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Vogels-Broeke M, Daemers D, Budé L, de Vries R, Nieuwenhuijze M. Women's Birth Beliefs During Pregnancy and Postpartum in the Netherlands: A Quantitative Cross-Sectional Study. J Midwifery Womens Health 2023; 68:210-220. [PMID: 36938758 DOI: 10.1111/jmwh.13473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 11/30/2022] [Accepted: 12/29/2022] [Indexed: 03/21/2023]
Abstract
INTRODUCTION Women and care providers increasingly regard childbirth as a medical process, resulting in high use of medical interventions, which could negatively affect a woman's childbirth experience. Women's birth beliefs may be key to understanding the decisions they make and the acceptance of medical interventions in childbirth. In this study we explore women's beliefs about birth as a natural and medical process and the factors that are associated with women's birth beliefs. METHODS Data were obtained from a cross-sectional survey of women living in the Netherlands asking them about their experiences during pregnancy and childbirth, including their beliefs about birth as a natural and medical process. RESULTS A total of 3494 women were included in this study. Mean scores of natural birth beliefs ranged between 3.73 and 4.01 points, and medical birth belief scores ranged between 2.92 and 3.12 points. There were significant but very small changes between prenatal and postnatal birth beliefs. Regression analyses showed that (previous) childbirth experiences were the most consistent predictor of women's birth beliefs. DISCUSSION Women's high scores on natural birth beliefs and lower scores on medical birth beliefs correspond with the philosophy of Dutch perinatal care that considers pregnancy and childbirth to be natural processes. Perinatal care providers must be aware of women's birth beliefs and recognize that they as professionals influence women's birth beliefs. They make an important contribution to women's perinatal experiences, which affects both women's natural and medical birth beliefs.
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Affiliation(s)
- Maaike Vogels-Broeke
- Research Centre for Midwifery Science, Zuyd University, Maastricht, The Netherlands.,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Darie Daemers
- Research Centre for Midwifery Science, Zuyd University, Maastricht, The Netherlands
| | - Luc Budé
- Research Centre for Midwifery Science, Zuyd University, Maastricht, The Netherlands
| | - Raymond de Vries
- Research Centre for Midwifery Science, Zuyd University, Maastricht, The Netherlands.,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.,Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, Michigan
| | - Marianne Nieuwenhuijze
- Research Centre for Midwifery Science, Zuyd University, Maastricht, The Netherlands.,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
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Cellissen E, Vogels-Broeke M, Korstjens I, Nieuwenhuijze M. Integrating women’s voices in quality improvement for maternity care: A qualitative study. Eur J Midwifery 2022; 6:57. [PMID: 36119403 PMCID: PMC9442975 DOI: 10.18332/ejm/152253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Improving the quality of maternity care is high on the national agenda in the Netherlands. One aspect gaining significant attention is integrating women’s experiences – as users of maternity care – in this quality improvement. The aim of this study was to gain deeper insights into how maternity care professionals in Dutch Maternity Care Collaborations integrate women’s voices into quality improvement as part of integrated maternity care and what role midwives can have in this. METHODS This was a descriptive qualitative study, using semi-structured individual interviews and content analysis for an in-depth exploration of maternity care professionals’ experiences and opinions on integrating women’s voices in quality improvement. Participants were twelve maternity care professionals involved in quality improvement activities from eight Dutch Maternity Care Collaborations. RESULTS Four themes emerged: ‘Quality improvement based on women's voices is still in its infancy’ and was experienced as an important but challenging topic; ‘Collecting women's voices’ was conducted, but needed more facilitation; Using women's voices’ was hindered by a lack of expertise and a structured feedback and feedforward system; and ‘Ensuring listening to women's voices’ and integrating them in quality improvement required further facilitation. CONCLUSIONS Care professionals emphasized that listening to women’s voices for quality improvement is important but challenging due to the lack of expertise, organizational structure, time, and financial resources. A feasible implementation strategy including concrete support is recommended by maternity care professionals to boost action.
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Affiliation(s)
- Evelien Cellissen
- Research Centre for Midwifery Science, University of Midwifery Education and Studies, Zuyd University of Applied Science, Maastricht, Netherlands
| | - Maaike Vogels-Broeke
- Research Centre for Midwifery Science, University of Midwifery Education and Studies, Zuyd University of Applied Science, Maastricht, Netherlands
| | - Irene Korstjens
- Research Centre for Midwifery Science, University of Midwifery Education and Studies, Zuyd University of Applied Science, Maastricht, Netherlands
| | - Marianne Nieuwenhuijze
- Research Centre for Midwifery Science, University of Midwifery Education and Studies, Zuyd University of Applied Science, Maastricht, Netherlands
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
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Vogels-Broeke M, Cellissen E, Daemers D, Budé L, de Vries R, Nieuwenhuijze M. Women's decision-making autonomy in Dutch maternity care. Birth 2022; 50:384-395. [PMID: 35977033 DOI: 10.1111/birt.12674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 07/15/2022] [Accepted: 07/30/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND A positive childbirth experience is an important outcome of maternity care. A significant component of a positive birth experience is the ability to exercise autonomy in decision-making. In this study, we explore women's reports of their autonomy during conversations about their care with maternity care practitioners during pregnancy and childbirth. METHOD Data were obtained from a cross-sectional survey of women living in The Netherlands that asked about their experiences during pregnancy and childbirth, including their role in conversations concerning decisions about their care. RESULTS A total of 3494 women were included in this study. Most women scored high on autonomy in decision-making conversations. During the latter stage of pregnancy (32+ weeks) and in childbirth, women reported significantly lower levels of autonomy in their care conversations with obstetricians as compared with midwives. Linear regression analyses showed that women's perception of personal treatment increased women's reported autonomy in their conversations with both midwives and obstetricians. Almost half (49.1%) of the women who had at least one intervention during birth reported pressure to accept or submit to that intervention. This was indicated by 48.3% of women with induced labor, 47.3% who had an instrumental vaginal birth, 45.2% whose labor was augmented, and 41.9% of women who had a cesarean birth. CONCLUSIONS In general, women's sense of autonomy in decision-making conversations during prenatal care and birth is high, but there is room for improvement, and this appeared most notably in conversations with obstetricians. Women's sense of autonomy can be enhanced with personal treatment, including shared decision-making and the avoidance of pressuring women to accept interventions.
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Affiliation(s)
- Maaike Vogels-Broeke
- Research Centre for Midwifery Science, Zuyd University, Maastricht, The Netherlands.,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Evelien Cellissen
- Research Centre for Midwifery Science, Zuyd University, Maastricht, The Netherlands
| | - Darie Daemers
- Research Centre for Midwifery Science, Zuyd University, Maastricht, The Netherlands
| | - Luc Budé
- Research Centre for Midwifery Science, Zuyd University, Maastricht, The Netherlands
| | - Raymond de Vries
- Research Centre for Midwifery Science, Zuyd University, Maastricht, The Netherlands.,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands.,Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Marianne Nieuwenhuijze
- Research Centre for Midwifery Science, Zuyd University, Maastricht, The Netherlands.,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
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Vogels-Broeke M, Daemers D, Budé L, de Vries R, Nieuwenhuijze M. Sources of information used by women during pregnancy and the perceived quality. BMC Pregnancy Childbirth 2022; 22:109. [PMID: 35135487 PMCID: PMC8827281 DOI: 10.1186/s12884-022-04422-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 01/17/2022] [Indexed: 11/25/2022] Open
Abstract
Background Access to reliable information is critical to women’s experience and wellbeing during pregnancy and childbirth. In our information-rich society, women are exposed to a wide range of information sources. The primary objective of this study was to explore women’s use of information sources during pregnancy and to examine the perceived usefulness and trustworthiness of these sources. Method A quantitative cross-sectional study of Dutch women's experiences with various information sources during pregnancy, including professional (e.g. healthcare system), and informal sources, divided into conventional (e.g. family or peers) and digital sources (e.g. websites or apps). Exploratory backward stepwise multiple regression was performed to identify associations between the perceived quality of information sources and personal characteristics. Results A total of 1922 pregnant women were included in this study. The most commonly used information sources were midwives (91.5%), family or friends (79.3%), websites (77.9%), and apps (61%). More than 80% of women found professional information sources trustworthy and useful, while digital sources were perceived as less trustworthy and useful. Personal factors explain only a small part of the variation in the perceived quality of information sources. Conclusion Even though digital sources are perceived as less trustworthy and useful than professional and conventional sources, they are among the most commonly used sources of information for pregnant women. To meet the information needs of the contemporary generation of pregnant women it is essential that professionals help in the development of digital information sources.
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Affiliation(s)
- Maaike Vogels-Broeke
- Research Centre for Midwifery Practice, Zuyd University of Applied Sciences, Maastricht, Netherlands. .,CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands.
| | - Darie Daemers
- Research Centre for Midwifery Practice, Zuyd University of Applied Sciences, Maastricht, Netherlands
| | - Luc Budé
- Research Centre for Midwifery Practice, Zuyd University of Applied Sciences, Maastricht, Netherlands
| | - Raymond de Vries
- Research Centre for Midwifery Practice, Zuyd University of Applied Sciences, Maastricht, Netherlands.,CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands
| | - Marianne Nieuwenhuijze
- Research Centre for Midwifery Practice, Zuyd University of Applied Sciences, Maastricht, Netherlands.,CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, Netherlands
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Vogels-Broeke M, de Vries PR, Nieuwenhuijze M. Validating a framework of women's experience of the perinatal period; a scoping review. Midwifery 2020; 92:102866. [PMID: 33181433 DOI: 10.1016/j.midw.2020.102866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 08/28/2020] [Accepted: 10/18/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aim of this paper is to identify and explain the factors that make up a woman's experience of the perinatal period. We accomplish this by validating a framework, described in an earlier study, that identifies the distinct dimensions of the perinatal experience. DESIGN We conducted a scoping review, using five online databases, to identify and categorize studies that investigate women's experience of the perinatal period. FINDINGS We found 251 publications that focused on the experience of the perinatal period. Our review confirmed the seven dimensions of our framework describing women's experiences of the perinatal period - the woman as unique individual, the woman as active participant in care, the responsiveness of maternity care and health services, the lived experience of being pregnant, giving birth and the postpartum period, communication and relationships with care providers, information and childbirth education, and support from social environment. One new dimension emerged from the studies we identified: societal influence. The resulting eight dimensions provide a comprehensive overview of the important aspects of women's experience of the perinatal period. While each dimension is distinct, there are significant overlaps and close relationships between them. CONCLUSION The framework is a useful guide for healthcare providers, researchers, and policy makers who wish to improve the experience of the perinatal period. It is important to remember, however, that the current framework is dynamic, open to new insights and further development and refinement.
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Affiliation(s)
- Maaike Vogels-Broeke
- PhD student Research Centre for Midwifery Science, Zuyd University, Maastricht, the Netherlands / Care and Public Health Research Institute (CAPHRI), Maastricht University, the Netherlands.
| | - Professor Raymond de Vries
- Associate Director University of Michigan, Center for Bioethics and Social Sciences in Medicine, US / em. professor at Research Centre for Midwifery Science, Zuyd University and CAPHRI School for Public Health and Primary Care, Maastricht University, the Netherlands
| | - Marianne Nieuwenhuijze
- Professor of Midwifery CAPHRI Care and Public Health Research Institute, Maastricht University and Head of the Research Centre for Midwifery Science, Zuyd University, Maastricht, the Netherlands
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