Midwifery最新文献

{"title":"Healthcare professionals’ perceptions of risk management on pregnancy and childbirth: An integrative review","authors":"Khayla Timothy ,&nbsp;Barbara Lloyd ,&nbsp;Carmel Bradshaw","doi":"10.1016/j.midw.2025.104376","DOIUrl":"10.1016/j.midw.2025.104376","url":null,"abstract":"<div><h3>Background</h3><div>Risk management in maternity care aims to reduce incidents and harm to women and babies, contributing to quality care. However, there is growing concern that risk management policies may lead to unnecessary interventions during pregnancy and childbirth, resulting in both short- and long-term morbidity for women and their babies.</div></div><div><h3>Aim</h3><div>To evaluate healthcare professionals’ perceptions of the effect of risk management on pregnancy and childbirth.</div></div><div><h3>Methods</h3><div>A five-stage methodological framework was utilised in this review. A comprehensive integrative review was undertaken using a computer-assisted database approach including CINAHL, EMBASE, MEDLINE (Pubmed), PsycINFO and Scopus from 2016–2024. This review is reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-analysis for Scoping Reviews (PRISMA-ScR).</div></div><div><h3>Findings</h3><div>The review identified five papers from four different countries. Two overarching themes were generated: The impact of the dominant medical model on risk management and decision-making in maternity care and the differences and similarities in healthcare professional's perceptions of risk management. The increasing medicalisation of pregnancy and childbirth shifts healthcare professionals' focus towards documentation and administrative tasks, driven by liability fears, rather than addressing clinical risks and providing woman-centred care.</div></div><div><h3>Conclusion</h3><div>Complex factors influence risk management in maternity care. Risk management is affecting the way healthcare professionals think and operate. This review reveals that the medical model significantly shapes healthcare professionals’ perceptions of risk management, often undermining midwives' autonomy and impacting decision-making in pregnancy and childbirth. Education and training are essential to restore midwives' autonomous roles, ensuring that women receive the most appropriate, safest and highest quality of care.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"145 ","pages":"Article 104376"},"PeriodicalIF":2.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674239","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":"Pulled in different directions – The experiences of birth partners and care-providers when supporting women to implement what they learn in childbirth education classes","authors":"Kerry Sutcliffe ,&nbsp;Hannah Dahlen ,&nbsp;Elizabeth Newnham ,&nbsp;Linda Mackay ,&nbsp;Kate Levett","doi":"10.1016/j.midw.2025.104372","DOIUrl":"10.1016/j.midw.2025.104372","url":null,"abstract":"<div><h3>Background</h3><div>Childbirth education (CBE) is often viewed as a singular intervention separate from the broader maternity system, meaning differences in effectiveness are attributed solely to the program delivered. Understanding the impact support people have on the translation of CBE techniques using Bowen theory as a wider systems-based lens, could offer important insights into the utilisation and effectiveness of CBE techniques.</div></div><div><h3>Aim</h3><div>To examine how the functioning of birth partners and care-providers during labour, impacts the use of CBE strategies employed by women.</div></div><div><h3>Methods</h3><div>In-depth, semi-structured interviews with 11 birth partners; and two focus groups with 12 care-providers, examined their experiences of supporting CBE techniques. Bowen family systems theory concepts were used as a guide for deductive analysis.</div></div><div><h3>Findings</h3><div>Interpersonal and systemic pressures presented a challenge to maintaining CBE strategies, captured in the over-arching theme ‘Pulled in different directions’. Support in using CBE strategies transitioned along two continuums; ‘Positioned with self or other’ and ‘Dominance of thoughts or emotions’, highlighting the challenge of balancing supportive encouragement for CBE with pressure that limits their application.</div></div><div><h3>Discussion</h3><div>Birth partners and care-providers are well positioned to help women utilise CBE techniques, but various factors impact their ability to do so. These factors largely relate to systemic pressures that impact inter-personal relations and subsequent individual responses.</div></div><div><h3>Conclusion</h3><div>While birth partners and care-providers aim to support the use of CBE techniques, maternity system level factors leave them feeling ‘pulled in different directions’. This impacts their capacity to continue supporting their use throughout labour.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"145 ","pages":"Article 104372"},"PeriodicalIF":2.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143682727","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":"Barriers to and enablers of type 2 diabetes screening among Indian and Chinese women with prior gestational diabetes: A qualitative study applying the Theoretical Domains Framework","authors":"Adriana C.H. Neven ,&nbsp;Amelia J Lake ,&nbsp;Amelia Williams ,&nbsp;Sharon Licqurish ,&nbsp;Siew Lim ,&nbsp;Sharleen L. O'Reilly ,&nbsp;Christel Hendrieckx ,&nbsp;Melinda Morrison ,&nbsp;James A. Dunbar ,&nbsp;Jane Speight ,&nbsp;Helena Teede ,&nbsp;Jacqueline A. Boyle ,&nbsp;ME-MaGDA study group","doi":"10.1016/j.midw.2025.104370","DOIUrl":"10.1016/j.midw.2025.104370","url":null,"abstract":"<div><h3>Problem</h3><div>Women with previous gestational diabetes mellitus (GDM) are at increased risk of type 2 diabetes (T2D).</div></div><div><h3>Background</h3><div>In Australia, GDM and T2D prevalence are particularly high among Indian and Chinese women. Attendance for recommended postpartum T2D screening is low. Our aim was to identify modifiable barriers to, and enablers of, postpartum T2D screening among Chinese and Indian women with prior GDM in Australia, compare these to those of women with prior GDM from the general Australian population, and make culturally appropriate recommendations for intervention (messaging) content.</div></div><div><h3>Methods</h3><div>Participants were recruited via the National Gestational Diabetes Register and social media platforms. Semi-structured interviews were conducted in March-May 2021. Using an inductive-deductive approach, data were coded to Theoretical Domains Framework (TDF) domains and mapped to the <em>Capability, Opportunity, Motivation-Behaviour (COM-B)</em> model.</div></div><div><h3>Findings</h3><div>Ten women participated: 6 Chinese born, 4 Indian born, nine of whom had previously screened for T2D. Nine influential TDF domains were identified, suggesting messaging content needs to address: <em>Motivation</em> (fear of T2D, encourage role modelling beliefs), <em>Opportunity</em> (encourage social support taking cultural and family norms into account), <em>Capability</em> (increase awareness of T2D risk, optimise prompts/reminders)</div></div><div><h3>Conclusions</h3><div>Use of the COM-B and TDF suggests nine modifiable barriers to, and enablers of, postpartum T2D screening among Indian and Chinese-born women in Australia with prior GDM, mostly consistent with those of general Australian GDM populations. Culture-specific needs, such as including family in knowledge and support, and providing specific information regarding genetic- versus behaviour related risks can be accounted for within an inclusive messaging intervention addressing topics applicable to all women.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"145 ","pages":"Article 104370"},"PeriodicalIF":2.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143784033","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":"Maternal health literacy and complementary medicine products: Information and recommendation sources used by pregnant and breastfeeding Australian women - results from a national online survey","authors":"Larisa Ariadne Justine Barnes ,&nbsp;Margaret I Rolfe ,&nbsp;Lesley Barclay ,&nbsp;Kirsten McCaffery ,&nbsp;Parisa Aslani","doi":"10.1016/j.midw.2025.104373","DOIUrl":"10.1016/j.midw.2025.104373","url":null,"abstract":"<div><h3>Background</h3><div>Pregnant and breastfeeding women commonly use complementary medicine products (CMPs) (dietary supplements/herbal medicines). Maternal health literacy highlights the importance of women seeking information to benefit their own and their children's health. However, little data on women's information-seeking behaviours regarding CMPs during pregnancy and lactation exists.</div></div><div><h3>Objectives</h3><div>Identify pregnant and breastfeeding women's CMP information and recommendation sources; determine their most trusted sources; and describe the influence of these sources on CMP use decisions during pregnancy and lactation.</div></div><div><h3>Methods</h3><div>This primary study utilised a national, online, cross-sectional survey conducted with pregnant and/or breastfeeding Australian women using CMPs. Purposeful and snowball recruitment were used. Screening questions ensured respondents were currently pregnant and/or breastfeeding, over 18, using CMPs, and living in Australia. Respondents reported on their use of CMP information and recommendation sources. Data were analysed using descriptive statistics and chi-square tests to compare differences between pregnant and breastfeeding cohorts.</div></div><div><h3>Findings</h3><div>810 women (354 pregnant, 456 breastfeeding) completed the survey; 93.3 % had adequate health literacy, 81.9 % were university educated, and 74.8 % had medium-high incomes. Almost all (99.6 %; <em>n</em> = 809) used dietary supplements; 57.3 % (<em>n</em> = 464) used herbal medicines. General practitioners (GPs) were the most trusted HCPs (27.0 %; <em>n</em> = 219). Significantly more breastfeeding women (<em>p</em> &lt; 0.0001) trusted naturopaths, herbalists, GPs, pharmacists, child and family health nurses, and lactation consultants. Significantly more pregnant women (<em>p</em> &lt; 0.0001) trusted midwives and obstetricians. Recommendations from HCPs positively influenced CMP use, while recommendations online or print media generally did not.</div></div><div><h3>Conclusions</h3><div>Pregnant and breastfeeding women seek information on CMPs from various sources but trust HCPs the most. Maternity care clinicians should consider the diverse information and recommendation sources women access when discussing CMP use.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"145 ","pages":"Article 104373"},"PeriodicalIF":2.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735219","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":"Exploring the perspectives of healthcare professionals on the most significant health disparities observed in perinatal settings: A qualitative study","authors":"Kayleigh A. Gregory ,&nbsp;Madelyn J. Hill ,&nbsp;Mastano Dzimbiri ,&nbsp;Ashley L. Merianos","doi":"10.1016/j.midw.2025.104366","DOIUrl":"10.1016/j.midw.2025.104366","url":null,"abstract":"<div><h3>Background</h3><div>Perinatal mood disorders impact an estimated 15–21% of pregnant and postpartum women and are the leading cause of maternal mortality. Research indicates that social and economic factors, racism, and persistent stress contribute to maternal and infant health outcomes. Healthcare professionals can play a key role in assisting perinatal mothers with their mental health and addressing systemic disparities that may impact access to care. Understanding healthcare professionals’ perceptions is the first step in tailoring existing evidence-based interventions, implementing training in perinatal settings, and providing patient-centered care during this period.</div></div><div><h3>Methods</h3><div>We used a purposive sampling technique to recruit 19 providers comprising of</div><div>OBGYN providers, nurse practitioners, and certified nurse midwives who work in the United States; specifically, Ohio, Kentucky, and Indiana. Semi-structured interviews with open-ended interview questions were conducted. Qualitative data were analyzed using thematic analysis, and main themes emerged from the transcripts.</div></div><div><h3>Results</h3><div>Five major themes were identified regarding the most significant health disparities observed in OBGYN practice in the Midwest area: (1) location-based disparities in access and support for perinatal care; (2) barriers to accessing perinatal care; (3) intersecting health risks; (4) racial disparities; (5) navigating isolation.</div></div><div><h3>Conclusions</h3><div>Study findings provide a comprehensive view of the health disparities perceived by these healthcare professionals during the perinatal period. These findings offer insight into the systemic inequities that affect maternal and infant outcomes. Overall, results may offer evidence for improving cultural competency in the medical setting and providing a greater understanding of the complex interplay of factors that influence outcomes for mothers and infants.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"145 ","pages":"Article 104366"},"PeriodicalIF":2.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644094","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":"Dutch midwives’ views on father-involvement practices","authors":"Lianne Aarntzen ,&nbsp;Anna Seijmonsbergen-Schermers ,&nbsp;Rutger Blom ,&nbsp;Jens Henrichs ,&nbsp;Belle Derks","doi":"10.1016/j.midw.2025.104371","DOIUrl":"10.1016/j.midw.2025.104371","url":null,"abstract":"<div><h3>Background</h3><div>Midwives are uniquely positioned to engage fathers already prenatally and facilitate an equal transition into parenthood for both parents. However, they may face barriers hindering their investment in involving fathers.</div></div><div><h3>Aim</h3><div>The aim was to investigate barriers and facilitators midwives experience when implementing two father-involvement practices 1) involving fathers in antenatal and postnatal care and (2) encouraging parental conversations about future work/care divisions.</div></div><div><h3>Methods</h3><div>Study 1 utilized a World Café with twelve midwives to identify barriers and facilitators, across motivation, opportunity, and ability. Study 2 used a Q-methodology with 31 midwives to assess these factors' relative importance and identify distinct viewpoints.</div></div><div><h3>Findings</h3><div>The World Café revealed that midwives are motivated to involve fathers, primarily because they anticipate positive outcomes for parents and infants. Key barriers included a lack of time, finances, and educational resources. The Q-study identified that midwives could be clustered in two profiles reflecting different perspectives on the ranking of barriers to involving fathers in prenatal care. The \"Educationally Constrained Midwife” lacks knowledge, educational materials, and training, while the \"Resource Constrained Midwife\" is hindered by time and financial constraints. For encouraging parents to discuss the future task division, only one profile was identified showing that midwives were motivated to incorporate this extra task if they receive additional time, finances, training, and educational materials to share with parents.</div></div><div><h3>Conclusion</h3><div>Addressing educational and resource barriers is crucial for enhancing father-involvement by midwives. Interventions tailored to these profiles can support midwives in adopting practices promoting father-involvement, potentially improving family outcomes and advancing gender equity in caregiving responsibilities.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"145 ","pages":"Article 104371"},"PeriodicalIF":2.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674225","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 perspectives on communication following the diagnosis of gestational or postpartum cancer: A qualitative study","authors":"Sultana Farhana ,&nbsp;Jane Frawley ,&nbsp;Antoinette Anazodo ,&nbsp;Elizabeth A. Sullivan","doi":"10.1016/j.midw.2025.104374","DOIUrl":"10.1016/j.midw.2025.104374","url":null,"abstract":"<div><h3>Background</h3><div>Cancer during pregnancy or the postpartum period is rare, and the clinical management of cancer during this period is complex due to a lack of evidence-based approaches and logistical challenges. Effective communication between women and healthcare providers (HCPs) is critical in navigating these challenges, and communication gaps may contribute to unmet informational and emotional needs, affecting decision-making and overall care experiences.</div></div><div><h3>Aim</h3><div>This study aimed to understand women's perspectives on communication with their healthcare providers (HCPs) following a gestational cancer diagnosis.</div></div><div><h3>Methods</h3><div>We conducted semi-structured interviews with women who experienced cancer during pregnancy or the postpartum period (12 months after giving birth). Data were analysed thematically.</div></div><div><h3>Results</h3><div>17 women participated in this study. Participants varied in age, timing, and cancer diagnosis. Seven women were diagnosed with breast cancer, while the remaining were diagnosed with a variety of cancers, including melanoma, lymphoma, thyroid, ovarian, uterine, bowel, and oropharyngeal cancer. Notably, 10 participants were diagnosed with cancer in the postpartum period, whereas seven were diagnosed during pregnancy. Three overarching themes emerged from the thematic analysis: 1) \"Scarcity of information,\" 2) \"Not involved in treatment decisions,\" and 3) \"Centralised resources and advocacy.\"</div></div><div><h3>Conclusions</h3><div>This study provides crucial insights into the challenges faced by women diagnosed with cancer during pregnancy and the postpartum period, particularly regarding communication with HCPs. This highlights the urgent need for enhanced communication, education, and support for HCPs along with tailored resources for women with gestational cancer. Coordinated multidisciplinary care and dedicated advocacy by nurses or midwives are essential to address these challenges and improve health care outcomes for women and their families.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"145 ","pages":"Article 104374"},"PeriodicalIF":2.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143629383","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":"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}