MidwiferyPub Date : 2025-06-28DOI: 10.1016/j.midw.2025.104500
Aline Seeger , Susanne Grylka-Baeschlin , Jonathan Domínguez Hernández
{"title":"The prevalence of compassion fatigue among midwives in German-speaking Switzerland: A quantitative cross-sectional study","authors":"Aline Seeger , Susanne Grylka-Baeschlin , Jonathan Domínguez Hernández","doi":"10.1016/j.midw.2025.104500","DOIUrl":"10.1016/j.midw.2025.104500","url":null,"abstract":"<div><h3>Problem</h3><div>Reports indicate that many midwives suffer from compassion fatigue (CF) as a result of exposure to heavy workloads, traumatic events, and other stressful situations.</div></div><div><h3>Background</h3><div>Studies have shown that CF often drives midwives to leave the profession. It also negatively affects their ability to provide compassionate care.</div></div><div><h3>Aim</h3><div>The study aimed to determine the prevalence of CF among midwives in German-speaking Switzerland and to examine the associations between demographic and work-related factors with CF.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted between September and December 2022, using the validated \"Professional Quality of Life\" (ProQOL) questionnaire to assess compassion fatigue. Relevant demographic and professional characteristics were added to the questionnaire. Descriptive statistics, bivariable analyses and the generalised additive model (GAM) were applied.</div></div><div><h3>Findings</h3><div>Of the 374 participating midwives, 31.8 % (<em>n</em> = 119) were affected by compassion fatigue. The GAM model indicated that frequent exposure to traumatic events had the strongest impact on compassion fatigue scores (estimate: 5.17). A smaller impact was observed for attending traumatic births occasionally (estimate: 4.16), followed by being rather/much dissatisfied with their job (estimate: 3.31) and experiencing psychological burden (estimate: 1.93). The weakest effect was found in midwives who were rather satisfied with their job (estimate: 1.49).</div></div><div><h3>Discussion</h3><div>Factors associated with CF are multidimensional and multifactorial. Identifying potential solutions and preventive measures can be complex.</div></div><div><h3>Conclusion</h3><div>Further research is essential to support midwives affected by compassion fatigue and to develop effective preventive measures.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"148 ","pages":"Article 104500"},"PeriodicalIF":2.6,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144605724","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}
MidwiferyPub Date : 2025-06-28DOI: 10.1016/j.midw.2025.104504
Thi Ly Tran , Adriana G Nevarez Flores , Eliza Nolan , Brett McDermott , Kate Chappell , Angela Hay , Amanda L Neil
{"title":"The impact of implementing universal screening for antenatal mental health conditions in Southern Tasmania, Australia: A retrospective observational study","authors":"Thi Ly Tran , Adriana G Nevarez Flores , Eliza Nolan , Brett McDermott , Kate Chappell , Angela Hay , Amanda L Neil","doi":"10.1016/j.midw.2025.104504","DOIUrl":"10.1016/j.midw.2025.104504","url":null,"abstract":"<div><h3>Problem</h3><div>The impact of universal screening for perinatal depression on referrals is unknown.</div></div><div><h3>Background</h3><div>The Australian National Perinatal Depression Initiative (NPDI) implemented in 2008 recommended universal screening of perinatal depression and provision of follow-up support and care when indicated.</div></div><div><h3>Aim</h3><div>To assess the impact of the implementation of the NPDI in public antenatal care in Southern Tasmania on screening levels and referrals provided to support services for mental health and/or psychosocial concerns.</div></div><div><h3>Methods</h3><div>Data were derived from a clinical audit of digital records for women who attended public antenatal services and gave birth from July-December 2011 (pre-implementation, <em>n</em> = 911) and 2014 (post-implementation, <em>n</em> = 896). Data included patient demographics and obstetric factors, Edinburgh Postnatal Depression Scale (EPDS) scores, and referrals given.</div></div><div><h3>Findings</h3><div>Pre-implementation, 1.32 % of women were screened with the EPDS and 95.98 % post-implementation, with 31.17 % and 26.00 % of women referred to support services respectively. Of those referred, referrals were provided at 1.25 visits on average pre-implementation, 1.57 visits post-implementation. Women younger than 20 years and women living in the most disadvantaged locations were more likely to have an EPDS score ≥10. Communication between antenatal care and primary care providers increased.</div></div><div><h3>Discussion</h3><div>Improved communication between care providers indicates a strengthened continuum of care. The impact of the concurrent introduction of an integrated care model on findings is unclear.</div></div><div><h3>Conclusion</h3><div>The introduction of the NPDI in Southern Tasmania led to higher screening rates but fewer women referred for support services. The findings support the need for embedded evaluations to ensure timely and informed decision-making.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"148 ","pages":"Article 104504"},"PeriodicalIF":2.6,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548641","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}
MidwiferyPub Date : 2025-06-27DOI: 10.1016/j.midw.2025.104506
Sara Bettison , Tracey J. Devonport
{"title":"Self-care in early motherhood: A qualitative exploration of sleep, exercise, and making time for oneself","authors":"Sara Bettison , Tracey J. Devonport","doi":"10.1016/j.midw.2025.104506","DOIUrl":"10.1016/j.midw.2025.104506","url":null,"abstract":"<div><h3>Problem</h3><div>The postpartum period is often associated with poor maternal mental health, which is of detriment to new mothers and potentially their new-born.</div></div><div><h3>Background</h3><div>Engaging in self-care behaviours is proven to prevent psychopathology and promote well-being, yet is often not prioritised among new mothers.</div></div><div><h3>Question</h3><div>This qualitative study examined new mothers’ experiences with the self-care behaviours of sleep, exercise, and having time for self.</div></div><div><h3>Methods</h3><div>Guided by the COM-B model of behaviour change, 12 women with babies less than 12-months old were interviewed to explore lived experiences regarding the three self-care behaviours. Reflexive thematic analysis was used to deductively explore capabilities, opportunities, and motivation to engage with these behaviours.</div></div><div><h3>Results</h3><div>Motivation to avoid the undesirable consequences of sleep deprivation and maintain daily functioning was high, with sleep a self-care priority. Exercise was known to be beneficial and often desirable, but often not prioritised as it was considered effortful to accommodate and undertake. Time for self was largely absent and when taken was associated with guilt.</div></div><div><h3>Discussion</h3><div>Findings highlight the need for targeted interventions that address barriers to postpartum self-care. Sleep interventions could improve sleep hygiene, exercise promotion explore the integration of movement into daily caregiving routines rather than relying on structured workouts, and finally, explore how personal time is perceived and supported to manage feelings of guilt.</div></div><div><h3>Conclusion</h3><div>By recognising and addressing challenges with maternal self-care, healthcare providers and families can better support new mothers in prioritising self-care, thus improving maternal well-being.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"148 ","pages":"Article 104506"},"PeriodicalIF":2.6,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144535844","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":"Using codesign to support the implementation of a midwifery unit in Europe","authors":"Laura Batinelli , Christine McCourt , Manila Bonciani , Lucia Rocca-Ihenacho","doi":"10.1016/j.midw.2025.104503","DOIUrl":"10.1016/j.midw.2025.104503","url":null,"abstract":"<div><h3>Background</h3><div>Midwifery units (MUs) have demonstrated to be a safe and cost-effective model of maternity care. Several European countries do not offer this model yet but are working towards its implementation to improve perinatal outcomes, service users’ and midwives’ satisfaction while making effective use of healthcare resources. Few research projects have focused on the implementation aspect. This study observed and supported the process for implementation of a new MU in Italy using participatory action research (PAR) and codesign.</div></div><div><h3>Methods</h3><div>A 4-stage project was conducted to codesign an implementation plan aimed at supporting the transition from the obstetrically led maternity unit to an integrated model with a MU. The study engaged maternity professionals, managers and service users via online focus groups and eSurveys.</div></div><div><h3>Findings</h3><div>Participants identified ten themes to focus the implementation work on: team vision, creation of a multidisciplinary advisory group, creation of a dedicated group of midwives, implementation of intrapartum guidelines for low-risk women, appropriate risk assessment, integration hospital-community, training, effective communication and information for service users and within the team, and reflective practice. Service users supported the initiatives proposed in the implementation plan and expressed openness towards the model of care and its implementation.</div></div><div><h3>Conclusions</h3><div>This was the first study using codesign and PAR including maternity team, managers and service users to support the implementation of a MU. This work showed value in a collaborative codesign approach. While this work is adapted to the Italian context, the process and findings could be useful in other international contexts.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"148 ","pages":"Article 104503"},"PeriodicalIF":2.6,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144656823","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}
MidwiferyPub Date : 2025-06-24DOI: 10.1016/j.midw.2025.104499
Huy N. Vo, Kirstie McKenzie-McHarg, Pauleen C. Bennett, Dac L. Mai
{"title":"Becoming a father in a new country and culture: Lived experiences of vietnamese perinatal fathers in Australia","authors":"Huy N. Vo, Kirstie McKenzie-McHarg, Pauleen C. Bennett, Dac L. Mai","doi":"10.1016/j.midw.2025.104499","DOIUrl":"10.1016/j.midw.2025.104499","url":null,"abstract":"<div><div>This study delved into the lived experiences of first-time Vietnamese fathers residing in Australia during the perinatal stage. Given the distinctions in parenting styles, gender norms, and cultural practices between Australians and Vietnamese, it was expected that challenges would be identified. Semi-structured interviews and Interpretative Phenomenological Analysis were used with twelve first-time fathers (average age 34.3 years). All participants and their partners were residents of Australia but had been born and raised in Vietnam. Eleven had babies (<em>M<sub>age</sub></em> = 8 months). One participant's partner was in the 7th month of pregnancy. Three prominent themes surfaced during data analysis: “Development of the Role as a Father – A New Father and Beyond”, “Negotiating the Changes – Evolving without Losing” and “Navigating Common Challenges – Applying the Old Teachings in a New Country”. Despite encountering several challenges in this important transitional stage, these first-time fathers had effectively adjusted and adapted to the new culture, employing diverse coping strategies. The findings also highlight the importance of culturally sensitive approaches in supporting this demographic. Effective support during the perinatal period goes beyond infant care, addressing both the cultural adaptation process and the challenges faced by fathers during this time.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"148 ","pages":"Article 104499"},"PeriodicalIF":2.6,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510907","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":"Incidence and associated factors of cesarean delivery following epidural analgesia for labor: A prospective cohort study at a Thai university hospital","authors":"Patchareya Nivatpumin , Namtip Triyasunant , Shusee Visalyaputra , Tripop Lertbunnaphong , Nuttawat Saenyasiri","doi":"10.1016/j.midw.2025.104501","DOIUrl":"10.1016/j.midw.2025.104501","url":null,"abstract":"<div><h3>Background</h3><div>Epidural analgesia with local anesthetics and opioids is highly effective for labor pain control. However, it may influence cesarean delivery rates. This study examined the incidence of cesarean delivery and its associated factors following epidural labor analgesia.</div></div><div><h3>Methods</h3><div>We conducted a prospective cohort study at the largest university hospital in Thailand. We enrolled women older than 18 years who received epidural labor analgesia, excluding those who could not communicate in Thai. Data were collected from intrapartum epidural recipients. Logistic regression analysis identified factors associated with cesarean delivery, presented as adjusted odds ratios (AORs) with 95 % confidence intervals (CIs).</div></div><div><h3>Results</h3><div>A total of 182 patients were included, and 54 (29.7 %; 95 % CI 23.5‒36.7) underwent cesarean delivery. Instrumental deliveries included 23 vacuum extractions (12.6 %) and 1 forceps extraction (0.5 %). Multivariate analysis identified three factors significantly associated with cesarean delivery. These included patient age > 27 years (AOR 2.708; 95 % CI 1.291‒5.679; <em>P</em> = 0.008) and no history of vaginal delivery (AOR 3.865; 95 % CI 1.668‒8.958; <em>P</em> = 0.002). Neonatal weight > 3270 g (AOR 4.870; 95 % CI 2.356‒10.036; <em>P</em> < 0.001) was also significant. Mean pain scores (numeric rating scale) decreased from 8.5 ± 1.7 to 2.2 ± 2.2 after epidural insertion (<em>P</em> < 0.001).</div></div><div><h3>Conclusion</h3><div>Approximately one-third of patients who received epidural analgesia underwent cesarean delivery. Maternal age, lack of prior vaginal delivery, and higher neonatal birth weight were significantly associated with cesarean delivery. Patients should be counseled about these factors before receiving epidural analgesia.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"148 ","pages":"Article 104501"},"PeriodicalIF":2.6,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144535787","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}
MidwiferyPub Date : 2025-06-20DOI: 10.1016/j.midw.2025.104498
Johanna Westergård , Jari Kylmä , Eija Paavilainen
{"title":"Obstetric violence in Finland: Analyzing the actions of healthcare staff in birthing narratives","authors":"Johanna Westergård , Jari Kylmä , Eija Paavilainen","doi":"10.1016/j.midw.2025.104498","DOIUrl":"10.1016/j.midw.2025.104498","url":null,"abstract":"<div><h3>Problem</h3><div>Obstetric violence is a form of gender-based violence rooted in structural inequality and discrimination. It is a globally prevalent phenomenon, affecting up to 59 % of birthing individuals globally and approximately 45 % in high-income countries. Despite its prevalence, research in Finland remains scarce, and little is known about how birthing individuals describe this phenomenon.</div></div><div><h3>Background</h3><div>Most research on obstetric violence has focused on structural and professional perspectives, with less attention to birthing individuals' experiences. Their accounts are essential for understanding how obstetric violence manifests and impacts maternity care. Studies highlight the role of communication, power dynamics, and institutional practices in shaping birthing experiences. However, research on these perceptions in Finland is limited.</div></div><div><h3>Aim</h3><div>This study aims to describe birthing individuals' experiences of healthcare staff actions in situations perceived as obstetric violence, providing insights to support ethical, patient-centered care.</div></div><div><h3>Methods</h3><div>This study employed a qualitative descriptive design with an inductive approach. Written birth narratives (<em>n</em> = 30) were analyzed using inductive content analysis. Background details such as age, number of births, or time elapsed since birth were unavailable. The narratives were coded and categorized to identify how healthcare staff actions were perceived.</div></div><div><h3>Findings</h3><div>Four categories emerged from the data: (1) ignoring, (2) manipulating, (3) showing aggression, and (4) nurturing.</div></div><div><h3>Discussion</h3><div>The findings demonstrate that obstetric violence in Finland is experienced through being ignored, manipulated, or subjected to aggression by healthcare staff. At the same time, nurturing care, characterized by compassion, professionalism, and responsible communication, was seen to protect birthing individuals' sense of dignity and sense of participation in care. These results support international evidence and underscore the importance of consistent, respectful care practices.</div></div><div><h3>Conclusion</h3><div>Preventing obstetric violence requires ethical decision-making and respect for birthing individuals' autonomy. Clinical expertise alone is insufficient; compassionate, respectful care is essential in matemity healthcare.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"148 ","pages":"Article 104498"},"PeriodicalIF":2.6,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365719","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}
MidwiferyPub Date : 2025-06-19DOI: 10.1016/j.midw.2025.104497
Milena Kovačević , Ljiljana Stanković , Branko Petrović , Aleksandra Catić Đorđević , Sandra Vezmar Kovačević , Branislava Miljković
{"title":"Promoting safe medication use during breastfeeding: uncontrolled interventional before-after study in community pharmacies","authors":"Milena Kovačević , Ljiljana Stanković , Branko Petrović , Aleksandra Catić Đorđević , Sandra Vezmar Kovačević , Branislava Miljković","doi":"10.1016/j.midw.2025.104497","DOIUrl":"10.1016/j.midw.2025.104497","url":null,"abstract":"<div><h3>Background</h3><div>Due to a lack of information or unreasonable fear of the effects of medication, breastfeeding mothers either stop taking medication or discontinue/interrupt breastfeeding while taking medication.</div></div><div><h3>Aim</h3><div>The aim of the study was to investigate and evaluate the role of community pharmacists in promoting safe medication use among breastfeeding mothers through evidence-based interventions.</div></div><div><h3>Methods</h3><div>The prospective uncontrolled interventional before- and after- study was conducted in 2022. The first phase involved a one-day comprehensive training session for community pharmacists. The second phase involved the provision and documentation of pharmaceutical care services.</div></div><div><h3>Findings and discussion</h3><div>A total of 1243 breastfeeding mothers participated in the study. Allergy, pain, sore throat, cough and urinary tract infections were the most common complaints. A total of 746 mothers (60.0 %) had been prescribed a medication while breastfeeding. The most commonly used medications were anti-infectives (15.1 %) and medications for respiratory system (10.9 %). Just over half of mothers stated that they had not received specific advice from their doctor about taking medication while breastfeeding (52.8 %). Pharmacists offered various interventions, such as dispensing a prescribed medication accompanied by breastfeeding counselling (41.8 %), recommending a change to a medication or supplement for safety reasons (15.3 %) and tailored recommendations for monitoring the infant (40.1 %). Pharmacist interventions, including the use of alternative medications/supplements, resulted in a decrease in the frequency of high-risk medications (from 1 % to 0.3 %, <em>p</em> < 0.001).</div></div><div><h3>Conclusion</h3><div>Community pharmacists play an important role in the care of breastfeeding mothers. In addition to providing breastfeeding counselling and support, community pharmacists significantly improved the safety of medications taken by using relevant sources of information.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"148 ","pages":"Article 104497"},"PeriodicalIF":2.6,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365720","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}
MidwiferyPub Date : 2025-06-18DOI: 10.1016/j.midw.2025.104475
María José Carrasco-López , Isabel Antón-Solanas , Eva Benito-Ruiz , Natalia Barrio-Forné , Carlos Navas-Ferrer , Enrique Ramón-Arbúes , Ana Belén Subirón-Valera
{"title":"Underpinnings of breastfeeding motivation: A systematic review","authors":"María José Carrasco-López , Isabel Antón-Solanas , Eva Benito-Ruiz , Natalia Barrio-Forné , Carlos Navas-Ferrer , Enrique Ramón-Arbúes , Ana Belén Subirón-Valera","doi":"10.1016/j.midw.2025.104475","DOIUrl":"10.1016/j.midw.2025.104475","url":null,"abstract":"<div><h3>Background</h3><div>Breastfeeding is a fundamental practice for child and maternal health, recommended by the World Health Organisation (WHO) and the United Nations International Children's Emergency Fund (UNICEF). However, despite its proven benefits, exclusive breastfeeding rates remain suboptimal in many countries. Mothers' motivation plays a crucial role in the initiation, continuation and prolongation of breastfeeding, but various factors can negatively influence this motivation<strong>.</strong></div></div><div><h3>Aim</h3><div>This research explores the complex motivational dynamics surrounding breastfeeding, encompassing both the intrinsic motivation of mothers and the motivational interventions of health professionals.</div></div><div><h3>Methods</h3><div>A systematic review encompassing both qualitative and quantitative inquiries, was undertaken. Research questions were formulated, and a search strategy devised, to review PubMed, Scopus, and Web of Science repositories, with a retrospective scope spanning the past three decades, applying filters and eligibility criteria. We included scientific articles whose participants were healthy mothers aged 18-48 years with uncomplicated eutocic deliveries, together with their healthy full-term infants. The study aimed to analyze the motivation for breastfeeding from the prenatal stage to prolongation beyond the two years recommended by the WHO.</div></div><div><h3>Findings</h3><div>A total of 23 studies, from a variety of perspectives and sociocultural contexts, were identified and recovered. Average breastfeeding duration was 2.73 months shorter than the recommended 6-month period. Deciding to breastfeed \"as long as possible\" and prior breastfeeding experience were associated with meeting breastfeeding expectations. Instead, maternal age, caesarean delivery, and socio-environmental factors negatively affected the breastfeeding process. Our findings highlighted intrinsic maternal motivations and the impact of healthcare professional interventions, revealing the complex interplay of psychological, social, and cultural factors in breastfeeding decisions.</div></div><div><h3>Conclusion</h3><div>An exhaustive typological analysis of maternal motivation throughout breastfeeding phases is feasible. Motivational dynamics may vary, concretely influencing breastfeeding exclusivity and duration. These dynamics are foreseen by maternal intent and bolstered by self-efficacy conducive to successful progression. Furthermore, sociocultural and clinical variables modulate motivational pathways. In-depth analysis allows for more effective professional interventions within the framework of humanized care and the development of innovative health plans and policies.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"148 ","pages":"Article 104475"},"PeriodicalIF":2.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144501512","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}
MidwiferyPub Date : 2025-06-18DOI: 10.1016/j.midw.2025.104496
Seyedeh Samira Mokhlesi , Vidanka Vasilevski , Linda Sweet
{"title":"Factors associated with breastfeeding in women with a history of bariatric surgery: A cross-sectional survey study","authors":"Seyedeh Samira Mokhlesi , Vidanka Vasilevski , Linda Sweet","doi":"10.1016/j.midw.2025.104496","DOIUrl":"10.1016/j.midw.2025.104496","url":null,"abstract":"<div><h3>Background</h3><div>As bariatric surgery rates rise among women of reproductive age, more are becoming pregnant post-surgery. These mothers have lower breastfeeding rates than those without bariatric surgery. Evidence on breastfeeding after bariatric surgery is limited, and the factors contributing to early cessation are not fully understood.</div></div><div><h3>Aim</h3><div>Identify the factors associated with exclusive breastfeeding and breastfeeding duration among mothers who have undergone bariatric surgery before pregnancy.</div></div><div><h3>Methods</h3><div>A cross-sectional online survey was conducted among women in Australia who had pre-pregnancy bariatric surgery. Data were collected using a demographic questionnaire and the Breastfeeding after Bariatric Surgery Scale (BBSS). Descriptive statistics and association analysis were conducted.</div></div><div><h3>Findings</h3><div>A total of 221 mothers completed the survey. Most participants (81.4 %) intended to exclusively breastfeed, with 59 % planning to continue for at least six months. However, only 47 % exclusively breastfed during the first three months. Intention to breastfeed was significantly associated with exclusive breastfeeding during the first three months postpartum (OR=5.41, 95 % CI: 1.30–22.41, <em>p</em> = 0.02) and with lower odds of stopping breastfeeding before six months (OR=0.16, 95 % CI: 0.03–0.71, <em>p</em> = 0.01). Mothers with real or perceived milk supply issues were 82 % less likely to exclusively breastfeed (OR = 0.18, 95 % CI: 0.07 – 0.45, <em>p</em> < 0.001), and those with loose breast skin were 75 % less likely to continue breastfeeding beyond 6-month (OR=0.24, 95 % CI: 0.08–0.77, <em>p</em> = 0.01), compared to those without these breastfeeding challenges.</div></div><div><h3>Conclusion</h3><div>A gap exists between breastfeeding intention and practice among post-bariatric surgery mothers. Unique challenges related to bariatric surgery can impact breastfeeding outcomes.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"148 ","pages":"Article 104496"},"PeriodicalIF":2.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144330053","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}