•Mothers exiting maternity group homes face adversity, crisis, and rejection.•Tension exists between offering mothers both structure and independence.•Mothers and providers recognize the power of ...developing meaningful connections.•Mothers’ small steps towards independence need recognition.
Pregnant and parenting teens aging out of foster care, and their children are high-risk groups that require access to comprehensive services. Using a resilience framework, this study examined one mechanism to serve the population: maternity group homes. Despite interest in meeting the needs of these young families, little is known about maternity group home services and the impact for mothers and their children.
This study aimed to understand maternity home characteristics, strengths, and challenges from mothers’ and providers’ perspectives.
Data were collected from qualitative interviews with maternity group home providers (N = 16) and young mothers aging out of foster care (N = 25) and analyzed using thematic analysis.
Findings reflected four themes: (1) adversity, crisis, and rejection, (2) tension between useful programs and structured delivery, (3) unfulfilled aspirations for connections, and (4) slow progress towards independence. Mothers desired independent living skills, supportive relationships, and successful transitions to adulthood. Providers shared these goals for mothers. Past trauma, chronic adversity, and instability interfered with mothers’ ability to fully capitalize on maternity home programs.
Maternity homes are important resources for pregnant and parenting teens aging out of foster care. Yet, residency did not universally support mothers. Specifically, mothers living in maternity homes face high levels of adversity and instability which may interfere with their ability to harness protective factors. To improve outcomes, mothers may benefit from opportunities to gradually build trust and increase responsibility with extended stay eligibility to prepare for independent living.
In order to analyze the system of medical care organization during pregnancy and labor, and to evaluate the effect of organization of obstetric and resuscitation aid to females on the parameter of ...maternal mortality (MM), the updated information on organization of medical care for pregnant, maternity patients and new mothers over the period of 2006 2009 in 85 subjects of RF, has been assessed. The assessment was carried out by level I obstetric aid institutions (obstetric departments of central district hospitals), level II institutions (inter regional and urban maternity hospitals, perinatal centers, maternity departments of urban multidisciplinary hospitals) and level III institutions (provincial, regional and republican perinatal centers, maternity homes, teaching hospital clinics and federal scientific research institutes). A statistically significant, strong and direct relationship was found between the percentage of obstetric beds in the level I obstetric institutions (r = 0.81), fraction of labors in the level I inpatient institutions (r = 0.99), percentage of beds for pregnant and maternity patients not provided for by round the clock on call service by hospital obstetrician gynecologist (r = 0.84) on the one hand, and the MM parameter on the other. There was a strong inverse relationship between the fraction of labors occurred in the level III obstetric care institutions (r = 0.89), availability of regional maternity home (department), perinatal center (r = 0.90), obstetric distance consultancy center (r = 0.89), percentage of obstetric care institutions equipped with departments (wards) of resuscitation and intensive care (r = 0.99), on the one hand, and the MM parameter on the other. Therefore, for prophylaxis and MM reduction it is necessary to implement modern organizational technologies of providing medical care for pregnant, maternity patients and new mothers based on a three level system organization, in which the perinatal centers take the leading role.
Poor social support is associated with adverse obstetric outcomes. Maternity group homes (MGHs), residential programs for pregnant women, have been found to improve social support in small studies. ...The present study aimed to verify these previous studies, discover whether there is a group of women whom MGHs most benefit, identify what services offer that benefit, and identify how to predict who will most benefit from MGH admission. Forty-three US MGHs from 14 states were surveyed from August 2015 to February 2017. The primary outcome was self-reported social support before and during MGH admission. The secondary outcome was the perception that MGH admission would help current and future relationships. Among 95 respondents, 54% perceived better in-MGH support compared to pre-MGH support. Women with poor pre-MGH support reported improvement; the converse was true of high pre-MGH support (P < 0.001). A total of 77% to 82% of participants anticipated that MGH admission would help current and future relationships, including 91% to 92% of women with stable or increased in-MGH support (P = 0.07 current, P < 0.01 future). Participants with increased in-MGH support reported more services as helpful (P < 0.05). In summary, MGHs are associated with improved support and relationships for most residents. The support score may identify which women may benefit most from MGH admission.
The Japanese Midwifery Association (JMA) guidelines allow midwives to manage group B Streptococcus (GBS)-positive women during pregnancy and labour at maternity homes. However, no guidelines exist to ...manage neonates born to GBS-positive women in Japan. We aimed to investigate the opinions of paediatricians regarding optimal management strategies for neonates born to GBS-positive women in maternity homes. A questionnaire was sent to paediatricians at 396 Japanese perinatal medical centres. We examined opinions regarding examinations and routine clinical tests for neonates born to GBS-positive women in maternity homes.
Of 235 paediatricians, only 11.2% considered that paediatric examinations were unnecessary for neonates born to GBS-positive women in maternity homes. Moreover, 20.5%, 13.2%, and 11.1% of paediatricians considered culture test of the nasal cavity, serum C-reactive protein level analysis, and blood cell count analysis, respectively, necessary for neonates born to GBS-positive pregnant women with intrapartum antibiotic prophylaxis (IAP), whereas 36.3%, 56.2%, and 40.6% of paediatricians considered these tests necessary in cases without IAP. The JMA guidelines had low penetration rates among paediatricians in Japan. To manage neonates born to GBS-positive women in maternity homes, midwives should engage with commissioned paediatricians in more detail and develop appropriate strategies to increase awareness and cooperation.
Per the 2014 Japanese Midwives Association (JMA) guidelines, midwives were allowed to manage the deliveries for group B streptococcus (GBS)-positive pregnant women in labour at maternity homes ...without the supervision of a medical doctor if they complied with the guidelines of the Japan Society of Obstetrics and Gynecology (JSOG), wherein midwives working for maternity homes are expected to cooperate with commissioned obstetricians and paediatricians in cooperative medical facilities. We examined the rate of compliance with these JMA and JSOG guidelines regarding the management of GBS-positive pregnant women among midwives at maternity homes in Japan.
Between October and December 2015, an anonymous questionnaire was distributed to 337 maternity homes registered with the JMA by mail. The questionnaire obtained information regarding the timing of GBS screening, specimen collection, transfer of GBS-positive pregnant women from a maternity home to a hospital, administration of intrapartum antibiotic prophylaxis, and collaboration between midwives and commissioned obstetricians. Data were analysed using descriptive statistics. We used frequency distribution as the statistical test.
Responses were received from 246 (73.0%) maternity homes, of which complete responses from 204 maternity homes (valid response rate, 60.5%) were analysed. Of these 204 maternity homes, only 97 (47.5%) conducted a GBS screening test during 33-37 weeks of gestation as recommended by the JSOG guidelines. Although midwives alone managed GBS-positive pregnant women in labour at 135 maternity homes (66.2%), intrapartum antibiotic prophylaxis, as recommended by the JSOG guidelines, was conducted in only 111 (54.4%). Moreover, only 37.0% (50/135) and 82.2% (111/135) of maternity homes ensured that GBS-positive pregnant women in labour with an elapse of ≥18 h after PROM and a body temperature of ≥38.0 °C, respectively, were transferred to a hospital by ambulance. Only at 58.3% (119/204) of maternity homes did midwives discuss the management of labour for GBS-positive pregnant women with commissioned obstetricians.
Some midwives working for maternity homes did not follow the JMA and JSOG guidelines of the management of GBS-positive pregnant women. For improving compliance rates, midwives at maternity homes should discuss the management of GBS-positive pregnant women with commissioned doctors more carefully and concretely per the existing guidelines.
to assess the effectiveness of promoting the use of the World Health Organization (WHO) partograph by midwives for labour in a maternity home by comparing outcomes after birth.
Medan city, North ...Sumatera Province, Indonesia.
20 midwives who regularly conducted births in maternity homes, randomly allocated into two equal groups.
cluster randomised-control trial.
under supervision from a team of obstetricians, midwives in the intervention group were introduced to the WHO partograph, trained in its use and instructed to use it in subsequent labours.
there were 304 eligible women with vertex presentations among 358 labouring women in the intervention group and 322 among 363 in the control group. Among the intervention group, 304 (92.4%) partographs were correctly completed. From 71 women with the graph beyond the alert line, 42 (65%) were referred to hospital. Introducing the partograph significantly increased referral rate, and reduced the number of vaginal examinations, oxytocin use and obstructed labour. The proportions of caesarean sections and prolonged labour were not significantly reduced. Apgar scores of less than 7 at 1
min was reduced significantly, whereas Apgar scores at 5
mins and requirement for neonatal resuscitation were not significantly different. Fetal death and early neonatal death rates were too low to compare.
a training programme with follow-up supervision and monitoring may be of use when introducing the WHO partograph in other similar settings, and the findings of this study suggest that the appropriate time of referral needs more emphasis in continuing education.
the WHO partograph should be promoted for use by midwives who care for labouring women in a maternity home.
La recherche présentée s’intéresse au devenir d’enfants accueillis avec leur mère en centre d’hébergement mère-enfant, sept à huit ans après leur sortie. Ce travail s’inscrit dans la perspective ...écologique du développement humain et s’appuie sur les acquis théoriques et méthodologiques des recherches concernant le devenir des bénéficiaires d’interventions socio-éducatives, et des recherches sur le bien-être de l’enfant. La démarche visait à observer les trajectoires après la sortie, à comprendre les processus de construction de ces parcours, et à appréhender la qualité de vie des enfants au moment de l’enquête. La démarche empirique comprend trois étapes (analyse séquentielle de deux cents trajectoires, entretiens avec quarante-neuf mères et questionnaires de qualité de vie et entretiens avec trente-trois enfants). Les résultats mettent en évidence l’interaction entre le parcours conjugal de la mère, l’évolution de la situation résidentielle et les mesures de protection de l’enfance. Ils soulignent également les effets de la centration du dispositif sur le lien mère-enfant. Enfin, la qualité de vie des enfants semble davantage liée à leur situation au moment de l’enquête qu’à leur parcours antérieur. L’analyse des entretiens permet de proposer des pistes pour comprendre la contribution des conditions matérielles de vie et des dimensions relationnelles à la qualité de vie des enfants.
This research analyses the trajectories and outcomes of children previously housed with their mothers in a maternity home, seven years later. The study falls within the framework of the ecology of human development, and is based on theoretical and methodological knowledge gained from studies concerning outcome after leaving care and from research into child well-being. The aim is to observe trajectories after leaving the maternity homes, in order to understand the building process of these trajectories, and to describe the quality of life of the children at the moment of the survey. There are three empirical phases (sequence analysis of two hundred trajectories, qualitative interviews with forty-nine mothers, and quality of life questionnaires and interviews with thirty-three children). The results show the interactions between the conjugal trajectory of the mother, the housing pathway and the child protection measures taken. They also highlight the effects of focusing social measures on the mother-child relationship. Finally, the children’s quality of life seems more related to their situations at the moment of the survey than to their previous pathways. The analysis of the interviews provides leads to follow in order to gain better understanding of how material conditions and relationships contribute to a child’s quality of life.
Provider: - Institution: - Data provided by Europeana Collections- February 1969. View of Morley Hall Maternity Home, a listed building. For most of its existence the Hall was a private dwelling, the ...earliest part of the building on the extreme right dating from the seventeenth century and being built by John Dawson. Most of the rest of the building, especially those parts with the castellations, were built in Victorian times when a large building to accommodate handlooms was erected close by on Dawson Hill. By 1969 the Maternity Home was being run down with preparations being made at Staincliffe to take mothers from Morley. However, before Morley Corporation came to an end the Hall was sand-blasted to get rid of the grime from the past hundred years or more. Photograph from the David Atkinson Archive.- All metadata published by Europeana are available free of restriction under the Creative Commons CC0 1.0 Universal Public Domain Dedication. However, Europeana requests that you actively acknowledge and give attribution to all metadata sources including Europeana
Provider: - Institution: - Data provided by Europeana Collections- c1940s. Photograph of Morley Hall Maternity Home, taken during the Second World War when sandbags were piled up in front of the ...building to protect it from bomb damage. Two young women are sitting in the garden with a baby, a dog and a pram. Photograph from the David Atkinson Archive.- All metadata published by Europeana are available free of restriction under the Creative Commons CC0 1.0 Universal Public Domain Dedication. However, Europeana requests that you actively acknowledge and give attribution to all metadata sources including Europeana
Provider: - Institution: - Data provided by Europeana Collections- c1950s. Staff looking after newly-born babies in the creche at Morley Hall Maternity Home. Photograph from the David Atkinson ...Archive from Phillis Duerden.- All metadata published by Europeana are available free of restriction under the Creative Commons CC0 1.0 Universal Public Domain Dedication. However, Europeana requests that you actively acknowledge and give attribution to all metadata sources including Europeana
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