Midwifery最新文献

{"title":"The PRIMROSE project: What is ‘physiological birth’? Exploring the perceptions of care providers and birthing persons in Australia: A qualitative descriptive study","authors":"Brooke.I. Henshall ,&nbsp;Heather.A. Grimes ,&nbsp;Jennifer Davis ,&nbsp;Christine.E. East","doi":"10.1016/j.midw.2025.104617","DOIUrl":"10.1016/j.midw.2025.104617","url":null,"abstract":"<div><h3>Background</h3><div>‘Physiological birth’ as a term, lacks consistency, and the current definition from the World Health Organization in 1997 does not consider the viewpoint of women/birthing persons. Differences in individual interpretations of physiological birth may complicate care provision and the advocation of physiological birth.</div></div><div><h3>Aim</h3><div>To explore the contemporary understanding of physiological birth from the perspective of women/birthing persons, midwives, obstetric doctors, and doulas in the Australian setting, and identify important elements to include in a consensus statement of ‘physiological birth’.</div></div><div><h3>Methods</h3><div>A qualitative descriptive study was undertaken using focus groups and interview. Data was audio-recorded, transcribed verbatim, and was thematically analysed using NVivo software.</div></div><div><h3>Results</h3><div>Ten participants took part in this study. Three aggregate themes were identified: (1) Connection to the natural process of birth, (2) Elements of decision, and (3) Challenges in the birthing setting. Participants agreed that ‘spontaneous onset’ and ‘vaginal birth’ were important terms to include in a consensus statement of physiological birth. Women/birthing persons, midwives and doulas believed physiological birth was a natural process, uninterrupted by intervention; however, the use of the term ‘intervention’ was amorphous. Antenatal education about physiological birth was identified as lacking, and physiological birth was considered not to be a ‘woman’s term’. Participants acknowledged a fear-based narrative around childbirth, and that ‘red tape’ within the hospital setting could challenge maternal choice.</div></div><div><h3>Conclusion</h3><div>Trusting in instinctive labour and birth is an important element of physiological birth. Multiple understandings of the term ‘physiological birth’ extend into the terms used to define it.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104617"},"PeriodicalIF":2.5,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidimensional sleep health and breastfeeding self-efficacy: A cross-sectional study","authors":"Sha Li ,&nbsp;Xianyan Hao ,&nbsp;Yanzhe Wang ,&nbsp;Xingchen Shang ,&nbsp;Qingyu Wang ,&nbsp;Jiayin Ruan","doi":"10.1016/j.midw.2025.104618","DOIUrl":"10.1016/j.midw.2025.104618","url":null,"abstract":"<div><h3>Background</h3><div>Breastfeeding is recommended for new mothers. However, the rate of breastfeeding is far below the recommendation, and researchers have devoted themselves to exploring the associated factors to promote breastfeeding.</div></div><div><h3>Aim</h3><div>To explore the association between maternal multidimensional sleep health and prenatal breastfeeding self-efficacy.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted among pregnant women attending obstetrics departments at three hospitals in Jiangsu, China. The RU_SATED 2.0, Prenatal Breastfeeding Self-efficacy Scale, Maternity Social Support Scale, 7-item Generalized Anxiety Disorder Scale, and 9-item Patient Health Questionnaire were administered to evaluate multidimensional sleep health, prenatal breastfeeding self-efficacy, social support, and anxiety and depression symptoms of pregnant women, respectively. Independent t-tests and multiple linear regression were applied to explore the association between multidimensional sleep health and prenatal breastfeeding self-efficacy.</div></div><div><h3>Findings</h3><div>A total of 349 pregnant women completed the survey, with a mean age of 30.59 years (SD=3.96, Range: 20–45). The scores of sleep health and prenatal breastfeeding self-efficacy were 15.07±3.65 and 56.96±15.31, respectively. Independent t-tests revealed that pregnant women with better sleep health demonstrated significantly higher scores in prenatal breastfeeding self-efficacy, including the skills and needs and information acquisition domains (Cohen’s d ranging from 0.330 to 0.435). Moreover, the linear regression model showed that better sleep health (B=0.58, P=0.011), more social support (B=0.65, P=0.022), and current children (B=14.05, P&lt;0.001) were associated with higher prenatal breastfeeding self-efficacy, while gestational age was negatively associated with prenatal breastfeeding self-efficacy (B=−0.21, P=0.027) after adjusting for covariates.</div></div><div><h3>Conclusion</h3><div>Optimal multidimensional sleep health is associated with better prenatal breastfeeding self-efficacy, and targeted sleep health interventions should be implemented to enhance maternal sleep health and promote better breastfeeding outcomes.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104618"},"PeriodicalIF":2.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Being on the edge, longing for the hand that shows the way”- A meta-synthesis of women's experiences of midwife support during the latent phase","authors":"Karin Glad ,&nbsp;Lena Miberg ,&nbsp;Viola Nyman","doi":"10.1016/j.midw.2025.104616","DOIUrl":"10.1016/j.midw.2025.104616","url":null,"abstract":"<div><h3>Background</h3><div>Women admitted to hospital during the latent phase are at higher risk of various interventions. Maternity care should enable informed decision-making and provide continuous support throughout the different labour phases.</div></div><div><h3>Aim</h3><div>To synthesise available research on women's experiences of labour ward midwife support during the latent phase.</div></div><div><h3>Methods</h3><div>A meta-synthesis as outlined by Walsh and Downe was conducted to generate a nuanced understanding of the findings from qualitative studies. A search using key words was undertaken in the following databases: PubMed, Cinahl, Scopus, Web of science and Psycinfo. Papers were included if published since 2014, in the English language and contained qualitative data addressing the study aim.</div></div><div><h3>Findings</h3><div>A total of nine studies were included. The result was divided into three themes: Telephone calls - being listened to or not, Video calls - seeing and being seen, In-person meeting – trying to pass the admission test. Women could feel either satisfied or dissatisfied after a phone call, video call, or visit to the labour ward; hence the form of contact was not the most significant factor, but how the midwife met and treated the woman.</div></div><div><h3>Synthesis</h3><div>Women who sought professional support, emphasized the need for a sensitive and individualized approach. The midwife—via phone, video, or in person—held the authority to decide on admission.</div></div><div><h3>Conclusion</h3><div>This meta-synthesis clearly highlights the gap in available care between the late stage of pregnancy and the active phase of labour, as well as the focus of midwives in labour ward care.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104616"},"PeriodicalIF":2.5,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145220502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and preliminary testing of a scenario-based instrument to measure nutrition literacy of pregnant women","authors":"Tzu-Ling Chen ,&nbsp;Li-Ling Liao ,&nbsp;Mi-Hsiu Wei ,&nbsp;Yueh-Yin Fang ,&nbsp;Chia-Hsun Wu","doi":"10.1016/j.midw.2025.104613","DOIUrl":"10.1016/j.midw.2025.104613","url":null,"abstract":"<div><h3>Background</h3><div>Nutrition literacy (NL) during pregnancy is important for both mothers and infants. The present study aimed to develop a scenario-based instrument to measure the NL abilities of pregnant women and test the validity and reliability of this instrument.</div></div><div><h3>Methods</h3><div>The development of the instrument comprised six phases: (1) identification of key domains through literature review; (2) a Delphi survey; (3) development of a scenario-based test; (4) evaluation of content validity; (5) pilot test; and (6) assessment of the instrument’s psychometric properties.</div></div><div><h3>Results</h3><div>A convenience sample of 489 pregnant Taiwanese women was used to assess NL via a 22-item scenario-based scale across four domains: “understand”, “analyse”, “appraise”, and “apply”. Item Response Theory analysis showed that most items provided the greatest precision for respondents with low to moderate ability levels (θ = −3 to 0). Confirmatory factor analysis supported a second-order, four-factor model. Internal consistency was acceptable (Cronbach’s α = 0.78), and item-total correlations ranged from 0.31 to 0.53 (<em>p</em> &lt; 0.001), indicating strong reliability.</div></div><div><h3>Conclusion</h3><div>The validated Nutrition Literacy Scale is psychometrically sound and suitable for research, clinical use, and future interventions to improve NL and dietary behaviours during pregnancy.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104613"},"PeriodicalIF":2.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145155480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and pilot test of a CTG skills test for midwives","authors":"Maija Männistö ,&nbsp;Kristiina Heinonen ,&nbsp;Marja Härkänen ,&nbsp;Reeta Lamminpää","doi":"10.1016/j.midw.2025.104614","DOIUrl":"10.1016/j.midw.2025.104614","url":null,"abstract":"<div><h3>Background</h3><div>High-quality obstetric care promotes maternal safety and fetal well-being. Modern cardiotocography (CTG) interpretation emphasises fetal physiology rather than isolated heart rate patterns, aiming to reduce unnecessary interventions and improve outcomes. Misinterpretation of CTG remains a key contributor to substandard perinatal care. Assessing interpretation skills is essential for evaluating competence and measuring the effects of training. Regular assessment supports clinical proficiency, identifies educational needs, and ultimately enhances the quality and safety of childbirth.</div></div><div><h3>Aim</h3><div>This study aimed to develop and pilot a CTG skills test to assess midwives' interpretation skills.</div></div><div><h3>Methods</h3><div>The skills test was constructed based on the existing literature and the content validity was evaluated by an expert panel (<em>n</em> = 8) through two rounds of online surveys. The pilot test was conducted at one birthing unit with midwives (<em>n</em> = 12) to assess the feasibility of the test. Data were analysed with inductive content analysis and quantitative methods, including the content validity index and descriptive statistics.</div></div><div><h3>Results</h3><div>The CTG skills test was validated through expert review and a pilot study. It showed excellent content validity (S-CVI/Ave = 0.94). Experts and midwives found it relevant but challenging, especially in fetal physiology. Revisions made to the test improved the clarity and usability of the test. The skills test is suitable for assessing CTG competence and identifying training needs.</div></div><div><h3>Conclusions</h3><div>CTG interpretation is crucial for safe childbirth, making midwives' competence and training essential for quality obstetric care. This validated skills test helps to assess CTG skills, identify training needs, and enhance delivery safety.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104614"},"PeriodicalIF":2.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145119398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic deprivation as a risk factor for stillbirth: A case-control study","authors":"Jessica V. Keane ,&nbsp;Paul Corcoran ,&nbsp;Sara Leitao ,&nbsp;Joye McKernan ,&nbsp;Edel Manning ,&nbsp;Keelin O’Donoghue ,&nbsp;Richard A. Greene","doi":"10.1016/j.midw.2025.104615","DOIUrl":"10.1016/j.midw.2025.104615","url":null,"abstract":"<div><h3>Background</h3><div>Stillbirth is a devastating outcome for families. Identifying and addressing risk factors is of crucial importance. Level of deprivation has been linked to adverse perinatal outcomes, including stillbirth.</div></div><div><h3>Methods</h3><div>An observational case-control study was conducted, matching cases of stillbirth (<em>n</em> = 127) with a control cohort of live births (<em>n</em> = 266, ratio 2:1). Retrospective data on maternal characteristics, pregnancy details and neonatal outcomes from 2018–2021 was collected from a tertiary maternity unit in the Republic of Ireland. The Pobal HP Deprivation Index was used to categorise small areas into levels of deprivation. Maternal age, parity, BMI, booking visit gestation were considered potential confounding factors. Statistical analysis using SPSS, included: descriptive statistics, Chi-squared tests, T-tests. Logistic regression for crude and multivariate analysis, including odds ratio calculations, were used to identify differences in risk of stillbirth across the deprivation levels and categories of confounding factors.</div></div><div><h3>Results</h3><div>The results demonstrated no statistically significant correlation between level of deprivation and risk of having a stillbirth (<em>p</em> = 0.288) in this sample. When readjusted into quintiles of deprivation, a slightly higher representation of stillbirth was noted in the more deprived levels, though not statistically significant. When examining by cause of death, there was a significant association between deprivation and placental causes of death (<em>p</em> = 0.048). High BMI was consistently associated with stillbirth, while late booking visit gestation and advanced maternal age also showed associations.</div></div><div><h3>Conclusions</h3><div>This study found no clear link between deprivation and stillbirth but observed higher placental-related stillbirth in deprived quintiles, emphasising the need for further national research.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104615"},"PeriodicalIF":2.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145096736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postnatal bedsharing advice, risk and exploitation: a feminist analysis","authors":"Anna Melamed","doi":"10.1016/j.midw.2025.104612","DOIUrl":"10.1016/j.midw.2025.104612","url":null,"abstract":"<div><h3>Problem</h3><div>Breastfeeding is beneficial to babies and mothers. Postnatal bedsharing is evidenced to support breastfeeding and maternal wellbeing. Advice against bedsharing creates a barrier to breastfeeding. It also frames women as an inherent risk to their baby, something statistically untrue in the absence of known risk factors. Women are advised to both breastfeed, and to not bedshare, which sets up a contradiction. Telling mothers they are simultaneously a risk to, and a resource for, the baby, can lead to exhaustion, shame, confusion and difficulties breastfeeding.</div></div><div><h3>Discussion</h3><div>To investigate this seeming contradiction in UK breastfeeding and bedsharing advice I examine the risk discourse and Douglas’ conception of risk and pollution. To explain why women’s bodies are a site of contestation, and why some risks (overlaying) are amplified over others (lower breastfeeding rates or maternal exhaustion) I use radical materialist feminism. I argue that risk discourses and taboos around bedsharing are part of a patriarchal ontology of the sovereign individual which denies the intrinsic interdependence and relationality. Denying the centrality of the mother-baby dyad as a relation is part of the mechanism of exploitation of women. The bedsharing advice reduces the woman’s subjectivity and agency, which is to the detriment of mothers and babies because their wellbeing is interdependent.</div></div><div><h3>Conclusion</h3><div>The prevalence of bedsharing advice is explained by an ontology in which individuals are imagined as a risk and/or a resource to one another. The driving force is not the wellbeing and support of the dyad, but exploitation of women and re-enforcement of patriarchal logic. Women-centred feminist postnatal advice would better support the dyad.</div></div><div><h3>Tweetable abstract</h3><div>Advice against postnatal bedsharing positions women as a risk and resource, to the detriment of the mother-baby dyad and breastfeeding, and in service of patriarchal exploitation of women as a resource.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104612"},"PeriodicalIF":2.5,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Witnessing a loss and the lived experiences of physicians, nurses, and midwives providing care in perinatal loss in Turkey: A phenomenological study\" [Midwifery 149 (2025) 104577].","authors":"Gül Büşra Altunay, Merve Yazar Renkyorgancı, Emel Ege, Şerife Didem Kaya","doi":"10.1016/j.midw.2025.104599","DOIUrl":"https://doi.org/10.1016/j.midw.2025.104599","url":null,"abstract":"","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":" ","pages":"104599"},"PeriodicalIF":2.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Food adaptations and challenges during early pregnancy: A qualitative exploration of women’s experience","authors":"Cindy Chevalley Gerber ,&nbsp;Isabelle Carrard ,&nbsp;Marielle Schmied ,&nbsp;Raphaël Hammer","doi":"10.1016/j.midw.2025.104609","DOIUrl":"10.1016/j.midw.2025.104609","url":null,"abstract":"<div><h3>Background</h3><div>Maternal nutrition is a significant factor influencing both fetal and maternal health. Barriers to healthy eating during pregnancy have been mostly investigated in terms of nutritional awareness and compliance with nutritional guidelines. However, little is known about women’s experiences of changing dietary practices in the first trimester of pregnancy specifically.</div></div><div><h3>Aim</h3><div>To explore women’s experiences of food adaptation in the context of daily life in early pregnancy, focusing on challenges and strategies to deal with them.</div></div><div><h3>Methods</h3><div>Face-to-face semi-structured interviews were conducted with a purposeful sample of 20 pregnant women after 16 weeks’ gestation in Switzerland. Data analysis followed the principles of thematic analysis.</div></div><div><h3>Findings</h3><div>We produced three core themes – “navigating the information jungle”, “handling pregnancy symptoms”, “keeping pregnancy secret and social norms around meals” – reflecting three significant challenges women faced in early pregnancy, and eight strategies they used to deal with these challenges.</div></div><div><h3>Conclusion</h3><div>Our findings highlight that food adaptations in early pregnancy lie at the intersection of bodily, cognitive, emotional, and psychosocial dimensions of eating. The absence of consultation with a perinatal health professional characterises early pregnancy, fostering women’s anxiety and uncertainty in relation to nutritional recommendations. Pregnant women should be entitled to an earlier reimbursed follow-up appointment during the first trimester. A consultation with a midwife or a dietitian would be particularly well-suited to provide them with reassurance and to help them achieve healthy diet despite the challenges they encounter.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104609"},"PeriodicalIF":2.5,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145096735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of the clinical practice guideline on intrapartum care for low-risk births in Belgium","authors":"Yvonne J Kuipers ,&nbsp;Roxanne Bleijenbergh ,&nbsp;Eveline Mestdagh","doi":"10.1016/j.midw.2025.104606","DOIUrl":"10.1016/j.midw.2025.104606","url":null,"abstract":"<div><h3>Background</h3><div>The newest Belgian clinical practice guideline on intrapartum care for low-risk births requires support to facilitate its implementation, as merely presenting guidelines does not guarantee adoption by end-users.</div></div><div><h3>Aim</h3><div>To systematically identify and prioritise clinical questions that need greater implementation support, understand the context of barriers and facilitators to implementation, and define a set of healthcare behavioural implementation activities for Belgian maternity services.</div></div><div><h3>Methods</h3><div>We employed an integrated knowledge translation approach, combining the Knowledge-To-Action and Intervention Mapping frameworks. This approach involves identifying clinical questions that require enhanced implementation support, analysing barriers within the context, and defining change and performance objectives. Feedback from a Belgian multi-stakeholder consulting group and Advisory Board informed the process.</div></div><div><h3>Findings</h3><div>Two clinical questions require greater support for implementation: (1) initial clinical investigations during labour and (2) ongoing investigations and interventions during a low-risk birth. Barriers to applying the recommendations include individual healthcare professional factors and professional interactions. Implementation demands healthcare professionals recognise the physiological aspects of labour and birth, stay updated on the evidence, accept the evidence supporting the management of low-risk births, and involve shared decision-making while seeking the woman’s consent. Achieving behavioural change consists of shifting attitudes, intentions, knowledge, social norms, and skills.</div></div><div><h3>Discussion</h3><div>The identified barriers to implementing recommendations emphasise the crucial role of interpersonal dynamics in successful guideline implementation. Therefore, policies should tackle structural challenges within Belgian maternity care.</div></div><div><h3>Conclusion</h3><div>To enhance maternity care services, communication, collaboration, and mutual understanding across professional boundaries are needed.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104606"},"PeriodicalIF":2.5,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}