Hyperemesis Gravidarum (HG) is a severe form of nausea and vomiting in pregnancy that affects 1–3 % of women and has profound nutritional, physical and psychological consequences. Previous research ...identified that women with HG report inadequate infrastructure for day case management.
A multi-disciplinary HG day case service (IRIS Hydration Clinic) was launched and provides routine care for women with HG in a dedicated unit. The multi-disciplinary team involves midwives, dietitians, obstetricians and perinatal mental health.
To explore women's experiences of HG and of attending the dedicated clinic.
Ten interviews were conducted with women who attended the clinic. Data were transcribed and analysed using Reflexive Thematic Analysis.
The physical and psychological impact of HG was captured. The appreciation for the dedicated clinic was a common theme, regarding having somewhere specific for treatment rather than ad-hoc treatment. 'Relationships' was a significant theme - women described the benefits of continuity of care and the positive impact of peer support. Areas for improvement were explored, such as expansion and extra sensitivity around some women’s issues around weight gain/loss.
HG causes significant ill-health and its impact remains undervalued. Women had highly positive experiences of attending the dedicated HG clinic. The impact of continuity and individualized care in a day-case setting improved women’s experiences of this condition.
The dedicated HG clinic was highly valued by women experiencing the condition. The IRIS clinic provides much-needed validation for a medical condition with little understanding from the general public or many healthcare professionals.
Introduction:
Adolescent pregnancy poses a significant concern in Indonesia, particularly in some regions, namely West Sumatra and Padang City. This issue has been addressed with two prominent ...approaches, the Continuity of Midwifery Care (CMC) model and the Mother-Child Health (MCH) Book.
Objective:
This study aims to compare the effectiveness of these approaches in enhancing knowledge about adolescent Pregnancy, including several aspects, such as domestic violence, substance risks, reproductive health, pregnancy, childbirth, and parenting roles.
Material and Methods:
A quantitative research approach was applied by utilizing a quasi-experimental design, conducting pre- and post-tests with the validated questionnaires during the third trimester of pregnancy, postpartum days 31 and 43. Conducted in Padang City, the research involved 70 young primiparous mothers, categorized into groups using the CMC model and MCH Book. The collected data analyzed the generalized linear models repeated measures.
Results:
Both groups exhibited a significant knowledge enhancement, with the CMC model yielding more substantial enhancement. The focused and continuous care approach in the CMC model effectively enhanced the knowledge across various aspects, compared to the MCH Book.
Conclusion:
The CMC model stands out as an effective means to enhance knowledge among young pregnant mothers, addressing their distinct challenges during their transition to parenthood. We suggest that the health authorities and policymakers consider the implementation of the CMC model alongside the existing MCH book as a more effective approach to enhance the knowledge of Adolescent mothers.
The 10-item Birth Satisfaction Scale-Revised (BSS-R) is a quick and easy survey instrument recommended by the International Consortium for Health Outcome Measures as the tool of choice for measuring ...women's birth satisfaction.
To translate and validate a Vietnamese-language version of the BSS-R.
A quantitative cross-sectional method was used to gather data post translation and back-translation of a Vietnamese version of the BSS-R (VN-BSS-R). Data collected were psychometrically evaluated using key indices of validity and reliability.
Vietnamese women who were within one month postpartum of birth (
= 383) took part in the study.
Findings illustrate that a two-factor model offered excellent psychometric properties. With the two-factor VN-BSS-R, five items loaded onto a subscale 'Positive birth experiences' and the other five onto a second subscale 'Negative birth experiences'. This two-factor model offered a fit to data (root mean square error of approximation RMSEA = 0.07, 90% confidence interval CI 0.05, 0.09, root square mean residual RMSE = 0.04 and comparative fit index CFI = 0.97). Mean scores for the exploratory factor analysis EFA-derived 'positive' and 'negative' sub-scales were 17.12 (
2.34) and 8.40 (
4.18) respectively.
The translated and validated VN-BSS-R is a psychometrically robust tool for measuring birth satisfaction in Vietnamese postpartum women.The VN-BSS-R is available for use to measure experiences and perceptions of intrapartum care received by Vietnamese women.
Background
Birth companions can have a positive effect on women's experiences in labor. However, companions can feel unprepared and need professional guidance to help them feel involved and provide ...effective support.
Methods
A convergent segregated mixed‐methods systematic review was conducted to explore women's, companions’, and midwives’ experiences of birth companion support and identify ways to improve the experience for women and companions. A thematic synthesis of qualitative data and a narrative summary of quantitative data were conducted followed by integration of the findings.
Results
Companions who cope well in labor reported feeling involved, able to preserve women's internal focus and have a defined role, providing physical or emotional support. LBGTQ+ partners faced barriers to inclusion due to “forefronting” of their sexuality by staff and a lack of recognition in the language and processes used. The experience of birth companions can be enhanced by promoting their role as co‐parent, guardian, and coach, provision of timely information and developing a trusting relationship with care providers. Only two papers reported midwives’ views on birth companions in labor.
Conclusions
Women's and companions’ satisfaction with birth is increased when companions can support the mother, feel supported themselves, and valued as a co‐parent. The midwives’ role in information provision and guidance can maximize birth companions’ experience and ability to provide positive support. LBGTQ+ families need more support to feel included and recognized.
Qualitative data from 32 studieswere analysed into six overarchingthemes: feeling connected; feeling overwhelmed; feeling supported; feeling ‘inthe way’; midwives’ perspectives and the specific experiences of lesbianpartners.
PurposeThe development and utilization of in-hospital midwifery and outpatient midwifery care have been promoted since around 2008 to address the diverse needs of pregnant women and postpartum ...mothers, improve the quality of care, and redistribute tasks due to the shortage and uneven distribution of obstetricians. Therefore, we conducted a literature review on the current status of in-hospital midwifery and outpatient midwifery care in Japan, assessing their safety and user satisfaction; this endeavor was aimed at further promoting in-hospital midwifery and outpatient midwifery care.MethodsWe conducted a literature review on the safety and user satisfaction of in-hospital midwifery and outpatient midwifery care in Japan over the past 10 years. We extracted 20 articles from the Japan Medical Abstracts Society Web using keywords such as “in-hospital midwifery system.” These articles were analyzed for the descriptions of the safety of in-hospital midwifery, including specific data on delivery outcomes; we also analyzed 15 articles that provided qualitative insights and satisfaction surveys from expectant mothers who had used in-hospital midwifery and outpatient midwifery care.ResultsRegarding the safety of in-hospital midwifery, the rate of medical intervention tended to be higher in the physician-controlled group than in the in-hospital midwifery group (e.g., 52.8% vs. 75.8%); however, there were no significant differences between the two groups in clinically significant delivery outcomes such as neonatal asphyxia and atonic bleeding. Satisfaction with in-hospital midwifery and outpatient midwifery care was high, exceeding 80% in both groups. Advantages highlighted by participants included feeling more relaxed and having extra time during visits, alongside increased peace of mind due to the trust established with the midwife.ConclusionThe safety of in-hospital midwifery was not significantly different from that of non-in-hospital midwifery, and satisfaction with both in-hospital and outpatient midwifery care was consistently high. In the future, it will be necessary to collect information on the quality of midwives who are in charge of in-hospital midwifery and outpatient midwifery care, as well as on how to inform users of such services, and to study the detailed requirements for the diffusion of safe and highly satisfactory in-hospital midwifery and outpatient midwifery care.
Families living in rural communities need to relocate, be transferred or travel long distances to access specialist maternal and neonatal care, leading to isolation from their support networks.
...High-risk maternal and neonatal complexities in rural maternity units results in more transfers and retrievals to metropolitan services. There is limited understanding of the physical and psychological impacts for women and their families when they are transferred or displaced from their rural communities during pregnancy.
To investigate the lived experience of relocation for specialist pregnancy, birthing, postnatal and neonatal care on women and families.
Women (n=5) and partners (n=4) from rural South Australia, participated in semi-structured interviews on their experiences of transfer from local maternity providers. Couples interviewed together, interactions were recorded, transcribed verbatim and thematically analysed to identify overarching and sub-themes.
The overarching theme was ‘mismatched expectations’, with three identified sub-themes: ‘communication’, ‘compassion’ and ‘safety’. Discrepancies between expectations and realities during relocation left participants feeling isolated, alone and needing to self-advocate during this vulnerable period. Despite receiving specialist care, women and partners encountered unique hardships when separated from their rural community. Their social needs were poorly understood and seldom addressed in specialist units, resulting in poor experiences.
Consideration regarding the impact of attending specialist maternity services for women and partners from rural areas is required. The ‘one size fits all’ approach for maternity care is unrealistic and research is needed to improve the experiences for those uprooted from rural communities for higher levels of care.
Abstract
Background
Midwifery group practice (MGP) has consistently demonstrated optimal health and wellbeing outcomes for childbearing women and their babies. In this model, women can form a ...relationship with a known midwife, improving both maternal and midwife satisfaction. Yet the model is not widely implemented and sustained, resulting in limited opportunities for women to access it. Little attention has been paid to how MGP is managed and led and how this impacts the sustainability of the model. This study clarifies what constitutes optimal management and leadership and how this influences sustainability.
Methods
This qualitative study forms part of a larger mixed methods study investigating the management of MGP in Australia. The interview findings presented in this study are part of phase one, where the findings informed a national survey. Nine interviews and one focus group were conducted with 23 MGP managers, clinical midwife consultants, and operational/strategic managers who led MGPs. Transcripts of the audio-recordings were analysed using inductive, reflexive, thematic analysis.
Results
Three themes were constructed, namely:
The manager, the person
, describing the ideal personal attributes of the MGP manager;
midwifing the midwives
, illustrating how the MGP manager supports, manages, and leads the group practice midwives; and
gaining acceptance
, explaining how the MGP manager can gain acceptance beyond group practice midwives. Participants described the need for MGP managers to display midwife-centred management. This requires the manager to have qualities that mirror what is generally accepted as requirements for good midwifery care namely: core beliefs in feminist values and woman-centred care; trust; inclusiveness; being an advocate; an ability to slow down or take time; an ability to form relationships; and exceptional communication skills. Since emotional labour is a large part of the role, it is also necessary for them to encourage and practice self-care.
Conclusions
Managers need to practice in a way that is midwife-centred and mimics good midwifery care. To offset the emotional burden and improve sustainability, encouraging and promoting self-care practices might be of value.
This study aimed to explore the existing knowledge about midwives’ views and experiences of providing care for women in the context of task shifting.
We conducted a qualitative systematic review ...using meta-ethnography to describe the views and experiences of midwives on providing care in the context of task shifting. Comparative textual analysis of published qualitative studies involved translation of first-order key concepts and meanings from included studies to generate second-and third-order concepts. A grid was made to identify core findings and compare them reciprocally.
Thirty-six qualitative studies met the inclusion criteria. The literature comprised of 32 first key concepts. Eight second-order constructs emerged, and three third-order interpretations were generated. The three overarching themes were: (1) midwives perceived themselves as providing culturally competent and high quality women-centered care; (2) they valued their profession but saw it as complex and challenging; (3) as health professionals, they reported a variety of organizational, cultural, and professional barriers to providing women-centered care.
While performing a specific task in the task shifting context, midwives perceived their crucial roles and responsibilities, along with achieved value and reward. However, due to a range of existing barriers, the caring task posed great challenges in completely implementing women-centered care. It is essential for systems to identify and eliminate these barriers early, to consider midwives’ emotional well-being, and to develop overall strategies to better support the midwifery workforce. Policy makers and administrators should establish a supportive environment to facilitate midwives to perform women-centered caring tasks in more effective and efficient ways.
Zusammenfassung
Hintergrund
Zur Sicherstellung der ambulanten Hebammenversorgung während der COVID-19-Pandemie wurden im März 2020 in Deutschland erstmals digitale Hebammenleistungen ermöglicht. Ziel ...der Studie „Digitale Hebammenbetreuung im Kontext der Covid-19-Pandemie“ war eine erste Evaluation der neu eingeführten digitalen Angebote aus Sicht von Hebammen und Müttern. In dieser Publikation werden die Ergebnisse der Mütterbefragung dargestellt.
Methode
Im Februar und März 2021 wurde die Querschnittstudie durchgeführt. Es wurden bei der BARMER versicherte Frauen, die zwischen Mai und November 2020 ein gesundes Kind geboren haben, bundesweit mithilfe eines explorativ entwickelten Online-Fragebogens zu Inanspruchnahme, Zufriedenheit und den Potenzialen der digitalen Hebammenbetreuung in Schwangerschaft und Wochenbett anonymisiert befragt.
Ergebnisse
1821 Mütter nahmen an der Befragung teil. Rund ein Drittel der antwortenden Frauen hatte in der Schwangerschaft und/oder im Wochenbett digitale Hebammenleistungen in Anspruch genommen und diese Leistungen zu über 80 % positiv bewertet. Aus Sicht der Befragten eignen sich Kurse und Beratung sehr gut, wohingegen die Wochenbettbetreuung oft die Präsenz der Hebamme erfordere. Als Vorteile wurden der Infektionsschutz sowie die Zeit- und Wegeersparnis gesehen.
Fazit
Die COVID-19-Pandemie hat auch in der Hebammenversorgung einen Digitalisierungsschub bewirkt. Die digitalen Angebote wurden von den freiberuflichen Hebammen schnell umgesetzt. Diese wurden von den Frauen gut angenommen und können die Betreuung in Präsenz sinnvoll ergänzen. Chancen und Weiterentwicklungsmöglichkeiten der digitalen Hebammenbetreuung sollten nun genutzt werden.
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