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Whitworth K, Donnellan-Fernandez R, Fleet JA. Digital transformation of antenatal education: A descriptive exploratory study of women's experiences of online antenatal education. Women Birth 2024; 37:188-196. [PMID: 37659877 DOI: 10.1016/j.wombi.2023.08.008] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/21/2023] [Accepted: 08/23/2023] [Indexed: 09/04/2023]
Abstract
PROBLEM Research on how women experience online antenatal education is currently limited. A more nuanced understanding may assist organisations to tailor future digitalisation that best meets the needs of users. BACKGROUND COVID-19 emergency measures forced a rapid implementation of online antenatal education. Women are known to enjoy some aspects of online antenatal education, but still desire social interaction. A marked digital divide is evident for more vulnerable populations. AIM To explore how pregnant women experience an online antenatal education program. METHODS A descriptive exploratory study was undertaken through collection of two concurrent data-sets. Quantitative data was collected from the online Parent Education Feedback Form (n = 38) Based on the six-stage process of Braun & Clarke, reflexive thematic analysis was used to analyse data sourced from semi-structured interviews with women (n = 5) who had undertaken online antenatal education. FINDINGS Four themes, and eight associated sub-themes, were identified to better understand how women experience online antenatal education. The four primary themes identified were: Experiential Digital Learning; Desired Journey; Contemporary Representation; and Human Connection in the Digital Age. DISCUSSION Well-designed digital platforms provide opportunities for interaction, content personalisation and self-tailored approaches in online antenatal education. Women require caregivers who hold specialist digital capabilities. Further research is warranted to better understand how digitalisation of antenatal education impacts women disadvantaged by digital exclusion. CONCLUSION The digital transformation of antenatal education impacts a vast array of factors in women's experiences during pregnancy. A specialist skill-set from midwives is needed to champion quality antenatal education in the digital age.
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Affiliation(s)
- Kassie Whitworth
- Clinical and Health Sciences, City East Campus, Corner Frome Road and North Terrace, Adelaide, SA 5000, Australia; Griffith University, School of Nursing and Midwifery, Logan Campus, 68 University Drive, Meadowbrook, Queensland 4131, Australia; Rosemary Bryant AO Research Centre, University of South Australia, Australia.
| | - Roslyn Donnellan-Fernandez
- Griffith University, School of Nursing and Midwifery, Logan Campus, 68 University Drive, Meadowbrook, Queensland 4131, Australia
| | - Julie-Anne Fleet
- Clinical and Health Sciences, City East Campus, Corner Frome Road and North Terrace, Adelaide, SA 5000, Australia; Rosemary Bryant AO Research Centre, University of South Australia, Australia
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2
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Levett KM, Sutcliffe KL, Keedle H, Dahlen H. Women's experiences of changes to childbirth and parenting education in Australia during the COVID-19 pandemic: The birth in the time of COVID-19 (BITTOC) study. Sex Reprod Healthc 2023; 38:100904. [PMID: 37659213 DOI: 10.1016/j.srhc.2023.100904] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 08/23/2023] [Accepted: 08/27/2023] [Indexed: 09/04/2023]
Abstract
OBJECTIVE As changes to Childbirth and Parenting Education (CBPE) classes during the COVID-19 pandemic remain unexplored in Australia, our objective was to understand how changes to CBPE in Australia during the COVID-19 pandemic impacted on women's birth and postnatal experiences. METHODS Survey responses were received from 3172 women (1343 pregnant and 1829 postnatal) for the 'Birth In The Time Of Covid-19 (BITTOC)' survey (August 2020 to February 2021) in Australia. One of the survey questions asked women if they had experienced changes to CBPE class schedules or format during the pandemic, with a follow up open ended text box inviting women to comment on the impact of these changes. The majority of women experienced changes to CBPE, with only 9 % stating they experienced no changes to classes. A content analysis was undertaken on the 929 open text responses discussing the impact these changes had on women's experience of pregnancy, birth and postpartum. RESULTS 929 women (29 %) made 1131 comments regarding changes to CBPE classes during the pandemic. The main finding 'I felt so unprepared', highlights how women perceived the cessation or alteration of classes impacted their birth preparation, with many reporting an increased sense of isolation. Some women reported feeling 'It was good enough' with adequate provision of online classes, and others feeling 'I was let down by the system' due to communication and technological barriers. CONCLUSIONS Results highlight the importance of ensuring continued provision of hybrid/online childbirth education models to enable versatility during times of crisis. Gaps in service provision, communication and resources for childbirth and parenting education need addressing.
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Affiliation(s)
- Kate M Levett
- National School of Medicine, University of Notre Dame, Australia; NICM Health Research Institute, and THRI, Western Sydney University, Australia'; Collective for Midwifery, Child and Family Health, University of Technology Sydney, Australia.
| | | | - Hazel Keedle
- School of Nursing and Midwifery, Western Sydney University, Australia'
| | - Hannah Dahlen
- School of Nursing and Midwifery, Western Sydney University, Australia'
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Diezi AS, Vanetti M, Robert M, Schaad B, Baud D, Horsch A. Informing about childbirth without increasing anxiety: a qualitative study of first-time pregnant women and partners' perceptions and needs. BMC Pregnancy Childbirth 2023; 23:797. [PMID: 37978462 PMCID: PMC10655283 DOI: 10.1186/s12884-023-06105-3] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Complications requiring medical interventions during childbirth are far from rare, even after uncomplicated pregnancies. It is often a challenge for maternity healthcare professionals to know how to prepare future parents for these eventualities without causing unnecessary anxiety. Studies on traumatic birth experiences have shown that feelings of loss of control, insufficient information, and lack of participation in medical decisions during childbirth are factors of difficult experiences. However, little is known about the information and communication needs of expectant parents about childbirth during the prenatal period. To gain a deeper understanding of the information and communication needs of first-time pregnant women and partners, we explored their perceptions and expectations for their upcoming childbirth, and the actions they initiated to prepare for it. METHODS Semi-structured interviews were conducted individually with first-time pregnant women and partners of pregnant women aged 18 years or older, with an uncomplicated pregnancy. Thematic analysis was used to identify themes and sub-themes. RESULTS Twenty expectant parents (15 pregnant women and five partners of pregnant women) were interviewed. Six themes were identified: Childbirth event; Childbirth experience; Childbirth environment; Organisation of care; Participation in decision making; Roles within the couple and transition to parenthood. CONCLUSIONS This study contributes to a better understanding of the information needs of future parents expecting their first child. Results highlighted that the notion of "childbirth risks" went beyond the prospect of complications during birth, but also encompassed concerns related to a feeling of loss of control over the event. Expectant parents showed an ambivalent attitude towards consulting risk information, believing it important to prepare for the unpredictability of childbirth, while avoiding information they considered too worrying. They expressed a desire to receive concrete, practical information, and needed to familiarise themselves in advance with the birth environment. Establishing a respectful relationship with the healthcare teams was also considered important. The findings suggest that information on childbirth should not be limited to the transmission of knowledge, but should primarily be based on the establishment of a relationship of trust with healthcare professionals, taking into account each person's individual values and expectations.
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Affiliation(s)
- Anne-Sylvie Diezi
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Route de La Corniche 10, 1011, Lausanne, Switzerland
- Communication Department, Lausanne University Hospital, Rue du Bugnon 21, 1011, Lausanne, Switzerland
| | - Mélanie Vanetti
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Route de La Corniche 10, 1011, Lausanne, Switzerland
| | - Marie Robert
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Route de La Corniche 10, 1011, Lausanne, Switzerland
| | - Béatrice Schaad
- Communication Department, Lausanne University Hospital, Rue du Bugnon 21, 1011, Lausanne, Switzerland
- Institute of Humanities in Medicine, Lausanne University Hospital and University of Lausanne, Av. de Provence 82, 1007, Lausanne, Switzerland
| | - David Baud
- Department Woman-Mother-Child, Lausanne University Hospital and University of Lausanne, Av. Pierre-Decker 10, 1011, Lausanne, Switzerland
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), University of Lausanne, Route de La Corniche 10, 1011, Lausanne, Switzerland.
- Department Woman-Mother-Child, Lausanne University Hospital and University of Lausanne, Av. Pierre-Decker 10, 1011, Lausanne, Switzerland.
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Fritzson M, Nordin A, Børøsund E, Johansson M, Varsi C, Ängeby K. A mobile application for early labour support -feasibility pilot study. Women Birth 2023; 36:495-503. [PMID: 37030985 DOI: 10.1016/j.wombi.2023.03.008] [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: 12/27/2022] [Revised: 03/24/2023] [Accepted: 03/27/2023] [Indexed: 04/08/2023]
Abstract
BACKGROUND Use of mobile applications (apps) are increasing during pregnancy but few of these are evidence-based or evaluated in research. AIM To examine the feasibility, including perceived usefulness and usability, and the preliminary effects of an app based on the Confident birth method. METHODS A mixed-method approach, including 48 women, was used to evaluate acceptability, usability and to test study design and procedures. iPhone-users (n = 24) tested the app during pregnancy while the remaining (n = 24) formed a control group. Background characteristics and outcome measurements were collected from all women at baseline. Women in the app group received two follow-up phone calls from a midwife concerning usefulness and ease of use of the app. A follow-up questionnaire after birth were used to measure preliminary effects of the intervention as well as system usability of the app. RESULTS Women using the app found the app exercises simple, understandable, and useful. System usability score showed a mean score of 85.3 indicating excellent system usability. Notes from phone calls resulted in four categories: positive feedback about the app, negative feedback about the app, partners involvement, and knowledge. Preliminary effects of labour experience showed no significant differences between the two groups, in terms of early labour or childbirth experience. CONCLUSION The app tested in this feasibility study, was perceived as useful and appreciated by women. Areas for improvement of the app were identified. The result shows promise for further efficacy testing in a forthcoming randomised controlled trial.
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Affiliation(s)
- Magdalena Fritzson
- Department of Children, Youth and Family Health, Region Värmland, Sweden; Karlstad University, Department of Health Science, Faculty of Health, Science, and Technology, Sweden
| | - Anna Nordin
- Karlstad University, Department of Health Science, Faculty of Health, Science, and Technology, Sweden; Department of Health, Education and Technology, Division of Nursing and Medical Technology, Lulea University of Technology, Lulea, Sweden
| | - Elin Børøsund
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway; Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Margareta Johansson
- Department of Women's and Children's Health, Faculty of Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden
| | - Cecilie Varsi
- Department of Digital Health Research, Division of Medicine, Oslo University Hospital, Oslo, Norway; Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Karin Ängeby
- Centre for Clinical Research and Education, Region Värmland, Karlstad, Sweden; School of Education, Health and Social Studies, Dalarna University, Falun, Sweden.
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Lewis-Jones B, Nielsen TC, Svensson J, Nassar N, Henry A, Lainchbury A, Kim S, Kiew I, McLennan S, Shand AW. Cross-sectional survey of antenatal education attendance among nulliparous pregnant women in Sydney, Australia. Women Birth 2023; 36:e276-e282. [PMID: 35987732 DOI: 10.1016/j.wombi.2022.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 05/02/2022] [Revised: 08/07/2022] [Accepted: 08/07/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND Antenatal education aims to provide expectant parents with strategies for dealing with pregnancy, childbirth and parenthood and may have the potential to reduce obstetric intervention and fear of childbirth. We aimed to investigate antenatal education attendance, reasons for and barriers to attending, and techniques taught and used to manage labour. METHODS Antenatal and postnatal surveys were conducted among nulliparous women with a singleton pregnancy at two maternity hospitals in Sydney, Australia in 2018. Classes were classified into psychoprophylaxis, birth and parenting, other, or no classes. Reasons for and barriers to attendance, demographic characteristics, and techniques taught and used in labour were compared by class type, using Pearson's Chi Squared tests of independence. FINDINGS 724 women were surveyed antenatally. The main reasons for attending classes were to better manage the birth (86 %), feel more secure in baby care (71 %) and as a parent (60 %); although this differed by class type. Reasons for not attending classes included being too busy (33 %) and cost (27 %). Epidural, breathing techniques, massage and nitrous oxide were the most common techniques taught. Women who attended psychoprophylaxis classes used a wider range of pain relief techniques in labour. Women found antenatal classes useful preparation for birth (94 %) and parenting (74 %). Women surveyed postnatally wanted more information on baby care/sleeping and breastfeeding. CONCLUSION The majority of women found antenatal education useful and utilised techniques taught. Education providers should ensure breastfeeding and infant care information is provided, and barriers to attendance such as times and cost should be addressed.
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Affiliation(s)
| | - Timothy C Nielsen
- Children's Hospital at Westmead Clinical School, The University of Sydney, Sydney, NSW, Australia
| | - Jane Svensson
- Royal Hospital for Women, Randwick, Sydney, NSW, Australia
| | - Natasha Nassar
- Children's Hospital at Westmead Clinical School, The University of Sydney, Sydney, NSW, Australia
| | - Amanda Henry
- School of Women's and Children's Health, UNSW Medicine and Health, Sydney, NSW, Australia; Department of Women's and Children's Health, St George Hospital, Sydney, NSW, Australia
| | | | - Sara Kim
- School of Women's and Children's Health, UNSW Medicine and Health, Sydney, NSW, Australia
| | - Isabelle Kiew
- School of Women's and Children's Health, UNSW Medicine and Health, Sydney, NSW, Australia
| | - Sarah McLennan
- School of Women's and Children's Health, UNSW Medicine and Health, Sydney, NSW, Australia
| | - Antonia W Shand
- Royal Hospital for Women, Randwick, Sydney, NSW, Australia; Children's Hospital at Westmead Clinical School, The University of Sydney, Sydney, NSW, Australia
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Middleton N, Hadjigeorgiou E, Kolokotroni O, Christodoulides V, Koliandri I, Nicolaou C, Papadopoulou M, Kouta C, Karanikola M, Baum A. Identifying barriers to the educational role of midwives in Cyprus and defining determinants in behaviour terms using the Behaviour Change Wheel: a mixed-method formative study. BMC Health Serv Res 2022; 22:1233. [PMID: 36199135 PMCID: PMC9534462 DOI: 10.1186/s12913-022-08599-7] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 09/23/2022] [Indexed: 12/01/2022] Open
Abstract
Background Τhe Baby Buddy Cyprus webapp was co-created with parents and health professionals within a Participatory Action Research framework. While using Baby Buddy in routine consultations can support the educational role of mother–child healthcare providers (HP), antenatal education (AE) may be currently perceived as a formal activity within the physical space of the antenatal class. We aimed to gain an understanding of influences on midwives engaging in an educational role during routine appointments and identify potential interventions using the Behaviour Change Wheel (BCW) framework. Methods This is a formative mixed-methods research study, with a convergent parallel design, guided by the COM-B model and related Theoretical Domains Framework (TDF). Complimentary methods were used to collect information from in-training and registered midwives: focus group (N = 11), questionnaire survey (N = 24) and Nominal Group Technique during workshops (N = 40). Deductive content analysis of qualitative data and quantitative survey analysis shaped the behaviour diagnosis along the 6 COM-B and 14 TDF domains, and informed the selection of relevant intervention functions and related Behaviour Change Techniques from the BCW taxonomy. Results AE is viewed as a core function of the professional role, yet neither supported nor prioritized by current practices. Problematic areas relate to organizational context, such as weak interprofessional collaboration and lack of policy, protocols and resources. In addition, medicalization of birth and related socio-cultural norms, pertaining to users and providers, are sustaining alienation of the midwife and conditions of power dynamics. AE was perceived as a means to enhance the autonomy of the profession but there might be issues with procedural knowledge and the need for skill development was identified. Several intervention functions were identified as promising, however cognitive re-framing through strategic communication and modelling may also be needed both in terms of providing “credible models” for the role itself as well as re-framing AE through the concept of “making every contact count”. Conclusions AE is currently perceived to be a ‘bad fit’ with routine practice. The study identified several barriers to the educational role of midwives, influencing Capacity, Opportunity and Motivation. While digital tools, such as Baby Buddy, can facilitate aspects of the process, a much wider behaviour and system change intervention is needed to enhance midwives’ educational role and professional identity. In addition to proposing a theory-driven research-informed intervention, the process functioned as a participatory learning experience through collective reflection. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08599-7.
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Affiliation(s)
- Nicos Middleton
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus. .,Birth Forward, Non-Governmental Organization, Nicosia, Cyprus.
| | - Eleni Hadjigeorgiou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Ourania Kolokotroni
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus.,Birth Forward, Non-Governmental Organization, Nicosia, Cyprus.,Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
| | | | - Ioanna Koliandri
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Christiana Nicolaou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Maria Papadopoulou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Christiana Kouta
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Maria Karanikola
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Alison Baum
- Best Beginnings, Registered Charity Organization, London, UK
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Bayrı Bingöl F, Demırgoz Bal M, Dişsiz M, Taylan Sormageç M, Özlükan Çimen B. Psychodrama as a new intervention for reducing fear of childbirth: a randomised controlled trial. J OBSTET GYNAECOL 2022; 42:2946-2953. [PMID: 36018050 DOI: 10.1080/01443615.2022.2114329] [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] [Indexed: 01/06/2023]
Abstract
This study was designed to examine the potential benefit of the addition of psychodrama classes to antenatal education as a new technique to address fear of childbirth. This was a randomised controlled trial. A total of 150 women were initially enrolled in two groups. Psychodrama sessions were added to standard antenatal education in the experiment group. The control group participated only in routine antenatal education classes. Birth outcomes and fear of childbirth were measured and analysed to assess the impact. The analysis was completed with an experimental group of 50 women and a control group of 49 women. At the conclusion of the training, it was observed that there was a greater decrease in fear of childbirth in the experiment group than in the control group. Additionally, in the postpartum period, the experimental group had a higher rate of vaginal childbirth and a shorter childbirth time than the control group. Psychodrama may be an effective means of reducing fear of childbirth and reduced caesarean section childbirth. Psychoeducation should be added antenatal education programs. Thus, it may represent an important tool in the efforts to improve maternal mental health and also provide broader social benefits.IMPACT STATEMENTWhat is already known on this subject? Studies examining means to reduce fear of childbirth have found that psychoanalysis, cognitive behavioural therapy, eye movement desensitisation and reprocessing, haptotherapy and art therapy were useful.What the results of this study add? Psychodrama as a new intervention may be beneficial decreased of fear of childbirth, increased of normal birth rate and at improving the experience of pregnancy and childbirth.What the implications are of these findings for clinical practice and/or further research? Protecting and caring for the mental health of the mother and child benefits the entire community. It has been reported that 1 in 5 mothers experience psychiatric difficulties during the postpartum period, and 7 of 10 do not receive treatment, which has a negative impact on the mother, the child and family. Assesment of the mental health of women during the postpartum period is not regularly performed in many countries and women are frequently left to struggle on their own. The identification of pregnant women who have a high fear of childbirth and who are at risk of developing a psychiatric disorder by nurses is an important element of providing of appropriate, high-quality care.
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Affiliation(s)
| | | | - Melike Dişsiz
- Health Science University, Hamidiye Nursing of Faculty, Istanbul, Türkiye
| | - Meltem Taylan Sormageç
- Sancaktepe Şehit Prof.Dr. Ilhan Varank Training and Research Hospital, Istanbul, Türkiye
| | - Büşra Özlükan Çimen
- Sancaktepe Şehit Prof.Dr. Ilhan Varank Training and Research Hospital, Istanbul, Türkiye
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Uludağ E, Serçekuş P, Vardar O, Özkan S, Alataş SE. Effects of online antenatal education on worries about labour, fear of childbirth, preparedness for labour and fear of covid-19 during the covid-19 pandemic: A single-blind randomised controlled study. Midwifery 2022; 115:103484. [PMID: 36155390 PMCID: PMC9461235 DOI: 10.1016/j.midw.2022.103484] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 06/01/2022] [Accepted: 09/08/2022] [Indexed: 11/19/2022]
Abstract
Objective To examine the effects of online antenatal education on worries about labour, fear of childbirth, preparedness for labour and fear of COVID-19 during the COVID-19 pandemic. Design A single-blind randomised controlled trial comparing two groups: an antenatal education group and a control group. Participants The sample consisted of 44 pregnant women. Measurements A demographic data form, The Oxford Worries on Labour Scale, The Fear of Birth Scale, The Prenatal Self Evaluation Questionnaire and The Fear of COVID-19 Scale were used for data collection. Findings Online antenatal education decreased worries about labour, fear of childbirth and fear of COVID-19 and improved preparedness for labour. Key conclusions Online antenatal education offered during the COVID-19 pandemic is effective in preparedness for labour. Implications for practice As an alternative, online antenatal education should be offered to pregnant women unable to attend face to face education programs due to fear of transmission of infection.
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Affiliation(s)
- Elif Uludağ
- Pamukkale University, Faculty of Health Sciences, Denizli, Turkey
| | - Pınar Serçekuş
- Pamukkale University, Faculty of Health Sciences, Denizli, Turkey.
| | - Okan Vardar
- Pamukkale University, Faculty of Health Sciences, Denizli, Turkey
| | - Sevgi Özkan
- Pamukkale University, Faculty of Health Sciences, Denizli, Turkey
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Montague A, Vandrevala T, Calvert A, Yeh LL, Star C, Khalil A, Griffiths P, Heath PT, Jones CE. Experiences of pregnant women and healthcare professionals of participating in a digital antenatal CMV education intervention. Midwifery 2022; 106:103249. [PMID: 35032932 DOI: 10.1016/j.midw.2022.103249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 01/04/2022] [Indexed: 11/24/2022]
Abstract
Objective The study aimed to explore the perspectives of participating pregnant women and Health Care Professionals (HCPs) towards receiving and providing cytomegalovirus (CMV) education so that barriers and facilitators towards incorporating CMV in routine antenatal care could be better understood. Design This process evaluation phase employed a qualitative design using individual, semi-structured, face-to-face interviews. Setting Recruitment and interviews took place within a large teaching hospital from an ethnically diverse area of South-west London Participants The study sample included 20 participants: 15 pregnant women, and five HCPs. All participants were involved in a single centre randomized controlled trial of a digital CMV educational intervention in pregnancy. Findings Pregnant participants expressed a strong desire to receive information about CMV as part of routine antenatal care. Although HCPs were accepting of the need for CMV education, it was evident that they felt unequipped to provide this; reasons included lack of time, uncertainty about clinical pathways and concern about the potential emotive impact of CMV education. Pregnant women suggested that expressing behaviour changes as risk reduction rather than prevention, made the behaviours feel more achievable and realistic. The support of partners was considered a key factor in the successful adoption of behavioural changes by pregnant women. Key conclusions and implications for practice There is an onus on HCPs to consider how CMV can be included as part of antenatal education, with messaging framed as risk reducing rather than prevention.
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Gün Kakaşçı Ç, Coşkuner Potur D, Karabulut Ö, Ertuğrul Abbasoğlu D, Demirci N, Doğan Merih Y. Does Antenatal Education Affect Level Of Empathy And Attachment Of Fathers? J Reprod Infant Psychol 2021; 40:366-383. [PMID: 34555950 DOI: 10.1080/02646838.2021.1979198] [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] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The study aimed to determine the effects of antenatal education on the paternal bonding and empathic tendency levels of men who would become fathers for the first time. BACKGROUND There are a limited number of studies in the literature that have investigated the effects of antenatal education programmes on fathers. METHODS This prospective, controlled quasi-experimental study was conducted in a hospital in Istanbul. The men in the antenatal educational group (EG) and their wives participated in training in antenatal classes. The men in the control group (CG) came for routine prenatal follow-up examinations with their wives. The Empathic Tendency and Paternal Postnatal Attachment Scales were used to collect the data. RESULTS The Empathic Tendency Scale was applied before the education (1) - after the education (2) and at the 6th postpartum week (3), whilst the Paternal Postnatal Attachment Scale was used at the 6th postpartum month (4). EG had higher emphatic tendency levels in the 2nd and 3rd measurements and higher paternal bonding levels in the 4th measurement in comparison to CG (p < 0.05). CONCLUSION Antenatal education increased the emphatic tendency of the fathers and the effects of this education continued in the postpartum period and affected paternal bonding positively.
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Affiliation(s)
- Çiğdem Gün Kakaşçı
- Department of Obstetrics and Gynecology Nursing, Division of Nursing, Mehmet Akif Ersoy University, Burdur, Turkey
| | - Dilek Coşkuner Potur
- Department of Obstetrics and Gynecology Nursing, Division of Nursing, Marmara University, İstanbul, Turkey
| | - Özlem Karabulut
- Zeynep Kamil Women and Child Disease Training and Research Hospital, Istanbul, Turkey
| | | | - Nurdan Demirci
- Department of Obstetrics and Gynecology Nursing, Division of Nursing, Marmara University, İstanbul, Turkey
| | - Yeliz Doğan Merih
- Department of Obstetrics Gynecology Nursing, University of Health Sciences, İstanbul, Turkey
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Calvert A, Vandrevala T, Parsons R, Barber V, Book A, Book G, Carrington D, Greening V, Griffiths P, Hake D, Khalil A, Luck S, Montague A, Star C, Ster IC, Wood S, Heath PT, Jones CE. Changing knowledge, attitudes and behaviours towards cytomegalovirus in pregnancy through film-based antenatal education: a feasibility randomised controlled trial of a digital educational intervention. BMC Pregnancy Childbirth 2021; 21:565. [PMID: 34407771 PMCID: PMC8375137 DOI: 10.1186/s12884-021-03979-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 06/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Congenital cytomegalovirus (CMV) is the most common congenital infection globally, however information about CMV is not routinely included in antenatal education in the United Kingdom. This feasibility study aimed to gather the essential data needed to design and power a large randomised controlled trial (RCT) to investigate the efficacy of a digital intervention in reducing the risk of CMV acquisition in pregnancy. In order to do this, we carried out a single-centre RCT, which explored the knowledge, attitudes and risk reduction behaviours in women in the intervention and treatment as usual groups, pre- and post-intervention. METHODS CMV seronegative women living with a child less than four years old, receiving antenatal care at a single UK tertiary centre, were randomised to the digital intervention or 'treatment as usual' groups. Participants completed questionnaires before the digital intervention and after and at 34 gestational weeks, and responses within groups and between groups were compared using tailored randomisation tests. CMV serology was tested in the first trimester and at the end of pregnancy. RESULTS Of the 878 women screened, 865 samples were analysed with 43% (n = 372) being CMV seronegative and therefore eligible to take part in the RCT; of these, 103 (27.7%) women were enrolled and 87 (84%) of these completed the study. Most participants (n = 66; 64%) were unfamiliar with CMV at enrolment, however at 34 gestational weeks, women in the intervention group (n = 51) were more knowledgeable about CMV compared to the treatment as usual group (n = 52) and reported engaging in activities that may increase the risk of CMV transmission less frequently. The digital intervention was highly acceptable to pregnant women. Overall, four participants seroconverted over the course of the study: two from each study group. CONCLUSIONS A large multi-centre RCT investigating the efficacy of a CMV digital intervention is feasible in the United Kingdom; this study has generated essential data upon which to power such a study. This single-centre feasibility RCT demonstrates that a digital educational intervention is associated with increase in knowledge about CMV and can result in behaviour change which may reduce the risk of CMV acquisition in pregnancy. TRIAL REGISTRATION Clinicaltrials.gov, NCT03511274 , Registered 27.04.18, http://www.Clinicaltrials.gov.
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Affiliation(s)
- Anna Calvert
- Paediatric Infectious Diseases Research Group, St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK.
- St George's University Hospitals NHS Foundation Trust, London, UK.
| | - Tushna Vandrevala
- Department of Psychology, Kingston University, Kingston-Upon-Thames, UK
| | - Robin Parsons
- Paediatric Infectious Diseases Research Group, St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK
- St George's University Hospitals NHS Foundation Trust, London, UK
| | - Victoria Barber
- Department of Psychology, Kingston University, Kingston-Upon-Thames, UK
| | - Alex Book
- Parent Caring for a Child With Congenital CMV Infection, London, UK
| | - Gayle Book
- Parent Caring for a Child With Congenital CMV Infection, London, UK
| | - David Carrington
- St George's University Hospitals NHS Foundation Trust, London, UK
| | - Vanessa Greening
- Paediatric Infectious Diseases Research Group, St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK
- St George's University Hospitals NHS Foundation Trust, London, UK
| | - Paul Griffiths
- University College London, Medical School, Institute of Immunity and Transplantation, London, UK
| | - Danielle Hake
- Paediatric Infectious Diseases Research Group, St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK
- St George's University Hospitals NHS Foundation Trust, London, UK
| | - Asma Khalil
- Paediatric Infectious Diseases Research Group, St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK
- St George's University Hospitals NHS Foundation Trust, London, UK
| | - Suzanne Luck
- Paediatric Infectious Diseases Research Group, St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK
- Kingston Hospital NHS Foundation Trust, Kingston-Upon-Thames, UK
| | - Amy Montague
- Department of Psychology, Kingston University, Kingston-Upon-Thames, UK
| | | | - Irina Chis Ster
- Institute of Infection and Immunity, St George's University of London, London, UK
| | | | - Paul T Heath
- Paediatric Infectious Diseases Research Group, St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK
- St George's University Hospitals NHS Foundation Trust, London, UK
| | - Christine E Jones
- Paediatric Infectious Diseases Research Group, St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, and NIHR Southampton Clinical Research Facility and NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, UK
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Tabib M, Humphrey T, Forbes-McKay K, Lau A. Expectant parents' perspectives on the influence of a single antenatal relaxation class: A qualitative study. Complement Ther Clin Pract 2021; 43:101341. [PMID: 33662893 DOI: 10.1016/j.ctcp.2021.101341] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 09/05/2020] [Revised: 02/10/2021] [Accepted: 02/23/2021] [Indexed: 11/29/2022]
Abstract
AIM This study explores the perspectives of expectant parents on the influence of a single antenatal class incorporating education on childbirth physiology and relaxation techniques. METHOD The data for this qualitative descriptive study were collected via in-depth interviews with six women and three birth partners. FINDINGS An enhanced understanding of childbirth physiology formed a 'different way of thinking' about childbirth, 'inspired and motivated' the exertion of the learnt relaxation techniques which led to a 'deepsense of calmness' associated with increased confidence and reduced fear. However, reaching such sense of calmness during childbirth required a 'space for relaxation' which was influenced by birth attendants. An overarching theme of 'a positive outlook' towards childbirth was identified. CONCLUSION Including education on childbirth physiology and a range of relaxation techniques may reduce fear, empower prospective parents and positively influence their experiences of pregnancy and childbirth.
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Affiliation(s)
- Mo Tabib
- School of Nursing and Midwifery, Robert Gordon University, Garthdee Campus, Garthdee Road, Aberdeen, AB10 7AQ, UK, Scotland, United Kingdom.
| | - Tracy Humphrey
- School of Nursing, Midwifery & Social Work, The University of Queensland, Brisbane, Qld, 4072, Australia.
| | - Katrina Forbes-McKay
- School of Applied Social Studies, Robert Gordon University, Garthdee Campus, Garthdee Road, Aberdeen, AB10 7QG, UK, Scotland, United Kingdom.
| | - Annie Lau
- School of Nursing and Midwifery, Robert Gordon University, Garthdee Campus, Garthdee Road, Aberdeen, AB10 7AQ, UK, Scotland, United Kingdom.
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Wright A, Elcombe E, Burns ES. "Paper, face-to-face and on my mobile please": A survey of women's preferred methods of receiving antenatal education. Women Birth 2020:S1871-5192(20)30371-1. [PMID: 33172801 DOI: 10.1016/j.wombi.2020.10.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/22/2020] [Accepted: 10/26/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Antenatal education prepares women for childbirth and can be delivered face-to-face, in hard-copy and electronically. Smartphones allow access to online learning and internet searching is common among pregnant women. It is unclear which mode of health information delivery women prefer. AIM This study aimed to investigate how women at one Local Health District (LHD) preferred to receive health information during pregnancy and the early postnatal period. METHODS We developed a survey to gather data on women's preferences for educational information. Women who were discharged from one LHD, in NSW Australia, were invited, in 2019, to participate in a simple 14 question survey, either online or in hard copy format. FINDINGS In total, 685 women completed the survey which represented a 40% response rate over a period of two months. The survey revealed women commonly used smart phones, or other devices, to source information. Despite this, most women preferred to receive antenatal education via non-electronic methods. Of note many participants felt underprepared for the post-birth period. The method of survey completion, whether hardcopy or online, aligned with individuals' preferences for information delivery. CONCLUSION Non-electronic methods of education delivery were the preferred method for most women, and this was consistent across all educational, cultural and socioeconomic levels. Women sought information online, or through apps, but these options did not always meet their knowledge needs, especially regarding the postnatal period. We recommend that hospitals continue to provide information in a variety of modes, as exclusively electronic methods may marginalise groups of women.
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Tan ML, Foong SC, Ho JJ, Foong WC, Mohd R, Harun Z. Postpartum women's perception of antenatal breastfeeding education: a descriptive survey. Int Breastfeed J 2020; 15:85. [PMID: 33054789 PMCID: PMC7557059 DOI: 10.1186/s13006-020-00328-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 10/05/2020] [Indexed: 11/26/2022] Open
Abstract
Background Antenatal breastfeeding education (ANBE) is provided to all pregnant women attending Ministry of Health (MOH) clinics and some private health facilities in Malaysia, in line with the WHO/UNICEF Baby-Friendly Hospital Initiative (BFHI). However, the 6 month exclusive breastfeeding prevalence remains relatively low in Malaysia, suggesting that there may be a gap between what is currently taught and what is received by the women. Objectives To determine how women perceived their ANBE experience in the first 8 weeks postpartum including what was useful and what they would like to have been included, sources of ANBE and infant feeding practices at the time of survey. Methods Women during their first 8 weeks postpartum who attended MOH clinics in Penang State, Malaysia were surveyed using a self-administered questionnaire in April and May 2015. Categorical responses were presented as numbers and proportions while free text responses were compiled verbatim and categorised into themes. The perceptions of primiparous and multiparous women were compared. Multivariate logistic regression adjusted to known confounders was used to determine if ANBE was associated with exclusive breastfeeding at the time of survey. Results A total of 421 women completed the 15-item questionnaire (84% response rate) of which 282 were complete and available for analysis. Of these, 95% had received ANBE, majority (88%) from MOH clinics. Almost all women found it useful. However, there were areas both in the delivery (e.g. too short) and the content (e.g. nothing new) that were described as not useful; and areas they would like more coverage (e.g. milk expression, storage and overcoming low milk supply). The exclusive breastfeeding prevalence at the time of survey was 61%. ANBE was significantly associated with exclusive breastfeeding even after adjusting for confounders (adjusted odds ratio [aOR] 8.1, 95% confidence interval 1.7, 38.3). Conclusions ANBE is widely implemented and perceived as useful and may be associated with exclusive breastfeeding. Our findings give insight into content that women would like more of and how delivery of ANBE could be improved, including individualized sessions and communicating at a suitable level and language. Future studies could focus on the quality of ANBE delivery.
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Affiliation(s)
- May Loong Tan
- Department of Paediatrics, RCSI & UCD Malaysia Campus (formerly Penang Medical College), 4 Jalan Sepoy Lines, 10450, George Town, Penang, Malaysia.
| | - Siew Cheng Foong
- Department of Paediatrics, RCSI & UCD Malaysia Campus (formerly Penang Medical College), 4 Jalan Sepoy Lines, 10450, George Town, Penang, Malaysia
| | - Jacqueline J Ho
- Department of Paediatrics, RCSI & UCD Malaysia Campus (formerly Penang Medical College), 4 Jalan Sepoy Lines, 10450, George Town, Penang, Malaysia
| | - Wai Cheng Foong
- Department of Paediatrics, RCSI & UCD Malaysia Campus (formerly Penang Medical College), 4 Jalan Sepoy Lines, 10450, George Town, Penang, Malaysia
| | - Rokiah Mohd
- Department of Public Health, Penang State Health Department, George Town, Penang, Malaysia
| | - Zuhaida Harun
- Nutrition & Community Health, Penang State Health Department, George Town, Penang, Malaysia
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Serçekuş P, Vardar O, Göral Türkçü S, Özkan S. Why are first time expectant fathers afraid of birth? : A qualitative study. Eur J Obstet Gynecol Reprod Biol 2020; 254:231-235. [PMID: 33011506 DOI: 10.1016/j.ejogrb.2020.09.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 08/05/2020] [Revised: 09/15/2020] [Accepted: 09/21/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine the fears associated with childbirth among first time expectant fathers and the reasons for these fears. STUDY DESIGN A descriptive, phenomenological approach was used. The sampling was composed of 16 men who were first time expectant fathers, who were at least primary school graduates, who were 18 years of age or older, whose partner was in her final trimester week of pregnancy, who did not have any psychiatric problems and who stated that they had a fear of childbirth. RESULTS The data were collected under the two main themes of fears about childbirth and the reasons for the fears. It was found that the expectant fathers had fears associated with the complications that could develop during childbirth and with the health personnel. CONCLUSIONS There were various fears associated with childbirth among expectant fathers. The reasons for the fears were mostly the negative stories heard. Health personnel have important duties in defining and decreasing the fears of expectant fathers associated with childbirth. It should not be forgotten that expectant fathers are also a part of childbirth in antenatal education.
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Affiliation(s)
- Pınar Serçekuş
- Pamukkale University, Faculty of Health Sciences, Denizli, Turkey.
| | - Okan Vardar
- Pamukkale University, Faculty of Health Sciences, Denizli, Turkey
| | | | - Sevgi Özkan
- Pamukkale University, Faculty of Health Sciences, Denizli, Turkey.
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de Campos EA, Narchi NZ, Moreno G. Meanings and perceptions of women regarding the practice of yoga in pregnancy: A qualitative study. Complement Ther Clin Pract 2020; 39:101099. [PMID: 32379641 DOI: 10.1016/j.ctcp.2020.101099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/18/2019] [Revised: 12/10/2019] [Accepted: 01/16/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND PURPOSE Considering that pregnancy triggers profound transformations in the life experience of women, among them the need to adapt to a body in a constant process of physiological, psychic, social and emotional change, it is important to identify to what extent yoga can contribute to this process. For this reason, the present study aimed to comprehend the meanings and perceptions of women regarding the practice of yoga during pregnancy. MATERIALS AND METHODS A qualitative and descriptive study was carried out with nine women at different gestational ages who were practicing yoga in places with alternative and integrative therapies for pregnant women located in São Paulo, Brazil. Data collection was performed through semi-structured interviews and the women's statements were transcribed, analysed and grouped into three thematic categories. RESULTS The analysis of the interviews allowed the identification of three categories 'Benefits of practicing yoga', 'Self-knowledge, autonomy and self-care' and 'Empowerment for the moment of the birth'. These findings allowed us to understand how the women perceived the practice of yoga in the pregnancy and considered it fundamental to the recognition that they were competent and skilled to manage and control their bodies during childbirth. CONCLUSION It was concluded that the practice of yoga provided physical and psychosocial benefits for the women of this study, including strengthening of the pelvic floor, pain relief, improvement of breathing, reduction of stress and anxiety, and strengthening of self-confidence, self-esteem and autonomy in the management of the pregnancy and in caring for themselves.
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Affiliation(s)
- Edemilson Antunes de Campos
- Direct-entry Midwifery Program of the School of Arts, Sciences and Humanities of the University of Sao Paulo, Av. Arlindo Bettio, 1000 - Ermelino Matarazzo, 03828-000, São Paulo, São Paulo, Brazil.
| | - Nádia Zanon Narchi
- Direct-entry Midwifery Program of the School of Arts, Sciences and Humanities of the University of Sao Paulo, Av. Arlindo Bettio, 1000 - Ermelino Matarazzo, 03828-000, São Paulo, São Paulo, Brazil.
| | - Gabriela Moreno
- Direct-entry Midwifery Program of the School of Arts, Sciences and Humanities of the University of Sao Paulo, Av. Arlindo Bettio, 1000 - Ermelino Matarazzo, 03828-000, São Paulo, São Paulo, Brazil.
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Hassanzadeh R, Abbas-Alizadeh F, Meedya S, Mohammad-Alizadeh-Charandabi S, Mirghafourvand M. Assessment of childbirth preparation classes: a parallel convergent mixed study. Reprod Health 2019; 16:160. [PMID: 31699110 PMCID: PMC6836369 DOI: 10.1186/s12978-019-0826-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 10/11/2019] [Indexed: 01/14/2023] Open
Abstract
Background Women’s fear from childbirth has been associated with increased medical interventions and traumatized birth experience. Although antenatal education is a crucial factor to empower and prepare women for their birth journey, it is not clear how Iranian childbirth classes can influence women’s fear and prepare them positively towards childbirth. This research is designed to evaluate childbirth preparation classes and their impact on women’s perception on their childbirth experiences. Methods/design This mixed method study with the parallel convergent design has two phases. The first phase will be a quantitative cohort study with 204 primiparous pregnant women at the gestational age of 35–37 weeks. The participants will be divided into three groups based on the number of their attendance into the childbirth preparation classes: a) regular participation (4 to 8 sessions), b) irregular participation (1 to 3 sessions), and c) no-participation. Participant will be followed-up to 1 month after birth. Antenatal data will be collected by using a demographic survey questionnaire, the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ, version A), the Van den Bergh Pregnancy-Related Anxiety Questionnaire, the Satisfaction with Childbirth Preparation Classes Questionnaire, the Edinburgh Postpartum Depression Scale (EPDS) and Knowledge regarding pregnancy and childbirth Questionnaire. Postnatal data will be collected by using an Obstetric and Labor Characteristics Questionnaire, EPDS, and Childbirth experience questionnaire (CEQ). The quantitative data will be analyzed using one-way ANOVA and the multivariate linear regression. The second phase of the study will be a qualitative study that will explore the women’s perceptions on the impact of participation in childbirth preparation classes on their childbirth experience. The sampling in this phase will be purposeful and the participants will be studied individually by using in-depth, semi-structured interviews. The qualitative data will be analyzed through content analysis with conventional approach. Discussion Assessing the impact of childbirth preparation classes on women’s childbirth experience in Iran will lead to developing recommendations about the content and quality of the childbirth classes that can improve women’s’ preparation towards positive childbirth.
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Affiliation(s)
- Robab Hassanzadeh
- Students' Research Committee, Tabriz University of Medical sciences, Tabriz, Iran
| | - Fatemeh Abbas-Alizadeh
- Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shahla Meedya
- South Asia Infant Feeding Research Network (SAIFRN), School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | | | - Mojgan Mirghafourvand
- Social determinants of Health Research Center, Midwifery Department, Tabriz University of Medical sciences, Tabriz, Iran.
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Shimpuku Y, Madeni FE, Horiuchi S, Kubota K, Leshabari SC. A family-oriented antenatal education program to improve birth preparedness and maternal-infant birth outcomes: A cross sectional evaluation study. Reprod Health 2019; 16:107. [PMID: 31311563 PMCID: PMC6636146 DOI: 10.1186/s12978-019-0776-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 07/10/2019] [Indexed: 11/12/2022] Open
Abstract
Background In Tanzania, the information on Birth Preparedness and Complication Readiness is insufficiently provided to pregnant women and their families. The aim of this study was to evaluate the maternal and infant outcomes of a family-oriented antenatal group education program that promotes Birth Preparedness and Complication Readiness in rural Tanzania. Methods Pregnant women and families were enrolled in a program about nutrition and exercise, danger signs, and birth preparedness. The cross sectional survey was conducted one year later to evaluate if the participants of the program (intervention group) were different from those who did not participate (control group) with respect to birth-preparedness and maternal and infant outcomes. Results A total of 194 participants (intervention group, 50; control group, 144) were analyzed. For Birth Preparedness and Complication Readiness, the intervention group participants knew a health facility in case of emergency (OR: 3.11, 95% CI: 1.39–6.97); arranged accompaniment to go to a health facility for birth (OR: 2.56, 95% CI: 1.17–5.60); decided the birthplace with or by the pregnant women (OR: 3.11, 95% CI: 1.44–6.70); and attended antenatal clinic more than four times (OR: 2.39, 95% CI: 1.20–4.78). For birth outcomes, the intervention group had less bleeding or seizure during labour and birth (OR: 0.28, 95%CI: 0.13–0.58); fewer Caesarean sections (OR: 0.16, 95% CI: 0.07–0.36); and less neonatal complications (OR: 0.28, 95% CI: 0.13–0.60). Conclusions The four variables were significantly better in the intervention group, i.e., identifying a health facility for emergencies, family accompaniment for facility birth, antenatal visits, and involvement of women in decision-making, which may be key factors for improving birth outcome variables. Having identified these key factors, male involvement and healthy pregnant lives should be emphasized in antenatal education to reduce pregnancy and childbirth complications. Trial registration No.2013–273-NA-2013-101. Registered 12 August 2013.
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Affiliation(s)
- Yoko Shimpuku
- Graduate School of Medicine, Kyoto University, 53 Shogoin-kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Frida E Madeni
- Magunga District Hospital, P. O. Box 430, Old-Korogwe, Tanga, Tanzania
| | - Shigeko Horiuchi
- Graduate School of Nursing Science, St. Luke's International University, 10-1 Akashi-cho, Chuo-ku, Tokyo, 104-0044, Japan
| | - Kazumi Kubota
- Department of Biostatistics, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Sebalda C Leshabari
- School of Nursing, Muhimbili University of Health and Allied Sciences, P. O. Box 65169, Dar es Salaam, Tanzania
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Abstract
BACKGROUND Despite advocating for male involvement in antenatal education, there is unmet need for antenatal education information for expectant couples. The objective of this study was to gain a deeper understanding of the education content for couples during antenatal education sessions in Malawi. This is needed for the development of a tailor-made curriculum for couple antenatal education in the country, later to be tested for acceptability, feasibility and effectiveness. METHODS An exploratory cross sectional descriptive study using a qualitative approach was conducted in semi-urban areas of Blantyre District in Malawi from February to August 2016. We conducted four focus group discussions (FGDs) among men and women independently. We also conducted one focus group discussion with nurses/ midwives, 13 key informant interviews whose participants were drawn from both health-related and non-health related institutions; 10 in-depth interviews with couples and 10 separate in-depth interviews with men who had attended antenatal clinics before with their spouses. All the interviews were audiotaped, transcribed verbatim and translated from Chichewa, the local language, into English. We managed data with NVivo 10.0 and used the thematic content approach as a guide for analysis. RESULTS We identified one overarching theme: couple antenatal education information needs. The theme had three subthemes which were identified based on the three domains of the maternity cycle which are pregnancy, labour and delivery and postpartum period. Preferred topics were; description of pregnancy, care of pregnant women, role of men during perinatal period, family life birth preparedness and complication readiness plan, coitus during pregnancy and after delivery, childbirth and baby care. CONCLUSION Antenatal education is a potential platform to disseminate information and discuss with male partners the childbearing period and early parenting. Hence, if both men and women were to participate in antenatal education, their information needs should be prioritized. Men and women had similar choices of topics to be taught during couple antenatal education, with some minor variations.
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Affiliation(s)
- Maria Chifuniro Chikalipo
- School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
- Kamuzu College of Nursing, University of Malawi, Blantyre, Malawi
| | | | - Adamson Sinjani Muula
- School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
- Africa Center of Excellence in Public Health and Herbal Medicine, University of Malawi, Blantyre, Malawi
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Heim MA, Miquelutti MA, Makuch MY. Perspective of pregnant women regarding antenatal preparation: A qualitative study. Women Birth 2018; 32:558-563. [PMID: 30528818 DOI: 10.1016/j.wombi.2018.11.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 04/17/2018] [Revised: 10/24/2018] [Accepted: 11/27/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Antenatal Education programs have been recommended for pregnant women to help them during gestation, childbirth and development of parenthood. Evidence on the perspectives and expectations of pregnant women regarding antenatal education in hospital settings, specifically in developing countries is still scarce. In-depth understanding is a key issue to organize interventions. AIM Identify experiences, needs and expectations of a group of pregnant women regarding antenatal education. METHODS A qualitative study was conducted. Data were collected through semi-structured interviews at the antenatal clinic of a public maternity teaching hospital in the southeastern region of Brazil. The interviews were recorded, transcribed verbatim and thematic analysis was performed. Twenty-two pregnant women were recruited following the logic of purposive sampling. FINDINGS All the participants reported they would like to receive guidance on non-pharmacological techniques for pain management during labor. The participants reported barriers to performed physical exercise; however, they also said that if they were encouraged by healthcare professionals they would exercise. According to the majority, the exercises should be of low intensity, and the improvement of general wellbeing was the most commented benefit. Also participants said that antenatal education meetings should be linked to antenatal consultations to facilitate participation. According to some participants, knowledge about antenatal education was acquired in conversations with other women, from lay media, and some reported a lack of guidance during antenatal consultation. CONCLUSION The participants of our study reported they would like to participate in antenatal education groups to receive guidance on non-pharmacological techniques to use during labor and childbirth.
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Affiliation(s)
- Maria Augusta Heim
- University of Campinas Medical School (UNICAMP), Departament of Obstetrics and Gynecology, Brazil
| | - Maria Amelia Miquelutti
- University of Campinas Medical School (UNICAMP), Departament of Obstetrics and Gynecology, Brazil
| | - Maria Y Makuch
- University of Campinas Medical School (UNICAMP), Departament of Obstetrics and Gynecology, Brazil.
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Abuidhail J, Mrayan L, Jaradat D. Evaluating effects of prenatal web-based breastfeeding education for pregnant mothers in their third trimester of pregnancy: Prospective randomized control trial. Midwifery 2018; 69:143-149. [PMID: 30513445 DOI: 10.1016/j.midw.2018.11.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 03/09/2018] [Revised: 11/20/2018] [Accepted: 11/28/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Education is the cornerstone supporting breastfeeding practices. However, the traditional oral education method cannot always satisfy the learning needs of mothers. OBJECTIVE to measure the effectiveness of prenatal web-based breastfeeding education program for Jordanian pregnant mothers in their third trimester of pregnancy on enhancing knowledge, attitude, and self-efficacy of breastfeeding after giving birth. METHODS prospective randomized control trial design was used with sample consisted of 112 pregnant mothers who were recruited from one antenatal clinic in Irbid Governorate. Data collection instruments were the infant feeding knowledge and attitudes (IIFAS) and Breastfeeding Self-Efficacy Scale (BSES) were used to measure self efficacy, knowledge and attitudes regarding breastfeeding. RESULTS Participants of the experimental group were at moderate level of BSES in pre and post intervention with increasing the number of mothers in the same level post intervention. Participants were at a neutral level of IIFAS in both groups generally, they were neither positive to breastfeeding nor to bottle feeding. There was no significant difference between the experimental and control groups on post- intervention scores on BSES and IIFAS. CONCLUSION This study is considered the first trial to use new teaching methodologies as internet and website in teaching mothers about breastfeeding. Despite that there were not differences between intervention and control groups, web-based breastfeeding education program may contribute in improving breastfeeding self efficacy. IMPLICATIONS Inclusion prenatal web-based breastfeeding education in antenatal clinics at MCHC centers of Ministry of Health. Further research is needed to replicate this study in other Jordanian health settings.
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Affiliation(s)
- Jamila Abuidhail
- Faculty of Nursing, Hashemite University, P.O. Box 330133, Zarqa, 13133, Jordan.
| | - Lina Mrayan
- Faculty of Nursing, Hashemite University, P.O. Box 330133, Zarqa, 13133, Jordan.
| | - Dima Jaradat
- Faculty of Nursing, Hashemite University, P.O. Box 330133, Zarqa, 13133, Jordan.
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Campbell V, Nolan M. 'It definitely made a difference': A grounded theory study of yoga for pregnancy and women's self-efficacy for labour. Midwifery 2018; 68:74-83. [PMID: 30396001 DOI: 10.1016/j.midw.2018.10.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [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: 05/16/2018] [Revised: 10/07/2018] [Accepted: 10/16/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To explore women's experience of attending yoga for pregnancy classes in order to generate a theory about which aspects, if any, are effective in enhancing self-efficacy for labour and birth. DESIGN A longitudinal grounded theory study. METHODS Semi-structured interviews were undertaken with women before they started yoga for pregnancy classes, after they had attended at least six classes, and finally, postnatally. Interview transcripts were analysed using constructive grounded theory and a self-efficacy framework. SETTING Three yoga for pregnancy teachers' classes in England. PARTICIPANTS Twenty two women attending yoga for pregnancy classes. FINDINGS Analysis of interviews with women at three time points led to a propositional theory that yoga for pregnancy enhances women's self-efficacy for labour by building their confidence and competence through a combination of techniques. These include repeated practice of a variety of pain management strategies, use of affirming language and the telling of positive labour stories, underpinned by yoga practice to lower somatic response to stress.
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Affiliation(s)
- Virginia Campbell
- University of Worcester, St John's Campus, Henwick Grove, Worcester WR2 6AJ, United Kingdom.
| | - Mary Nolan
- University of Worcester, St John's Campus, Henwick Grove, Worcester WR2 6AJ, United Kingdom.
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Shimpuku Y, Madeni FE, Horiuchi S, Kubota K, Leshabari SC. Evaluation of a family-oriented antenatal group educational program in rural Tanzania: a pre-test/post-test study. Reprod Health 2018; 15:117. [PMID: 29954398 PMCID: PMC6025829 DOI: 10.1186/s12978-018-0562-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 06/18/2018] [Indexed: 11/18/2022] Open
Abstract
Background To increase births attended by skilled birth attendants in Tanzania, studies have identified the need for involvement of the whole family in pregnancy and childbirth education. This study aimed to develop, implement, and evaluate a family-oriented antenatal group educational program to promote healthy pregnancy and family involvement in rural Tanzania. Methods This was a quasi-experimental 1 group pre-test/post-test study with antenatal education provided to pregnant women and their families in rural Tanzania. Before and after the educational program, the pre-test/post-test study was conducted using a 34-item Birth Preparedness Questionnaire. Acceptability of the educational program was qualitatively assessed. Results One-hundred and thirty-eight participants (42 pregnant women, 96 family members) attended the educational program, answered the questionnaire, and participated in the feasibility inquiry. The mean knowledge scores significantly increased between the pre-test and the post-test, 7.92 and 8.33, respectively (p = 0.001). For both pregnant women and family members, the educational program improved Family Support (p = 0.001 and p = 0.000) and Preparation of Money and Food (p = 0.000 and p = 0.000). For family members, the scores for Birth Preparedness (p = 0.006) and Avoidance of Medical Intervention (reversed item) (p = 0.002) significantly increased. Despite the educational program, the score for Home-based Value (reversed item) (p = 0.022) and References of SBA (p = 0.049) decreased in pregnant women. Through group discussions, favorable comments about the program and materials were received. The comments of the husbands reflected their better understanding and appreciation of their role in supporting their wives during the antenatal period. Conclusions The family-oriented antenatal group educational program has potential to increase knowledge, birth preparedness, and awareness of the need for family support among pregnant women and their families in rural Tanzania. As the contents of the program can be taught easily by reading the picture drama, lay personnel, such as community health workers or traditional birth attendants, can use it in villages. Further development of the Birth Preparedness Questionnaire is necessary to strengthen the involved factors. A larger scale study with a more robust Birth Preparedness Questionnaire and documentation of skilled care use is needed for the next step. Trial registration No.2013–273-NA-2013-101. Registered 12 August 2013.
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Affiliation(s)
- Yoko Shimpuku
- Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Shogoin-kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Frida E Madeni
- Magunga District Hospital, P. O. Box 430, Old-Korogwe, Tanga, Tanzania
| | - Shigeko Horiuchi
- Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Shogoin-kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Kazumi Kubota
- Department of Biostatistics, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Sebalda C Leshabari
- School of Nursing, Muhimbili University of Health and Allied Sciences, P. O. Box 65169, Dar es Salaam, Tanzania
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Newnham E, McKellar L, Pincombe J. 'It's your body, but…' Mixed messages in childbirth education: Findings from a hospital ethnography. Midwifery 2017; 55:53-9. [PMID: 28942214 DOI: 10.1016/j.midw.2017.09.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 09/05/2017] [Accepted: 09/08/2017] [Indexed: 11/24/2022]
Abstract
OBJECTIVE to investigate the personal, social, cultural and institutional influences on women making decisions about using epidural analgesia in labour. In this article we discuss the findings that describe practices around the gaining of consent for an epidural in labour, which we juxtapose with similar processes relating to use of water for labour and/or birth. DESIGN ethnography. SETTING tertiary hospital in Australian city. PARTICIPANTS sequential interviews were conducted with 16 women; hospital staff (primarily midwives and doctors) participated during six months of participatory observation fieldwork. FINDINGS women were not given full disclosure of either practice and midwives tailored the information they gave according to the institutional policies rather than evidence. KEY CONCLUSIONS informed consent is an oft-cited human right in health care, yet in maternity care the micro-politics of how informed consent is gained is difficult to ascertain, leading to a situation whereby the concept of informed consent is more robust than the reality of practice; an illusion of informed consent exists, yet information is often biased towards medicalised birth practices. IMPLICATIONS FOR PRACTICE as primary maternity care-givers, midwives have a role in providing unbiased information to women; however it appears that hospital culture and policy affect the way that this information is presented. It is arguable whether women in such instances are giving true informed consent, and for this reason, the ethics of these hidden practices are questioned.
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Suto M, Takehara K, Yamane Y, Ota E. Effects of prenatal childbirth education for partners of pregnant women on paternal postnatal mental health and couple relationship: A systematic review. J Affect Disord 2017; 210:115-121. [PMID: 28024222 DOI: 10.1016/j.jad.2016.12.025] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [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: 08/16/2016] [Accepted: 12/17/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Partner education during pregnancy may be able to prevent postnatal mental health problems, and support expectant fathers in their transition to parenthood. The aim of this systematic review is to investigate the effects of prenatal childbirth education among partners of pregnant women, particularly regarding paternal postnatal mental health and couple relationship. METHODS We searched Medline, CINAHL, EMBASE, PsycINFO, ERIC, and CENTRAL using terms such as "partners of pregnant women," "education," and "prenatal support." Searches were limited to randomized trials. RESULTS We included 11 trials out of 13 reports that addressed the following topics: childbirth preparation, couple relationship, infants and parenting, postpartum psychosocial issues, and housework sharing. Overall risk of bias was low or unclear. Study outcomes, including parents' mental health (e.g., anxiety, depression, distress), couple relationship, parents' transition adjustment and parenting stress, and parents' satisfaction with their experience of childbirth and prenatal childbirth education programs were reported. LIMITATIONS The studies included in this review were very diverse regarding intervention intensity and content, outcome types, measurement tools, and outcome timing. This impeded evaluation of the interventions' effectiveness. CONCLUSION No sufficient evidence was identified that prenatal childbirth education for partners of pregnant women protects against paternal postnatal depression and couple relationship; however, paternal postnatal mental health is important to maternal and perinatal healthcare. The results of this review suggest that further research and intervention are required to provide partners of pregnant women with evidence-based information and support whole families during the perinatal period.
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Affiliation(s)
- Maiko Suto
- Graduate School of International and Cultural Studies, Tsuda College, Tokyo, Japan
| | - Kenji Takehara
- National Center for Child Health and Development, Tokyo, Japan
| | - Yumina Yamane
- College, National Rehabilitation Center for Persons with Disabilities, Saitama, Japan
| | - Erika Ota
- Graduate School of Nursing Science, St.Luke's International University, Tokyo, Japan.
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Salmon VE, Hay-Smith EJC, Jarvie R, Dean S, Oborn E, Bayliss SE, Bick D, Davenport C, Ismail KM, MacArthur C, Pearson M. Opportunities, challenges and concerns for the implementation and uptake of pelvic floor muscle assessment and exercises during the childbearing years: protocol for a critical interpretive synthesis. Syst Rev 2017; 6:18. [PMID: 28122608 PMCID: PMC5267404 DOI: 10.1186/s13643-017-0420-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 01/18/2017] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Pregnancy and childbirth are important risk factors for urinary incontinence (UI) in women. Pelvic floor muscle exercises (PFME) are effective for prevention of UI. Guidelines for the management of UI recommend offering pelvic floor muscle training (PFMT) to women during their first pregnancy as a preventive strategy. The objective of this review is to understand the relationships between individual, professional, inter-professional and organisational opportunities, challenges and concerns that could be essential to maximise the impact of PFMT during childbearing years and to effect the required behaviour change. METHODS Following systematic searches to identify sources for inclusion, we shall use a critical interpretive synthesis (CIS) approach to produce a conceptual model, mapping the relationships between individual, professional, inter-professional and organisational factors and the implementation, acceptability and uptake of PFME education, assessment and training during the childbearing years. Purposive sampling will be used to identify potentially relevant material relating to topics or areas of interest which emerge as the review progresses. A wide range of empirical and non-empirical sources will be eligible for inclusion to encompass the breadth of relevant individual, professional, inter-professional and organisational issues relating to PFME during childbearing years. Data analysis and synthesis will identify key themes, concepts, connections and relationships between these themes. Findings will be interpreted in relation to existing frameworks of implementation, attitudes and beliefs of individuals and behaviour change. We will collate examples to illustrate relationships expressed in the conceptual model and identify potential links between the model and drivers for change. DISCUSSION The CIS review findings and resulting conceptual model will illustrate relationships between factors that might affect the implementation, acceptability and uptake of PFME education, assessment and training during the childbearing years. The model will inform the development and evaluation of a training package to support midwives with implementation and delivery of effective PFME during the antenatal period. The review forms part of the first phase of the United Kingdom National Institute for Health Research funded 'Antenatal Preventative Pelvic floor Exercises And Localisation (APPEAL)' programme (grant number: RP-PG-0514-20002) to prevent poor health linked to pregnancy and childbirth-related UI. SYSTEMATIC REVIEW REGISTRATION PROSPERO: CRD42016042792.
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Affiliation(s)
- Victoria E Salmon
- NIHR Collaboration for Leadership in Applied Health Research & Care South West Peninsula (PenCLAHRC), Institute of Health Research, University of Exeter Medical School, South Cloisters, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | | | - Rachel Jarvie
- NIHR Collaboration for Leadership in Applied Health Research & Care South West Peninsula (PenCLAHRC), Institute of Health Research, University of Exeter Medical School, South Cloisters, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - Sarah Dean
- NIHR Collaboration for Leadership in Applied Health Research & Care South West Peninsula (PenCLAHRC), Institute of Health Research, University of Exeter Medical School, South Cloisters, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - Eivor Oborn
- Warwick Business School, University of Warwick, Coventry, UK
| | | | | | | | | | | | - Mark Pearson
- NIHR Collaboration for Leadership in Applied Health Research & Care South West Peninsula (PenCLAHRC), Institute of Health Research, University of Exeter Medical School, South Cloisters, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK.
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Kearney L, Kynn M, Craswell A, Reed R. The relationship between midwife-led group-based versus conventional antenatal care and mode of birth: a matched cohort study. BMC Pregnancy Childbirth 2017; 17:39. [PMID: 28103820 PMCID: PMC5244557 DOI: 10.1186/s12884-016-1216-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 12/29/2016] [Indexed: 11/10/2022] Open
Abstract
Background Midwife facilitated, group models of antenatal care have emerged as an alternative to conventional care both within Australia and internationally. Group antenatal care can be offered in a number of different ways, however usually constitutes a series of sessions co-ordinated by a midwife combining physical assessment, antenatal education and peer support in a group setting. Midwife-led group antenatal care is viewed positively by expectant mothers, with no associated adverse outcomes identified in the published literature for women or their babies when compared with conventional care. Evidence of an improvement in outcomes is limited. The aim of this study was to compare mode of birth (any vaginal birth with caesarean birth) between pregnant women accessing midwife-led group antenatal care and conventional individual antenatal care, in Queensland, Australia. Methods This was a retrospective matched cohort study, set within a collaborative antenatal clinic between the local university and regional public health service in Queensland, Australia. Midwife-led group antenatal care (n = 110) participants were compared with controls enrolled in conventional antenatal care (n = 330). Groups were matched by parity, maternal age and gestation to form comparable groups, selecting a homogeneous sample with respect to confounding variables likely to affect outcomes. Results There was no evidence that group care resulted in a greater number of caesarean births. The largest increase in the odds of caesarean birth was associated with a previous caesarean birth (p < 0.001), no previous birth (compared with previous vaginal birth) (p < 0.003), and conventional antenatal care (p < 0.073). The secondary outcomes (breastfeeding and infant birth weight) which were examined between the matched cohorts were comparable between groups. Conclusions There is no evidence arising from this study that there was a significant difference in mode of birth (caesarean or vaginal) between group and conventional care. Group care was associated with a lower risk of caesarean birth after controlling for previous births, with the highest chance for a vaginal birth being a woman who has had a previous vaginal birth and was in group care. Conversely, the highest risk of caesarean birth was for women who have had a previous caesarean birth and conventional care.
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Affiliation(s)
- Lauren Kearney
- University of the Sunshine Coast, Locked Bag 4, Maroochydore DC, 4558, Queensland, Australia. .,Women and Families Service Group, Sunshine Coast Hospital and Health Service, Maroochydore DC, Queensland, Australia.
| | - Mary Kynn
- University of the Sunshine Coast, Locked Bag 4, Maroochydore DC, 4558, Queensland, Australia
| | - Alison Craswell
- University of the Sunshine Coast, Locked Bag 4, Maroochydore DC, 4558, Queensland, Australia
| | - Rachel Reed
- University of the Sunshine Coast, Locked Bag 4, Maroochydore DC, 4558, Queensland, Australia
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Moniz MH, O'Connell LK, Kauffman AD, Singer DC, Clark SJ, Davis MM. Perinatal Preparation for Effective Parenting Behaviors: A Nationally Representative Survey of Patient Attitudes and Preferences. Matern Child Health J 2016; 20:298-305. [PMID: 26525554 DOI: 10.1007/s10995-015-1829-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To characterize patient preferences about parenting preparation during pregnancy and the role of healthcare providers. METHODS A nationally representative, cross-sectional survey was administered to parents of children 0-3 years old. Respondents (N = 459 non-institutionalized US adults from the GfK Knowledge Panel®) completed an online survey about parenting preparation (response rate = 61.2 %). Primary outcomes were perceived importance of parenting, regret about opportunities to prepare for parenting, acceptability of parenting support from healthcare workers, and preferred healthcare setting for perinatal parenting support. Statistical analyses included descriptive statistics, Chi square analyses and logistic regression. RESULTS A majority of respondents (87.6 %, 95 % CI 83.3-90.8) believed that parenting had an equal or greater effect on early childhood behavior than the child's personality. Overall, 68.7 % (63.5-73.5 %) wished there were more opportunities during pregnancy to prepare for parenting, and a large majority (89.2, 84.9-92.4 %) believed that it would be helpful to receive parenting information from healthcare providers during pregnancy, with no differences across demographic groups. The preferred clinical encounters for receiving parenting education were at "a visit with my ObGyn/midwife" during pregnancy (58.2, 52.5-63.7 %) and at "a visit with my child's doctor/nurse practitioner" during 0-2 months postpartum (60.7, 55.0-66.2 %). CONCLUSION A majority of US parents of young children express interest in receiving parenting support at perinatal healthcare visits. Preferences for parenting support at prenatal visits during pregnancy and at pediatric visits in the immediate postpartum period should guide clinicians, community-based outreach organizations, and governmental stakeholders seeking to design and evaluate parenting preparation interventions.
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Fitzgerald C, Heery E, Conneally N, Linnane B, George S, Fitzpatrick P. An evaluation of pregnant women's knowledge and attitudes about newborn bloodspot screening. Midwifery 2016; 45:21-27. [PMID: 27978478 DOI: 10.1016/j.midw.2016.11.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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: 01/06/2016] [Revised: 08/11/2016] [Accepted: 11/20/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVES research suggests that information provided to parents about newborn bloodspot screening (NBS) can be inconsistent. The majority of international NBS programmes recommend that parents should receive information about NBS in the antenatal period, however prior studies have mostly focused on postnatal women's knowledge, with no quantitative study of women's knowledge in the antenatal period conducted to date. Thus, the aim of this study was to determine if antenatal women received information about NBS in the antenatal period and to evaluate their knowledge and attitudes about NBS. DESIGN/PARTICIPANTS we conducted a cross-sectional study among antenatal attendees at three maternity hospitals in Ireland. A total of 662 antenatal women (≥36 weeks gestation) were recruited into the study (279 primiparous, 368 multiparous). Women were asked to complete a self reported knowledge and attitude questionnaire about NBS. FINDINGS primiparity (OR 2.75; 95% CI 1.65, 4.59) lower educational status (OR 1.79; 95% CI 1.02, 3.15) and not having private health insurance (OR 1.84; 95% CI 1.19, 2.85) were independently associated with poor NBS knowledge. Fourteen per cent of antenatal women recalled receiving an information leaflet about NBS, yet over 87 % reported that they would like more information. Thirty four per cent of women agreed that they understand everything they need to know about NBS. CONCLUSIONS/IMPLICATIONS FOR PRACTICE the process of providing women with information about NBS in the antenatal period is inconsistent; consequently their awareness about NBS is limited. To make an informed choice about NBS women require information to be provided in a more structured format. There are many missed opportunities in the antenatal period for maternity care providers to provide women with information about NBS. Our study recommends that healthcare providers should have a more formal and structured approach with regard to the provision of information about NBS in the antenatal period. This could be achieved by incorporating NBS education into antenatal education classes or through multimedia while women are waiting in the antenatal clinic. Healthcare providers may need education about the importance and benefits of providing women with information about NBS in the antenatal period.
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Affiliation(s)
- Catherine Fitzgerald
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Woodview House, Belfield, Dublin 4, Ireland.
| | - Emily Heery
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Woodview House, Belfield, Dublin 4, Ireland
| | - Neasa Conneally
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Woodview House, Belfield, Dublin 4, Ireland
| | - Barry Linnane
- Department of Paediatrics, University Hospital Limerick, Ireland; Graduate Entry Medical School and Centre for Interventions in Infection, Inflammation & Immunity (4i), University of Limerick, Limerick, Ireland
| | - Sherly George
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Woodview House, Belfield, Dublin 4, Ireland
| | - Patricia Fitzpatrick
- School of Public Health, Physiotherapy and Sports Science, University College Dublin, Woodview House, Belfield, Dublin 4, Ireland
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Brixval CS, Thygesen LC, Axelsen SF, Gluud C, Winkel P, Lindschou J, Weber T, Due P, Koushede V. Effect of antenatal education in small classes versus standard auditorium-based lectures on use of pain relief during labour and of obstetric interventions: results from the randomised NEWBORN trial. BMJ Open 2016; 6:e010761. [PMID: 27288375 PMCID: PMC4908902 DOI: 10.1136/bmjopen-2015-010761] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To examine the effect of an antenatal education programme in small classes versus standard auditorium-based lectures. DESIGN Randomised trial using random-generated web-based 1:1 allocation. SETTING The largest birth site in the Capital Region of Denmark, from August 2012 to May 2014. PARTICIPANTS 1766 pregnant women. Inclusion criteria ≥18 years, pregnant with a single child, and able to speak and understand Danish. Women were enrolled in the trial from 10+0 to 20+0 weeks of gestation. INTERVENTIONS The intervention programme consisted of three times 2.5 hours of antenatal education in small classes (n=6-8 women), and focused on improving information and problem-solving skills for expectant parents in order to ease birth and the transition to parenthood. The control group received standard auditorium-based lectures consisting of two times 2 hours in an auditorium with participation of ∼250 people. MAIN OUTCOME MEASURES The primary trial outcome was use of epidural analgesia. Other types of pain relief and obstetric interventions were analysed as explorative outcomes. RESULTS There was no statistically significant difference in use of epidural analgesia between participants in the intervention group (30.9%) versus the control group (29.1%), adjusted OR 1.10 (95% CI 0.87 to 1.34). Also, the two groups did not differ regarding other types of pain relief or obstetric interventions. Concomitant birth preparation was common in both groups and highest in the control group, but did not seem to influence our results noticeably. CONCLUSIONS Antenatal education in small groups versus standard auditorium-based lectures did not differ regarding use of epidural analgesia, other pain relief, or obstetric interventions. TRIAL REGISTRATION NUMBER NCT01672437; Results.
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Affiliation(s)
- Carina Sjöberg Brixval
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | | | - Christian Gluud
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Per Winkel
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Jane Lindschou
- Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Tom Weber
- Department of Obstetrics and Gynaecology, Hvidovre Hospital, Copenhagen University Hospital, Hvidovre, Denmark
| | - Pernille Due
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Vibeke Koushede
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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Levett KM, Smith CA, Bensoussan A, Dahlen HG. The Complementary Therapies for Labour and Birth Study making sense of labour and birth - Experiences of women, partners and midwives of a complementary medicine antenatal education course. Midwifery 2016; 40:124-31. [PMID: 27428108 DOI: 10.1016/j.midw.2016.06.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [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: 11/03/2015] [Revised: 05/03/2016] [Accepted: 06/08/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVE to gain insight into the experiences of women, partners and midwives who participated in the Complementary Therapies for Labour and Birth Study, an evidence based complementary medicine (CM) antenatal education course. DESIGN qualitative in-depth interviews and a focus group as part of the Complementary Therapies for Labour and Birth Study. SETTING AND PARTICIPANTS thirteen low risk primiparous women and seven partners who had participated in the study group of a randomised controlled trial of the complementary therapies for labour and birth study, and 12 midwives caring for these women. The trial was conducted at two public hospitals, and through the Western Sydney University in Sydney, Australia. INTERVENTIONS the Complementary Therapies for Labour and Birth (CTLB) protocol, based on the She Births® course and the Acupressure for labour and birth protocol, incorporated six evidence-based complementary medicine (CM) techniques; acupressure, relaxation, visualisation, breathing, massage, yoga techniques and incorporated facilitated partner support. Randomisation to the trial occurred at 24-36 weeks' gestation, and participants attended a two-day antenatal education programme, plus standard care, or standard care alone. FINDINGS the overarching theme identified in the qualitative data was making sense of labour and birth. Women used information about normal birth physiology from the course to make sense of labour, and to utilise the CM techniques to support normal birth and reduce interventions in labour. Women's, partners' and midwives' experience of the course and its use during birth gave rise to supporting themes such as: working for normal; having a toolkit; and finding what works. KEY CONCLUSIONS the Complementary Therapies for Labour and Birth Study provided women and their partners with knowledge to understand the physiology of normal labour and birth and enabled them to use evidence-based CM tools to support birth and reduce interventions. IMPLICATIONS FOR PRACTICE the Complementary Therapies for Labour and Birth Study introduces concepts of what constitutes normal birth and provides skills to support women, partners and midwives. It appears to be an effective form of antenatal education that supports normal birth, and maternity services need to consider how they can reform current antenatal education in line with this evidence.
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Affiliation(s)
- K M Levett
- National Institute of Complementary Medicines (NICM), Western Sydney University, Sydney, Australia.
| | - C A Smith
- National Institute of Complementary Medicines (NICM), Western Sydney University, Sydney, Australia.
| | - A Bensoussan
- National Institute of Complementary Medicines (NICM), Western Sydney University, Sydney, Australia.
| | - H G Dahlen
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia.
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Peberdy L, Young J, Kearney L. Health care professionals' knowledge, attitudes and practices relating to umbilical cord blood banking and donation: an integrative review. BMC Pregnancy Childbirth 2016; 16:81. [PMID: 27094796 PMCID: PMC4837592 DOI: 10.1186/s12884-016-0863-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2015] [Accepted: 04/05/2016] [Indexed: 01/29/2023] Open
Abstract
Background Collection and storage of an infant’s cord blood at birth is an option available to many new parents. Antenatal health care providers have an important role in providing non-biased and evidence based information to expectant parents about cord blood and tissue banking options. The aim of this paper was to identify and review studies of health care professionals’ knowledge, attitudes and practices concerning cord blood banking and the sources by which healthcare professionals obtained their information on this topic. Methods An integrative review was conducted using several electronic databases to identify papers on health care professionals’ knowledge, attitudes and practices pertaining to cord blood banking. The CASP tool was used to determine validity and quality of the studies included in the review. Results The search of the international literature identified nine papers which met review inclusion criteria. The literature review identified that there was little focus placed on antenatal health care professionals’ knowledge of cord blood banking options despite these health care professionals being identified by expectant parents as their preferred, key source of information. Conclusion Limited high quality studies have investigated what health care professionals know and communicate to expectant parents regarding cord blood banking. Further research should focus on understanding the knowledge, attitudes and practices of healthcare professionals and how they communicate with expectant parents about this issue. In addition, how this knowledge influences professional practice around birth is also important, as this may positively or negatively impact the information that is provided to expectant parents.
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Affiliation(s)
- Lisa Peberdy
- University of the Sunshine Coast, Sippy Downs, QLD, Australia.
| | - Jeanine Young
- University of the Sunshine Coast, Sippy Downs, QLD, Australia
| | - Lauren Kearney
- University of the Sunshine Coast, Sippy Downs, QLD, Australia
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Paz Pascual C, Artieta Pinedo I, Grandes G, Espinosa Cifuentes M, Gaminde Inda I, Payo Gordon J. [Perceived needs of women regarding maternity. Qualitative study to redesign maternal education]. Aten Primaria 2016; 48:657-664. [PMID: 27039971 PMCID: PMC6875922 DOI: 10.1016/j.aprim.2015.12.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 12/07/2015] [Accepted: 12/09/2015] [Indexed: 11/29/2022] Open
Abstract
Objetivo Explorar las necesidades expresadas por las mujeres a lo largo del proceso de convertirse en madre y sus demandas relacionadas con la educación maternal. Diseño Estudio cualitativo con grupos focales. Emplazamiento Área de salud de Bizkaia, Servicio Vasco de Salud/Osakidetza. Participantes Treinta mujeres seleccionadas de forma consecutiva por matronas de atención primaria de 6 centros de salud diferentes. Métodos Entre septiembre y noviembre de 2010 se formaron 4 grupos focales estratificados por situación socioeconómica y etapa del proceso (embarazo/puerperio). Para recoger las preocupaciones de las embarazadas, de las puérperas y su opinión sobre la educación maternal se siguió el método de análisis del contenido temático con el apoyo del software ATLAS.ti. Resultados El foco de preocupación de las mujeres va cambiando con el tiempo. Pasaba de la necesidad de confirmar que «todo va bien» a necesitar más apoyo emocional y confianza para enfrentarse a sus miedos al parto y al cuidado de los hijos. Necesitaban mayor acompañamiento en el puerperio y menos presión con la lactancia materna. En cuanto a la educación maternal, demandaban un programa de educación perinatal en lugar de solo prenatal, más actualizado, con mayor participación de su pareja, más interactivo y flexible. Conclusión Las mujeres de nuestro entorno perciben necesidades similares a las de los países anglosajones, independientemente de las diferencias culturales. Parece claro la necesidad de rediseñar un programa de educación perinatal extenso, personalizado, dinámico, que empodere a las mujeres para gestionar su propia salud y la de su familia
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Affiliation(s)
- Carmen Paz Pascual
- Servicio Vasco de Salud/Osakidetza, Unidad Docente de Matronas del País Vasco, Centro de Salud de Markonzaga , OSI Barakaldo Sestao , Bizkaia, España.
| | - Isabel Artieta Pinedo
- Servicio Vasco de Salud/Osakidetza, Escuela Universitaria de Enfermería de la EHU-UPV, Centro de Salud de Zuazo , OSI Barakaldo Sestao , Bizkaia, España
| | - Gonzalo Grandes
- Medicina Familiar y Comunitaria, Medicina Preventiva y Salud Pública, Unidad de Investigación de Atención Primaria, Servicio Vasco de Salud/Osakidetza, Bilbao, Bizkaia, España
| | - Maite Espinosa Cifuentes
- Unidad de Investigación de Atención Primaria, Servicio Vasco de Salud/Osakidetza, Bilbao, Bizkaia, España
| | - Idoia Gaminde Inda
- Unidad de Evaluación, Servicio de Investigación, Innovación y Formación Sanitaria, Departamento de Salud, Gobierno de Navarra, Pamplona, Navarra, España
| | - Janire Payo Gordon
- Unidad de Investigación de Atención Primaria, Servicio Vasco de Salud/Osakidetza, Bilbao, Bizkaia, España
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Ferguson S, Browne J, Taylor J, Davis D. Sense of coherence and women׳s birthing outcomes: A longitudinal survey. Midwifery 2016; 34:158-65. [PMID: 26689770 DOI: 10.1016/j.midw.2015.11.017] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 09/13/2015] [Accepted: 11/24/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND in Western countries, caesarean section rates are increasing at an alarming rate. This trend has implications for women׳s health and calls into question the use of pathogenesis to frame maternity services. The theory of salutogenesis offers an alternative as it focuses on health rather than illness. Sense of coherence (SOC), the cornerstone of salutogenesis, is a predictive indicator of health. This study aimed to explore associations between pregnant women׳s SOC, their birthing outcomes and factors associated with SOC changes. METHODS a longitudinal survey was conducted where women completed a questionnaire in the antenatal and postnatal period. Questionnaire one provided information on SOC scores, Edinburgh Postnatal Depression Scale (EPDS) scores, Support Behaviour Inventory (SBI) scores, pregnancy choices and demographics. Questionnaire two provided information on SOC scores, EPDS scores and birthing outcomes. FINDINGS 1074 women completed questionnaire one and 753 women completed questionnaire two. Compared to women with low antenatal SOC, women with high antenatal SOC were less likely to experience caesarean section (OR 0.437 95% CI 0.209-0.915) and more likely to experience assisted vaginal birth (AVB) (OR 3.108 95% CI 1.557-6.203). Higher birth satisfaction, higher antenatal EPDS scores and lower antenatal SOC were associated with an increase in SOC. Epidural, AVB and decreased birth satisfaction were associated with a decrease in SOC. CONCLUSION high sense of coherence in pregnant women is associated with half the likelihood of caesarean section compared to women with low sense of coherence. Women׳s sense of coherence is raised and lowered by degree of satisfaction with their births and lowered by some labour interventions.
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Serçekuş P, Başkale H. Effects of antenatal education on fear of childbirth, maternal self-efficacy and parental attachment. Midwifery 2015; 34:166-172. [PMID: 26656473 DOI: 10.1016/j.midw.2015.11.016] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [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: 01/27/2015] [Revised: 05/29/2015] [Accepted: 11/19/2015] [Indexed: 11/24/2022]
Abstract
OBJECTIVE to examine the effects of antenatal education on fear of childbirth, maternal self-efficacy, and maternal and paternal attachment. DESIGN quasi-experimental study, comparing an antenatal education group and a control group. PARTICIPANTS 63 pregnant women and their husbands. MEASUREMENTS demographic data forms, the Wijma Delivery Expectancy/Experience Questionnaire, the Childbirth Self-Efficacy Inventory, the Maternal Attachment Inventory and the Postnatal Paternal-Infant Attachment Questionnaire were used for data collection. FINDINGS antenatal education was found to reduce the fear of childbirth and to increase childbirth-related maternal self-efficacy. However, antenatal education was found to have no effect on parental attachment. KEY CONCLUSIONS it is recommended that widespread antenatal education programmes should be provided in developing countries, and the content of the education programme about parental attachment should be increased. IMPLICATIONS FOR PRACTICE this study found that antenatal education has no influence on maternal and paternal attachment. As such, there is a need to increase the content of the education programme about parental attachment.
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Affiliation(s)
- Pınar Serçekuş
- Pamukkale University, Faculty of Health Sciences, Denizli, Turkey.
| | - Hatice Başkale
- Pamukkale University, Faculty of Health Sciences, Denizli, Turkey.
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Barry M. An evaluation of expectant parents knowledge, satisfaction and use of a self-instructional infant CPR kit. Midwifery 2015; 31:805-10. [PMID: 25960113 DOI: 10.1016/j.midw.2015.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [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: 05/26/2014] [Revised: 03/31/2015] [Accepted: 04/07/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE in many parts of Europe as in Ireland, maternity services do not provide infant CPR training routinely to expectant or new parents. Little is known of the views of expectant women and their partners about learning the skills of infant CPR as part of their antenatal education. The aim of this study was to evaluate knowledge, satisfaction and use of a 22 minute Self-Instructional Infant CPR kit to facilitate the teaching of infant CPR and the relief of choking in an infant. METHODS expectant women with their partners were recruited through the antenatal education classes from one maternity hospital in Ireland. An uncontrolled pre-post-test design was used and participants were surveyed immediately pre- and post-training and six months following training. FINDINGS the study sample comprised of 77 participants including 42 nulliparous women at least 32 weeks gestation or greater. It found significant difference in knowledge scores following training compared to baseline p=<0.0001 and at six months p=<0.0001 compared to immediate post training for both infant CPR and choking prevention. There was a 70% (n=58) response rate at six months with 84.5% reporting average or above confidence levels for performance of Infant CPR. The multiplier educational effect was 37.9% with 22 out of 58 participants sharing the kits with family and friends. Participants (57 out of 58) indicated that the maternity services should facilitate infant CPR training for expectant women and their partners. CONCLUSION expectant women and their partners are very motivated to learn the skills of infant CPR. The facilitation of a 22 minute self-instructional infant CPR kit is effective in increasing infant CPR knowledge and confidence in parents at six months post training. Findings provide the views of expectant and new parents on the relevance of acquiring the skills of infant CPR as part of their preparation for parenthood.
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Affiliation(s)
- Maebh Barry
- Department of Nursing and Midwifery, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland.
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McArdle A, Flenady V, Toohill J, Gamble J, Creedy D. How pregnant women learn about foetal movements: sources and preferences for information. Women Birth 2014; 28:54-9. [PMID: 25457375 DOI: 10.1016/j.wombi.2014.10.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [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: 08/22/2014] [Revised: 10/03/2014] [Accepted: 10/07/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Unexplained late gestation stillbirth is a significant health issue. Antenatal information about foetal movements has been demonstrated to reduce the stillbirth rate in women with decreased foetal movements. Midwives are ideally placed to provide this information to women. AIM To investigate pregnant women's perceptions of information about foetal movements and preferences for receiving information. METHODS This prospective, descriptive study was conducted in the antenatal clinic of a large metropolitan maternity hospital. FINDINGS Pregnant women (n=526) at 34 weeks gestation or later were recruited. Only 67% of women reported receiving information about foetal movements. Women reported that midwives (80%), family (57%), friends (48%) and own mother (48%) provided this information. Midwives were the most preferred source of information. Around half (52%) of the women used the internet for information but only 11% nominated the web as their preferred information source. CONCLUSION Women prefer to be given as much information about foetal movements as possible. Women favour information from health professionals, mainly from a midwife. Midwives are well-placed to partner with pregnant women and give them unbiased and evidenced based information enabling them to make decisions and choices regarding their health and well-being. While the internet is a prevalent information source, women want to be reassured that it is trustworthy and want direction to reliable pregnancy related websites.
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Affiliation(s)
- Annie McArdle
- Griffith Health Institute, School of Nursing & Midwifery, Griffith University, University Drive, Meadowbank, Queensland 4131, Australia; Mater Research Institute, University of Queensland, Aubigny Place, Mater Health Services, Raymond Tce, South Brisbane, Queensland 4101, Australia.
| | - Vicki Flenady
- Mater Research Institute, University of Queensland, Aubigny Place, Mater Health Services, Raymond Tce, South Brisbane, Queensland 4101, Australia.
| | - Jocelyn Toohill
- Griffith Health Institute, School of Nursing & Midwifery, Griffith University, University Drive, Meadowbank, Queensland 4131, Australia.
| | - Jenny Gamble
- Griffith Health Institute, School of Nursing & Midwifery, Griffith University, University Drive, Meadowbank, Queensland 4131, Australia.
| | - Debra Creedy
- Griffith Health Institute, School of Nursing & Midwifery, Griffith University, University Drive, Meadowbank, Queensland 4131, Australia.
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Dalton JA, Rodger DL, Wilmore M, Skuse AJ, Humphreys S, Flabouris M, Clifton VL. "Who's afraid?": attitudes of midwives to the use of information and communication technologies (ICTs) for delivery of pregnancy-related health information. Women Birth 2014; 27:168-73. [PMID: 25070730 DOI: 10.1016/j.wombi.2014.06.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [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: 02/03/2014] [Revised: 06/24/2014] [Accepted: 06/25/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Usage rates for information and communication technologies (ICTs) in healthcare have been increasing in recent years, but often lag behind general usage rates for populations as a whole. Research into such differential rates of ICT use across different segments of the population has identified a number of possible causal factors that limit usage. AIM The research investigated midwives' attitudes and experiences of ICT use to identify potential causal factors that encourage or inhibit their usage in antenatal care. METHODS Semi-structured interviews, focus groups and short surveys were conducted with midwives who provide antenatal education at an Australian metropolitan hospital. Thematic and statistical analyses were used to interpret the data. FINDINGS Although midwives recognised the potential benefits of using ICTs to deliver pregnancy-related health information many had reservations about their use in everyday work. These reservations centred on lack of training in use of ICTs, the perceived legal risks associated with social media, potential violations of patient privacy, misdiagnosis and misunderstandings between midwife and client. CONCLUSION Midwives face a number of barriers to effective use of ICTs in healthcare including material access, skills access, usage access and motivational access. Motivational access appears to be a key concern due to the high perception of risk associated with social media in particular. Reducing the motivational barriers through a range of interventions with midwifery staff may assist in overcoming other barriers to ICT use in antenatal care. Further research is required to determine whether these findings are generalisable to other healthcare contexts.
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Affiliation(s)
- J A Dalton
- Faculty of Health Sciences, School of Paediatrics and Reproductive Health, Discipline of Obstetrics and Gynaecology, The University of Adelaide, Adelaide, SA 5005, Australia; The Robinson Research Institute, Lyell McEwin Hospital, Elizabeth Vale, SA 5112, Australia
| | - D L Rodger
- Faculty of Humanities and Social Sciences, School of Social Sciences, Discipline of Anthropology and Development Studies, The University of Adelaide, Adelaide, SA 5005, Australia.
| | - M Wilmore
- Faculty of Humanities and Social Sciences, School of Humanities, Discipline of Media, The University of Adelaide, Adelaide, SA 5005, Australia
| | - A J Skuse
- Faculty of Humanities and Social Sciences, School of Social Sciences, Discipline of Anthropology and Development Studies, The University of Adelaide, Adelaide, SA 5005, Australia
| | - S Humphreys
- Faculty of Humanities and Social Sciences, School of Humanities, Discipline of Media, The University of Adelaide, Adelaide, SA 5005, Australia
| | - M Flabouris
- Faculty of Humanities and Social Sciences, School of Humanities, Discipline of Media, The University of Adelaide, Adelaide, SA 5005, Australia
| | - V L Clifton
- Faculty of Health Sciences, School of Paediatrics and Reproductive Health, Discipline of Obstetrics and Gynaecology, The University of Adelaide, Adelaide, SA 5005, Australia; The Robinson Research Institute, Lyell McEwin Hospital, Elizabeth Vale, SA 5112, Australia
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