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Colciago E, Robinson A, Ornaghi S, Fumagalli S, Antolini L, Nespoli A, Brown AM. Are expectations of labour and birth fulfilled? A qualitative investigation of first-time parents. J Adv Nurs 2024. [PMID: 38923600 DOI: 10.1111/jan.16274] [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: 05/08/2023] [Revised: 05/03/2024] [Accepted: 05/29/2024] [Indexed: 06/28/2024]
Abstract
AIM To describe if first-time parents' expectations of labour and birth, explored during the third trimester of pregnancy, were fulfilled or not when investigated 1 year following birth. DESIGN Qualitative Husserlian phenomenological approach. METHODS The sample comprises 10 parents (five couples), who participated in an online semi-structured audio-recorded individual interview conducted 1 year after birth, between September 2020 and October 2020. Parents' expectations of labour and birth, described throughout a focus group discussion on pregnancy, were compared with their experience explored 1 year after birth. A thematic analysis was adopted and member checking was used to validate participants' thoughts. RESULTS Participants gave birth in a II level maternity unit and one-to-one midwifery care was provided. Although during the focus group conducted in pregnancy, women reported being aware of the unpredictable nature of childbirth, they expressed sadness and failure after experiencing some unexpected interventions. The midwife was a reassuring guide, as expected; however, sometimes, the communication was not effective, and women perceived lack of support. Some women partly blame themselves for not being prepared to manage labour pain, which hurt more than expected. Feeling of uncertainty about events were experienced in relation to seeking care at an early stage of labour, which confirmed the fears expressed during pregnancy. During the antenatal focus group discussion, fathers doubted they could be helpful for the labouring women. This negative emotion was confirmed after birth. However, they understood the importance to be present and to support their partner. CONCLUSIONS One year after birth, participants had consistent memories of their birth experience. Professionals might identify fundamental components of quality maternity care that are meaningful for parents, with the potential to generate a long-term positive health impact on them. Respectful maternity care should be ensured through a family-centred approach, with the aim to promote satisfaction. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE The study highlights the importance of taking parents' expectations into account when providing antenatal care to tailor individualized support that addresses their distinct needs and preferences. Healthcare professionals might consider initiating a post-natal discussion with parents to assess whether their needs and perspectives have been addressed. This perspective may present valuable insights to achieve long-term positive outcomes, provide high-quality maternity care, address issues and make improvements. IMPACT The study showed that 1 year after birth, parents can accurately recall their birth. They might also give significant insights into fundamental components of care that they value as crucial to shape a positive birthing experience. Professionals should use this information to build solutions, promoting long-term well-being for parents. Respectful interactions and trusting relationships emerged as key elements in parents' experience. A midwifery care focused on parents' needs may contribute to the achievement of positive birth memories. REPORTING METHOD This study used the Standards for Reporting Qualitative Research checklist. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
| | - Ann Robinson
- Division of Midwifery, University of Surrey-School of Health and Medical Sciences, Guildford, Surrey, UK
| | - Sara Ornaghi
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- Department of Obstetrics, Foundation IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Simona Fumagalli
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- Department of Obstetrics, Foundation IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Laura Antolini
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Antonella Nespoli
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- Department of Obstetrics, Foundation IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Anna Maria Brown
- Division of Midwifery, University of Surrey-School of Health and Medical Sciences, Guildford, Surrey, UK
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Liu C, Underhill K, Aubey JJ, Samari G, Allen HL, Daw JR. Disparities in Mistreatment During Childbirth. JAMA Netw Open 2024; 7:e244873. [PMID: 38573636 PMCID: PMC11192180 DOI: 10.1001/jamanetworkopen.2024.4873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 02/06/2024] [Indexed: 04/05/2024] Open
Abstract
Importance Lack of respectful maternity care may be a key factor associated with disparities in maternal health. However, mistreatment during childbirth has not been widely documented in the US. Objectives To estimate the prevalence of mistreatment by health care professionals during childbirth among a representative multistate sample and to identify patient characteristics associated with mistreatment experiences. Design, Setting, and Participants This cross-sectional study used representative survey data collected from respondents to the 2020 Pregnancy Risk and Monitoring System in 6 states and New York City who had a live birth in 2020 and participated in the Postpartum Assessment of Health Survey at 12 to 14 months' post partum. Data were collected from January 1, 2021, to March 31, 2022. Exposures Demographic, social, clinical, and birth characteristics that have been associated with patients' health care experiences. Main Outcomes and Measures Any mistreatment during childbirth, as measured by the Mistreatment by Care Providers in Childbirth scale, a validated measure of self-reported experiences of 8 types of mistreatment. Survey-weighted rates of any mistreatment and each mistreatment indicator were estimated, and survey-weighted logistic regression models estimated odds ratios (ORs) and 95% CIs. Results The sample included 4458 postpartum individuals representative of 552 045 people who had live births in 2020 in 7 jurisdictions. The mean (SD) age was 29.9 (5.7) years, 2556 (54.4%) identified as White, and 2836 (58.8%) were commercially insured. More than 1 in 8 individuals (13.4% [95% CI, 11.8%-15.1%]) reported experiencing mistreatment during childbirth. The most common type of mistreatment was being "ignored, refused request for help, or failed to respond in a timely manner" (7.6%; 95% CI, 6.5%-8.9%). Factors associated with experiencing mistreatment included being lesbian, gay, bisexual, transgender, queer identifying (unadjusted OR [UOR], 2.3; 95% CI, 1.4-3.8), Medicaid insured (UOR, 1.4; 95% CI, 1.1-1.8), unmarried (UOR, 0.8; 95% CI, 0.6-1.0), or obese before pregnancy (UOR, 1.3; 95% CI, 1.0-1.7); having an unplanned cesarean birth (UOR, 1.6; 95% CI, 1.2-2.2), a history of substance use disorder (UOR, 2.6; 95% CI, 1.3-5.1), experienced intimate partner or family violence (UOR, 2.3; 95% CI, 1.3-4.2), mood disorder (UOR, 1.5; 95% CI, 1.1-2.2), or giving birth during the COVID-19 public health emergency (UOR, 1.5; 95% CI, 1.1-2.0). Associations of mistreatment with race and ethnicity, age, educational level, rural or urban geography, immigration status, and household income were ambiguous. Conclusions and Relevance This cross-sectional study of individuals who had a live birth in 2020 in 6 states and New York City found that mistreatment during childbirth was common. There is a need for patient-centered, multifaceted interventions to address structural health system factors associated with negative childbirth experiences.
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Affiliation(s)
- Chen Liu
- Department of Health Policy and Management, Columbia University Mailman School of Public Health, New York, New York
| | | | - Janice J. Aubey
- Department of Obstetrics and Gynecology, NewYork-Presbyterian/Columbia University Medical Center, New York, New York
| | - Goleen Samari
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles
| | - Heidi L. Allen
- Columbia University School of Social Work, New York, New York
| | - Jamie R. Daw
- Department of Health Policy and Management, Columbia University Mailman School of Public Health, New York, New York
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Demir Yildirim A, Yilmaz Esencan T, Premberg A, Hotun Şahin N. The validity and reliability study of the first-time fathers questionnaire in Turkish. Heliyon 2024; 10:e23957. [PMID: 38205293 PMCID: PMC10777063 DOI: 10.1016/j.heliyon.2023.e23957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/06/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
The father's participation in the birth contributes significantly to the mother's birth experiences as well as to the fatherhood process. Since fathers have traditionally not been allowed to attend childbirth in Turkish public hospitals, which now is changing, there is a lack of research in this area. To remedy this shortcoming, a questionnaire that explores the Turkish fathers' experiences of childbirth is needed. The study aims to translate, validate, and adapt the pre-existing First-Time Fathers' Questionnaire to the Turkish language and culture. In the first stage of the study, the questionnaire was translated to Turkish. Expert opinions of the First Time Father Questionnaire were taken, and the content validity was checked. The revised questionnaire was then completed by 110 fathers. The average age of the fathers participating in the study was 32.12 ± 6.8 and 80 % of them were found to be middle class. The construct validity of the questionnaire was tested with explanatory factor analysis and confirmatory factor analysis, finally a test-retest was performed. The Cronbach's alpha coefficient for each dimension of the 20-items questionnaire was as follows: knowledge = 0.90, acceptance = 0.90, anxiety = 0.88, and emotional support = 0.66. All sub-dimensions correspond to 68.5 % of the total variance. The confirmatory factor analysis model showed consistency for the data (X2/DF = 1.078; RMSA = 0.027; CFI = 0.992; GFI = 0.900; AGFI.0.829). Therefore, the adaptation of the First Time Fathers Questionnaire is a valid and reliable instrument in evaluating the childbirth experiences of first-time fathers in Turkish culture.
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Affiliation(s)
- Ayça Demir Yildirim
- Department of Midwifery, Faculty of Health Sciences, Uskudar University, Istanbul, Turkey
| | - Tuğba Yilmaz Esencan
- Department of Midwifery, Faculty of Health Sciences, Uskudar University, Istanbul, Turkey
| | - Asa Premberg
- Research and Development Centre, Primary Health Care, Gothenburg, Sweden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Nevin Hotun Şahin
- Florence Nightingale Faculty of Nursing, Department of Women's Health and Diseases, Istanbul University-Cerrahpaşa, Istanbul, Turkey
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Doering K, McAra-Couper J, Gilkison A. Seeking a connection: Women's lived experience of the woman-midwife relationship in mainstream maternity services in Japan. Women Birth 2023; 36:e598-e604. [PMID: 37277260 DOI: 10.1016/j.wombi.2023.05.007] [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: 12/01/2022] [Revised: 05/21/2023] [Accepted: 05/21/2023] [Indexed: 06/07/2023]
Abstract
PROBLEM In Japan, women continue to suffer from mental health and other postpartum issues despite good clinical outcomes of maternity care. BACKGROUND As key care providers, midwives potentially affect women's overall birth experience. Most women in Japan give birth in hospitals or obstetric clinics where different midwives and nurses provide one woman with fragmented care. Women's lived experiences of the woman-midwife in these birth facilities are not well known in Japan. AIM To understand women's birth experience and relationship with midwives in the mainstream maternity care system in Japan to improve maternity care and women's birth experience. METHODS Face-to-face individual interviews with 14 mothers were conducted. The data were analysed using van Manen's hermeneutic phenomenological approach, which reveals the meaning of human experience in the everyday world. FINDINGS Four themes were derived from the hermeneutic phenomenological analysis; 1) Closed hearts and bodies in insecure relationships, 2) Alienation, 3) Hopelessness and helplessness, and 4) Women's vulnerability and desire for positive relationships. DISCUSSION In institutionalised and fragmented maternity care settings, it is difficult for women and midwives to develop a relationship. In such a care environment, women's birth experience with midwives is negative or even traumatic; yet, women still need and seek the midwife relationship. Respectful care-necessary for women's positive birth experience-requires positive relationship between women and midwives. CONCLUSION Women's negative birth experience may affect their mental health and parenting. Maternity and midwifery care in Japan needs to develop relationship-based care to improve women's birth experience.
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Affiliation(s)
- Keiko Doering
- Department of Human Health Sciences, Kyoto University, 53 Kawahara-cho Shogo-in, Sakyo-ku, Kyoto, Japan.
| | - Judith McAra-Couper
- School of Clinical Sciences, Auckland University of Technology, 640 Great South Road, Manukau, Auckland, New Zealand
| | - Andrea Gilkison
- School of Clinical Sciences, Auckland University of Technology, 90 Akoranga Drive, Northcote, Auckland, New Zealand
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Mheta D, Sibiya MN, Nkosi PB. Experiences of Women with Disabilities in Accessing Maternal Healthcare Services: A South African Case Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6966. [PMID: 37947524 PMCID: PMC10647398 DOI: 10.3390/ijerph20216966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 10/16/2023] [Accepted: 10/19/2023] [Indexed: 11/12/2023]
Abstract
Access to maternal healthcare services is a challenge in most low- and middle-income countries. South Africa is one of the countries striving to improve the accessibility of maternal healthcare services. Although South Africa has put some interventions in place to improve the accessibility of maternal healthcare services, vulnerable women including women with disabilities are still facing numerous challenges when trying to access these services. The aim of this study was to explore the experiences of women with disabilities in the province of KwaZulu-Natal in South Africa in accessing public maternal healthcare services. The objectives of this study were to describe the experiences of women with disabilities in accessing maternal healthcare services during pregnancy, childbirth and post-partum care; explore the inhibitors of access to maternal healthcare services for women with disabilities; and explore the facilitators of access to maternal healthcare services for women with disabilities. Twelve women with disabilities (four with physical impairments, four with hearing impairments and four with visual impairments) were interviewed for this study. Data were transcribed verbatim and analysed utilising the Framework of Assessing Access to Maternal Healthcare Services by Peters et al., 2008. Our study found that narrow passages and information in inaccessible formats were a challenge for women with visual impairments. Women with hearing impairments faced communication difficulties due to the lack of sign language interpreters in most facilities. Moreover, healthcare professionals displayed unfavourable attitudes toward women with hearing impairments, and these women were often overlooked when seeking help. The women with physical impairments encountered inaccessible buildings, narrow passages, small consultation rooms and equipment that is not adjustable, such as beds and scales.
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Affiliation(s)
- Doreen Mheta
- Faculty of Health Sciences, Durban University of Technology, Durban 4000, South Africa;
| | - Maureen Nokuthula Sibiya
- Division of Research, Innovation and Engagement, Mangosuthu University of Technology, Durban 4031, South Africa;
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Seefeld L, von Soest T, Dikmen-Yildiz P, Garthus-Niegel S. Dyadic analyses on the prospective association between birth experience and parent-child-bonding: The role of postpartum depression, anxiety, and childbirth-related posttraumatic stress disorder. J Anxiety Disord 2023; 98:102748. [PMID: 37517159 DOI: 10.1016/j.janxdis.2023.102748] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/10/2023] [Accepted: 07/20/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVE Negative birth experiences are associated with postpartum mental health difficulties in parents. However, research considering the long-term impact of a negative birth experience on parent-child-bonding and the interdependence between parents is rare. This study aimed to investigate actor as well as partner effects for the association between parents' birth experience and parent-child-bonding and whether this association is mediated by postpartum psychiatric symptoms. METHOD A community sample of couples (N = 743) completed questionnaires during pregnancy, 2, and 14 months after birth. RESULTS Applying Actor-Partner Interdependence Mediation Models, structural equation modeling showed that parents' own negative birth experience predicted a poorer bond to their child 14 months postpartum. Compared to mothers, this association was twice as strong for partners and was mediated by symptoms of postpartum depression (mothers and partners), anxiety (partners), and childbirth-related posttraumatic stress disorder (mothers). Negative birth experiences of one parent were not related to the other parent's bonding with the child. CONCLUSION Results underline the importance of parents' positive birth experience for their postpartum mental health and secure bond to their child. The other parent's birth experience or postpartum mental health does not seem to affect one's own bond to the child in the long term.
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Affiliation(s)
- Lara Seefeld
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine TU Dresden, Dresden, Germany; Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine TU Dresden, Dresden, Germany.
| | - Tilmann von Soest
- PROMENTA Research Center, Department of Psychology, University of Oslo, Norway
| | | | - Susan Garthus-Niegel
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine TU Dresden, Dresden, Germany; Institute for Systems Medicine (ISM) and Faculty of Human Medicine, MSH Medical School Hamburg, Hamburg, Germany; Department of Childhood and Families, Norwegian Institute of Public Health, Oslo, Norway
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Vahidi F, Mirghafourvand M, Naseri E, Ghanbari-Homaie S. Birth-related posttraumatic stress disorder and negative childbirth experience related to maternal functioning among adolescent mothers: a cross-sectional study. BMC Pregnancy Childbirth 2023; 23:371. [PMID: 37217921 DOI: 10.1186/s12884-023-05717-z] [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: 01/26/2023] [Accepted: 05/18/2023] [Indexed: 05/24/2023] Open
Abstract
BACKGROUND Adolescent pregnancy is an important issue in terms of reproductive health. Adolescent mothers have to overcome two crises at the same time: motherhood and maturity. Childbirth experience and posttraumatic stress disorder may influence the mother's perception of her infant and postpartum care behaviors. METHODS This cross-sectional study was conducted on 202 adolescent mothers referring to health centers in Tabriz and its suburbs between May and December, 2022. Data were collected by PTSD Symptom Scale, Childbirth Experience Questionnaire 2.0, and Barkin Index of Maternal Functioning. The association between childbirth experience, posttraumatic stress disorder and maternal functioning was assessed by multivariate analysis. RESULTS After adjusting the effect of socio-demographic and obstetric characteristics, the score of maternal functioning among mothers without posttraumatic stress disorder was statistically significantly higher than mothers with posttraumatic stress disorder diagnosis [β (95% CI) = 2.30 (0.39 to 4.20); p = 0.031]. The score of maternal functioning increased with the increase in the childbirth experience score [β (95% CI) = 7.34 (3.87 to 10.81); p < 0.001]. The score of maternal functioning among mothers with wanted sex of baby was statistically significantly higher than unwanted sex of baby [β (95% CI) = 2.70 (0.37 to 5.02); p = 0.023]. CONCLUSION Healthcare professionals should pay special attention to improving maternal functioning among adolescent mothers. One of the important actions can be to create a positive experience of childbirth for avoiding of posttraumatic stress disorder following birth and counseling with mothers who stated sex of fetus is undesired.
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Affiliation(s)
- Fereshteh Vahidi
- Students Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elaheh Naseri
- Department of Psychology, Faculty of Education and Psychology, University of Tabriz, Tabriz, Iran
| | - Solmaz Ghanbari-Homaie
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
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Ribeiro CSZ, Gondim EC, Scorzafave LGDS, Gomes-Sponholz FA, Santos DDD, Mello DFD. Parental stress during pregnancy and maternity. Rev Esc Enferm USP 2023; 57:e20220351. [PMID: 37011287 PMCID: PMC10081624 DOI: 10.1590/1980-220x-reeusp-2022-0351en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 01/27/2023] [Indexed: 04/05/2023] Open
Abstract
OBJECTIVE To identify factors related to parental stress of women during pregnancy and the child's first month of life. METHOD Prospective longitudinal study in two stages. Analysis of home interviews with 121 participants, Gestational Stress Scale, and Parental Stress Scale. Fisher's exact test, Spearman's correlation, and linear and logistic multivariate regression were applied, with p < 0.05. RESULTS Most of the participants were between 18 and 35 years old, had 11 to 13 years of education, had no paid work, had a partner, usually the child's father, planned pregnancy, were multiparous, and underwent prenatal care. During pregnancy, 67.8% had stress. In the first month after the child's birth, most had low parental stress (52.1%). High parental stress correlated with some gestational stress. Planning pregnancy decreased parental stress. CONCLUSION Gestational and parental stress in the child's first month of life were correlated and pregnancy planning was a factor that reduced stress levels. Timely actions to reduce parental stress are essential for parenting and the child's overall health.
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Affiliation(s)
- Carine Sanches Zani Ribeiro
- Universidade São Paulo, Escola de Enfermagem de Ribeirão Preto, Programa de Pós-Graduação Enfermagem em Saúde Pública, Ribeirão Preto, SP, Brazil
| | - Ellen Cristina Gondim
- Universidade São Paulo, Escola de Enfermagem de Ribeirão Preto, Programa de Pós-Graduação Enfermagem em Saúde Pública, Ribeirão Preto, SP, Brazil
| | - Luiz Guilherme Dacar Silva Scorzafave
- Universidade São Paulo, Faculdade de Economia, Aministração e Contabilidade de Ribeirão Preto, Laboratório de Estudos e Pesquisas em Economia Social, Ribeirão Preto, SP, Brazil
| | - Flávia Azevedo Gomes-Sponholz
- Universidade São Paulo, Escola de Enfermagem de Ribeirão Preto, Programa de Pós-Graduação Enfermagem em Saúde Pública, Ribeirão Preto, SP, Brazil
| | - Daniel Domingues Dos Santos
- Universidade São Paulo, Faculdade de Economia, Aministração e Contabilidade de Ribeirão Preto, Laboratório de Estudos e Pesquisas em Economia Social, Ribeirão Preto, SP, Brazil
| | - Débora Falleiros de Mello
- Universidade São Paulo, Escola de Enfermagem de Ribeirão Preto, Programa de Pós-Graduação Enfermagem em Saúde Pública, Ribeirão Preto, SP, Brazil
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Shahhosseini Z, Nikbakht R, Motaghi Z, Hosseini Tabaghdehi M. Development of the short form Iranian women childbirth experience questionnaire: a confirmatory factor analysis approach item reduction. BMC Pregnancy Childbirth 2023; 23:48. [PMID: 36670388 PMCID: PMC9854137 DOI: 10.1186/s12884-023-05378-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 01/12/2023] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Considering that childbirth experience has short- and long-term effects on women's lives, it is necessary to examine their delivery experiences. This study aimed to prepare the short form of a 52-item Iranian women's childbirth experience questionnaire with seven factors: professional support, preparation, control, positive perception, baby, family support, and fear. METHODS This methodological research was conducted on women aged 15 to 49 years (n = 770) with uncomplicated vaginal delivery. The short form of the Iranian women's childbirth experience questionnaire was prepared in four stages. The first stage was exploratory factor analysis, conducted on 250 samples, the second stage was confirmatory factor analysis which was performed on 260 samples, independent of the first stage, to report goodness and fit indices, and the third stage employed items from modification indices, expected parameter change, and standardized residual covariance, leading to the short form of Iranian women childbirth experience questionnaire. Finally, confirmatory factor analysis was run on 260 samples, independent of the previous two stages, to confirm the short form and compare it with the original questionnaire for psychometric analysis. RESULTS In the exploratory factor analysis stage, nine items with a factor load of less than 0.4 were removed, and the number of domains was reduced to five. The second stage showed that the questionnaire had a goodness of fit index. However, the third stage resulted in removing 11 overlapping items and making a short questionnaire with 33 items. Finally, the confirmatory factor analysis in the last stage showed appropriate goodness of fit for the short form of the Iranian women's childbirth experiences questionnaire (𝛘2/df = 2.352, CFI = 0.881, PCFI = 0.750, RMSEA = 0.072, SRMR = 0.0862). CONCLUSION The short form of the Iranian women's childbirth experiences questionnaire enjoyed from an appropriate psychometric evaluation. It is recommended when applying the original questionnaire is not feasible due to lack of time.
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Affiliation(s)
- Zohreh Shahhosseini
- grid.411623.30000 0001 2227 0923Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Roya Nikbakht
- grid.411623.30000 0001 2227 0923Department of Biostatistics and Epidemiology, Faculty of Health, Mazandaran University of Medical Science, Sari, Iran
| | - Zahra Motaghi
- grid.444858.10000 0004 0384 8816Department of Midwifery, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Monirolsadate Hosseini Tabaghdehi
- grid.467532.10000 0004 4912 2930Department of Midwifery, Health Reproductive Research Center, Sari Branch, Islamic Azad University, Sari, Iran
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Ribeiro CSZ, Gondim EC, Scorzafave LGDS, Gomes-Sponholz FA, Santos DDD, Mello DFD. Estresse parental na gestação e maternidade. Rev Esc Enferm USP 2023. [DOI: 10.1590/1980-220x-reeusp-2022-0351pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
Abstract
RESUMO Objetivo: Identificar fatores relacionados ao estresse parental de mulheres na gestação e primeiro mês de vida da criança. Método: Estudo longitudinal prospectivo em duas etapas. Análise de entrevistas em domicílio com 121 participantes, Escala de Estresse Gestacional e de Estresse Parental. Aplicados teste exato de Fisher, correlação de Spearman e regressão multivariada linear e logística, com p < 0,05. Resultados: A maior parcela das participantes tinha entre 18 e 35 anos, 11 a 13 anos de estudo, sem trabalho remunerado, com companheiro, geralmente o pai da criança, gestação planejada, multípara e realização do pré-natal. Na gestação, 67,8% apresentaram estresse. No primeiro mês após o nascimento do filho, a maioria teve baixo estresse parental (52,1%). Estresse parental alto apresentou correlação com algum estresse gestacional. Planejar a gestação diminuiu o estresse parental. Conclusão: Estresse gestacional e parental no primeiro mês de vida da criança foram correlacionados e o planejamento da gestação constituiu fator de diminuição dos níveis de estresse. Ações oportunas para reduzir o estresse parental são fundamentais para a parentalidade e saúde integral da criança.
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Schmiedhofer M, Derksen C, Dietl JE, Haeussler F, Strametz R, Huener B, Lippke S. The Impact of a Communication Training on the Birth Experience: Qualitative Interviews with Mothers after Giving Birth at Obstetric University Departments in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811481. [PMID: 36141754 PMCID: PMC9517065 DOI: 10.3390/ijerph191811481] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 09/04/2022] [Accepted: 09/05/2022] [Indexed: 05/27/2023]
Abstract
(1) Background: Patient safety is a pressing issue in healthcare. Besides economical and organizational issues, human factors play a crucial role in providing safe care. Safe and clear communication on both the healthcare workers' and patients' sides contribute to the avoidance of medical errors and increase patients' and healthcare workers' satisfaction. Globally, the incidence of experiencing at least one adverse event in obstetrics is about 10%, of which half are classified as preventable. According to international research, improving communication skills may decrease preventable adverse events. The research question was to what extent communication training for pregnant women impacts the quality of communication and mutual understanding during birth. (2) Methods: Communication interventions with pregnant women were conducted in two German university obstetric departments in a mixed methods research design, based on the Health Action Process Approach. The online classes covered the awareness of personal wishes, the understanding and usage of communication strategies, self-efficacy and empathy. This study presents the qualitative results. Out of 142 mothers who answered two questionnaires before the communication training and after the birth, 24 in-depth semistructured interviews were conducted to explore the subjective impact of the communication training. The results were analyzed with qualitative content analysis. (3) Results: The majority of participants felt incentivized to be aware of their personal wishes for birth and to express them. Perceived positive experiences with sufficient competency in communication, empathy and mutual understanding outweighed negative treatments and experiences in the hospital, some of which could be attributed to structural problems. (4) Discussion: The reported positive effects of the communication training underline the need but also the potential for communication lessons to reflect and improve communication skills in obstetrics. However, negative experiences due to structural problems in the healthcare system may be buffered by communication skills but not solved.
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Affiliation(s)
- Martina Schmiedhofer
- German Coalition for Patient Safety (Aktionsbündnis Patientensicherheit), 10179 Berlin, Germany
- Department of Psychology & Methods, Jacobs University Bremen GmbH, 28759 Bremen, Germany
| | - Christina Derksen
- Department of Psychology & Methods, Jacobs University Bremen GmbH, 28759 Bremen, Germany
| | - Johanna Elisa Dietl
- German Coalition for Patient Safety (Aktionsbündnis Patientensicherheit), 10179 Berlin, Germany
- Department of Psychology & Methods, Jacobs University Bremen GmbH, 28759 Bremen, Germany
| | - Freya Haeussler
- German Coalition for Patient Safety (Aktionsbündnis Patientensicherheit), 10179 Berlin, Germany
| | - Reinhard Strametz
- German Coalition for Patient Safety (Aktionsbündnis Patientensicherheit), 10179 Berlin, Germany
- Wiesbaden Business School, Rhein Main University of Applied Science, 65183 Wiesbaden, Germany
| | - Beate Huener
- Department of Gynecology and Obstetrics, University Hospital Ulm, 89070 Ulm, Germany
| | - Sonia Lippke
- Department of Psychology & Methods, Jacobs University Bremen GmbH, 28759 Bremen, Germany
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Schmiedhofer M, Derksen C, Dietl JE, Häussler F, Louwen F, Hüner B, Reister F, Strametz R, Lippke S. Birthing under the Condition of the COVID-19 Pandemic in Germany: Interviews with Mothers, Partners, and Obstetric Health Care Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1486. [PMID: 35162509 PMCID: PMC8835455 DOI: 10.3390/ijerph19031486] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/23/2022] [Accepted: 01/24/2022] [Indexed: 12/17/2022]
Abstract
BACKGROUND The COVID-19 pandemic and the necessary containment measures challenge obstetric care. Support persons were excluded while protection measures burdened and disrupted the professionals' ability to care and communicate. The objective of this study was to explore the first-hand experience of the impact of the COVID-19 pandemic on mothers, their partners, and obstetric professionals regarding birth and obstetric care in a university hospital. METHODS To answer the descriptive research questions, we conducted a qualitative content analysis using a data triangulation approach. We carried out 35 semi-structured interviews with two stratified purposive samples. Sample one consisted of 25 mothers who had given birth during the pandemic and five partners. Sample two included 10 obstetric professionals whose insights complemented the research findings and contributed to data validation. Participants were recruited from the study sample of a larger project on patient safety from two German university hospitals from February to August 2021. The study was approved by two ethics committees and informed consent was obtained. RESULTS Mothers complied with the rules, but felt socially isolated and insecure, especially before transfer to the delivery room. The staff equally reported burdens from their professional perspective: They tried to make up for the lack of partner and social contacts but could not live up to their usual professional standards. The exclusion of partners was seen critically, but necessary to contain the pandemic. The undisturbed time for bonding in the maternity ward was considered positive by both mothers and professionals. CONCLUSION The negative effects of risk mitigation measures on childbirth are to be considered carefully when containment measures are applied.
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Affiliation(s)
- Martina Schmiedhofer
- German Coalition for Patient Safety (Aktionsbündnis Patientensicherheit), 10179 Berlin, Germany; (J.E.D.); (F.H.); (R.S.)
- Department of Psychology & Methods, Jacobs University Bremen GmbH, 28759 Bremen, Germany; (C.D.); (S.L.)
| | - Christina Derksen
- Department of Psychology & Methods, Jacobs University Bremen GmbH, 28759 Bremen, Germany; (C.D.); (S.L.)
| | - Johanna Elisa Dietl
- German Coalition for Patient Safety (Aktionsbündnis Patientensicherheit), 10179 Berlin, Germany; (J.E.D.); (F.H.); (R.S.)
- Department of Psychology & Methods, Jacobs University Bremen GmbH, 28759 Bremen, Germany; (C.D.); (S.L.)
| | - Freya Häussler
- German Coalition for Patient Safety (Aktionsbündnis Patientensicherheit), 10179 Berlin, Germany; (J.E.D.); (F.H.); (R.S.)
| | - Frank Louwen
- Department of Gynecology and Obstetrics, Division of Obstetrics and Prenatal Medicine, University Hospital Frankfurt, 60596 Frankfurt am Main, Germany;
| | - Beate Hüner
- Department of Gynecology and Obstetrics, University Hospital Ulm, 89070 Ulm, Germany; (B.H.); (F.R.)
| | - Frank Reister
- Department of Gynecology and Obstetrics, University Hospital Ulm, 89070 Ulm, Germany; (B.H.); (F.R.)
| | - Reinhard Strametz
- German Coalition for Patient Safety (Aktionsbündnis Patientensicherheit), 10179 Berlin, Germany; (J.E.D.); (F.H.); (R.S.)
- Wiesbaden Business School, Rhein Main University of Applied Science, 65183 Wiesbaden, Germany
| | - Sonia Lippke
- Department of Psychology & Methods, Jacobs University Bremen GmbH, 28759 Bremen, Germany; (C.D.); (S.L.)
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