| 1. |
- Ayala, Ana, et al.
(författare)
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Fathers' care of the newborn infant after caesarean section in Chile : A qualitative study
- 2016
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Ingår i: Sexual & Reproductive HealthCare. - : Elsevier BV. - 1877-5756 .- 1877-5764. ; 8, s. 75-81
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Tidskriftsartikel (refereegranskat)abstract
- Background: In Chilean hospitals the current model of care after caesarean section is to separate newborn infants from both parents. The care of newborn infants and the parents' experience immediately after caesarean section requires further exploration. Aim: To describe fathers' experiences and perceptions of being the primary caregiver to their newborn infant during the first 90 minutes after caesarean section in a public general maternity hospital setting in Santiago de Chile. Method: The questionnaire was one part of a larger research programme named: "Caregiving Models after Elective Caesarean Section Parents' perceptions and effects on infants' wellbeing". Four open ended questions were used to gather written text on the experiences and perceptions of 95 fathers who were the primary caregiver to their newborn infant. Ethical approval was obtained from the Ethics Committee, Scientific Assessment Metropolitan Health Service South East. Systematic text condensation according to Malterud's description was used for analysis of the written text. Findings: Two themes were identified: "understanding the first moment of life" and "shared responsibility for future family life" with each theme divided into six categories. Conclusion: This study concludes by arguing that in situations where the mother is unavailable or unable to provide basic care, the father should be supported to care for the newborn infant. Clinical implications: Parents should be made aware of the benefits of this caring model especially when mother and baby have been separated after birth.
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| 2. |
- Ayala, Ana, et al.
(författare)
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Mother’s Experiences and Perceptions of a Continuous Caring Model with Fathers after Caesarean Section : A Qualitative Study
- 2015
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Ingår i: The Open Women's Health Journal. - : Openventio Publishers. - 1874-2912. ; 1:3, s. 63-71
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Tidskriftsartikel (refereegranskat)abstract
- Background: In Chile, mothers and newborns are separated after caesarean sections. The caesarean section rate in Chile is approximately 40%. Once separated, newborns will miss out on the benefits of early contact unless a suitable model of early newborn contact after caesarean section is initiated.Aim: To describe mothers experiences and perceptions of a continuous parental model of newborn care after caesarean section during mother-infant separation.Methods: A questionnaire with 4 open ended questions to gather data on the experiences and perceptions of 95 mothers in the obstetric service of Sótero Del Rio Hospital in Chile between 2009 and 2012. Data were analyzed using qualitative content analysis.Results: One theme family friendly practice after caesarean section and four categories. Mothers described the benefits of this model of caring. The fathers presence was important to mother and baby. Mothers were reassured that the baby was not left alone with staff. It was important for the mothers to see that the father could love the baby as much as the mother. This model of care helped create ties between the father and newborn during the period of mother-infant separation and later with the mother.Conclusions: Family friendly practice after caesarean section was an important health care intervention for the whole family. This model could be stratified in the Chilean context in the case of complicated births and all caesarean sections.Clinical Implications: In the Chilean context, there is the potential to increase the number of parents who get to hold their baby immediately after birth and for as long as they like. When the mother and infant are separated after birth, parents can be informed about the benefits of this caring model. Further research using randomized control trials may support biological advantages.
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| 3. |
- Ayala, Ana, et al.
(författare)
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Newborn infants who received skin-to-skin contact with fathers after Caesarean sections showed stable physiological patterns.
- 2021
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 110:5, s. 1461-1467
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Tidskriftsartikel (refereegranskat)abstract
- AIM: Separating infants and their parents after a Caesarean section is still the routine care worldwide. This study investigated three caregiving models on the wakefulness and physiological parameters of full-term infants after an elective Caesarean section.METHODS: Newborn infants born in a Chilean public hospital in 2009-12 were randomised to three groups: cot, fathers' arms or skin-to-skin contact with their father. They were assessed at 15-minute intervals, from 45 to 120 minutes after the Caesarean section. Their physiological parameters were measured, and their wakefulness was assessed using the Neonatal Behavioural Assessment Scale.RESULTS: We studied 95 infant (53% girls) born at a mean gestational age of 38.9 ± 0.9 weeks. Heart rates were significantly higher in the skin-to-skin than cot or fathers' arms groups and showed greater stability over time. Wakefulness was initially higher in the skin-to-skin group, but there were no significant differences by the end of the observation. There were no differences between the groups in peripheral oxygen saturation. Skin-to-skin contact had no negative impact on the infants.CONCLUSION: The skin-to-skin group showed some advantages over the cot and fathers' arms groups when it came to establishing stable physiological parameters and wakefulness. This approach should be supported during mother-infant separation.
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| 4. |
- Blix-Lindström, S, et al.
(författare)
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Midwives' navigation and perceived power during decision-making related to augmentation of labour
- 2007
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Ingår i: Midwifery. - : Elsevier BV. - 0266-6138. ; 24:2, s. 190-198
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: to explore and understand how midwives perceive and experience decision-making about augmentation of labour. DESIGN: focus-group discussions. SETTING: Stockholm, Sweden. PARTICIPANTS: 20 midwives experienced in working in labour wards. FINDINGS: five categories were identified that illustrate the factors considered by the midwives to influence decision-making during augmentation of labour: 'regulations and guidelines'; 'shortage of delivery rooms'; 'influence of obstetricians'; 'women in labour'; and 'midwives' professional selves'. The theme identified was how midwives managed to 'navigate' these factors, which provided midwives with a decisive influence during the decision-making process. KEY CONCLUSIONS AND IMPLICATIONS: midwife job satisfaction can result from a sense of professional power over the possibility of navigating factors that influence decision-making during augmentation of labour. This sense of power can subsequently influence co-operation with both obstetricians and women during labour.
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| 5. |
- Blix- Lindström, S., et al.
(författare)
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Women's satisfaction with decision-making related to augmentation of labour
- 2004
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Ingår i: Midwifery. - : Elsevier BV. - 0266-6138. ; 20:1, s. 104-112
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Forskningsöversikt (refereegranskat)abstract
- OBJECTIVE: to describe women's experiences of participating in decision-making related to augmentation of labour. DESIGN: a qualitative approach using modified grounded theory technique. Open-ended interviews were conducted 1-3 days after childbirth. SETTING: the interviews were performed in the postnatal wards in five hospitals (tertiary level) in Stockholm, Sweden. PARTICIPANTS: 20 newly delivered women who had received oxytocin infusion for augmentation of labour during childbirth. FINDINGS AND KEY CONCLUSIONS: support and guidance from midwives in combination with knowledge and expectations about the intervention seemed to be important for women's satisfaction with decision-making concerning augmentation of labour. Four patterns of decision-making were found. One group of women participated in the decision-making regarding augmentation of labour while a second group was invited, but refrained from participation. These women were satisfied with the decisions made. A third group of women did not participate, but wanted to and they were dissatisfied with the decisions made. The fourth group did not participate in the decision-making-and did not want to. These women accepted the decisions made. The desire for information exceeded the desire for involvement in decision-making and the majority of women had confidence in the midwives' assessment.
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| 6. |
- Christensson, Kyllike, et al.
(författare)
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The Challenge of Improving Perinatal Care in settings with Limited Resources : Observations of Midwifery Practices in Mozambique
- 2006
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Ingår i: African Journal of Reproductive Health. - Benin City, Edo State, Nigeria : Women's Health and Action Research Centre. - 1118-4841. ; 10:1, s. 47-61
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to observe and analyze midwifery care routine related to asphyxia and hypothermia during the perinatal period and to investigate the effect of an in-service education program. A direct non-participant pre-and post intervention observation study of midwifery a performance during childbirth was conducted at a labour ward in Maputo. The observed groups consisted of 702 and 616 midwifery –attended deliveries. Examination was also conducted of the partographs (702 vs. 616). The quality of midwifery care related to prevention and early detection of asphyxia and hypothermia was found to be inadequate and the intervention had no significant effect upon the midwives' performances. This could be attributed to the quality of the intervention itself or to failure of implementing managerial decisions such as transfer to partograph documentation from obstetricians to midwives. Change in professional performance does not automatically follow awareness of evidence-based midwifery practices, but requires behavioural change, which may be more difficult to achieve.
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| 7. |
- Dsilna, Ann, et al.
(författare)
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Behavioral stress is affected by the mode of tube feeding in very low birth weight infants
- 2008
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Ingår i: The Clinical journal of pain. - 1536-5409. ; 24:5, s. 447-55
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare the effect of continuous versus bolus feeding on behavioral responses of stress in very low birth weight infants during early postnatal life. METHODS: In a randomized, controlled trial conducted at 3 neonatal units, 70 premature infants with gestational age 24 to 29 weeks and birth weight <1200 g were randomly assigned to 1 of 3 feeding methods: continuous nasogastric feeding, bolus nasogastric feeding, and bolus orogastric feeding. Behavioral responses were video recorded during feeding at 7 and 15 days of postnatal age and at 32 weeks of postmenstrual age. The odds ratio (OR) of manifest behavioral stress was calculated by means of logistic regression. RESULTS: A significantly higher risk of a behavioral stress response in bolus-fed infants compared with continuous-fed infants at 15 days of age was observed, [adjusted OR=4.1 (95% confidence interval: 1.1-15.4)]. A similar difference was observed at 32 weeks of postmenstrual age [adjusted OR=4.2 (95% confidence interval: 1.0-17.8)]. In addition, bolus-fed infants showed statistically significant higher need of behavioral and physiologic stabilization during feeding. DISCUSSION: This trial suggests that continuous feeding is associated with lower behavioral stress response as compared with bolus feeding among very low birth weight infants, in early postnatal life.
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| 8. |
- Dsilna, Ann, et al.
(författare)
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Continuous feeding promotes gastrointestinal tolerance and growth in very low birth weight infants
- 2005
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Ingår i: Journal of Pediatrics. - : Elsevier BV. - 0022-3476 .- 1097-6833. ; 147:1, s. 43-49
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare the effects of continuous versus intermittent feeding on gastrointestinal tolerance and growth in very low birth weight (VLBW) infants. STUDY DESIGN: In a randomized, controlled trial conducted at 3 neonatal units, 70 premature infants with a gestational age 24 to 29 weeks and birth weight < 1200 g were assigned to 1 of 3 feeding methods: continuous nasogastric feeding, intermittent nasogastric feeding, or intermittent orogastric feeding. Feeding was initiated within 30 hours of birth. Daily enteral and parenteral volumes, caloric and protein intakes, growth, enteral intolerance, and clinical complications were recorded. Cox regression analysis was used to determine primary outcome, the time to achieve full enteral feeding. RESULTS: The continuously fed infants achieved full enteral feeding significantly faster than the intermittently fed infants (hazard ratio [HR] = 1.86; 95% confidence interval [CI] = 1.07 to 3.22). In stratified analysis according to birth weight, the improvement was even more pronounced in the smallest infants, those with birth weight < or = 850 g (adjusted HR = 4.13; 95% CI = 1.48 to 11.53). Growth rate was significantly faster in the continuously fed infants ( P = .002). CONCLUSION: In VLBW infants, continuous feeding seems to be better than intermittent feeding with regard to gastrointestinal tolerance and growth.
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| 9. |
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| 10. |
- Erlandsson, Kerstin, 1961-, et al.
(författare)
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Do caregiving models after caesarean birth influence the infant's breathing adaptation and crying? A pilote study
- 2008
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Ingår i: Journal of Children's and Young People's Nursing. - : MA Healthcare. - 1753-1594 .- 2052-2886. ; 2:1, s. 7-12
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Tidskriftsartikel (refereegranskat)abstract
- Cesarean birth is a mode of delivery that often minimizes the mothers’ possibility to handle her term baby skin-to-skin while the father takes care of the baby for part, or all, of the first hours. No attention has, as far as we know, been given to different caregiving models and their eventual effects on the adaptation of breathing for the term infant born by elective cesarean. Previous publications on breathing patterns in newborn infants have mostly been conducted on premature infants in kangaroo care. The aim of this pilot study was to compare the effects of two caregiving models on the adaptation of breathing and infant crying after elective cesarean section, in term infants during the first hours after birth. Term infants born by elective cesarean were held skin-to-skin on their father’s chest or cared for in a cot during the mother’s post-operative observation stay. Thirteen father-infant pairs participated in a pilot sub-study with a randomized control trial design. Data were collected both by respiratory inductance plethysmography (RIP) and by tape-recorded crying time. The data raises important questions about the effects on breathing adaptation in relation to caregiving models. The infants in the skin-to-skin group showed significantly higher inspiratory and expiratory air flows, larger breath volume (all p<0.001) and minute ventilation, compared with the cot group. The infants in the skin-to-skin group cried less than the infants in the cot group (p<0.001). A caregiving model where fathers hold their infants skin-to-skin in an upright position on their chest has a positive impact on the infants’ respiratory adaptation and reduced infant crying. Larger studies of caregiving models after elective cesarean birth on the adaptation of breathing need to be conducted.
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