To explore women's and health professionals' views on the development of a midwifery-led mHealth app intervention in antenatal care and their demands for app functionality.
Descriptive qualitative ...research was utilized.
In total, 15 pregnant or postpartum women were interviewed via in-depth interviews and 10 health professionals including obstetricians, midwives and obstetric nurses were invited to participate in a focus group discussion (FGD). All interviews and the FGD were analysed using qualitative content analysis.
Four key themes emerged from the data, including (1) limitations of current maternity care services; (2) potential benefits for mHealth app-based midwifery care; (3) possible challenges for providing midwifery care through mHealth apps and (4) suggestions and needs for developing a midwifery-led mHealth app. Participants agreed on the potential need of developing a midwifery-led mHealth app in antenatal care to increase access to midwifery care services and to meet women's diverse needs. Participants preferred to develop professional, reliable, full-featured and interactive mobile applications. The main functions of midwifery-led mHealth apps included personalized assessment and health education, self-monitoring and feedback, data sharing and interactive functions. Women mentioned that online communication and consultation with midwives could help them receive continuous support outside facilities. Health professionals expressed it would be of great convenience and timeliness to send personalized messages to women and to inform them of healthy lifestyles during pregnancy. The challenges included a shortage of human resources, medico-legal risks associated with mHealth and data security risks.
This study explores the individual views and functional needs of target users and healthcare providers for developing a midwifery-led mHealth app in antenatal care, which will serve as a reference for future application development.
Our study has important and practical implications for guiding the development of future midwifery-led mHealth app interventions.
No patient or public contribution.
Background: Gender sensitive midwifery services are needed by women, especially during pregnancy, childbirth and puerperium. Gender inequality in society has a negative impact on the acceptance of ...antenatal care for mothers. Gender sensitive midwifery care is needed to improve maternal health status during pregnancy.
Purpose: This study aims to determine the impact of gender sensitive midwifery care on pregnant women’s knowledge, attitude and acceptance of midwifery care
Method: This was a quantitative experimental study with pre-posttest for 1 group design. The subjects of this study were pregnant women who received midwifery care from 40 midwives, totaling 200 pregnant women obtained through purposive sampling in 2 provinces. Paired t-test was used to measure the difference in the results of the variables measured in pregnant women before and after 3 months of the intervention given by midwives.
Results: Pregnant women’s knowledge, attitude and acceptance of midwifery care increased after they received intervention from midwives. The mean difference (MD) for knowledge was -2.07 (r=0.864), p value=0.000 in DKI Jakarta, and MD=-2.70 (r=0.467), p value= 0.000 in South Kalimantan. For attitude in DKI Jakarta, MD=-1.03 (r= 0.99, p value=0.000) and in South Kalimantan the mean difference (MD) was -2.8 (r= 0.445, p value=0.000). For acceptance of gender sensitive midwifery care in DKI Jakarta MD=-2.71 (r= 0.67, p value= 0.000) and South Kalimantan MD=-4.5 (r= p value=0.000).
Conclusion: There was a difference and increase in score for knowledge, attitude and acceptance of midwifery care with gender sensitivity in pregnant women before and after the intervention was given to the midwives in the two provinces. It takes great attention from midwives to ensure that all pregnant women receive a gender sensitive midwifery care.
Abstract
Introduction
The aim of this study was to compare maternal and neonatal outcomes in the care provided by Doula, trained lay companion, and routine midwifery care in the labor and obstetric ...units. In this study, only results related to maternal outcomes were presented.
Method
This is a quasi-experimental study, which was conducted on 150 women with low-risk pregnancies who had been selected for vaginal birth at private clinics and public hospitals of Arak, Iran. Participants were divided into three groups, two intervention groups, doula and trained lay companion, and one control group, midwife’s routine care. The intervention groups, in addition to receiving routine care from the labor and maternity units, also received support and training by doula or a trained lay companion, but 50 the control group received only routine midwifery care. In the control group and the trained companion, the samples were taken from 10 clinics of different parts of the city by random sampling method using the SIB center system. Then, among selected numbers, we randomly selected samples for each group. But in Doula group, because of limited number of samples, convenience sampling was used and all women enrolled in doula care were included in the study until the number reached 50. In each group, outcomes such as the duration of active phase and second stage of labor, as well as the severity of pain, anxiety and maternal satisfaction with birth were measured and compared with other groups. Data were collected by a researcher-made checklist, the Spielberger’s State-Trait Anxiety Inventory (STAI), the Pain Visual Assessment Scale (VAS), and the Hollins Martin’s Birth Satisfaction Scale-Revised (BSS-R). Data were analyzed by SPSS-22 statistical software using Kruskal Wallis, Chi-Square, ANOVA and Fisher’s exact tests.
Findings
Based on the results, the mean duration of active phase between three groups was 234.68 ± 118.74, 256.66 ± 108.75 and 279 ± 94.37 min, respectively (p = 0.022). Also, the mean duration of second stage in three groups was 10 ± 5.61, 10.35 ± 5.1 and 22.30 ± 75.57 min, respectively (p < 0.001). The difference between mean pain scores in the first, second, third, fourth and fifth hours was not statistically significant. The average difference in anxiety score in the two stages of labor was higher in the lay companion group, and this difference was statistically significant (p < 0.001); however, the level of satisfaction in doula group was higher compared to the lay companion and control groups (p < 0.00 1).
Conclusion
According to present study, doula care has a greater effect on reducing the duration of labor than other care models. Based on the study, there was no statistically significant difference between the three groups in terms of variables such as the severity of labor pain. However, the level of anxiety of pregnant mothers in the group supported by lay companion was lower than the other two groups, which indicates the positive effect of mothers’ training on increasing maternal comfort and satisfaction. It is suggested that further research investigate the severity of labor pain in groups supported by different care models and also we recommend the use of lay companion’ support during childbearing of mothers who could not afford doula.
Trail registration
This article has been registered in Iran’s Clinical Trial Center with the code: IRCT20230620058548N1. 2023/08/29.
PurposeRecently, an increasing numbers of women are requesting epidural anesthesia during vaginal delivery (hereinafter referred to as epidural delivery) in Japan. While this number is expected to ...increase, there appears to be a negative view regarding epidural delivery among the midwives, and some midwives find it difficult to accept. The purpose of this study was to ascertain the feelings and perceptions of the midwives involved in epidural delivery and to determine the kind of care they provide.MethodsThis was a qualitative descriptive study. Sixteen midwives with an experience in epidural delivery underwent semi-structured interviews. The obtained data was transcribed; and the sections, where the midwives expressed their feelings on involvement in epidural delivery, were extracted, coded, and categorized.ResultsThe midwives' perceptions regarding epidural delivery were collated into six categories. Perceptions such as “feeling that epidural delivery also has merit” and “willingness to accept epidural delivery” included positive opinions held by the midwives due to their involvement in epidural delivery, where they were trying to respond to the increase in epidural deliveries. Contrastingly, the midwives also held the opinion that, “I find it difficult to support women, who receive epidural anesthesia, to ensure that the delivery progresses safely and smoothly,” and “I find it difficult and I feel anxious about my lack of knowledge about epidural delivery.” These perceptions show that the midwives find providing support in epidural delivery difficult. Feelings such as “involvement in epidural delivery has reiterated my feelings on the merits of natural delivery” described how the midwives truly believed the merits of natural delivery when they were involved in epidural delivery. In the background of the aforementioned categories was “conflict with my own feelings as a midwife that arises while providing support for an epidural delivery as per the pregnant woman's wishes.”ConclusionMidwives involved in epidural delivery have variable point of views, perceiving the benefit of epidural delivery, but finding the provision of support difficult. It was clarified that even under these circumstances, midwives are involved in safe epidural deliveries per the pregnant women's wishes. Midwives need to acquire accurate knowledge to be able to provide highly safe and satisfactory care during epidural deliveries, and to align themselves with the pregnant woman's wishes and expectations.
PurposeRecently, an increasing numbers of women are requesting epidural anesthesia during vaginal delivery (hereinafter referred to as epidural delivery) in Japan. While this number is expected to ...increase, there appears to be a negative view regarding epidural delivery among the midwives, and some midwives find it difficult to accept. The purpose of this study was to ascertain the feelings and perceptions of the midwives involved in epidural delivery and to determine the kind of care they provide.MethodsThis was a qualitative descriptive study. Sixteen midwives with an experience in epidural delivery underwent semi-structured interviews. The obtained data was transcribed; and the sections, where the midwives expressed their feelings on involvement in epidural delivery, were extracted, coded, and categorized.ResultsThe midwives' perceptions regarding epidural delivery were collated into six categories. Perceptions such as “feeling that epidural delivery also has merit” and “willingness to accept epidural delivery” included positive opinions held by the midwives due to their involvement in epidural delivery, where they were trying to respond to the increase in epidural deliveries. Contrastingly, the midwives also held the opinion that, “I find it difficult to support women, who receive epidural anesthesia, to ensure that the delivery progresses safely and smoothly,” and “I find it difficult and I feel anxious about my lack of knowledge about epidural delivery.” These perceptions show that the midwives find providing support in epidural delivery difficult. Feelings such as “involvement in epidural delivery has reiterated my feelings on the merits of natural delivery” described how the midwives truly believed the merits of natural delivery when they were involved in epidural delivery. In the background of the aforementioned categories was “conflict with my own feelings as a midwife that arises while providing support for an epidural delivery as per the pregnant woman's wishes.”ConclusionMidwives involved in epidural delivery have variable point of views, perceiving the benefit of epidural delivery, but finding the provision of support difficult. It was clarified that even under these circumstances, midwives are involved in safe epidural deliveries per the pregnant women's wishes. Midwives need to acquire accurate knowledge to be able to provide highly safe and satisfactory care during epidural deliveries, and to align themselves with the pregnant woman's wishes and expectations.
PurposeThe purpose of this study was to clarify the characteristics of midwifery care for foreign Muslim women living in Japan.MethodsA qualitative descriptive study was conducted with five midwives ...who had experience providing midwifery care to Muslim women in obstetric outpatient clinics and hospital wards in Japan. Data were collected through semi-structured interviews using an interview guide and analyzed qualitatively and inductively.ResultsUpon analysis we identified 34 subcategories, 14 categories and three core categories as characteristics of midwifery care for Muslim women. Midwives who provided care to Muslim women focused more on the religious background of the patient than on the background of the patient, such as country of origin or linguistic communication level, which is usually the focus when caring for foreigners, and they were “aware that the patient was a Muslim”. From the early stage, the midwives were “practicing religious considerations based on one's nursing perspective” as professionals, while giving “informed consent and sharing information on religious considerations” with the patient, family members, and medical staff.ConclusionReligious considerations were found to be a significant characteristic of midwifery care for Muslim women. Midwives gave informed consent for religious considerations to Muslim women and their families from the early stages of midwifery care, and they practiced religious considerations through trial and error based on one's own nursing perspectives. However, as religion is a sensitive issue, midwives tended to hesitate in addressing the individual needs of Muslim women, even though they were aware of the diversity and uniqueness of each woman's needs. As a result, midwives tended to give Muslim women only uniform consideration. Our study showed that in order to improve midwifery care for Muslim women, it is necessary to factor in the diverse needs of each individual woman and connect them to more culturally appropriate care.
PurposeThe purpose of this study was to clarify the characteristics of midwifery care for foreign Muslim women living in Japan.MethodsA qualitative descriptive study was conducted with five midwives ...who had experience providing midwifery care to Muslim women in obstetric outpatient clinics and hospital wards in Japan. Data were collected through semi-structured interviews using an interview guide and analyzed qualitatively and inductively.ResultsUpon analysis we identified 34 subcategories, 14 categories and three core categories as characteristics of midwifery care for Muslim women. Midwives who provided care to Muslim women focused more on the religious background of the patient than on the background of the patient, such as country of origin or linguistic communication level, which is usually the focus when caring for foreigners, and they were “aware that the patient was a Muslim”. From the early stage, the midwives were “practicing religious considerations based on one's nursing perspective” as professionals, while giving “informed consent and sharing information on religious considerations” with the patient, family members, and medical staff.ConclusionReligious considerations were found to be a significant characteristic of midwifery care for Muslim women. Midwives gave informed consent for religious considerations to Muslim women and their families from the early stages of midwifery care, and they practiced religious considerations through trial and error based on one's own nursing perspectives. However, as religion is a sensitive issue, midwives tended to hesitate in addressing the individual needs of Muslim women, even though they were aware of the diversity and uniqueness of each woman's needs. As a result, midwives tended to give Muslim women only uniform consideration. Our study showed that in order to improve midwifery care for Muslim women, it is necessary to factor in the diverse needs of each individual woman and connect them to more culturally appropriate care.
PurposeThis study aimed to clarify the components related to midwifery care for pregnant women's continued self-care for relieving “hiesho” (sensitivity to cold) at birth centers.MethodsIn total, 129 ...midwives working at birth centers for at least five years, handling deliveries across the country, and who provided support for pregnant women's self-care for relieving hiesho at prenatal checkups were selected for this study. An anonymous self-administered questionnaire survey was conducted. The main method of analysis was an exploratory factor analysis of midwifery care for pregnant women's continued self-care to relieve hiesho. This study was approved by the Ethical Review Committee of Yokohama City University and followed all relevant ethical considerations (approval number: F221000004).ResultsIn total, 95 valid questionnaire survey responses were received (valid response rate 92.2%). The two items that were “always implemented” (response rate of >95%) for midwifery care of pregnant women's continued self-care for relieving hiesho were “Interacting with pregnant women to be aware of the presence of the fetus” and “Interacting with pregnant women so that they can have the desire to give birth on their own.” The four components of midwifery care were as follows: (1) Promoting awareness while understanding pregnant women's thoughts of continuing self-care for hiesho, (2) Motivating pregnant women to start with self-care for hiesho that they can do, (3) Creating opportunities for pregnant women to access information about self-care for hiesho themselves, and (4) Sharing information among midwives that leads to promote self-care for hiesho with respect for the individuality of pregnant women.ConclusionIt was deemed important, in the context of midwifery care for pregnant women's continued self-care for relieving hiesho, to increase the intrinsic motivation of pregnant women for self-care, and related efforts were implemented at a high frequency. The four components of midwifery care extracted in this study encouraged pregnant women to continue self-care for relieving hiesho by motivating them to change their behavior, increasing their self-efficacy for self-care, creating opportunities for them to actively access information about self-care for hiesho, and implementing care that respects their individuality.
PurposeThis study aimed to clarify the components related to midwifery care for pregnant women's continued self-care for relieving “hiesho” (sensitivity to cold) at birth centers.MethodsIn total, 129 ...midwives working at birth centers for at least five years, handling deliveries across the country, and who provided support for pregnant women's self-care for relieving hiesho at prenatal checkups were selected for this study. An anonymous self-administered questionnaire survey was conducted. The main method of analysis was an exploratory factor analysis of midwifery care for pregnant women's continued self-care to relieve hiesho. This study was approved by the Ethical Review Committee of Yokohama City University and followed all relevant ethical considerations (approval number: F221000004).ResultsIn total, 95 valid questionnaire survey responses were received (valid response rate 92.2%). The two items that were “always implemented” (response rate of >95%) for midwifery care of pregnant women's continued self-care for relieving hiesho were “Interacting with pregnant women to be aware of the presence of the fetus” and “Interacting with pregnant women so that they can have the desire to give birth on their own.” The four components of midwifery care were as follows: (1) Promoting awareness while understanding pregnant women's thoughts of continuing self-care for hiesho, (2) Motivating pregnant women to start with self-care for hiesho that they can do, (3) Creating opportunities for pregnant women to access information about self-care for hiesho themselves, and (4) Sharing information among midwives that leads to promote self-care for hiesho with respect for the individuality of pregnant women.ConclusionIt was deemed important, in the context of midwifery care for pregnant women's continued self-care for relieving hiesho, to increase the intrinsic motivation of pregnant women for self-care, and related efforts were implemented at a high frequency. The four components of midwifery care extracted in this study encouraged pregnant women to continue self-care for relieving hiesho by motivating them to change their behavior, increasing their self-efficacy for self-care, creating opportunities for them to actively access information about self-care for hiesho, and implementing care that respects their individuality.
Digital midwifery services were enabled for the first time in Germany from March 2020 to ensure outpatient midwifery care in times of COVID-19.
In February and March 2021, a cross-sectional study ...with an online survey of midwives and mothers was conducted to find out to what extent digital services were offered by the midwives and used by the women, and to obtain information about the level of satisfaction and potential of digital midwifery care in pregnancy and post partum.
1821 mothers of 18,784 women, who had given birth between May and November 2020 and were asked to participate in the survey, provided feedback (response rate: 9,7%). 1551 midwives responded to the call to participate in the survey and completed the questionnaire. Around one third of the responding mothers had used digital midwifery services in pregnancy and/or the postpartum period and rated these services positively by over 80%. Half of the responding midwives offered digital services and wished to continue this care option. However, not all services were considered equally suitable for digital implementation. From the respondents' point of view, classes and counselling are very well suited whereas postpartum care often requires the midwife's presence. Mothers and midwives alike saw the advantages in COVID-19 infection control and in saving time and travel. The main challenges were seen in handling IT equipment and providing high quality care despite the lack of physical examination and direct assessment of clinical findings. The mothers wished for more interactivity and networking with each other.
The COVID-19 pandemic has become a catalyst for digitalisation in midwifery care in Germany. The digital services were, mostly, well accepted and seen to usefully complement the in-person care of midwives. IT-support, guidelines and quality standards could help to optimise the digital services.
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