggest a need for health care practitioners to build better rapport and provide more culturally relevant informational support to both women and their birthing partners, so they are better able to make informed decisions on their preferred birthing position.
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Affiliation(s)
- Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, Level 2, Clinical Research Centre, Block MD11, National University of Singapore, Singapore, Singapore
| | - Valerie Chan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, Level 2, Clinical Research Centre, Block MD11, National University of Singapore, Singapore, Singapore
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Miyauchi A, Shishido E, Horiuchi S. Women's experiences and perceptions of women-centered care and respectful care during facility-based childbirth: A meta-synthesis. Jpn J Nurs Sci 2022; 19:e12475. [PMID: 35133066 DOI: 10.1111/jjns.12475] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 12/12/2021] [Accepted: 01/06/2022] [Indexed: 11/26/2022]
Abstract
AIM The World Health Organization has recommended intrapartum care for a positive childbirth experience through respectful care based on women-centered care. This study aimed to explore women's experiences of facility-based childbirth to gain insights into their perceptions of women-centered care, including humanized childbirth and respectful maternity care during intrapartum care. METHODS Used the Joanna Briggs Institute method as the framework for this meta-synthesis, we searched the PubMed, EMBASE, CINAHL, PsycINFO, and LILCAS databases, and included qualitative studies and interviews of women's experiences and perceptions of women-centered care during facility-based childbirth published from 1990 to 2020 in English. Study quality was assessed using the Critical Appraisal Skills Programme checklist. NVivo software was used for data extraction and synthesis. RESULTS There were 22 studies from 19 countries that met the established inclusion criteria. Five categories of experiences of facility-based childbirth and perceptions of women-centered care from the synthesized voices of women were generated: (i) value of women through childbirth; (ii) overwhelmed by unpleasant childbearing experiences; (iii) a sense of being respected and valued; (iv) a sense of being disrespected and abused; and (v) inadequate systems and resources. Our meta-synthesis indicated that respectful and helpful interaction between women and healthcare providers produced positive perceptions among women. CONCLUSIONS This study emphasizes the importance of respectful interactions and intrapersonal experiences. Strong systems and positive environments lead to positive interactions between women and healthcare providers. Future studies need to consider cultural and economic differences in women-centered care and respectful care for childbirth in different contexts.
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Affiliation(s)
- Ai Miyauchi
- Japanese Red Cross College of Nursing, Tokyo, Japan
| | - Eri Shishido
- St. Luke's International University, Tokyo, Japan
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Christe DM, Padmanaban S. Respectful Maternity Care Initiative: A Qualitative Study. J Obstet Gynaecol India 2022; 72:32-37. [PMID: 35125736 PMCID: PMC8804021 DOI: 10.1007/s13224-021-01482-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 04/12/2021] [Indexed: 02/03/2023] Open
Abstract
AIM To assess the available standards for respectful maternity care in a public maternity hospital by evaluation of responses to a questionnaire given to birthing women. METHODOLOGY Assessment was done to find out the level of respectful maternity care provided under the most sensitive and important areas, namely (1) confidentiality and privacy, (2) physical harm or ill treatment, (3) dignity and respect, (4) left without care, (5) right to information, informed consent, and choice/preferences, by obtaining the response of birthing women. RESULTS Confidentiality and Privacy: No birthing woman (0%) expressed her opinion that she was dissatisfied with privacy provided, at any time of her stay in the hospital. Physical harm or ill treatment: It was significant to note that no woman reported being ill-treated or physically harmed. Dignity and Respect: A response of satisfaction regarding this important aspect of maternity care was received by nearly 95% of birthing women, A very small percent of 5.1% of women were not completely satisfied. Left without care or Attention given at all times:1.9% of women felt that they were not given immediate response when they called for any need. Right to information, informed consent, and choice/preferences: The greater majority of 95.7% of women were satisfied with methods engaged by hospital staff regarding right to information, informed consent and practices. CONCLUSION The response from a significant majority of birthing women was that they had respectful maternity care given to them at Government hospital for Women and Children.
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Affiliation(s)
- D. M. Christe
- Department of Clinical Research, NIRT, Indian Council of Medical Research, [ICMR], Chetpet, Chennai, 600031 India
| | - S. Padmanaban
- Statistics Department, NIRT, Indian Council of Medical Research, [ICMR], Chetpet, Chennai, 600031 India
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Lavender T, Bedwell C, Kasengele CT, Kimaro D, Kuzenza F, Lyangenda K, Mills TA, Nsemwa L, Shayo H, Tuwele K, Wakasiaka S, Laisser R. Respectful care an added extra: a grounded theory study exploring intrapartum experiences in Zambia and Tanzania. BMJ Glob Health 2021; 6:bmjgh-2020-004725. [PMID: 33926891 PMCID: PMC8094336 DOI: 10.1136/bmjgh-2020-004725] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 04/14/2021] [Accepted: 04/16/2021] [Indexed: 11/17/2022] Open
Abstract
Background Quality of maternal and newborn care is integral to positive clinical, social and psychological outcomes. Respectful care is an important component of this but is suboptimum in many low-income settings. A renewed energy among health professionals and academics is driving an international agenda to eradicate disrespectful health facility care around the globe. However, few studies have explored respectful care from different vantage points. Methods We used Strauss and Corbin’s grounded theory methodology to explore intrapartum experiences in Tanzania and Zambia. In-depth interviews were conducted with 98 participants (48 women, 18 partners, 21 health-providers and 11 key stakeholders), resulting in data saturation. Analysis involved constant comparison, comprising three stages of coding: open, axial and selective. The process involved application of memos, reflexivity and positionality. Results Findings demonstrated that direct and indirect social discrimination led to inequity of care. Health-providers were believed to display manipulative behaviours to orchestrate situations for their own or the woman’s benefit, and were often caring against the odds, in challenging environments. Emergent categories were related to the core category: respectful care, an added extra, which reflects the notion that women did not always expect or receive respectful care, and tolerated poor experiences to obtain services believed to benefit them or their babies. Respectful care was not seen as a component of good quality care, but a luxury that only some receive. Conclusion Both quality of care and respectful care were valued but were not viewed as mutually inclusive. Good quality treatment (transactional care) was often juxtaposed with disrespectful care; with relational care having a lower status among women and healthcare providers. To readdress the balance, respectful care should be a predominant theme in training programmes, policies and audits. Women’s and health-provider voices are pivotal to the development of such interventions.
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Affiliation(s)
- Tina Lavender
- Liverpool School of Tropical Medicine, Department of International Public Health, Liverpool, Liverpool, UK
| | - Carol Bedwell
- Liverpool School of Tropical Medicine, Department of International Public Health, Liverpool, Liverpool, UK
| | | | - Debora Kimaro
- Archbishop Antony Mayala School of Nursing, Catholic University of Health and Allied Sciences Bugando, Mwanza, Tanzania
| | - Flora Kuzenza
- Archbishop Antony Mayala School of Nursing, Catholic University of Health and Allied Sciences Bugando, Mwanza, Tanzania
| | - Kutemba Lyangenda
- Department of Public Health and Research, Ministry of Health, Lusaka, Zambia
| | - Tracey A Mills
- Liverpool School of Tropical Medicine, Department of International Public Health, Liverpool, Liverpool, UK
| | - Livuka Nsemwa
- Archbishop Antony Mayala School of Nursing, Catholic University of Health and Allied Sciences Bugando, Mwanza, Tanzania
| | - Happiness Shayo
- Archbishop Antony Mayala School of Nursing, Catholic University of Health and Allied Sciences Bugando, Mwanza, Tanzania
| | - Khuzuet Tuwele
- Department of Public Health and Research, Ministry of Health, Lusaka, Zambia
| | - Sabina Wakasiaka
- School of Nursing Sciences, University of Nairobi, Nairobi, Kenya
| | - Rose Laisser
- Archbishop Antony Mayala School of Nursing, Catholic University of Health and Allied Sciences Bugando, Mwanza, Tanzania
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Espada-Trespalacios X, Ojeda F, Perez-Botella M, Milà Villarroel R, Bach Martinez M, Figuls Soler H, Anquela Sanz I, Rodríguez Coll P, Escuriet R. Oxytocin Administration in Low-Risk Women, a Retrospective Analysis of Birth and Neonatal Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4375. [PMID: 33924137 PMCID: PMC8074312 DOI: 10.3390/ijerph18084375] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/16/2021] [Accepted: 04/16/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND In recent years, higher than the recommended rate of oxytocin use has been observed among low-risk women. This study examines the relationship between oxytocin administration and birth outcomes in women and neonates. METHODS A retrospective analysis of birth and neonatal outcomes for women who received oxytocin versus those who did not. The sample included 322 women with a low-risk pregnancy. RESULTS Oxytocin administration was associated with cesarean section (aOR 4.81, 95% CI: 1.80-12.81), instrumental birth (aOR 3.34, 95% CI: 1.45-7.67), episiotomy (aOR 3.79, 95% CI: 2.20-6.52) and length of the second stage (aOR 00:18, 95% CI: 00:04-00:31). In neonatal outcomes, oxytocin in labor was associated with umbilical artery pH ≤ 7.20 (OR 3.29, 95% CI: 1.33-8.14). Admission to neonatal intensive care unit (OR 0.56, 95% CI: 0.22-1.42), neonatal resuscitation (OR 1.04, 95% CI: 0.22-1.42), and Apgar score <7 (OR 0.48, 95% CI: 0.17-1.33) were not associated with oxytocin administration during labor. CONCLUSIONS Oxytocin administration during labor for low-risk women may lead to worse birth outcomes with an increased risk of instrumental birth and cesarean, episiotomy and the use of epidural analgesia for pain relief. Neonatal results may be also worse with an increased proportion of neonates displaying an umbilical arterial pH ≤ 7.20.
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Affiliation(s)
- Xavier Espada-Trespalacios
- Department of Obstetrics and Gynecology, Hospital General de Granollers, Avinguda Francesc Ribas s/n, 08402 Granollers, Spain; (F.O.); (M.B.M.); (H.F.S.)
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra (UPF), Doctor Aiguader 88, 08003 Barcelona, Spain
- Research Group in Global Health, Gender and Society (GHenderS), Universitat Ramon Llull, Carrer Padilla 326, 08025 Barcelona, Spain;
| | - Felipe Ojeda
- Department of Obstetrics and Gynecology, Hospital General de Granollers, Avinguda Francesc Ribas s/n, 08402 Granollers, Spain; (F.O.); (M.B.M.); (H.F.S.)
| | - Mercedes Perez-Botella
- Research in Childbirth and Health Unit (ReaRH), University of Central Lancashire, Preston PR1 2HE, UK;
- Department of Neonatology, Hospital General de Granollers, Avinguda Francesc Ribas s/n, 08402 Granollers, Spain
| | - Raimon Milà Villarroel
- School of Health Sciences Blanquerna, Universitat Ramon Llull, Carrer Padilla 326, 08025 Barcelona, Spain; (R.M.V.); (I.A.S.)
| | - Montserrat Bach Martinez
- Department of Obstetrics and Gynecology, Hospital General de Granollers, Avinguda Francesc Ribas s/n, 08402 Granollers, Spain; (F.O.); (M.B.M.); (H.F.S.)
| | - Helena Figuls Soler
- Department of Obstetrics and Gynecology, Hospital General de Granollers, Avinguda Francesc Ribas s/n, 08402 Granollers, Spain; (F.O.); (M.B.M.); (H.F.S.)
| | - Israel Anquela Sanz
- School of Health Sciences Blanquerna, Universitat Ramon Llull, Carrer Padilla 326, 08025 Barcelona, Spain; (R.M.V.); (I.A.S.)
| | - Pablo Rodríguez Coll
- Obstetric Care Area, Hospital Germans Trias i Pujol, Carretera de Canyet s/n, 08916 Badalona, Spain;
| | - Ramon Escuriet
- Research Group in Global Health, Gender and Society (GHenderS), Universitat Ramon Llull, Carrer Padilla 326, 08025 Barcelona, Spain;
- Catalan Health Service, Government of Catalonia, Travessera de les Corts 131, 08028 Barcelona, Spain
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Finlayson K, Vogel JP, Althabe F, Widmer M, Oladapo OT. Healthcare providers experiences of using uterine balloon tamponade (UBT) devices for the treatment of post-partum haemorrhage: A meta-synthesis of qualitative studies. PLoS One 2021; 16:e0248656. [PMID: 33735300 PMCID: PMC7971480 DOI: 10.1371/journal.pone.0248656] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 03/02/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Postpartum haemorrhage (PPH) is a leading cause of maternal mortality and severe morbidity globally. When PPH cannot be controlled using standard medical treatments, uterine balloon tamponade (UBT) may be used to arrest bleeding. While UBT is used by healthcare providers in hospital settings internationally, their views and experiences have not been systematically explored. The aim of this review is to identify, appraise and synthesize available evidence about the views and experiences of healthcare providers using UBT to treat PPH. METHODS Using a pre-determined search strategy, we searched MEDLINE, CINAHL, PsycINFO, EMBASE, LILACS, AJOL, and reference lists of eligible studies published 1996-2019, reporting qualitative data on the views and experiences of health professionals using UBT to treat PPH. Author findings were extracted and synthesised using techniques derived from thematic synthesis and confidence in the findings was assessed using GRADE-CERQual. RESULTS Out of 89 studies we identified 5 that met our inclusion criteria. The studies were conducted in five low- and middle-income countries (LMICs) in Africa and reported on the use of simple UBT devices for the treatment of PPH. A variety of cadres (including midwives, medical officers and clinical officers) had experience with using UBTs and found them to be effective, convenient, easy to assemble and relatively inexpensive. Providers also suggested regular, hands-on training was necessary to maintain skills and highlighted the importance of community engagement in successful implementation. CONCLUSIONS Providers felt that administration of a simple UBT device offered a practical and cost-effective approach to the treatment of uncontrolled PPH, especially in contexts where uterotonics were ineffective or unavailable or where access to surgery was not possible. The findings are limited by the relatively small number of studies contributing to the review and further research in other contexts is required to address wider acceptability and feasibility issues.
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Affiliation(s)
- Kenneth Finlayson
- Research in Childbirth and Health (ReaCH) Unit, University of Central Lancashire, Preston, Lancashire, United Kingdom
| | - Joshua P. Vogel
- Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia
| | - Fernando Althabe
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Mariana Widmer
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Olufemi T. Oladapo
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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15
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Okonofua FE, Ntoimo LFC, Ekezue BF, Ohenhen V, Agholor K, Igboin B, Maduako K, Imongan W, Gidago Y, Galadanci H, Ogu R. Outcomes of a multifaceted intervention to improve maternal satisfaction with care in secondary hospitals in Nigeria. Glob Health Action 2020; 13:1856470. [PMID: 33334274 PMCID: PMC7751393 DOI: 10.1080/16549716.2020.1856470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/23/2020] [Indexed: 11/10/2022] Open
Abstract
Background: Data in Nigeria suggests a high level of dissatisfaction among women attending maternity care in health facilities due to long wait times, disrespectful care, and poor attention by healthcare personnel. Objective: To examine the effectiveness of a multifaceted intervention in improving self-reported indicators of maternal healthcare satisfaction by women who use referral facilities in two regions of Nigeria. Method: The design was quasi-experimental and consisted of two intervention facilities and two control facilities. The interventions included strategic planning, staff re-training, a computerized appointment system, health education/feedback, maternal death reviews and surveillance, and advocacy. A random sample of 2262 women was selected (1205 in the intervention sites and 1057 in the two control sites) to respond to a 24-item questionnaire on service satisfaction as they exited the health facilities. Adjusted Poisson and binary regression analyses were used to assess and compare proportions of reported satisfaction by women between the intervention and control sites. Results: Women in the intervention sites were 54% more likely than those in control sites to report overall satisfaction with services. They were significantly less likely to report inadequate security arrangements in accessing the health facilities (p < .1); and three times more likely to agree that health workers were extremely thorough and careful in attending to them (p < .1). Conclusion: The interventions had positive effects on improving women's satisfaction with care. The findings from this study have implications for the design and implementation of interventions that address women's concerns relating to the provision of care and consequently improve service utilization.
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Affiliation(s)
- Friday E. Okonofua
- Women’s Health and Action Research Centre (WHARC), Benin City, Nigeria
- The Centre of Excellence in Reproductive Health Innovation, University of Benin, Benin City, Nigeria
- The Department of Obstetrics and Gynaecology, University of Benin and University of Benin Teaching Hospital, Nigeria
| | - Lorretta Favour C. Ntoimo
- Women’s Health and Action Research Centre (WHARC), Benin City, Nigeria
- Department of Demography and Social Statistics, The Federal University, Oye-Ekiti, Nigeria
| | - Bola F. Ekezue
- Department of Accounting, Finance, Healthcare Administration & Information Systems, Fayetteville State University, Fayetteville, USA
| | - Victor Ohenhen
- Department of Obstetrics and Gynaecology, The Central Hospital, Benin City, Nigeria
| | - Kingsley Agholor
- Department of Obstetrics and Gynaecology/Anti-Retroviral Therapy Centre, The Central Hospital, Warri, Delta State, Nigeria
| | - Brian Igboin
- Women’s Health and Action Research Centre (WHARC), Benin City, Nigeria
| | - Kenneth Maduako
- The Centre of Excellence in Reproductive Health Innovation, University of Benin, Benin City, Nigeria
- The Department of Obstetrics and Gynaecology, University of Benin and University of Benin Teaching Hospital, Nigeria
| | - Wilson Imongan
- Women’s Health and Action Research Centre (WHARC), Benin City, Nigeria
| | - Yagana Gidago
- Department of Obstetrics and Gynaecology, The General Hospital, Minna, Nigeria
| | - Hadiza Galadanci
- Department of Obstetrics and Gynaecology, The Bayero University, Kano, Nigeria
| | - Rosemary Ogu
- Department of Obstetrics and Gynaecology, University of Port Harcourt, Rivers State, Nigeria
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Barry PL, McMahon LE, Banks RA, Fergus AM, Murphy DJ. Prospective cohort study of water immersion for labour and birth compared with standard care in an Irish maternity setting. BMJ Open 2020; 10:e038080. [PMID: 33277276 PMCID: PMC7722381 DOI: 10.1136/bmjopen-2020-038080] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To examine the birth outcomes for women and babies following water immersion for labour only, or for labour and birth. DESIGN Prospective cohort study. SETTING Maternity hospital, Ireland, 2016-2019. PARTICIPANTS A cohort of 190 low-risk women who used water immersion; 100 gave birth in water and 90 laboured only in water. A control group of 190 low-risk women who received standard care. METHODS Logistic regression analyses examined associations between water immersion and birth outcomes adjusting for confounders. A validated Childbirth Experience Questionnaire was completed. MAIN OUTCOME MEASURES Perineal tears, obstetric anal sphincter injuries (OASI), postpartum haemorrhage (PPH), neonatal unit admissions (NNU), breastfeeding and birth experiences. RESULTS Compared with standard care, women who chose water immersion had no significant difference in perineal tears (71.4% vs 71.4%, adj OR 0.83; 95% CI 0.49 to 1.39) or in OASI (3.3% vs 3.8%, adj OR 0.91; 0.26-2.97). Women who chose water immersion were more likely to have a PPH ≥500 mL (10.5% vs 3.7%, adj OR 2.60; 95% CI 1.03 to 6.57), and to exclusively breastfeed at discharge (71.1% vs 45.8%, adj OR 2.59; 95% CI 1.66 to 4.05). There was no significant difference in NNU admissions (3.7% vs 3.2%, adj OR 1.06; 95% CI 0.33 to 3.42). Women who gave birth in water were no more likely than women who used water for labour only to require perineal suturing (64% vs 80.5%, adj OR 0.63; 95% CI 0.30 to 1.33), to experience OASI (3.0% vs 3.7%, adj OR 1.41; 95% CI 0.23 to 8.79) or PPH (8.0% vs 13.3%, adj OR 0.73; 95% CI 0.26 to 2.09). Women using water immersion reported more positive memories than women receiving standard care (p<0.01). CONCLUSIONS Women choosing water immersion for labour or birth were no more likely to experience adverse birth outcomes than women receiving standard care and rated their birth experiences more highly.
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Affiliation(s)
- Paula L Barry
- Midwifery, Coombe Women and Infants University Hospital, Dublin, Ireland
| | - Lean E McMahon
- National Clinical Programme for Obstetrics & Gynaecology/National Women & Infants Health Programme, Coombe Women's Hospital, Dublin, Ireland
| | - Ruth Am Banks
- Midwifery, Coombe Women and Infants University Hospital, Dublin, Ireland
| | - Ann M Fergus
- Midwifery, Coombe Women and Infants University Hospital, Dublin, Ireland
| | - Deirdre J Murphy
- Obstetrics & Gynaecology, Trinity College Dublin, Dublin, Ireland
- Obstetrics, Coombe Women and Infants University Hospital, Dublin, Ireland
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17
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Yuill C, McCourt C, Cheyne H, Leister N. Women's experiences of decision-making and informed choice about pregnancy and birth care: a systematic review and meta-synthesis of qualitative research. BMC Pregnancy Childbirth 2020; 20:343. [PMID: 32517734 PMCID: PMC7285707 DOI: 10.1186/s12884-020-03023-6] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 05/20/2020] [Indexed: 11/18/2022] Open
Abstract
Background The purpose of this systematic review (PROSPERO Ref: CRD42017053264) was to describe and interpret the qualitative research on parent’s decision-making and informed choice about their pregnancy and birth care. Given the growing evidence on the benefits of different models of maternity care and the prominence of informed choice in health policy, the review aimed to shed light on the research to date and what the findings indicate. Methods a systematic search and screening of qualitative research concerning parents’ decision-making and informed choice experiences about pregnancy and birth care was conducted using PRISMA guidelines. A meta-synthesis approach was taken for the extraction and analysis of data and generation of the findings. Studies from 1990s onwards were included to reflect an era of policies promoting choice in maternity care in high-income countries. Results Thirty-seven original studies were included in the review. A multi-dimensional conceptual framework was developed, consisting of three analytical themes (‘Uncertainty’, ‘Bodily autonomy and integrity’ and ‘Performing good motherhood’) and three inter-linking actions (‘Information gathering,’ ‘Aligning with a birth philosophy,’ and ‘Balancing aspects of a choice’). Conclusions Despite the increasing research on decision-making, informed choice is not often a primary research aim, and its development in literature published since the 1990s was difficult to ascertain. The meta-synthesis suggests that decision-making is a dynamic and temporal process, in that it is made within a defined period and invokes both the past, whether this is personal, familial, social or historical, and the future. Our findings also highlighted the importance of embodiment in maternal health experiences, particularly when it comes to decision-making about care. Policymakers and practitioners alike should examine critically current choice frameworks to ascertain whether they truly allow for flexibility in decision-making. Health systems should embrace more fluid, personalised models of care to augment service users’ decision-making agency.
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Affiliation(s)
- Cassandra Yuill
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, 1 Myddelton Street, London, EC1R 1UW, UK.
| | - Christine McCourt
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, 1 Myddelton Street, London, EC1R 1UW, UK
| | - Helen Cheyne
- Nursing Midwifery and Allied Health Professions, University of Stirling, Stirling, Scotland, FK9 4LA, UK
| | - Nathalie Leister
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, 1 Myddelton Street, London, EC1R 1UW, UK
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18
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Faucher MA, Kennedy HP. Women's Perceptions on the Use of Video Technology in Early Labor: Being Able to See. J Midwifery Womens Health 2020; 65:342-348. [PMID: 32277583 DOI: 10.1111/jmwh.13091] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 12/03/2019] [Accepted: 12/12/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Delaying admission to the birth setting until active labor has commenced has known benefits. However, women and their partners often struggle to stay home in early labor. Research on telephone triage during early labor at home has illuminated significant disadvantages with this model of care, contributing to women feeling dissatisfied with the early birth experience. Research conducted with midwives on the potential benefits of using video technology suggests it might be a helpful strategy for early labor support. This study examined women's perspectives on the potential use of this technology. METHODS Focus groups and individual interviews were conducted with 23 English-speaking women who experienced spontaneous labor within the last year. The recordings were transcribed verbatim. Content analysis was used to interpret women's perceptions. RESULTS The women identified potential advantages of video technology in early labor connected to the major theme of being able to see, which could enable closer human connections between the intrapartum care provider, the woman, and her partner, as well as better assessments of labor. This human connection was integral to enhancing empathy and building confidence. Concerns about using video calls during early labor at home focused on privacy issues and the need to practice beforehand. Concerns about privacy depended upon having a prior relationship with the intrapartum care provider and women being able to decide if they wanted to use the technology. DISCUSSION One way of optimizing the experience of staying home in early labor and overall satisfaction with the birth experience may be with video technology, which could offer enhancements over traditional telephone triage.
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Affiliation(s)
- Mary Ann Faucher
- Louise Herrington School of Nursing, Baylor University, Dallas, Texas
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19
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Spranzi F, Norton C. From handover to takeover: should we consider a new conceptual model of communication? ACTA ACUST UNITED AC 2020. [DOI: 10.12968/bjom.2020.28.3.156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Objective This service evaluation aimed to collect data on clinical handover on labour ward and compare them with the local guideline. Design and methods This service evaluation was structured in four stages, each using a different design and research methods. Setting The study was undertaken between September 2013 and August 2014 in a maternity unit in a large NHS teaching hospital in London, UK. Findings and conclusion Communication breakdown is widely considered to be a significant factor contributing to poor patient outcomes, with handover being a major risk point. The discrepancy between the local guideline and current clinical practice reinforces the belief that urgent action is needed to improve clinical handover on labour ward. The results of this service evaluation suggest that a drastic overhaul of the communication model during handover should be considered, ie from handover to takeover, and that the mnemonic SBAR may not be fit-for-purpose in maternity care and should be replaced with a different format that reflects the chronological flow of clinical events.
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Affiliation(s)
- Francesca Spranzi
- Risk management support midwife, Imperial College Healthcare, NHS Trust
| | - Christine Norton
- Professor of clinical nursing research, Florence Nightingale faculty of nursing, midwifery and palliative care, King's College London
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20
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Neerland CE, Avery MD, Saftner MA, Gurvich OV. Maternal confidence for physiologic birth: Associated prenatal characteristics and outcomes. Midwifery 2019; 77:110-116. [PMID: 31319365 DOI: 10.1016/j.midw.2019.07.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 06/18/2019] [Accepted: 07/08/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Pregnancy, labor, and birth are normal, physiologic processes. Women often seek information during pregnancy to enhance their confidence for physiologic birth. Little is known about confidence for physiologic birth and associated prenatal characteristics and birth outcomes such as provider type, source of labor and birth information, mode of birth, and use of pain medication in labor. The purpose of this study was to examine prenatal confidence for physiologic birth and associated prenatal characteristics and birth outcomes. DESIGN This study was completed as part of a multi-phased instrument development study, the Preparation for Labor and Birth (P-LAB) instrument. P-LAB confidence scores were examined for their relationship with variables including labor type, provider type, source of labor support, pain medication use, and birth mode. SETTING AND PARTICIPANTS Women (N = 192) from five prenatal clinics in the Midwestern United States who had completed the P-LAB instrument participated in postpartum telephone interviews. FINDINGS Women with previous birth experience had higher confidence than nulliparous women. Prenatal care providers were reported as main source of labor and birth information. Confidence for birth was associated with intention to not use pain medication in labor. Women's overall intention to use or not use pain medication was consistent with use. Prenatal confidence was not associated with mode of birth. IMPLICATIONS FOR FUTURE RESEARCH Special emphasis should be paid to nulliparous women when developing interventions to enhance confidence for physiologic birth. Women rely on their care providers for information regarding labor and birth, therefore one area to strengthen confidence for physiologic birth is within the provider-patient relationship.
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Affiliation(s)
- Carrie E Neerland
- University of Minnesota School of Nursing, 5-140 Weaver-Densford Hall, 308 Harvard St SE, Minneapolis, MN 55455, USA.
| | - Melissa D Avery
- University of Minnesota School of Nursing, 5-140 Weaver-Densford Hall, 308 Harvard St SE, Minneapolis, MN 55455, USA
| | - Melissa A Saftner
- University of Minnesota, 1035 University Dr, SMed 351, Duluth, MN 55812, USA
| | - Olga V Gurvich
- University of Minnesota School of Nursing, 5-140 Weaver-Densford Hall, 308 Harvard St SE, Minneapolis, MN 55455, USA
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