Midwifery and Sexuality Geuens, Sam; Polona Mivsek, Ana; Gianotten, Woet L
2023, 2023-03-09
eBook
Open access
This first open-access book on midwifery and sexuality integrates sexual health into the care for the pregnant and postpartum couple. It addresses sexuality and intimacy from an education and ...prevention perspective instead of just focusing on treating problems, aiming to foster the development of sexual well-being and happy couplehood. Sexuality and intimacy are essential elements in the bonding of the couple and the parents-to-be. That process can be seriously hampered by sexual problems due to mutual misunderstanding, fear and sexual troubles (especially when the natural processes of conceiving, pregnancy and delivery are disturbed). In this phase of life, disruption of intimacy, sexuality and sexual relationship is a significant risk factor for developing couple and family problems. The need for such a book stems from the very limited attention given to this health area in the daily practice of most midwives and related healthcare professionals. In building a close relationship with the couple through frequent, intense, longstanding contact, the midwife acquires a perfect position to address sexuality and intimacy. With 36 authors from 14 countries, the book comprises five modules: 1. Sexuality; 2. Sexual aspects of the various phases of reproduction when things develop without complications; 3. Sexual aspects when those same phases deviate from physiology; 4. Special topics on sexuality relevant to daily midwifery practice; 5. Teaching, learning, skills and competencies with regard to sexuality. This new practical textbook guides healthcare professionals such as midwives, obstetricians, gynaecologists, nurses, general practitioners, pelvic floor therapists, etc., by offering both basic knowledge and skills on sexual health and wellbeing, combined with modern sexological knowledge, like the entirely new topic of sexual aspects of preconception care.
Introduction. The aim of the study was to explore two aspects of neonatal prophylaxis: the application of the vitamin K injection to the newborns and the prophylaxis against chlamydial and gonococcal ...eye infections, comparing Slovenian and Croatian practices.
Methods. A causal non-experimental method of quantitative empirical approach was used. The data was collected by means of predesigned questionnaires. The questionnaires were sent to 14 Slovenian and 32 Croatian birth hospitals. The data wasanalysed with descriptive statistics and the Kullback test.
Results. Vitamin K is applied to all newborns in 9 (out of 14) Slovene and 22 (out of 32) Croatian birth hospitals that returned the questionnaire. The prophylaxis against chlamydial gonococcal eye infections is applied to all newborns in 9 Slovene and 16 Croatian birth hospitals that offered answers to the questionnaire. The majority of Slovene and Croatian birth hospitals perform these procedures in the first hour after birth. The majority of Slovene birth hospitals still apply vitamin K in the gluteal muscle, whereas the majority of Croatian birth hospitals usually use the thigh as an injection site. In Slovenia, 1 % Targesin is used for the prophylaxis against chlamydial and gonococcal eye infections, whereas in Croatia the prevailing medicine is Erythromycin.
Conclusions. The possibility of oral vitamin K application should be offered to parents, and pain management in practice should be discussed. The form of written informed consent could be offered to parents. Health professionals should provide intimacy and exclude routine procedures in the first couple of hours after birth. However, more research is needed as delayed administration might be related to lower efficacy and, as a consequence of that, the safety of newborns is questionable.
Uvod. Namen opisane raziskave je bil proučiti določene vidike neonatalne profilakse: prakso aplikacije vitamina K novorojenčkom in profilakse proti klamidijski in gonokokni okužbi oči v slovenskih in hrvaških porodnišnicah.
Metode. V raziskavi je bila uporabljena kavzalna neeksperimentalna metoda kvantitativnega empiričnega načina raziskovanja. Podatki so bili pridobljeni z vnaprej pripravljenimi vprašalniki, ki so bili razdeljeni v 14 slovenskih in 32 hrvaških porodnišnicah. Analiza podatkov je potekala z uporabo deskriptivne statistike in Kullbackovega preizkusa.
Rezultati. Ugotovili smo, da se praksa v slovenskih in hrvaških porodnišnicah glede raziskovanih parametrov neonatalne profilakse razlikuje. Devet slovenskih porodnišnic (od vseh 14) in 22 hrvaških (od vseh 32), ki so sodelovale v raziskavi, aplicira vitamin K vsem novorojenčkom. Profilaktično zaščito proti klamidijskim ali gonokoknim očesnim okužbam pa izvajajo v 9 slovenskih in 16 hrvaških porodnišnicah (od vseh sodelujočih v raziskavi). Večina slovenskih in hrvaških porodnišnic opravi oba posega v prvi uri po rojstvu. Večina slovenskih porodnišnic aplicira vitamin K v glutealno mišico, medtem ko je na Hrvaškem pogostejša aplikacija v stegensko mišico. V slovenskih porodnišnicah pri apliciranju profilakse proti klamidijskim in gonokoknim okužbam oči prevladuje 1-odstotni Targezin, v hrvaških pa Eritromicin.
Zaključek. Staršem je treba ponuditi možnost oralne aplikacije vitamina K. Dobro bi bilo spregovoriti o lajšanju bolečine ob tovrstnem posegu ter hkrati starše spodbuditi, da pisno in informirano privolijo v poseg. Naloga zdravstvenih delavcev je, da družini v prvih urah po porodu zagotovijo intimnost ter v tem času poskusijo odložiti rutinske postopke. Za slednje pa so potrebne dodatne raziskave, saj lahko kasnejša administracija vodi v manjšo učinkovitost profilakse in hkrati zmanjšuje varnost novorojenčkov
The aim of the study was to explore two aspects of neonatal prophylaxis: the application of the vitamin K injection to the newborns and the prophylaxis against chlamydial and gonococcal eye ...infections, comparing Slovenian and Croatian practices.
A causal non-experimental method of quantitative empirical approach was used. The data was collected by means of predesigned questionnaires. The questionnaires were sent to 14 Slovenian and 32 Croatian birth hospitals. The data was analysed with descriptive statistics and the Kullback test.
Vitamin K is applied to all newborns in 9 (out of 14) Slovene and 22 (out of 32) Croatian birth hospitals that returned the questionnaire. The prophylaxis against chlamydial gonococcal eye infections is applied to all newborns in 9 Slovene and 16 Croatian birth hospitals that offered answers to the questionnaire. The majority of Slovene and Croatian birth hospitals perform these procedures in the first hour after birth. The majority of Slovene birth hospitals still apply vitamin K in the gluteal muscle, whereas the majority of Croatian birth hospitals usually use the thigh as an injection site. In Slovenia, 1 % Targesin is used for the prophylaxis against chlamydial and gonococcal eye infections, whereas in Croatia the prevailing medicine is Erythromycin.
The possibility of oral vitamin K application should be offered to parents, and pain management in practice should be discussed. The form of written informed consent could be offered to parents. Health professionals should provide intimacy and exclude routine procedures in the first couple of hours after birth. However, more research is needed as delayed administration might be related to lower efficacy and, as a consequence of that, the safety of newborns is questionable.
V príspevku so kot kazalniki procesne ravni kakovosti v zdravstvu in sociálnem delu analizirani koncepti subjektivnih teorij in stališč z raziskovalnim vprašanjem, kako je mogoče subjektivne teorije ...in stališča zaposlenih raziskovati in spreminjati. Vsebinska analiza konceptov na primeru socialnih modelov je pokazala, da se lahko družbene ideologije »pretakajo« v subjektivne teorije in stališča zaposlenih in da je njihovo spreminjaje in usmerjanje, v primeru njihove neustreznosti, prvi pogoj za povečanje kakovosti zdravstvenega in socialnega dela zaposlenih v instituciji.
A majority of women will experience some degree of perineal trauma during vaginal birth. The morbidity of women related to perineal trauma can reveal in perineal pain, urinary or faecal incontinence ...and dyspareunia. Midwives can adopt many techniques to protect the perineum from injury. However, there are still no clear guidelines regarding the hands-on and hands-poised approaches of perineal management during the second stage of labour. The current evidence remains contradictory, so which technique should midwives adopt?
vaginal birth is often accompanied with perineal trauma that affects postpartum morbidity. There are many techniques for protecting the perineum from injury during childbirth. The Hands-On or Hands ...Poised (HOOP) study (McCandlish et al., 1998) was the first trial that compared different techniques of perineal protection during the second stage of labour with very little research subsequently being undertaken.
to systematically review all available literature that compares the hands-on and hands-poised techniques of perineal management during the second stage of labour.
using the principles of a modified systematic literature review, quantitative, comparative and primary research studies were selected. These were assessed for quality using the Critical Appraisal Skills Programme (CASP) framework including a data extraction form. The results were reported narratively.
five studies were included and outlined the importance of both techniques. The hands-poised technique appeared to cause less perineal trauma and reduced rates of episiotomy. The hands-on technique resulted in increased perineal pain after birth and higher rates of postpartum haemorrhage.
as the five studies selected for this review have widely differing variables, comparisons that have been drawn must be viewed with caution. Evidence would suggest that the hands-poised technique is a safe and recommended technique for perineal management and discussions of such a technique should be included in all midwifery education and training programmes.
The challenge for midwives is how to support women in making informed choices about perineal management during childbirth. Until there is conclusive evidence, the choice of the hands-on or hands-poised technique will ultimately be determined by the clinical judgment of the individual midwife at the time of birth.
Further research is recommended. Thorough conclusions could significantly impact on reducing postpartum morbidity and improving women׳s sexual health and well-being in the long term, throughout the world.
•We reviewed quantitative studies that compared the hands-on and hands-poised technique of perineal management in labour.•Since data were aquired from countries with disimmilar maternity care systems, this modified review did not provide definitive answers.•The hands-poised technique could be preferable in terms of reducing perineal trauma.•Midwives should be knowledgable of of using BOTH techniques and use their clinical judgement in clinical practice to optimise a woman׳s birth outcome.
to examine potential association between mediolateral episiotomy and reduced incidence of obstetrical anal sphincter injuries (OASIS) diagnosed by endoanal ultrasound.
prospective cohort study.
...tertiary referral university hospital.
sixty nulliparous women at 28–33 weeks of gestation with singleton pregnancies were included between 2010 and 2012.
participants were examined with endoanal ultrasound at 28–33 weeks gestation and at 6–7 weeks post-partum. At both visits, symptoms of anal incontinence were assessed using Cleveland Clinic (Wexner) faecal incontinence scoring system. Mann Whitney U-test and χ2 test was used to compare groups with vs. without episiotomy and groups with vs. without OASIS diagnosed by ultrasound. χ2 test was used to assess correlation between OASIS and anal incontinence symptoms (p≤0.05 considered significant). None of the women included had sphincter injury or anal incontinence before childbirth. All delivered vaginally. Mediolateral episiotomy was performed in 33 (55%) cases. Six (10%) had OASIS on endoanal ultrasound (two were also diagnosed clinically), and 11 had symptoms of anal incontinence post-partum. No significant differences were seen in clinical characteristics between groups with vs. without episiotomy. No significant differences were seen in episiotomy rate (p=0.14), angle (p=0.42) and length (p=0.14) between groups with vs. without OASIS on ultrasound. Correlation between anal incontinence symptoms and sonographically diagnosed OASIS was statistically significant (p=0.04).
mediolateral episiotomy does not seem to be protective against clinically or sonographically diagnosed OASIS even when episiotomy technique is considered. Endoanal ultrasound allows a significantly better detection of symptomatic OASIS compared to clinical examination alone.
mediolateral episiotomy should be considered only when shortening the second stage of labour is indicated due to foetal distress, and not as a means of OASIS prevention.
•Endoanal ultrasound allows better detection of OASIS than clinical examination.•Sonographically diagnosed OASIS is associated with symptoms of anal incontinence.•Mediolateral episiotomy does not prevent sonographically diagnosed OASIS.•Episiotomy does not seem to be protective regardless of its angle and length.
Cilj rada bio je istražiti postupke vezane uz njegu pupkovine i batrljaka u rodilištima u Sloveniji i Hrvatskoj. Studija je bila temeljena na metodama empirijskog upitničkog istraživanja pomoću ...upitnika i kvantitativne istraživačke paradigme, a obuhvatila je sva slovenska rodilišta (n=14) i sva hrvatska rodilišta (n=35). Primalje iz 14 rodilišta u Sloveniji i 35 rodilišta u Hrvatskoj pozvani su da sudjeluju u istraživanju. Istraživanje je provedeno 2013. godine, a sudjelovalo je 67% slovenskih rodilišta i 66% hrvatskih rodilišta. Primijenjene su kauzalne i ne-eksperimentalne metode empirijskog istraživanja. Instrument istraživanja bio je upitnik. Opisne statistike su pripremljene. Teza neovisnosti testirana je χ2-testom odnosno Kullbackovim 2Î-testom. Rezultati su pokazali da velika većina rodilišta primjenjuje metodu DUCC (delayed umbilical cord clamping), tj. pupkovina se klema tek nakon što prestane pulsirati. Samo 10% slovenskih rodilišta u odnosu na 36,4% hrvatskih rodilišta prakticira suhu njegu batrljka. U ostalim rodilištima se batrljak dezinficira; u Sloveniji se za to najčešće rabi kalijev permanganat u 6%-tnoj otopini, dok se u Hrvatskoj najčešće upotrebljava kombinacija oktenidinklorida i fenoksietanola. Većina rodilišta u Hrvatskoj (95,7%) i dalje pokrivaju batrljak gazom, dok to nije najčešća praksa u Sloveniji. Autori procjenjuju da su najzastupljenije metode za njegu pupkovine koje se primjenjuju u slovenskim i hrvatskim rodilištima u skladu s dokazima, dok se poboljšanja mogu primijeniti u njezi batrljka; preporuča se suhu njegu bez pokrivanja.
PDF
