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Whitworth K, Donnellan-Fernandez R, Fleet JA. Women's experiences of online antenatal education: An integrative literature review. J Adv Nurs 2024; 80:1761-1775. [PMID: 37975435 DOI: 10.1111/jan.15957] [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: 12/21/2022] [Revised: 10/05/2023] [Accepted: 10/29/2023] [Indexed: 11/19/2023]
Abstract
AIM To identify what is currently known about how women experience online antenatal education. DESIGN Integrative literature review. REVIEW METHODS This integrative review applied the five-stage methodological framework outlined by Whittemore and Knafl (2005), supporting rigour in problem identification, selection and critical appraisal of quality literature, data analysis and synthesis of findings. DATA SOURCES A literature search was conducted in May/June 2022, utilizing databases including OVID Embase, CINAHL, Joanna Briggs Institute EBP database, Nursing and Allied Health database, Wiley Online Library, Google scholar search engine and related reference lists. The search was limited to English language and primary research articles published in the last 10-year period (2012-2022). RESULTS 12 articles met inclusion criteria. Three primary themes were identified: Comprehensibility: Looking back - understanding women's needs and preferences; Manageability: In the moment - flexibility versus social connection; and Meaningfulness & sustainability: Looking forward - the future of digital maternity education. CONCLUSION Findings identified a marked digital divide for women accessing online antenatal education, placing vulnerable women at risk of continuing inequity. E-health literacy frameworks need to be implemented to create genuine accessibility, comprehensibility and cultural responsiveness to best meet the needs of users. IMPLICATIONS FOR THE PROFESSION AND/OR HEALTH CARE CONSUMER As digital health is an emerging field, there is strong evidence that online antenatal education requires further evaluation to better meet the needs of pregnant women and their support people. Enhancing digital health literacy for health professionals will also promote a greater understanding for how to uphold and support the socio-technical dimensions of online service delivery. PATIENT OR PUBLIC CONTRIBUTION There were no patient or public contributions as part of this integrative review of the literature.
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Affiliation(s)
- Kassie Whitworth
- University of South Australia, Clinical and Health Sciences, City East Campus, Adelaide, South Australia, Australia
- School of Nursing and Midwifery, Griffith University, Meadowbrook, Queensland, Australia
| | | | - Julie-Anne Fleet
- Rosemary Bryant AO Research Centre, University of South Australia, Clinical and Health Sciences, City East Campus, Adelaide, South Australia, Australia
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Sparks JR, Redman LM, Drews KL, Sims CR, Krukowski RA, Andres A. Healthful Eating Behaviors among Couples Contribute to Lower Gestational Weight Gain. Nutrients 2024; 16:822. [PMID: 38542733 PMCID: PMC10974170 DOI: 10.3390/nu16060822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 03/08/2024] [Accepted: 03/10/2024] [Indexed: 04/01/2024] Open
Abstract
Through longitudinal analysis from the GLOWING cohort study, we examined the independent and joint relationships between couples' eating behaviors and gestational weight gain (GWG). Pregnant persons (n = 218) and their non-pregnant partners (n = 157) completed an Eating Inventory. GWG was calculated as gestation weight at 36 weeks minus that at 10 weeks. General linear models were used to examine the relationships between GWG and the pregnant persons, non-pregnant partners, and couples (n = 137; mean of pregnant persons and non-pregnant partners) cognitive restraint (range 0-21), dietary disinhibition (range 0-18), and perceived hunger (range 0-14), with higher scores reflecting poorer eating behaviors. The adjusted models included race/ethnicity, education, income, marital status, and age. The pregnant persons and their non-pregnant partners' cognitive restraint, dietary disinhibition, and perceived hunger scores were 9.8 ± 4.7, 4.8 ± 3.2, and 4.4 ± 2.5 and 6.6 ± 4.6, 5.4 ± 3.4, and 4.7 ± 3.2, respectively. Higher cognitive restraint scores among the pregnant persons and couples were positively associated with GWG (p ≤ 0.04 for both). Stratified analyses revealed this was significant for the pregnant persons with overweight (p ≤ 0.04). The non-pregnant partners' eating behaviors alone were not significantly associated with GWG (p ≥ 0.31 for all). The other explored relationships between GWG and the couples' eating behaviors were insignificant (p ≥ 0.12 for all). Among the pregnant persons and couples, reduced GWG may be achieved with higher levels of restrained eating. Involving non-pregnant partners in programs to optimize GWG may be beneficial.
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Affiliation(s)
- Joshua R. Sparks
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA 70808, USA; (J.R.S.); (L.M.R.); (K.L.D.)
- Expeditionary and Cognitive Sciences Research Group, Department of Warfighter Performance, Naval Health Research Center, Leidos Inc. (Contract), San Diego, CA 92152, USA
| | - Leanne M. Redman
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA 70808, USA; (J.R.S.); (L.M.R.); (K.L.D.)
| | - Kimberly L. Drews
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA 70808, USA; (J.R.S.); (L.M.R.); (K.L.D.)
| | - Clark R. Sims
- Arkansas Children’s Nutrition Center, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA;
| | | | - Aline Andres
- Arkansas Children’s Nutrition Center, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA;
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Soepnel LM, Mabetha K, Norris SA, Motlhatlhedi M, Nkosi N, Klingberg S, Lye S, Draper CE. The role of a community health worker-delivered preconception and pregnancy intervention in achieving a more positive pregnancy experience: the Bukhali trial in Soweto, South Africa. BMC Womens Health 2024; 24:161. [PMID: 38443924 PMCID: PMC10916028 DOI: 10.1186/s12905-024-02982-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 02/19/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND A patient-centered, human-rights based approach to maternal care moves past merely reducing maternal mortality and morbidity, towards achieving a positive pregnancy experience. When evaluating an intervention, particularly in the context of the complex challenges facing maternal care in South Africa, it is therefore important to understand how intervention components are experienced by women. We aimed to qualitatively explore (i) factors influencing the pregnancy and postpartum experience amongst young women in Soweto, South Africa, and (ii) the influence of Bukhali, a preconception, pregnancy, and early childhood intervention delivered by community health workers (CHWs), on these experiences. METHODS Semi-structured, in-depth interviews were conducted with 15 purposively sampled participants. Participants were 18-28-year-old women who (i) were enrolled in the intervention arm of the Bukhali randomized controlled trial; (ii) were pregnant and delivered a child while being enrolled in the trial; and (iii) had at least one previous pregnancy prior to participation in the trial. Thematic analysis, informed by the positive pregnancy experiences framework and drawing on a codebook analysis approach, was used. RESULTS The themes influencing participants' pregnancy experiences (aim 1) were participants' feelings about being pregnant, the responsibilities of motherhood, physical and mental health challenges, unstable social support and traumatic experiences, and the pressures of socioeconomic circumstances. In terms of how support, information, and care practices influenced these factors (aim 2), four themes were generated: acceptance and mother/child bonding, growing and adapting in their role as mothers, receiving tools for their health, and having ways to cope in difficult circumstances. These processes were found to be complementary and closely linked to participant context and needs. CONCLUSION Our findings suggest that, among women aged 18-28, a CHW-delivered intervention combining support, information, and care practices has the potential to positively influence women's pregnancy experience in South Africa. In particular, emotional support and relevant information were key to better meeting participant needs. These findings can help define critical elements of CHW roles in maternal care and highlight the importance of patient-centred solutions to challenges within antenatal care. TRIAL REGISTRATION Pan African Clinical Trials Registry PACTR201903750173871, 27/03/2019.
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Affiliation(s)
- Larske M Soepnel
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa.
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
| | - Khuthala Mabetha
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Shane A Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
- School of Human Development and Health, University of Southampton, Southampton, UK
| | - Molebogeng Motlhatlhedi
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Nokuthula Nkosi
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Sonja Klingberg
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - Stephen Lye
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Department of Obstetrics and Gynecology, Department of Physiology and Medicine, University of Toronto, Toronto, ON, Canada
| | - Catherine E Draper
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
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Nagineviciute M, Bartuseviciene E, Blazeviciene A. Woman-Centered Care: Standardized Outcomes Measure. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1537. [PMID: 37763656 PMCID: PMC10533153 DOI: 10.3390/medicina59091537] [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: 07/27/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 09/29/2023]
Abstract
Background and Objectives: Patient- or woman-centered care, prioritizing women's perspectives, needs, and preferences, is a widely recommended approach to enhance the quality of maternity care services. It aligns with the broader principles of patient-centered care, emphasizing the importance of a collaborative and respectful relationship between healthcare providers and women. This study evaluates low-risk pregnancies managed by midwives and obstetrician-gynecologists in Lithuania using patient-reported outcome measures and patient-reported experience measures. Materials and Methods: A prospective cohort study was conducted between September 2022 and April 2023. Data were collected through patient-reported questionnaires. Results: A total of 153 pregnant women who had singleton, low-risk pregnancies participated in the study, of whom 24.8% had their pregnancies supervised by a midwife, and 75.2% of the participants had their pregnancies supervised by an obstetrician-gynecologist. The study found no statistically significant differences in assessed patient-reported outcome measures and patient-reported experience measures between both models of care. Conclusions: Adopting patient-centered approaches enables healthcare systems to understand and address women's specific needs and preferences, fostering high-quality and woman-centered care. This research adds to the growing evidence supporting midwife-led care and emphasizes the importance of personalized, woman-centered approaches in maternity care, ultimately enhancing maternal health outcomes and promoting positive experiences for low-risk pregnant women. The quality of care provided by midwives remains uncompromised and equivalently proficient compared to the care provided by collaborative teams.
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Affiliation(s)
- Milda Nagineviciute
- Department of Nursing, Faculty of Nursing, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania;
| | - Egle Bartuseviciene
- Department of Obstetrics and Gynecology, Faculty of Medicine, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania;
| | - Aurelija Blazeviciene
- Department of Nursing, Faculty of Nursing, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania;
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Lalor JG, Sheaf G, Mulligan A, Ohaja M, Clive A, Murphy-Tighe S, Ng ED, Shorey S. Parental experiences with changes in maternity care during the Covid-19 pandemic: A mixed-studies systematic review. Women Birth 2023; 36:e203-e212. [PMID: 35973917 PMCID: PMC9364727 DOI: 10.1016/j.wombi.2022.08.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 08/01/2022] [Accepted: 08/08/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND During the COVID-19 pandemic, pregnant women were identified as a high-risk and vulnerable group. To reduce risk of transmission, maternity healthcare services were modified to limit exposure but maintain services for pregnant women. However, the change in hospital practice may have compromised quality maternal care standards. Therefore, this review aims to explore parental experiences and views with maternity care received from healthcare institutions during the COVID-19 pandemic. METHODS A mixed studies systematic review was conducted. Six electronic databases (Medline, CINAHL, Embase, PsycInfo, Web of Science, and Maternity and Infant Care) were searched for qualitative, observational, and mixed method studies from the year 2019 to February 2022. Study quality was appraised using the Mixed Methods Appraisal Tool. Quantitative findings were converted to narrative findings. Data was synthesised thematically using a convergent synthesis design. RESULTS Fifty-eight articles were included. Four themes were generated: (1) Distress associated with COVID-19 regulations (perception of hospital restrictions, confusion with ever changing policies), (2) adaptability with maternity services (prenatal: changes in birth plans, prenatal: altered antenatal appointments, education, and care, intrapartum: medicalization of birth, postpartum: varied views on care received and Breastfeeding woes, postpartum: skin-to-skin contact and mother infant bonding) (3) importance of support persons, and (4) future direction for maternity services. CONCLUSIONS Parental experiences highlighted how maternity care during the COVID-19 pandemic did not adhere to WHO standards of quality maternity care. This calls for healthcare institutions to continuously appraise the implementation of restrictive practices that deviate from evidence-based frameworks underpinning quality care.
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Affiliation(s)
- Joan Gabrielle Lalor
- School of Nursing and Midwifery, Trinity College Dublin, 24 D’Olier St, Dublin 2, Ireland
| | - Greg Sheaf
- The Library of Trinity College Dublin, Dublin 2, Ireland
| | - Andrea Mulligan
- School of Law, Trinity College Dublin, House 39, New Square, Dublin 2, Ireland
| | - Magdalena Ohaja
- School of Nursing and Midwifery, National University of Ireland Galway, Ireland
| | - Ashamole Clive
- School of Nursing and Midwifery, Trinity College Dublin, 24 D’Olier St, Dublin 2, Ireland
| | | | - Esperanza Debby Ng
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11,10 Medical Drive, 117597, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11,10 Medical Drive, 117597, Singapore.
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Buultjens M, Gill J, Fielding J, Lambert KA, Vondeling K, Mastwyk SE, Sloane S, Fedele W, Karimi L, Milgrom J, von Treuer K, Erbas B. Maternity care during a pandemic: Can a hybrid telehealth model comprising group interdisciplinary education support maternal psychological health? Women Birth 2022; 36:305-313. [PMID: 36184532 PMCID: PMC9551992 DOI: 10.1016/j.wombi.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 07/21/2022] [Accepted: 09/16/2022] [Indexed: 11/17/2022]
Abstract
Background The transition to parenthood is one of the most challenging across the life course, with profound changes that can impact psychological health. In response to the coronavirus disease 2019 (COVID-19), came the rapid implementation of remote antenatal care, i.e., telehealth, with fewer in-person consultations. A change in service delivery in addition to the cancellation of antenatal education represented a potential threat to a woman’s experience – with likely adverse effects on mental health and wellbeing. Aim To explore a hybrid model of pregnancy care, i.e., telehealth and fewer in-person health assessments, coupled with concurrent small group interdisciplinary education delivered via video conferencing, extending into the postnatal period. Methods Using a quasi-experimental design with an interrupted time series and a control group, this population-based study recruited low-risk women booking for maternity care at one community health site affiliated with a large public hospital in Victoria, Australia. Findings Whilst there was no difference in stress and anxiety scores, a significant interactive effect of the hybrid model of care with time was seen in the DASS depression score (−1.17, 95% CI: −1.81, −0.53) and the EPDS (−0.83, 95% CI: −1.5, −0.15). Discussion The analyses provide important exploratory findings regarding the positive effects of a hybrid model of care with interdisciplinary education in supporting mental health of first-time mothers. Conclusion This study demonstrates that small group online education scheduled in conjunction with individual pregnancy health assessments can be executed within a busy antenatal clinic with promising results and modest but dedicated staff support.
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Affiliation(s)
- Melissa Buultjens
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia.
| | - Jessica Gill
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Jennifer Fielding
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Katrina A Lambert
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Kirsty Vondeling
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Sally E Mastwyk
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Sarita Sloane
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Wendy Fedele
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Leila Karimi
- School of Applied Health, Psychology Department, RMIT University, Melbourne, Australia.
| | - Jeannette Milgrom
- Parent-Infant Research Institute (PIRI), Australia and Melbourne School of Psychological Science, University of Melbourne, Australia
| | | | - Bircan Erbas
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
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Heinonen K. Listening to the Fathers of Twins-Being Sensitive to Fathers' Needs in Maternity and Child Healthcare. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10639. [PMID: 36078352 PMCID: PMC9517739 DOI: 10.3390/ijerph191710639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/05/2022] [Accepted: 08/19/2022] [Indexed: 06/15/2023]
Abstract
Objective: In a multiple-birth family, parenthood means being a parent to more than one child of the same age. The aim of this study was to describe the experiences of fathers of twins in order to contribute to the understanding of twin fatherhood and the needs for support. This article also provides some concrete guidance for midwives and nurses. Design: This qualitative research study was guided by the hermeneutic phenomenological approach. Setting: Notification of the study was published on the Multiple Births Association website for the fathers of twins. The data comprised fathers' (n = 6) diaries and/or notes and in-depth interviews. Results: The following themes describe the phenomenon of being a father of twins: "Fatherhood of twins grows gradually", "Strengthening of twin fatherhood by being present and involved", "Father develops his relationship with each and both of the twins", and "Making space for multiple fatherhood". This article concentrates on the latter two themes. Conclusions: Fatherhood/parenthood is a very special time in a person's life and has many effects on a child's health and wellbeing and his/her life. Fathers of twins want to create a close bond with them by being actively present and involved in the children's daily life, also with a view to the future. The staff of the hospital and maternity and child health clinic play a vital role in implementing services meant for multiple-birth families in the holistic understanding of and support for fathers/parents during the transition to parenthood and after the children's birth. Implications for practice: Midwives and nurses are vital in providing support for, sharing knowledge with, and giving advice to fathers and different kinds of families. Multiprofessional cooperation that links evidence-based knowledge, theory, and practice, ensuring that the voices of both parents are heard and respected, is key to improving the care for different kinds of families and families with special needs.
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Affiliation(s)
- Kristiina Heinonen
- Faculty of Health Sciences, Department of Nursing Science, University of Eastern Finland, Yliopistonranta 1, 70210 Kuopio, Finland
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Yeneabat T, Hayen A, Getachew T, Dawson A. The effect of national antenatal care guidelines and provider training on obstetric danger sign counselling: a propensity score matching analysis of the 2014 Ethiopia service provision assessment plus survey. Reprod Health 2022; 19:132. [PMID: 35668529 PMCID: PMC9167913 DOI: 10.1186/s12978-022-01442-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 05/18/2022] [Indexed: 11/10/2022] Open
Abstract
Background Most pregnant women in low and lower-middle-income countries do not receive all components of antenatal care (ANC), including counselling on obstetric danger signs. Facility-level ANC guidelines and provider in-service training are major factors influencing ANC counselling. In Ethiopia, little is known about the extent to which guidelines and provider in-service training can increase the quality of ANC counselling. Methods We examined the effect of national ANC guidelines and ANC provider in-service training on obstetric danger sign counselling for pregnant women receiving ANC using the 2014 Ethiopian service provision assessment plus (ESPA +) survey data. We created two analysis samples by applying a propensity score matching method. The first sample consisted of women who received ANC at health facilities with guidelines matched with those who received ANC at health facilities without guidelines. The second sample consisted of women who received ANC from the providers who had undertaken in-service training in the last 24 months matched with women who received ANC from untrained providers. The outcome variable was the number of obstetric danger signs described during ANC counselling, ranging from zero to eight. The covariates included women’s socio-demographic characteristics, obstetric history, health facility characteristics, and ANC provider characteristics. Results We found that counselling women about obstetric danger signs during their ANC session varied according to the availability of ANC guidelines (61% to 70%) and provider training (62% to 68%). After matching the study participants by the measured covariates, the availability of ANC guidelines at the facility level significantly increased the average number of obstetric danger signs women received during counselling by 24% (95% CI: 12–35%). Similarly, providing refresher training for ANC providers increased the average number of obstetric danger signs described during counselling by 37% (95% CI: 26–48%). Conclusion The findings suggest that the quality of ANC counselling in Ethiopia needs strengthening by ensuring that ANC guidelines are available at every health facility and that the providers receive regular ANC related in-service training. Supplementary Information The online version contains supplementary material available at 10.1186/s12978-022-01442-6. Maternal death from preventable pregnancy-related complications remains a global health challenge. In 2017, there were 295,000 maternal deaths worldwide, and about two-thirds of these deaths were from Sub-Saharan Africa. Ethiopia is a Sub-Saharan African country with 401 maternal deaths per 100,000 live births in 2017, and this rate is higher than the target indicated in sustainable development goals. Most maternal deaths are due to obstetric complications and could have been averted through early detection and treatment. Providing antenatal care counselling about obstetric danger signs enhances women’s awareness of obstetric complications and encourages women to seek treatment from a skilled care provider. However, most women from low-income settings, including Ethiopia, do not receive counselling about obstetric danger signs. Facility-level antenatal care guidelines and provider in-service training improve antenatal care counselling. In Ethiopia, little is known to what extent antenatal care guidelines and provider training increase counselling on obstetric danger signs. The present study used the 2014 Ethiopian service provision assessment data and estimated the effect of antenatal care guidelines and provider training on counselling about obstetric danger signs. The analysis involved a propensity score matching method and included 1725 pregnant women. The study found that antenatal care guidelines at health facilities and antenatal care provider in-service training significantly increase counselling on obstetric danger signs by 24% and 37%, respectively. The finding suggests improving the quality of antenatal care counselling in Ethiopia needs antenatal care guidelines at each antenatal care clinic and refresher training for the providers.
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Affiliation(s)
- Tebikew Yeneabat
- Department of Midwifery, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia. .,School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia.
| | - Andrew Hayen
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Theodros Getachew
- Health System and Reproductive Health Research Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Angela Dawson
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
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Colciago E, Brown AM, Ornaghi S, Antolini L, Nespoli A, Fumagalli S, Robinson A. The unpredictable nature of labour and birth: a qualitative investigation regarding expectations of Italian parents to-be. Midwifery 2022; 108:103286. [DOI: 10.1016/j.midw.2022.103286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 01/10/2022] [Accepted: 02/10/2022] [Indexed: 12/01/2022]
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Van den Branden L, Van de Craen N, Van Leugenhaege L, Mestdagh E, Timmermans O, Van Rompaey B, Kuipers YJ. Flemish midwives' perspectives on supporting women during the transition to motherhood - A Q-methodology study. Midwifery 2021; 105:103213. [PMID: 34902679 DOI: 10.1016/j.midw.2021.103213] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 11/05/2021] [Accepted: 11/24/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE In this study we aimed to reveal midwives' distinct perspectives about midwifery support of women in their transition process during the continuum from pregnancy to one-year postpartum. DESIGN A Q-methodology study, a mixed quantitative-qualitative approach, was conducted. Participants (P-set) rank-ordered 36 statements (Q-set) about how midwives provide support during the woman's transition to motherhood, followed by interviews to motivate their ranking. To extract the perspectives/factors on support during this transition process, centroid by-person factor analysis and varimax rotation was used. The transcripts of the interviews were interpreted per factor. SETTING Independent (self-employed) and employed, community and hospital-based practising midwives in Flanders, Belgium. PARTICIPANTS 83 practicing midwives participated, selected on: variation in practice setting, years of experience, views on the woman's domestic role in family life, and motherhood status. FINDINGS Two distinct perspectives (factors) on supporting women in transition to motherhood emerged. The job-focused midwife acts according to evidence, knowledge and guidelines and adheres to the scope and tasks within the professional profile (Factor 1). The woman-focused midwife acts within a relationship of trust emphasizing the one-on-one connection while supporting transition to motherhood and the woman's needs (Factor 2). Both factors showed an explained total variance of 59% of the Q-set. KEY CONCLUSIONS Both the job-focused midwife and the woman-focused midwife represent distinct perspectives about the midwife's execution of supporting transition to motherhood, including salotugenic elements. This provides an understanding of midwives' thoughts and experiences about why and how support is given. IMPLICATIONS FOR PRACTICE More awareness about the subjective distinct ways of thinking about supporting transition to motherhood should be integrated in practice, midwifery education and professional development.
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Affiliation(s)
- Laura Van den Branden
- AP University of Applied Sciences, Department of Health and Social Care, School of Midwifery, Noorderplaats 2, 2000 Antwerp, Belgium; University of Antwerp, Faculty of Medicine & Health Sciences, Department of Nursing and Midwifery, Universiteitsplein 1, 2610 Wilrijk, Belgium.
| | - Natacha Van de Craen
- AP University of Applied Sciences, Department of Health and Social Care, School of Midwifery, Noorderplaats 2, 2000 Antwerp, Belgium
| | - Luka Van Leugenhaege
- AP University of Applied Sciences, Department of Health and Social Care, School of Midwifery, Noorderplaats 2, 2000 Antwerp, Belgium; University of Antwerp, Faculty of Medicine & Health Sciences, Department of Nursing and Midwifery, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Eveline Mestdagh
- AP University of Applied Sciences, Department of Health and Social Care, School of Midwifery, Noorderplaats 2, 2000 Antwerp, Belgium; University of Antwerp, Faculty of Medicine & Health Sciences, Department of Nursing and Midwifery, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Olaf Timmermans
- University of Antwerp, Faculty of Medicine & Health Sciences, Department of Nursing and Midwifery, Universiteitsplein 1, 2610 Wilrijk, Belgium; Professorship Healthy Region, HZ University of Applied sciences, Edisonweg 4, 4382 NW Vlissingen, The Netherlands
| | - Bart Van Rompaey
- University of Antwerp, Faculty of Medicine & Health Sciences, Department of Nursing and Midwifery, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Yvonne J Kuipers
- AP University of Applied Sciences, Department of Health and Social Care, School of Midwifery, Noorderplaats 2, 2000 Antwerp, Belgium; University of Antwerp, Faculty of Medicine & Health Sciences, Department of Nursing and Midwifery, Universiteitsplein 1, 2610 Wilrijk, Belgium; Edinburgh Napier University, School of Health & Social Care, Sighthill Court, Edinburgh EH11 4BN, Scotland, UK
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