In 2017, a total of 295,000 women lost their lives due to pregnancy and childbirth across the globe, with sub-Saharan Africa and South Asia accounting for approximately 86 % of all maternal deaths. ...The maternal mortality ratio in Ghana is exceptionally high, with approximately 308 deaths/100,000 live births in 2017. Most of these maternal deaths occur in rural areas than in urban areas. Thus, we aimed to explore and gain insights into midwives' experiences of working and providing women-centred care in rural northern Ghana.
A qualitative descriptive exploratory design was used to explore the challenges midwives face in delivering women-centred midwifery care in low-resource, rural areas. A total of 30 midwives practicing in the Upper East Region of Ghana were purposefully selected. Data were collected using individual semistructured interviews and analysed through qualitative content analysis.
Five main themes emerged from the data analysis. These themes included were: inadequate infrastructure (lack of bed and physical space), shortage of midwifery staff, logistical challenges, lack of motivation, and limited in-service training opportunities.
Midwives experience myriad challenges in providing sufficient women-centred care in rural Ghana. To overcome these challenges, measures such as providing adequate beds and physical space, making more equipment available, and increasing midwifery staff strength to reduce individual workload, coupled with motivation from facility managers, are needed.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Demand for caseload midwifery care continues to outstrip supply. We know little about what sustains midwives working in caseload models of care.
This review systematically identifies and synthesises ...research findings reporting on factors which contribute to job satisfaction, and therefore the sustainability of practice, of midwives working in caseload models of care.
A comprehensive search strategy explored the electronic databases CINAHL Plus with Full Text, MEDLINE, PubMED, Cochrane Database of Systematic Reviews, and Scopus. Articles were assessed using the Crowe Critical Appraisal Tool. Data analysis and synthesis of these publications were conducted using a narrative synthesis approach.
Twenty-two articles were reviewed. Factors which contribute to the job satisfaction and sustainability of practice of midwives working in caseload models are: the ability to build relationships with women; flexibility and control over own working arrangements; professional autonomy and identity; and, organisational and practice arrangements.
Insights into the factors which contribute to the job satisfaction and sustainability of practice of midwives in caseload models of care enables both midwives and healthcare administrators to more effectively implement and support midwifery-led caseload models of care which have been shown to improve outcomes for childbearing women.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Aims:
To explore the perceptions of community midwives about their work experiences after deployment in the rural settings of Chitral, Khyber Pakhtunkhwa, Pakistan.
Methods:
A qualitative descriptive ...approach was used, conducting in-depth semi-structured interviews with 13 community midwives.
Findings:
The three major themes that emerged from the analysis of the data were: (1) rural community midwives' perceptions of their role and competencies, (2) factors facilitating and hindering the rural community midwives' ability to function, and (3) continuation of community midwives' services in the future.
Conclusions:
The study findings highlighted the factors that empower and obstruct community midwives in providing services in rural areas. The majority of the community midwives felt empowered because of their increased earning capacity and enhanced competencies in performing their roles. However, some of them shared challenges in terms of socio-cultural and financial constraints. These findings have important implications for midwives working in rural areas.
To validate the Italian-language version of the Birth Satisfaction Scale-Revised (BSS-R) and report key measurement properties of the tool. To evaluate the impact of antenatal class attendance on ...BSS-R assessed birth satisfaction.
Maternal satisfaction is one of the standards of care defined by the World Health Organisation (WHO) to improve the quality of services. The BSS-R is a multi-dimensional self-report measure of the experience of labour and birth.
Cross-sectional instrument evaluation design examining factor structure and key aspects of validity and reliability. Embedded between-subjects design to examine known-group discriminant validity and the impact of antenatal class attendance on BSS-R sub-scale and total scores as dependent variables. After giving birth, 297 women provided data for analysis.
The Italian version of the BSS-R (I-BSS-R) was the key study measure. The established three-factor and bi-factor models of the BSS-R were found to offer an excellent fit to the data. Comparison of the tri-dimensional measurement model and the bi-factor model of the BSS-R found no significant differences between models. Women who attended antenatal classes had significantly lower stress experienced during childbearing sub-scale scores (I-BSS-R SE), compared to those who did not. Good convergent, divergent validity and known-groups discriminant validity were established for the I-BSS-R. Internal consistency observations were found to be sub-optimal in this population.
On all key psychometric indices, with the exception of internal consistency that requires further investigation, the I-BSS-R was found to be a valid translation of the original BSS-R. The impact of antenatal classes on birth satisfaction warrants further research.
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BFBNIB, DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
Background: Mortality in Indonesia has significantly increased. Students’ comprehension about maternity care “woman centered care” philosophy is an important thing in high quality maternity care, it ...is one solution to decrease the number of mortality rate. Continuity of care maternal clinic model of learning (PKK-CoC) is giving for student to learn the philosophy.Objectives: reveals level and form of students’ comprehension about maternity care “woman centered care” philosophy.Method: Mixed method with sequential explanatory strategy. The quatitative are use analitic descriptive design, while the quantitative use case study design. Population and sample is 55 students of Estu Utomo Boyolali institute health and science who have taken PKK-CoC. Sampling use criterion and intensity.Result: qualitatively, students overall comprehension is good. Quantitatively, students comprehension on personalized care, holistic care, collaborative care, and evidence based care is also good. Partnership care is the only aspect considered in effective.Conclusion: continuity of care shows that client and family are in good heatlth, zero mortality rate, client fells safe and comfortable, and client has correct and fast care. It is also found that students’ confidence, skills, and comprehension about maternity care “woman centered care” philosophy are increased. It is suggested including the PKK-CoC model into curriculum of midwifery education
To determine the relationship of psychological well‐being and cognitive emotion regulation and breastfeeding self‐efficacy in mothers in the postpartum period. The research was designed as ...cross‐sectional and correlational and carried out between 1 November 2021 and 1 January 2022 in the pediatric outpatient clinic of a Medical Faculty Hospital of a province in the Central Anatolian Region of Turkey. Responses from a total of 325 mothers who were in postpartum 1–6 months were analyzed. Data were collected using a Personal Information Form, the Scales of Psychological Well‐Being (SPWB), the Cognitive Emotion Regulation Questionnaire (CERQ), and the Breastfeeding Self‐Efficacy Scale‐Short Form (BSES‐SF). The following factors were found to be important associated risk factors that negatively affected breastfeeding self‐efficacy in 29% of the mothers (F = 14.536, p < .001): mothers' poor mental health, using self‐blaming maladaptive cognitive coping strategy, inability to use positive reappraisal coping strategy, and feeding the baby only formula or both breast milk and formula. Weak and positive correlations were found between psychological well‐being of mothers and adaptive cognitive coping subdimensions, and negative and weak correlations were found between psychological well‐being of the mothers and maladaptive cognitive coping subdimensions (p < .001). Breastfeeding self‐efficacy of mothers in a well psychological state, who can use adaptive cognitive coping strategies, and who exclusively breastfeed their babies is positively affected.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
One indirect causes of maternal mortality in Indonesia is "Three Delays", delays in: (1) deciding to seek appropriate medical help for an obstetric emergency; (2) reaching an appropriate obstetric ...facility; and (3) receiving adequate care when a facility is reached, which has relation with the lack of women's ability in empowering herself to actively participate and to make suitable decisions about midwifery care they need. The research aims to explore the partnership between woman and midwife in midwifery care. A descriptive qualitative study was conducted using a convenience sample of six low-risk women after they had given birth and six midwives from six geographically distinct midwife-led care clinic in Bantul Regency. Data were collected through semi‑structured in‑depth interviews. The interview was conducted two to three times and recorded by audio record. Interviews were transcribed and analyzed by the thematic analysis according to Cresswell approach. Seven major themes were identified: (a) midwives ability to partner with women, (b) equality and reciprocity, (c) negotiation, (d) empowerment, (e) trust and time, (f) sharing power and responsibility, and (g) professional friendship. Most of the women are not capable to empower themselves such as less participating in decision making, less considerate in choosing a birthing position, and worsen by the limitations of midwives availability during the delivery process. Midwives need to reflect more the philosophy meaning inside the midwifery care and strengthen the midwifery professionals curriculum in order to persuade women as a partner who capable to empower themselves and to participate actively.
To investigate the association between one-to-one midwifery care and birth outcomes with pain relief as the primary outcome. Secondary outcomes include obstetric and neonatal outcomes, such as mode ...of birth and Apgar score.
A cohort study of women originally included in a cluster randomised trial.
The analysis is based on data from The Labour Progression Study (LaPS), a cluster randomised controlled trial (RCT) including 7,277 women, conducted in fourteen obstetric units in Norway, between 2014 and 2017. The participants were nulliparous with a singleton full-term foetus in a cephalic presentation and spontaneous onset of labour. In this cohort, 7,103 women with information about on one-to-one midwifery care were included.
Logistic regression analysis show that nulliparous women receiving one-to-one midwifery care in the active phase of labour are less likely to have an epidural analgesia, adjusted OR of 0.81 (95% CI 0.72,0.91), less likely to be given nitrous oxide, adjusted OR of 0.77 (95% CI 0.69,0.85), and they more often received massages, adjusted OR of 1.76 (95% CI 1.47,2.11), compared with women not receiving one-to-one midwifery care. Descriptive analyses show that women receiving one-to-one midwifery care in the active phase of labour are less likely to have a caesarean section (5.8% vs. 7.2%) and they are less likely to have an operative vaginal birth (16.5% vs. 23.7%). No significant differences were observed between the groups in terms of low Apgar scores at five minutes.
We found that one-to-one midwifery care in the active phase of labour may be associated with birth outcomes, including decreased use of epidural analgesia and a decreased rate of caesarean sections and operative vaginal birth.
The results of this study could encourage midwives to be present during the active phase of labour to promote physiological birth.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
•Caring for women undergoing late TOP has some positive but mostly negative effects on midwives.•Midwives have described late TOP care as challenging, distressing and burdensome. Grief, burnout, ...compassion fatigue and signs of secondary traumatic stress are common amongst midwives who provide late TOP care.•Lacking regular, dedicated support midwives rely predominantly on each other for support and debriefing during and after work.•It is apparent midwives need support, although current evidence has not identified the most appropriate strategy to support midwives in this role.
Midwives provide reproductive healthcare to women, including during termination of pregnancy (TOP) after 12 weeks (late TOP). Their expertise, knowledge and woman-centred care approach sees them ideally placed for this role. However, the medical, social and emotional complexities of late TOP can cause midwives significant distress. An integrative review methodology was used to examine the research on midwifery care for late TOP and identify support strategies and interventions available to midwives in this role. Five databases and reference lists were searched for relevant studies published between 2000 and 2021. A total of 2545 records were identified and 24 research studies included. Synthesis of research findings resulted in three themes: Positive aspects, negative aspects and carers need care. Midwives reported a high level of job satisfaction when caring for women during late TOP. Learning new skills and overcoming challenges were positive aspects of their work. Yet, midwives felt unprepared to deal with challenging aspects of late TOP care such as the grief and the psychological burden of the role. Caring for the baby with dignity had both positive and negative aspects. Midwives relied predominantly on close colleagues for help and debriefing as they felt poorly supported by management, judged by co-workers and lacked appropriate support to reduce the emotional effects of late TOP care. Midwives need support, although current evidence has not identified the most appropriate and effective strategy to support them in this role.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
•Midwives found it challenging to provide continuity in care to undocumented migrants.•They expressed concerns regarding increasing restrictions at public hospitals.•In lack of guidelines, they had ...developed their own strategies to care for women.
To explore community midwives’ experiences caring for pregnant undocumented migrants seeking prenatal care in Norway.
Due to the relatively limited previous research and number of pregnant undocumented migrants we used an explorative approach through qualitative method. Ten community midwives were interviewed after snowball sampling in Oslo, the capital of Norway. The main themes emerged through a qualitative analysis of the transcripts, and meaning units were extracted.
Midwives with no prior experience with pregnant undocumented migrants expressed uncertainty regarding the women’s rights. In contrast, those midwives who had had prior experience with this group, developed their own solutions and enacted certain strategies to help them without any guidelines from their employer. All the midwives found it challenging to provide follow-up care to the undocumented migrants during pregnancy and postpartum. They also expressed concerns regarding increasing challenges creating clinical trusting relationships and restrictions and practices at public hospitals.
To ensure adequate perinatal care, it is needed to reassure pregnant undocumented migrants free and safe care at all stages in the birth giving process. Community midwives need professional support in establishing trusting clinical relationships with pregnant undocumented migrants to reduce maternal stress and facilitate continuity in perinatal care.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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