Midwifery最新文献

{"title":"A qualitative exploration of perceptions of the aetiology of preterm birth among pregnant Black women","authors":"Emily Dove-Medows ,&nbsp;Jenna M. Wheeler ,&nbsp;Lindsey Esparza ,&nbsp;Dawn P. Misra ,&nbsp;Carmen Giurgescu","doi":"10.1016/j.midw.2025.104365","DOIUrl":"10.1016/j.midw.2025.104365","url":null,"abstract":"<div><h3>Background</h3><div>Preterm birth (PTB; &lt;37 weeks completed gestation) is a significant public health problem with both acute and long-term ramifications for individuals and families. Despite decades of research, inequities in health outcomes persist in the United States such that Black women are nearly 1.6 times more likely to experience PTB compared to white women. In order to adequately address persistent inequities in PTB, more must be understood from the nuanced experiences of Black women. The purpose of this qualitative study was to explore how pregnant Black women perceive the aetiology of PTB.</div></div><div><h3>Methods</h3><div>Data were collected as part of the Biosocial Impact on Black Birth (BIBB) study which prospectively explored the structural and maternal factors on birth outcomes among self-identified Black women between the ages of 18 and 45 who had singleton pregnancies and were between 8- and 30-weeks’ gestation. Semi-structured interviews were conducted remotely using telephone, were anonymized and transcribed, and analysed using thematic analysis.</div></div><div><h3>Results</h3><div>A total of 61 participants completed interviews. Three main themes developed: (1) Doing Too Much; (2) Black Women Have it Harder; and (3) Patriarchy and Privilege.</div></div><div><h3>Conclusion</h3><div>There is a complex and layered structure in place for Black women which reinforces that the responsibility for PTB belongs to those who experience it the most. Although study participants alluded to the structural vulnerabilities and intersectional stigma, participants turned inward to themselves and to their group identity to explain PTB.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"145 ","pages":"Article 104365"},"PeriodicalIF":2.6,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143620477","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":"Best practice guidelines and service provision for supporting women with birth-related trauma: A scoping review of international literature","authors":"Harriet Donegan ,&nbsp;Lin Zhao ,&nbsp;Suzi Mansu","doi":"10.1016/j.midw.2025.104364","DOIUrl":"10.1016/j.midw.2025.104364","url":null,"abstract":"<div><h3>Problem</h3><div>Birth trauma (BT) is a significant public health concern affecting approximately one-third of the 140 million annual births worldwide, yet it lacks a unified approach for effective intervention. This study investigates the global landscape of BT management, focusing on the current best practice guidelines and service provisions for supporting women with birth-related trauma and the practicable actionable gaps that needs to be addressed.</div></div><div><h3>Methods</h3><div>This scoping review followed the PRISMA Extension for Scoping Reviews guidelines, and systematically searched 13 electronic databases and websites for clinical guidelines, policy documents, care standards, practice recommendations and service provisions related to BT. The search yielded eight guidelines, of which were assessed using the AGREE II appraisal tool. Additionally, eight peer-reviewed articles focusing on current practices and service recommendations were analysed alongside the guidelines using a narrative synthesis approach.</div></div><div><h3>Findings</h3><div>There are gaps between guideline recommendations and service experiences, barriers and facilitators at the patient, provider, and system levels as well as between research, policy and clinical practice. Of the guidelines included, only three rated high quality (&gt;70 %).</div></div><div><h3>Discussion</h3><div>There was consistency in recommending trauma-informed care, collaborative care between health professionals, patient and practitioner education and debriefing as an intervention. However, there were inconsistencies in the definition of BT and most lacked details on the steps, structure or practical tools that should be used. Seven key themes were identified regarding gaps between proposed guidelines and actual experiences of women after traumatic birth.</div></div><div><h3>Conclusion</h3><div>There is an urgent need for standardised, evidence-based guidelines that are user-friendly and provide practical advice for implementing trauma-informed care.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"145 ","pages":"Article 104364"},"PeriodicalIF":2.6,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Choosing for a Homebirth during COVID-19 Lockdown in The Netherlands, who and why: A national prospective questionnaire study","authors":"Benjamin Y. Gravesteijn ,&nbsp;Nienke Boderie ,&nbsp;Roseriet Beijers ,&nbsp;Loes Bertens ,&nbsp;Thomas van den Akker ,&nbsp;Jeroen van Dillen ,&nbsp;Arie Franx ,&nbsp;Marion van den Heuvel ,&nbsp;Ank de Jonge ,&nbsp;Brenda Kazemier ,&nbsp;Igna Kwint-Reijnders ,&nbsp;Ben Willem Mol ,&nbsp;Sylvia A. Obermann-Borst ,&nbsp;Lilian Peters ,&nbsp;Stefania Vacaru ,&nbsp;Carolina de Weerth ,&nbsp;Sam Schoenmakers ,&nbsp;Christianne de Groot ,&nbsp;Jasper V. Been ,&nbsp;PREPARE consortium","doi":"10.1016/j.midw.2025.104361","DOIUrl":"10.1016/j.midw.2025.104361","url":null,"abstract":"<div><h3>Objective</h3><div>During the first COVID-19 lockdown in the Netherlands (9 March–1 June 2020), the homebirth rate increased from 27 % to 37 % among women with low-risk pregnancies starting labour in primary midwife-led care (overall population: 15 % in 2020). We explored characteristics and motivations of women who change their preference from a hospital birth to a home birth.</div></div><div><h3>Design</h3><div>A nationwide prospective online questionnaire.</div></div><div><h3>Setting</h3><div>Questionnaires were distributed during the first COVID-19 wave (4 April-11 May 2020), as well as at follow-up (infant ±6 months old).</div></div><div><h3>Population</h3><div>Women who were pregnant during the first COVID-19 wave (N = 778), who either changed their preferred birth location from a hospital to a home birth or who maintained their original preference.</div></div><div><h3>Methods and main outcome measures</h3><div>We compared characteristics, anticipatory worries, and mental health between these groups, using descriptive statistics.</div></div><div><h3>Results</h3><div>The most frequently reported change in preferred birth location among included women was from a hospital to a homebirth (15 %). This was primarily experienced as a choice rather than out of necessity (84 %). Women preferring homebirths had fewer risk factors (-11 %, 95 % CI: -5 % to -16 %) and had higher COVID-19 related worry scores (+0.09, 95 % CI: 0.01 to 0.18; for scale: IQR 0.45–1.09) compared to women who maintained their original preference. Main concerns were the absence of the support of friends or family during or after birth, and exposure to COVID-19.</div></div><div><h3>Conclusion</h3><div>During the first COVID-19 lockdown in the Netherlands, women changing their preferred location of birth to a homebirth had fewer risk factors and more COVID-19 related worries pertaining to a hospital birth.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"144 ","pages":"Article 104361"},"PeriodicalIF":2.6,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience of contraceptive care by midwives for nonpostpartum individuals in the Netherlands: A mixed methods study","authors":"Merel Sprenger ,&nbsp;Megan D. Newton ,&nbsp;Renee N.N. Finkenflügel ,&nbsp;Matty R. Crone ,&nbsp;Jessica C. Kiefte-de Jong ,&nbsp;M. Nienke Slagboom","doi":"10.1016/j.midw.2025.104362","DOIUrl":"10.1016/j.midw.2025.104362","url":null,"abstract":"<div><div>Since 2015, Dutch midwives have been authorised to prescribe all contraception. Initially providing contraceptive care to postpartum clients, they increasingly offer it to anyone. It remains unknown how this broader population experiences this care. Therefore, this mixed methods study aims to explore experiences of nonpostpartum individuals receiving contraceptive care from Dutch primary care midwives. At 15 practices in the Netherlands, participants were recruited to complete a survey and participate in an in-depth semi-structured interview, both based on Levesque's Conceptual Framework of Access to Health. Univariate and multivariate logistic regression analyses were applied to survey data (<em>n</em> = 91) and thematic analysis to interview data (<em>n</em> = 10). Most survey participants (87.8 %) received an intrauterine device during their appointment. A majority (58.2 %) rated their care a 10 out of 10. Giving full marks was significantly associated with a higher perceived income (adjusted OR = 3.19, 95 % CI = 1.21–8.81, <em>p</em> = 0.021), adjusted for appointment type and time since appointment. Participants reported receiving understandable information, being taken seriously, and having enough time during their appointment. Interviews revealed that participants especially appreciate how midwives make them feel at ease, midwives’ expertise, and the convenience of access. To conclude, given the positive experiences reported by nonpostpartum individuals with contraceptive care from midwives, efforts should be made to improve task sharing and to increase awareness of midwives as contraception providers. Future research should compare care experiences across all types of providers (including midwives, general practitioners, abortion doctors, and gynaecologists) amongst a more representative population.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"145 ","pages":"Article 104362"},"PeriodicalIF":2.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143637585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women's perceptions of maternal and fetal health benefits of physical activity during pregnancy and what factors impact them—A cross-sectional study","authors":"Alexander F. Mahen ,&nbsp;Annalise O. Wihongi ,&nbsp;Christopher P. Connolly","doi":"10.1016/j.midw.2025.104363","DOIUrl":"10.1016/j.midw.2025.104363","url":null,"abstract":"<div><h3>Background</h3><div>Despite the WHO and ACOG's recommendations for at least 150 min of weekly moderate-intensity physical activity during pregnancy, adherence remains low, partly due to concerns about safety and efficacy of specific exercise modalities.</div></div><div><h3>Objective</h3><div>To evaluate pregnant women's outcome expectancy for maternal and fetal health regarding specific physical activity modalities and the influence of healthcare provider discussions on these perceptions.</div></div><div><h3>Methods</h3><div>A cross-sectional survey, distributed through Qualtrics (a platform to help design and distribute surveys) and word of mouth of 507 pregnant women assessed perceptions of moderate, vigorous, and resistance activities. Provider discussions and past adverse pregnancy experiences were likewise examined for their influence on outcome expectancy.</div></div><div><h3>Results</h3><div>Walking and yoga were perceived as the most beneficial modalities for both maternal and fetal health, with the outcome expectancies being 9.5 ± 2.1 and 8.8 ± 2.9 for maternal health and 9.0 ± 2.5 and 8.2 ± 3.0 for fetal health. Higher intensity and resistance activities were viewed less favorably, especially CrossFit® resistance training with outcome expectancies being 5.2 ± 3.4 for maternal health and 4.8 ± 3.3 for fetal health. All physical activities were viewed as more beneficial for maternal health than fetal health. Discussions with healthcare providers occurred in over 70 % of cases but did not generally relate to these perceptions. Past adverse pregnancy experiences were not related to statistically significant changes in outcome expectancy. Previously being prescribed bed rest had some weak associations with greater maternal and fetal outcome expectancy for a few physical activity modalities.</div></div><div><h3>Conclusions</h3><div>Pregnant women's perceptions of health benefits clearly differ based on modality of activity and dependent on whether maternal or fetal health. Targeted communication strategies from healthcare providers and public health efforts are needed to improve perceptions of physical activity during pregnancy, especially for vigorous and resistance activities.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"145 ","pages":"Article 104363"},"PeriodicalIF":2.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"History of mental health problems moderates the association between partner support during childbirth and women's mental health in the postpartum period","authors":"Daniela Tavares ,&nbsp;Daniela Fidalgo ,&nbsp;Matilde Sousa ,&nbsp;Ana Morais ,&nbsp;Inês Jongenelen ,&nbsp;Diogo Lamela ,&nbsp;Stephanie Alves ,&nbsp;Raquel Costa ,&nbsp;Tiago Miguel Pinto","doi":"10.1016/j.midw.2025.104359","DOIUrl":"10.1016/j.midw.2025.104359","url":null,"abstract":"<div><h3>Background</h3><div>Partner support during childbirth is an important protective factor for women's perinatal mental health. However, its protective role in women experiencing vulnerabilities is largely unknown, namely in those with history of mental health problems.</div></div><div><h3>Aim</h3><div>This study analysed (1) the association between partner support during childbirth and depressive, anxiety, and childbirth-related post-traumatic stress disorder symptoms in the postpartum period; and (2) the moderating role of previous diagnosis of mental health problems in those associations.</div></div><div><h3>Design</h3><div>Cross-sectional study with 284 women.</div></div><div><h3>Methods</h3><div>At 2 months postpartum, participants reported on sociodemographic, obstetric, and mental health-related data, partner support during childbirth, and depressive (Edinburgh Postnatal Depression Scale), anxiety (State Anxiety Inventory), and childbirth-related post-traumatic stress disorder (City Birth Trauma Scale) symptoms.</div></div><div><h3>Findings</h3><div>More partner support during childbirth was associated with lower depressive, anxiety, and childbirth-related post-traumatic stress disorder symptoms. Previous diagnosis of mental health problems was associated with higher depressive, anxiety, and childbirth-related post-traumatic stress disorder symptoms and moderated the association between partner support during childbirth and depressive and anxiety symptoms. Higher partner support during childbirth was associated with lower depressive and anxiety symptoms, only in women without a previous diagnosis of mental health problems.</div></div><div><h3>Discussion</h3><div>Findings suggest that partner support during childbirth can be a protective factor for women's postpartum mental health, particularly for women without a previous diagnosis of mental health problems. However, for those with a previous diagnosis of mental health problems, this support was not associated with symptoms.</div></div><div><h3>Conclusion</h3><div>Women with a history of mental health problems may require additional support beyond that provided by their partners to prevent or mitigate postpartum mental health problems.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"144 ","pages":"Article 104359"},"PeriodicalIF":2.6,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143551323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary management in the first stage of labor: A scoping review","authors":"Peimin Xie ,&nbsp;Linglin Pan ,&nbsp;Hong Li ,&nbsp;Xiaojing Hu ,&nbsp;Yiting Xu ,&nbsp;Lina Yang ,&nbsp;Rong Huang","doi":"10.1016/j.midw.2025.104343","DOIUrl":"10.1016/j.midw.2025.104343","url":null,"abstract":"<div><h3>Aims</h3><div>The aims herein are to describe the principal components of dietary management during the first stage of labor and to assess the outcome of childbirth.</div></div><div><h3>Design</h3><div>A scoping review.</div></div><div><h3>Methods</h3><div>We conducted a systematic search of eight databases from database establishment until June 30, 2024. Papers accessed through manual searching were also listed. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for Scoping Reviews in our research. Two independent reviewers screened the papers, extracted the data, and synthesized the findings using a table.</div></div><div><h3>Results</h3><div>After systematic searching, 10 articles on diet management during the first stage of labor were included in this scoping review. We identified six primary components by analyzing the implementation of this diet management model. By extracting data, we concluded that this dietary management can exert a positive effect on birth outcomes by shortening the labor process and reducing postpartum hemorrhage. It is evident that our dietary management model is feasible and can improve birth outcomes. Further research, however, is required to strengthen the evidence that dietary management during the first stage of labor will improve birth outcomes.</div></div><div><h3>Impact</h3><div>This scoping review provided evidence for the positive role of dietary management during the first stage of labor on birth outcomes. We posit that our analysis will contribute to the implementation of dietary management during the first stage of labor.</div></div><div><h3>No patient or public contribution</h3><div>No further public or patient contribution was made in view of the review-based nature of this investigation.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"144 ","pages":"Article 104343"},"PeriodicalIF":2.6,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating a midwife-led consultation for women after a traumatic birth experience: Preliminary results","authors":"Valérie Avignon ,&nbsp;Valentine Annen ,&nbsp;David Baud ,&nbsp;Julie Bourdin ,&nbsp;Antje Horsch","doi":"10.1016/j.midw.2025.104358","DOIUrl":"10.1016/j.midw.2025.104358","url":null,"abstract":"<div><h3>Background</h3><div>Approximately 9 to 50 % of women report a traumatic birth experience and 12 % develop childbirth-related posttraumatic stress disorder symptoms (CB-PTSS). A recent study using a postpartum midwifery-led counselling session showed promising results in reducing CB-PTSS, but more evidence is needed.</div></div><div><h3>Objectives</h3><div>The main objective of the study was to evaluate the impact of a midwifery-led counselling session 6 weeks post-partum or later, on depression and CB-PTSS.</div></div><div><h3>Study Design</h3><div>The pre-post-intervention study, including 159 women, took place in a Swiss 18 university hospital. It was designed as a healthcare service quality project and therefore was therefore not registered a priori in a clinical trial registry. Ethical approval from the institutional board was obtained (n° 2020–06). A midwifery-led counselling session, six weeks or more after birth, allowed women to discuss their childbirth experience and to receive additional information about childbirth. Women completed the Edinburgh Postnatal Depression Scale (EPDS) and the PTSD Checklist for DSM-5 (PCL-5) two weeks before and three months after the consultation.</div></div><div><h3>Results</h3><div>Results showed a significant decrease in depression and CB-PTSS, and in cases with probable childbirth-related posttraumatic stress disorder diagnosis (CB-PTSD): 24.7 % (36/146) before counselling versus 6.3 % (5/80) three months after (<em>p</em> &lt; 0.01). The session was rated as extremely/very satisfactory by 91 % of women and extremely/very useful by &gt;87 % of women. No associations were found between depression and CB-PTSD scores and obstetrical or neonatal data.</div></div><div><h3>Conclusion</h3><div>A midwifery-led single-session offered to women 6 weeks or more after birth seemed to be associated with a decrease of depression and CB-PTSS. However, the attrition rate (49 %) made definitive conclusions difficult. More research is needed with a larger sample, a randomized design, and a wait-list control group to consider the effect of time on depression or CB-PTSS.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"144 ","pages":"Article 104358"},"PeriodicalIF":2.6,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What are the experiences of women and midwives of non-severe perineal trauma assessment? A meta-synthesis","authors":"Giada Giusmin,&nbsp;Ginny Mounce,&nbsp;Sue Schutz","doi":"10.1016/j.midw.2025.104360","DOIUrl":"10.1016/j.midw.2025.104360","url":null,"abstract":"<div><h3>Background</h3><div>In the UK, most women giving birth vaginally experience perineal trauma, predominantly non-severe, yet there is no validated assessment tool to evaluate wound healing postnatally. Current NICE guidelines provide only generic advice on how to complete this assessment, exposing the potential for a variety of non-standardised practices. Criticism of UK postnatal care is widespread, and inadequate perineal trauma assessment might contribute to this.</div></div><div><h3>Question</h3><div>What are the experiences of women and midwives of non-severe perineal trauma assessment?</div></div><div><h3>Methods</h3><div>Systematic literature review with meta-synthesis using three online databases. Data was synthesised using constant comparative analysis.</div></div><div><h3>Databases</h3><div>CINAHL, PubMed, and Web of Science.</div></div><div><h3>Findings</h3><div>Nine studies exploring the experiences of women (8/9) and midwives (1/9) on non-severe perineal trauma were included. Three themes emerged: ‘<em>How society and healthcare professionals are silencing women's experiences</em>’, ‘<em>The inadequate provision of perineal care</em>’, and ‘<em>A glimmer of hope, examples of positive experiences</em>’.</div></div><div><h3>Discussion</h3><div>Women report being underprepared about the extent of their perineal trauma, the potential impact on their lives and the services available if concerns. Some women are not offered perineal assessment and feel their concerns are trivialised by clinicians. These issues are not unique to the UK, as similar challenges exist globally. Improving postnatal care requires better communication, a therapeutic woman-midwife relationship, and societal change to reduce stigma around perineal trauma, which impacts women's psycho-physical health.</div></div><div><h3>Conclusion</h3><div>Improving postnatal perineal trauma care is crucial, with research needed on assessment practices and tools. Therapeutic relationships and women-centred clinical pathways can enhance experiences.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"144 ","pages":"Article 104360"},"PeriodicalIF":2.6,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disgust sensitivity in the first trimester predicts anxiety levels in advanced pregnancy","authors":"Lea Takács ,&nbsp;Jana Ullmann ,&nbsp;Daniela Dlouhá ,&nbsp;Catherine Monk ,&nbsp;Kamila Nouzová ,&nbsp;Hana Hrbáčková ,&nbsp;Šárka Kaňková","doi":"10.1016/j.midw.2025.104357","DOIUrl":"10.1016/j.midw.2025.104357","url":null,"abstract":"<div><h3>Problem</h3><div>Disgust contributes to anxiety-based psychopathology, and in turn, anxiety increases disgust proneness.</div></div><div><h3>Background</h3><div>Disgust and anxiety undergo significant changes in pregnancy, but no previous study has examined their longitudinal associations in this time period.</div></div><div><h3>Aim</h3><div>This prospective longitudinal study aimed to identify longitudinal associations between disgust sensitivity and state anxiety across the three trimesters of pregnancy, while exploring the directionality of the effect between those two variables.</div></div><div><h3>Methods</h3><div>At each trimester of pregnancy, the pregnant women (<em>n</em> = 261) completed the Disgust Scale-Revised (DS-R), the Pathogen disgust domain of the Three Domains of Disgust Scale (TDDS), and the State-Trait Anxiety Inventory. A path analysis (structural equation model) was used to assess cross-lagged effects between disgust sensitivity and state anxiety across the three pregnancy trimesters.</div></div><div><h3>Findings</h3><div>We found significant cross-lagged associations between disgust and anxiety such that higher disgust (overall DS-R score, Core disgust subscale of DS-R and Pathogen disgust domain of TDDS) in the first trimester predicted greater anxiety in the third. No significant cross-lagged associations were found between Animal-reminder or Contamination disgust subscales of DS-R and state anxiety. State anxiety did not predict disgust sensitivity at any time point.</div></div><div><h3>Discussion</h3><div>Our results indicate a unidirectional association between disgust sensitivity and state anxiety in pregnant women such that disgust sensitivity in early pregnancy predicts state anxiety in late pregnancy, but anxiety does not predict disgust sensitivity at any time point.</div></div><div><h3>Conclusion</h3><div>Assessing disgust in early pregnancy could help to identify women at risk of higher anxiety levels in advanced pregnancy.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"144 ","pages":"Article 104357"},"PeriodicalIF":2.6,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593215","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}