Midwifery最新文献

{"title":"The effect of early skin-to-skin contact on pain and anxiety during episiotomy repair: A systematic review and meta-analysis of randomized controlled trials","authors":"Saeed Baradwan ,&nbsp;Bandr Hafedh ,&nbsp;Khalid Khadawardi ,&nbsp;Noor Alanazi ,&nbsp;Afnan Baradwan ,&nbsp;Yasser Mohamed Said Diab ,&nbsp;Bahaa Eldin Elmohamady Mohamed ,&nbsp;Mohamed Ali Mohamed ,&nbsp;Ateia Ahmad Ateia Abdelaziz ,&nbsp;Elsayed Mohammad Taha ,&nbsp;Abdullah Gamal Mostafa Mohammed ,&nbsp;Albayoumi AB Fouda ,&nbsp;Somaia Ragab Eid Mohamed ,&nbsp;Ahmed Mohamed Abdelhakim ,&nbsp;Mohammed Mamdouh Saleh","doi":"10.1016/j.midw.2025.104460","DOIUrl":"10.1016/j.midw.2025.104460","url":null,"abstract":"<div><h3>Objectives</h3><div>Episiotomy pain contributes to mothers' apprehension about vaginal birth and preference for cesarean sections. Analgesics like lidocaine-related drugs for nerve blockage, as well as sedatives and sleep-inducing medications to alleviate pain and anxiety during episiotomy repair have several side effects. We aimed to investigate the impact of skin-to-skin contact (SCC) on pain and anxiety levels during episiotomy repair.</div></div><div><h3>Methods</h3><div>We conducted a comprehensive search of four electronic databases (PubMed, Scopus, Cochrane Library, and ISI Web of Science) to identify eligible randomized controlled trials (RCTs) from inception to January 2024. Studies were included if they compared skin-to-skin contact as an intervention during episiotomy repair with a control group that did not receive SSC. A meta-analysis was performed using RevMan software. The primary outcome was pain intensity during and after episiotomy repair, assessed using the 10-cm Visual Analog Scale (VAS). The secondary outcome was anxiety levels during the procedure, measured using the Spielberger State-Trait Anxiety Inventory (STAI) questionnaire. To evaluate the quality of included studies, we used the Cochrane Risk of Bias tool (RoB 1).</div></div><div><h3>Results</h3><div>Six RCTs, encompassing 833 women, met the inclusion criteria. The results showed that SSC led to a significant decrease in pain scores during and after episiotomy repair (<em>p</em> &gt; 0.001). The anxiety levels during the procedure were also significantly lowered in the SSC group compared to the control group.</div></div><div><h3>Conclusion</h3><div>Skin-to-skin contact has been demonstrated as an effective method for alleviating pain and anxiety during episiotomy repair.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"148 ","pages":"Article 104460"},"PeriodicalIF":2.6,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144139649","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":"Point of care ultrasound screening, performed by midwives, outperforms standard selective screening for hip dysplasia. A diagnostic accuracy study","authors":"Hans-Christen Husum ,&nbsp;Rikke Damkjær Maimburg ,&nbsp;Michel Bach Hellfritzsch ,&nbsp;Bjarne Møller-Madsen ,&nbsp;Mads Henriksen ,&nbsp;Natallia Lapitskaya ,&nbsp;Søren Kold ,&nbsp;Ole Rahbek","doi":"10.1016/j.midw.2025.104459","DOIUrl":"10.1016/j.midw.2025.104459","url":null,"abstract":"<div><h3>Background and purpose</h3><div>To investigate the accuracy of pubo-femoral distance (PFD) ultrasound (US) performed by midwives as a referral criterion for diagnostic Graf hip US, compared to standard screening for developmental dysplasia of the hip (DDH) in newborns.</div></div><div><h3>Methods</h3><div>PFD US screening was performed along standard screening for DDH in a prospective cohort. The accuracy of PFD US was compared to the standard referral criteria for diagnostic hip US in terms of sensitivity, specificity and positive predictive value in detecting abnormal hips, as well as proportion of abnormal hips found and referral rates.</div></div><div><h3>Results</h3><div>We included 2735 newborns of which 488 received a diagnostic hip US. Mean age at diagnostic US was 35.5 days (±12.8). 317 newborns (11.7 %) were referred by Danish standard screening criteria and 206 newborns (7.6 %) were referred by the PFD criterion.</div><div>Sensitivities/specificities for detecting ≥Graf type IIc hips were: 50 %/68 % for risk factors, 30 %/94 % for clinical examination, 60 %/62 % for risk factors + clinical examination, and 80 %/89 % for PFD US using a cut-off of 6.2 mm. Difference in sensitivity between PFD and standard screening criteria did not reach statistical significance, but specificity and PPV did.</div><div>The number of detected ≥ Graf type IIc hips were 6 and 9 for standard screening and PFD screening respectively.</div></div><div><h3>Interpretation</h3><div>Early point-of-care PFD US screening for DDH has significantly higher accuracy in classifying abnormal hips, when compared to standard screening. PFD US increases the detection rate of dysplastic hips (≥ Graf IIc) by 60 % while reducing referral rates.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"147 ","pages":"Article 104459"},"PeriodicalIF":2.6,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071159","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":"Black women perceptions regarding the birthing experience: A qualitative study","authors":"Amanda Dantas-Silva ,&nbsp;Odette del Risco Sánchez ,&nbsp;Debora Bicudo Faria-Schützer ,&nbsp;Silvia Maria Santiago ,&nbsp;Fernanda Garanhani Surita","doi":"10.1016/j.midw.2025.104458","DOIUrl":"10.1016/j.midw.2025.104458","url":null,"abstract":"<div><h3>Background</h3><div>Positive experience of labour and birth is an outcome that should be sought in all maternity services. Negative birthing experiences are associated with poorer health outcomes and preventing them improves the quality of maternity care. Racial disparities impact negatively in maternal health and reflect structural inequalities in health. Understanding Black women’s perspectives and expectations regarding birth can help to improve the quality of care.</div></div><div><h3>Aim</h3><div>this study aims to realize the meanings Black women attribute to their birthing experiences.</div></div><div><h3>Methods</h3><div>We developed a qualitative study through open, face-to-face, semi-structured interviews with postpartum Black women in a maternity care service in Southeast Brazil. For data analysis, we conducted a thematic analysis to identify codes, themes, and subthemes of the data based on the academic work of researchers on the ethno-racial theme in the Brazilian context and woman-centered care framework.</div></div><div><h3>Findings</h3><div>We interviewed 21 postpartum women between October 2023 and February 2024. Based on the analysis, three themes were identified: (1) The unspoken: experiences of skin colour and maternity care; (2) The many manifestations of pain in the birth experience; (3) Autonomy and information: the lack of information can lead to a feeling of losing control of the process.</div></div><div><h3>Conclusion</h3><div>In our study, Black women denied skin colour influence over their birthing experience and reported pain in its various manifestations, both physical and psychological, and lack of information and autonomy. These reflect the complexity of racism regarding obstetric care, and highlights the importance of woman-centered and respectful maternity care.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"147 ","pages":"Article 104458"},"PeriodicalIF":2.6,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144138749","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":"Improving respectful maternity care through group antenatal care: Findings from a cluster randomized controlled trial","authors":"Theresa Norpeli Lanyo ,&nbsp;Ruth Zielinski ,&nbsp;Vida A. Kukula ,&nbsp;Veronica E․A Apetorgbor ,&nbsp;Bidisha Ghosh ,&nbsp;Nancy A. Lockhart ,&nbsp;Jody R. Lori","doi":"10.1016/j.midw.2025.104457","DOIUrl":"10.1016/j.midw.2025.104457","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Disrespect and patient mistreatment have been cited as barriers to adherence and healthcare utilization, contributing to the slow progress in meeting maternal and child health targets, particularly in Ghana. Group antenatal care, an alternative to routine individualized care, is recommended by the World Health Organization as an effective service delivery model for low- and middle-income countries. This study examined the impact of group antenatal care on respectful maternity care compared to individual-based antenatal care, including mothers' perceptions of respectful care.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We conducted a cluster randomized controlled trial (RCT: NCT04033003) across 14 health facilities in the Eastern Region of Ghana from September 2018 to August 2024. Facilities were randomized using a matched-pairs design. Pregnant women were recruited using predetermined inclusion criteria with a total sample size of 1761. Written and verbal consent were obtained. Data on respectful maternity care-related outcomes were collected at time 2 (6 weeks postpartum). Data were analyzed on an intent-to-treat basis. Chi-square test was used to compare the outcome between the group antenatal (intervention) (&lt;em&gt;n&lt;/em&gt; = 877) and individual (control) groups (&lt;em&gt;n&lt;/em&gt; = 884). Results are reported individually as percentages with significance set at a &lt;em&gt;p&lt;/em&gt;-value less than 0.05. Focus group discussions were conducted with women as part of a process evaluation. Content analysis was employed for the qualitative data.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Women in the group antenatal care reported greater respectful maternity outcomes than those in the control group (93.5 % vs. 83 %). A greater proportion (84 %) of midwives introduced themselves in the intervention group compared to 53 % in the control group. Waiting times were reduced (92 % vs. 81 %, &lt;em&gt;p&lt;/em&gt; &lt; 0.0001) in the intervention groups. Informed consent was also higher (95 % vs. 81 %). Women reported receiving information on nutrition (99.7 % vs. 94 %), what to expect during delivery (95 % vs. 87 %), delivery plans (99 % vs. 87 %), where to go to when complications arise (97 % vs. 94 %); breastfeeding (97 % vs. 81 %). Qualitative results indicated that group care ensured privacy and confidentiality, upheld dignity, was free from abuse and mistreatment, and generally contributed to satisfaction with group antenatal care.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Group antenatal care is an innovative strategy that promotes respectful maternity care, which is crucial for enhancing care quality and adherence among pregnant women. By improving respect in care through group antenatal care, we can address inequities, promote maternal health, and contribute to the achievement of Sustainable Development Goal 3 globally and in Ghana. These insights underscore the potential of group antenatal care as an impactful intervention to enhance respectful maternity care.&lt;/div","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"147 ","pages":"Article 104457"},"PeriodicalIF":2.6,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069753","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":"Mother’s experiences of shame and compassion in the early postnatal period: A thematic analysis","authors":"Julia Marsden ,&nbsp;Koa Whittingham ,&nbsp;Jenny Ziviani ,&nbsp;Sophie O’Brien ,&nbsp;Rebecca Redmond ,&nbsp;Julie Jomeen ,&nbsp;Pamela Meredith","doi":"10.1016/j.midw.2025.104454","DOIUrl":"10.1016/j.midw.2025.104454","url":null,"abstract":"<div><h3>Background</h3><div>Mothers are less likely to seek support from maternity care providers who appear critical or judgmental. While compassion from providers can help mitigate the impact of shame, the experiences of shame within a mothers’ close support network remains unexplored.</div></div><div><h3>Aim</h3><div>The aim of the present study was to explore mothers’ experiences of shame and compassion within their support networks in the early postpartum period.</div></div><div><h3>Methods</h3><div>Fourteen mothers were recruited when their babies were approximately 3-months old from a larger Australian study on shame and compassion. A thematic analysis of semi-structured interviews was undertaken.</div></div><div><h3>Findings</h3><div>Six themes were identified by the authors: (1) unravelling judgment; (2) are you with me or against me?; (3) the voice of doubt: am I failing at this?; (4) when mothering ideals don’t work out: managing shame in your village; (5) finding the right kind of support; and (6) weaving kindness into your role as a mother. All mothers, regardless of <em>who</em> shamed them turned towards others who were sensitive, sympathetic, and empathic, to cope with the shame experience.</div></div><div><h3>Discussion</h3><div>Shame experiences can significantly influence mothers’ willingness to access support, impacting their mental health. Maternity care providers can play a critical role in recognising and addressing these dynamics to foster a more supportive environment.</div></div><div><h3>Conclusion</h3><div>Understanding the complexities of shame and compassion can guide providers in creating compassionate care strategies that better serve mothers during this vulnerable period.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"147 ","pages":"Article 104454"},"PeriodicalIF":2.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143940683","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":"Gestational diabetes education management interventions implemented across Arabic-speaking countries: A systematic scoping review","authors":"Abeer Salman Alzaben ,&nbsp;Nahla Mohammed Bawazeer ,&nbsp;Fatmah Almoayad ,&nbsp;Nada Benajiba ,&nbsp;Elizabeth Dodge ,&nbsp;Basil H. Aboul-Enein","doi":"10.1016/j.midw.2025.104453","DOIUrl":"10.1016/j.midw.2025.104453","url":null,"abstract":"<div><div><strong>Background</strong> The prevalence of Gestational Diabetes Mellitus (GDM) in Arabic-speaking countries varies from 1.2 % (Jordan) to almost 40 % (Saudi Arabia). Untreated GDM increases the risk of poor maternal and neonatal health outcomes.</div><div><strong>Objective</strong> This systematic scoping review aims to examine the current literature to determine the effectiveness of interventions designed to manage and prevent GDM across Arabic-speaking countries.</div><div><strong>Design</strong> Systematic scoping review.</div><div><strong>Methods</strong> Employing the PRISMA-ScR and the AND-EAL for study quality and bias assessment, a comprehensive review of the literature was conducted using 12 databases and search terms relevant to GDM interventions conducted across the League of Arab states. The search period includes intervention studies published up to and including August 31st, 2024.</div><div><strong>Findings</strong> Eight studies met the inclusion criteria. Interventions conducted included those modeled on the Health Behavior Change model, Theory of Reasoned Action and the PRECEDE model, constructs of Social Cognitive Theory including self-efficacy, GDM self-management, lifestyle management and BASNEF model-based empowerment. The intervention studies had positive effect on GDM knowledge, self-efficacy, A1C levels, quality of life, maternal and neonatal outcomes.</div><div><strong>Conclusion</strong> Prevention and management of GDM is important in addressing maternal and neonatal health outcomes. Interventions designed with a theoretical framework and those that are culturally tailored are more likely to elicit behavior change.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"147 ","pages":"Article 104453"},"PeriodicalIF":2.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143940678","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":"Midwifery students and preceptors shared experiences of practice assessment: A qualitative descriptive study","authors":"Carmel Bradshaw ,&nbsp;Mary Fitzpatrick ,&nbsp;Judith Pettigrew","doi":"10.1016/j.midw.2025.104452","DOIUrl":"10.1016/j.midw.2025.104452","url":null,"abstract":"<div><h3>Background</h3><div>Practice placement is a vital part of midwifery programs, enabling students to develop competence in caring for women and their babies under the supervision of preceptor midwives, who assess clinical skills while managing complex caseloads. Midwifery students and preceptor midwives are however contending with significant changes within the practice environment. These include changes to routes of entry to midwifery programmes, a move to a competency-based approach to assessment and increasing complexity of care required for women and their babies.</div></div><div><h3>Aim</h3><div>To examine the experiences of midwifery students and preceptor midwives with clinical assessment in an Irish university during a period of significant transformation in midwifery education and practice.</div></div><div><h3>Methods</h3><div>A qualitative descriptive design was used to interview students (<em>n</em> = 32) and preceptors (<em>n</em> = 29). Data were analysed using content analysis.</div></div><div><h3>Results</h3><div>Within an overarching theme of ‘the context of assessment in practice’, students and preceptors reported some commonalities in their experiences of practice assessment. A clear process of assessment was valued by participants, however, lack of continuity of preceptor and resource deficits, including inadequate staffing levels, affected this process. Preceptors and students highlighted the importance of support for practice assessment.</div></div><div><h3>Conclusion</h3><div>The findings emphasise the critical importance of the context of the practice environment in shaping stakeholders' experiences and is unique in eliciting the views of preceptors and students simultaneously. While resourcing midwifery services is essential, it must also encompass the resourcing of preceptorship, as safe practice depends on robust student assessment. Preceptors and students are supported in assessment by an explicit assessment process yet there are opportunities to further bolster supports, contributing to a quality practice learning environment for all. These insights hold significance for midwifery education and other practice-based professions.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"147 ","pages":"Article 104452"},"PeriodicalIF":2.6,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143937130","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":"Respectful maternity care in Indonesia: A factor analysis with a multicenter study approach","authors":"Sofia Al Farizi ,&nbsp;Endyka Erye Frety ,&nbsp;Dewi Setyowati ,&nbsp;Alifina Izza ,&nbsp;Azra Fauziyah Azyanti ,&nbsp;Dyah Ayu Fatmaningrum ,&nbsp;Devi Arine Kusumawardani","doi":"10.1016/j.midw.2025.104442","DOIUrl":"10.1016/j.midw.2025.104442","url":null,"abstract":"<div><h3>Background</h3><div>Respectful Maternity Care (RMC) is an international interest that relates to the ethical, psychological and cultural aspects of childbirth. Indonesia has not fully implemented this, women still do not have the power over their own bodies. Medical interventions during childbirth also dominate, such as cesarean birth and episiostomy in vaginal birth. This study aims to analyse RMC and the factors that influence it in referral hospitals.</div></div><div><h3>Methods</h3><div>A multi-centre institution-based cross-sectional study design. The population of this study were late second trimester (26–27 weeks) and early third trimester (28–30 weeks) pregnant women who checked their pregnancy at one of the referral hospitals in this study, which were selected using a simple random sampling technique. Analysis used a linear regression approach to determine the influential variables (<em>p</em> ≤ 0.05). Significance testing used multiple linear regression analysis.</div></div><div><h3>Results</h3><div>There were 6 variables that influenced the RMC score, including method of childbirth, prolonged labour, postpartum hemorrhage (PPH), repeated vaginal examination, episiostomy and choice of childbirth position. These six factors had an influence power on RMC of 44.1 %.</div></div><div><h3>Conclusions</h3><div>Medical interventions (cesarean delivery, episiostomy) and excessive invasive measures (repeated vaginal examination) negatively affect RMC scores. This should be a reflection for Indonesia to promote women-centered care that protects women's rights to their bodies. Thus, women who suffer from complications such as postpartum hemorrhage and prolonged labour can still have a good birth experience.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"147 ","pages":"Article 104442"},"PeriodicalIF":2.6,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932021","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":"Navigating weight stigma: An integrative review of midwives' knowledge, attitudes and beliefs about caring for larger-bodied women","authors":"Anna J Robins ,&nbsp;Bec Jenkinson ,&nbsp;Lauren Kearney","doi":"10.1016/j.midw.2025.104444","DOIUrl":"10.1016/j.midw.2025.104444","url":null,"abstract":"<div><h3>Problem</h3><div>Women are vulnerable to weight bias during their reproductive years. However, little is known about midwives’ knowledge, attitudes and beliefs about caring for larger bodied women.</div></div><div><h3>Background</h3><div>Women have reported experiencing weight stigma during interactions with healthcare providers, including midwives. Weight stigma is associated with reduced quality of health and primary healthcare avoidance. In Australia over half of pregnant women are of a higher weight during their reproductive years.</div></div><div><h3>Aim</h3><div>To describe what is currently known about midwives' knowledge, attitudes and beliefs relating to caring for larger bodied women across the peripartum period.</div></div><div><h3>Methods</h3><div>An integrative review was undertaken, involving a systematic literature search, quality appraisal, and synthesis of findings within the socioecological framework.</div></div><div><h3>Findings</h3><div>Sixteen articles were included. Across the socioecological levels: individual level themes related to midwives’ attitudes and beliefs and midwives’ own body size; interpersonal themes related to communication and relationships; community themes related to the influence of cultural norms; organisation/institutional level themes related to BMI and weight checks, the need for training and education, and the role of healthcare practices and guidelines emerged; finally, at the policy level, system level factors and a weight inclusive approach were identified.</div></div><div><h3>Discussion</h3><div>This review highlighted that some midwives and student midwives hold negative, stigmatising views towards larger bodied women. Midwives are impacted by their own attitudes and beliefs as well as interpersonal, societal, organisational and system level factors.</div></div><div><h3>Conclusion</h3><div>Efforts to reduce weight stigma require a multi-level socio-ecological approach, including educational strategies aimed at shifting current and future midwives’ stigmatising attitudes and beliefs towards larger bodied women.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"147 ","pages":"Article 104444"},"PeriodicalIF":2.6,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932093","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":"Impact of the Covid-19 pandemic on bereavement care provided within maternity services: A focused mapping review and synthesis","authors":"Ashling Walsh,&nbsp;Jan McCarthy,&nbsp;Carmel Bradshaw","doi":"10.1016/j.midw.2025.104445","DOIUrl":"10.1016/j.midw.2025.104445","url":null,"abstract":"<div><h3>Background</h3><div>Perinatal bereavement is the experience of parents after the death of an infant due to miscarriage, stillbirth, neonatal death, or elective termination of pregnancy for fetal anomaly. Perinatal loss is a traumatic event for parents and the quality of care provided by healthcare professionals (HCPs) can impact their grieving process. In March 2020, Covid-19 was declared a global pandemic, with significant consequences on perinatal bereavement services.</div></div><div><h3>Aim</h3><div>To explore parents and HCPs experiences of perinatal bereavement care during the Covid-19 pandemic.</div></div><div><h3>Methods</h3><div>A focused mapping review and synthesis was used to identify papers which concentrated on perinatal bereavement care within maternity services during the Covid-19 pandemic. Studies meeting the criteria in peer reviewed midwifery, obstetric and healthcare journals (<em>n</em> = 6), published between Jan 2020-Feb 2025 were descriptively analysed, providing a topography and synthesis of the key trends identified.</div></div><div><h3>Findings</h3><div>Fourteen relevant studies were identified in the review period, six of which met the inclusion criteria, with two themes identified: Maternity service reconfiguration due to Covid-19 restrictions and Loneliness and anxiety inducing experiences among parents.</div></div><div><h3>Conclusion</h3><div>The Covid-19 pandemic negatively impacted bereavement care within maternity services. Maternity reconfiguration because of the pandemic was a major contributor to dissatisfaction and frustration amongst bereaved parents and HCPs. Exclusion of partners had a negative effect on parents’ experiences of care, augmenting the loneliness and anxiety felt by parents when dealing with loss. Perinatal bereavement guidelines need to accentuate the importance of partner inclusion in any context but particularly when providing care to women requiring isolation or barrier nursing. Guidelines must be reviewed to clearly outline when the use of virtual care is appropriate within the maternity setting. Additional research is needed to assess the long-term impacts of Covid 19 on HCPs. Such research includes identifying effective mechanisms to help staff deal with the stress and emotional impact of future public health emergencies.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"147 ","pages":"Article 104445"},"PeriodicalIF":2.6,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143932092","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}