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- Anderson, Rondi, et al.
(författare)
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Implementing midwifery services in public tertiary medical college hospitals in Bangladesh: A longitudinal study.
- 2023
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Ingår i: Women and birth : journal of the Australian College of Midwives. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 36:3, s. 299-304
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Tidskriftsartikel (refereegranskat)abstract
- A necessary precursor for quality maternity care provision is high quality education. The quality of care that students are exposed to during clinical education on maternity wards shapes their competencies and professional identities. In this study, we look at the introduction of midwives educated to international standards - with facility mentorship - deployed in tertiary level teaching hospitals in Bangladesh with the intention of improving the use of World Health Organization (WHO)-recommended birth practices.To examine the outcomes of introducing midwifery services into tertiary level care facilities in Bangladesh, on the use of WHO-recommended birth practices.A retrospective review of patient register data was carried out to understand level of changes in use of WHO-recommended birth practices after the introduction of a midwifery service. Multivariate linear regression was applied using an interrupted time series analysis, with and without a delayed effect, to assess both level and trend change following the introduction of the midwifery service.A significant increase (p<0.001) in use of WHO-recommended birth practices was found, both immediately following the midwives' introduction and after one year. Quality improvement was observed not only in births attended by midwives, but also in those attended by doctors and nurses.By introducing quality maternity care provision through midwives in clinical sites, especially in tertiary-level care hospitals with large numbers of students, international standard midwives can improve the quality of clinical education in maternity wards, a critical priority for maternal health worldwide.
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- Andrén, Anna, et al.
(författare)
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One size does not fit all : Perspectives from Swedish midwives on fetal movement counselling
- 2024
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Ingår i: Women and Birth. - 1871-5192 .- 1878-1799. ; 37:4
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Tidskriftsartikel (refereegranskat)abstract
- PROBLEM: Migration continues to play a role in determining health outcomes related to pregnancy and childbirth in Sweden.BACKGROUND: Migrant women have, compared to Swedish-born women, increased risks of adverse birth outcomes. Previous research suggests that migrant women seek care for decreased fetal movements less than Swedish-born women. Given these documented risks, understanding midwives' perspectives in this context is crucial to address maternal health inequities.AIM: To explore midwives' experiences conveying information about fetal movement to migrant women in antenatal healthcare settings.METHODS: Semi-structured, individual interviews with midwives (n=15) experienced in providing information about fetal movements to migrant women. The interviews were analysed using reflexive thematic analysis.FINDINGS: The midwives' efforts to compensate for the deficiencies within the antenatal healthcare organisation and to ensure that all women received access to information and care regarding fetal movements are described in four themes: (a) building a trusting relationship; (b) empowering women through guidance and support; (c) overcoming communication challenges; and d) navigating safety measures.DISCUSSION: Our findings suggest that the standard antenatal care programme does not support midwives to provide holistic and individualised care that aligns with midwifery care philosophy.CONCLUSION: To reduce health inequities for migrant women, this study highlights the need for more flexible guidelines within the standard antenatal care programme. These guidelines should prioritise the individual woman's needs over institutional protocols, acknowledge the midwife-woman relationship as the core of midwifery practice and support midwives to build a partnership with women through continuity of care.
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- Baylis, Rebecca, et al.
(författare)
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Women's experiences of internet-delivered Cognitive Behaviour Therapy (iCBT) for Fear of Birth
- 2020
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Ingår i: Women and Birth. - : ELSEVIER. - 1871-5192 .- 1878-1799. ; 33:3, s. E227-E233
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Tidskriftsartikel (refereegranskat)abstract
- Background: Fear of Birth is common in pregnant women and associated with negative physical and mental health. There is a clear comorbidity with anxiety and depression. Internet-delivered Cognitive Behaviour Therapy has been suggested as a treatment option for Fear of Birth and a randomized controlled trial comparing internet-delivered Cognitive Behaviour Therapy with midwifery led counselling as standard care has been conducted.Objective: The aim of this study was to describe women's experiences of guided internet-delivered Cognitive Behaviour Therapy for Fear of Birth and to describe the content of their fear.Methods: The present study is a qualitative, follow-up interview study following the randomized controlled trial, the U-CARE Pregnancy Trial. In total 19 women allocated to internet-delivered Cognitive Behaviour Therapy for Fear of Birth were interviewed by telephone. A semi-structured interview guide was used and the transcripts were analyzed with thematic analysis.Results: The women's descriptions of Fear of Birth differed, however their fear was most often associated with fear of losing control, fear for the baby's life or health or own life threatening events. The experiences of internet-delivered Cognitive Behaviour Therapy for Fear of Birth varied, some women were positive to its flexibility although most women preferred a face-to face meeting. The treatment did not pin-point their fears, it was challenging to maintain motivation and to work with the treatment in solitude.Conclusions: Women's descriptions of Fear of Birth varied. Most women undergoing internet-delivered Cognitive Behaviour Therapy would have preferred a face-to-face meeting which they imagined would have soothed their fear. Internet-delivered Cognitive Behaviour Therapy for Fear of Birth may be an alternative for some women.
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- Begley, Cecily, 1954, et al.
(författare)
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A qualitative exploration of techniques used by expert midwives to preserve the perineum intact
- 2019
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192. ; 32:1, s. 87-97
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Tidskriftsartikel (refereegranskat)abstract
- Background: The perineum stretches during birth to allow passage of the baby, but 85% of women sustain some degree of perineal trauma during childbirth, which is painful post-partum. Episiotomy rates vary significantly, with some countries having rates of >60%. Recent Irish and New Zealand studies showed lower severe perineal trauma and episiotomy rates than other countries. Aim: To explore expert Irish and New Zealand midwives' views of the skills that they employ in preserving the perineum intact during spontaneous vaginal birth. Methods: Following ethical approval a qualitative, descriptive study was undertaken. Semi-structured, recorded, interviews were transcribed and analysed using the constant comparative method. Expert midwives employed in New Zealand and one setting in Ireland, were invited to join the study. "Expert" was defined as achieving, in the preceding 3.5 years, an episiotomy rate for nulliparous women of <11.8%, a `no suture' rate of 40% or greater, and a severe perineal tear rate of < 3.2%. Twenty-one midwives consented to join the study. Results: Fourcore themes emerged: 'Calm, controlled birth', 'Position and techniques in early second stage', 'Hands on or off?' and 'Slow, blow and breathe the baby out.' Using the techniques described enabled these midwives to achieve rates, in nulliparous women, of 3.91% for episiotomy, 59.24% for 'no sutures', and 1.08% for serious lacerations. Conclusions: This study provides further understanding of the techniques used by expert midwives at birth. These findings, combined with existing quantitative research, increases the evidence on how to preserve the perineum intact during spontaneous birth. (c) 2018 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
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| 7. |
- Bergh, Ingrid H. E., et al.
(författare)
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Assessment and documentation of women's labour pain : A cross-sectional study in Swedish delivery wards
- 2015
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Ingår i: Women and Birth. - : Elsevier. - 1871-5192 .- 1878-1799. ; 28:2, s. E14-E18
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Tidskriftsartikel (refereegranskat)abstract
- Background: A woman's pain during labour plays a dominant role in childbirth. The midwife's role is to assess the degree of pain experienced during labour. When professionals respond to labour pain with acknowledgement and understanding, the woman's sense of control and empowerment is increased, which could contribute to a positive experience of childbirth. The aim of this study is to describe how labour pain in Swedish delivery wards is assessed and documented. Methods: This quantitative descriptive study was designed as a national survey performed through telephone interviews with the representatives of 34 delivery wards in Sweden. Results and conclusion: The majority of the participating delivery wards assessed and documented women's labour pain, but in an unstructured manner. The wards differed in how the assessments and documentation were performed. In addition, almost all the delivery wards that participated in the survey lacked guidelines for the assessment and documentation of the degree of pain during labour. The findings also showed that the issue of labour pain was sometimes discussed in the delivery wards, but not in a structured or consistent way. (C) 2015 Australian College of Midwives. Published by Elsevier Australia (a division of Reed International Books Australia Pty Ltd). All rights reserved.
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| 8. |
- Bergh, Ingrid H. E., et al.
(författare)
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Midwifery students attribute different quantitative meanings to "hurt", "ache" and "pain" : A cross-sectional survey
- 2013
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Ingår i: Women and Birth. - : Elsevier. - 1871-5192 .- 1878-1799. ; 26:2, s. 143-146
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Tidskriftsartikel (refereegranskat)abstract
- Background: Assessment of women's labor pain is seldom acknowledged in clinical practice or research. The words "aching" and "hurting" are frequently used by women to describe childbirth pain. The aim of this study was to determine the quantitative meanings midwifery students attribute to the terms "hurt", "ache" and "pain". Data was collected by self-administered questionnaire from students at seven Swedish midwifery programs. A total of 230 filled out and returned a completed questionnaire requesting them to rate, on a visual analog scale, the intensity of "hurt", "ache" or "pain" in the back, as reported by a fictitious parturient. Results: The midwifery students attributed, with substantial individual variation, different quantitative meanings to the studied pain descriptors. Conclusions: To be able to communicate about pain with a woman in labor, it is essential that the midwife be familiar with the value of different words and what they mean to her as this may affect her assessment when the woman describes her pain. © 2012.
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| 9. |
- Bogren, Malin, 1970, et al.
(författare)
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Barriers to delivering quality midwifery education programmes in the Democratic Republic of Congo — An interview study with educators and clinical preceptors
- 2021
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 34:1
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Tidskriftsartikel (refereegranskat)abstract
- © 2020 The Author(s) Background: In the Democratic Republic of Congo, the education of midwives at a higher education level has recently been introduced as a strategy to improve maternal and neonatal health. However, little is known about the preconditions for such an education. Aim: To explore the barriers to delivering high-quality midwifery education programmes in the DRC and reflect on potential areas for improvement. Method: Data was collected through 14 focus group discussions with 85 midwifery educators and clinical preceptors, at four higher education institutions delivering midwifery education programmes. Transcribed discussions were inductively analysed using content analysis. Findings: Overall, the teaching environment was insufficient. Most midwifery educators and clinical preceptors had deficient competencies, and there was a shortage of didactic resources and equipment as well as poor communication routines between the education institutions and clinical education sites. The barriers varied between locations; for instance, the institution in the country's capital was overall well equipped. Conclusion: The identified barriers constitute major risks undermining the quality of future midwives in the DRC. Reforming the education of midwives, together with general higher education reform, will be critical for achieving the Sustainable Development Goal on health in the country. We therefore suggest that (i) midwifery educators have at least one academic level above the programme in which they teach, (ii) continuing education be available for midwifery educators and clinical preceptors, (iii) education institutes and clinical sites are fit for purpose, and (vi) routines for clear communication links between education and clinical sites be used.
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| 10. |
- Bogren, Malin, 1970, et al.
(författare)
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Contextual factors influencing the implementation of midwifery-led care units in India
- 2023
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Ingår i: Women and Birth. - : Elsevier BV. - 1871-5192 .- 1878-1799. ; 36:1, s. e134-e141
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The Government of India has committed to educate 90,000 midwives functioning in midwifery-led care units (MLCUs) to care for women during labour and birth. There is a need to consider local circumstances in India, as there is no 'one size fits all' prescription for MLCUs.AIM: To explore contextual factors influencing the implementation of MLCUs across India.METHOD: Data were collected through six focus group interviews with 16 nurses, midwives, public health experts and physicians, representing six national and international organisations supporting the Indian Government in its midwifery initiative. Transcribed interviews were analysed using content analysis.FINDINGS: Four generic categories describe the contextual factors which influence the implementation of MLCUs in India: (i) Perceptions of the Nurse Practitioner in Midwifery and MLCUs and their acceptance, (ii) Reversing the medicalization of childbirth, (iii) Engagement with the community, and (iv) The need for legal frameworks and standards.CONCLUSION: Based on the identified contextual factors in this study, we recommend that in India and other similar contexts the following should be in place when designing and implementing MLCUs: legal frameworks to enable midwives to provide full scope of practice in line with the midwifery philosophy and informed by global standards; pre- and in-service training to optimize interdisciplinary teamwork and the knowledge and skills required for the implementation of the midwifery philosophy; midwifery leadership acknowledged as key to the planning and implementation of midwifery-led care at the MLCUs; and a demand among women created through effective midwifery-led care and advocacy messages.
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