European Journal of Midwifery最新文献

{"title":"Health problems experienced by women during the first year postpartum: A systematic review.","authors":"Marije M Gmelig Meyling, M Evelyn Frieling, Johanna P M Vervoort, Esther I Feijen-de Jong, Danielle E M C Jansen","doi":"10.18332/ejm/173417","DOIUrl":"10.18332/ejm/173417","url":null,"abstract":"<p><strong>Introduction: </strong>During pregnancy and childbirth, health issues can arise that can negatively influence women's postpartum health. Although it is imperative to identify these health problems in order to tailor care to women's needs, they often remain unrecognized. A comprehensive overview of postpartum health problems does not exist in the current literature. This systematic review aimed to explore the health problems experienced by women residing in high-income countries during the first year postpartum.</p><p><strong>Methods: </strong>Scientific databases were searched for articles on health problems experienced by women during the first year postpartum, published between January 2000 and 2 July 2021. Studies investigating the experiences of healthy women from the age of 18 years, residing in high-income countries, who gave birth to a healthy neonate, were included. Identified health issues were divided into five categories and presented in an overview.</p><p><strong>Results: </strong>A total of 25 articles were eligible for inclusion. In all, 83 health problems were identified and divided into five different categories (physical health problems, mental health problems, social health problems, problems related to feeding the infant, and other challenges). Common health issues postpartum were exhaustion, urinary incontinence, painful breasts, depressive symptoms, problems related to sexuality and sleep, lack of social support, and problems with breastfeeding.</p><p><strong>Conclusions: </strong>This systematic review contributes to a wider understanding of postpartum health problems and can be used to adapt healthcare to women's needs. It distinguishes itself from previous studies by the wide variety of identified health problems and its specific focus on women's experiences in the postpartum period.</p>","PeriodicalId":32920,"journal":{"name":"European Journal of Midwifery","volume":"7 ","pages":"42"},"PeriodicalIF":1.5,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10726257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138810602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality midwifery care during the COVID-19 pandemic in Bangladesh: A focus group study with midwives, nurses, and midwifery educators.","authors":"Noor I Pappu, Jonna Holmedahl, Svava Gudjonsdottir, Kerstin Erlandsson, Ulrika Byrskog","doi":"10.18332/ejm/174234","DOIUrl":"https://doi.org/10.18332/ejm/174234","url":null,"abstract":"<p><strong>Introduction: </strong>Bangladesh has made remarkable strides in the development of the midwifery profession. However, the COVID-19 pandemic has had profound effects on healthcare systems worldwide, including those related to reproductive, perinatal, and maternal health. Given the recent advancements in the midwifery field in Bangladesh, it is crucial to examine the pandemic's impact on existing barriers and the capacity of midwifery professionals to deliver high-quality care. The aim of this study is to describe the possibility of midwives being able to provide quality midwifery care in Bangladesh during the COVID-19 pandemic.</p><p><strong>Methods: </strong>To gather insights, data were collected from July to October 2020 via four qualitative focus group discussions online; 23 actively practicing midwives, nurses specializing in midwifery care, and midwifery educators, participated. The data analysis employed reflexive thematic analysis.</p><p><strong>Results: </strong>The COVID-19 crisis posed significant threats to women's safety and health, with lockdowns exacerbating gender inequalities in society. Midwives faced added challenges due to their relatively low professional status and increased workloads. Insufficient policy implementation further compromised midwives' safety. Fear of contracting the virus and working during their free time also raised concerns about the quality of care provided. Nevertheless, the pandemic provided opportunities for midwives to demonstrate their ability to deliver independent midwifery care in Bangladesh.</p><p><strong>Conclusions: </strong>The pandemic underscored the importance of creating respectful and dignified working conditions for midwives. It revealed that professional midwives can work independently when provided with the necessary space and a supportive work environment. This opens the door for the implementation of a midwifery-led care model. Further research is recommended to investigate the medical safety and efficacy of independent midwifery care in the context of Bangladesh.</p>","PeriodicalId":32920,"journal":{"name":"European Journal of Midwifery","volume":"7 ","pages":"41"},"PeriodicalIF":1.9,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10722304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138810606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Midwives’ experiences of facilitating normal birth in midwifery-led units in Norway: A qualitative study","authors":"Liv Remvik-Larsen, Anne Marte W. Gran, Bente Dahl","doi":"10.18332/ejm/173388","DOIUrl":"https://doi.org/10.18332/ejm/173388","url":null,"abstract":"INTRODUCTION Normal birth has significant benefits for mothers and infants. However, the advancement of technology has led to increased medicalization of childbirth. Midwives play a pivotal role in promoting normal birth, and positive outcomes are seen in births led by a midwife. The purpose of the study is to gain a deeper understanding of midwives’ experiences of facilitating normal birth in midwifery-led units. METHODS The study has a qualitative design. It was conducted in 2022 and included semi- structured interviews with seven midwives throughout Norway. They were all currently working, or had previously worked, in a midwifery-led unit. The data material was analyzed using systematic text condensation. RESULTS The data analysis resulted in three result categories. The first category concerned the importance of relationships, continuity and a safe atmosphere. The second concerned being a midwife in the hand, in the heart, and in the mind. The third related to having confidence in the physiological process of childbirth, midwifery autonomy, and a common ideology. CONCLUSIONS The study highlights several elements that may help to promote normal birth in midwifery units. Relationships, midwifery skills, confidence in normal birth and a supportive collegial environment that fosters midwife autonomy, are prominent factors. These elements were viewed by the midwives as key to their ability to promote normal birth in a midwifery-led unit.","PeriodicalId":32920,"journal":{"name":"European Journal of Midwifery","volume":"6 6","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138584347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of screening for neonatal hypoglycemia in large-for-gestational-age newborns without risk factors, and proposed changes in practice at Grenoble University Hospital","authors":"Marina Tamborowski, Sonia Ghelfi-Dufournet, Lucie Terrier, Pierre Gillois, Lionel Di Marco","doi":"10.18332/ejm/174489","DOIUrl":"https://doi.org/10.18332/ejm/174489","url":null,"abstract":"INTRODUCTION The aim of this study was to evaluate the relevance of screening for neonatal hypoglycemia as it is currently performed, in order to improve the comfort of newborns by reducing the number of painful procedures such as venipunctures or capillary punctures. The primary objective was to determine the prevalence of neonatal hypoglycemia in large-for-gestational-age newborns. The secondary objective was to determine a threshold percentile of birth weight for optimal screening for hypoglycemia. METHODS We performed a descriptive, cross-sectional, single-center study, based on a structured review of obstetrical records from 11 January 2017 to 21 January 2020, from the maternity department of the University Hospital of Grenoble. Eligible neonates were large-for-gestational-age (birth weight >90th percentile) at term (37–42 weeks) without other risk factors for hypoglycemia. The primary outcome was the prevalence of neonates with capillary or venous glucose levels <2.2 mmol/L in the first 48 hours of life. We performed a sensitivity and specificity analysis of the birth weight percentile as a determinant of the threshold for hypoglycemia detection (ROC curve, area under the curve, Youden index, Brier score, Hosmer-Lemeshow test). RESULTS In all, 19.2% of the newborns presented at least one hypoglycemic episode during the first 48 hours of life, and 75.7% of the hypoglycemic episodes occurred at 1 hour of life. The cut-off percentile that seemed most appropriate for screening was determined to be the 97th percentile of birth weight (AUC=0.64; 95% CI: 0.52–0.75). CONCLUSIONS Our statistical model is robust and allows us to state that the currently used birth weight percentile threshold can be revised upwards. Thus, the protocol for neonatal hypoglycemia screening can be updated to improve the comfort of newborns at risk of hypoglycemia.","PeriodicalId":32920,"journal":{"name":"European Journal of Midwifery","volume":"6 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138589590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breastfeeding among parous women offered home-visit by a midwife after early discharge following planned cesarean section: Secondary analysis of a randomized controlled trial","authors":"A. R. Kruse, F. Lauszus, Axel Forman, U. Kesmodel, Marie Bender Rugaard, Randi Karkov Knudsen, Eva-Kristina Persson, I. Sundtoft, Niels Uldbjerg","doi":"10.18332/ejm/173089","DOIUrl":"https://doi.org/10.18332/ejm/173089","url":null,"abstract":"INTRODUCTION Early discharge holds several advantages and seems safe after planned cesarean section among low-risk women. However, breastfeeding rates are lower after cesarean section. Thus, concern has been raised that early discharge among these women may affect breastfeeding even further. Therefore, we aimed to assess the effect of early discharge the day after planned cesarean section on breastfeeding, among parous women when a home-visit by a midwife was provided the day after discharge. METHODS We conducted a secondary analysis of a randomized trial. Parous women (n=143) planned for cesarean section were allocated to either discharge within 28 hours after planned cesarean section followed by a home visit the day after (early discharge) or discharge at least 48 hours after planned cesarean section (standard care). The participants filled in questionnaires approximately 2 weeks before delivery and 1 week, 4 weeks, and 6 months postpartum. RESULTS The proportions of women initiating breastfeeding were 84% versus 87% (early discharge vs standard care). After 6 months, 23% versus 21% were exclusively breastfeeding, while 29% versus 42% were partially breastfeeding. The mean duration of exclusive breastfeeding was 3.4 months (SD=2.3) in both groups. None of these differences was statistically significant. In both groups, the women’s breastfeeding self-efficacy score before cesarean section correlated with the duration of breastfeeding. After 4 weeks, low-score rates were 28% versus 30%. CONCLUSIONS Early discharge with follow-up home visits by a midwife after planned cesarean section in parous women is feasible without compromising breastfeeding.","PeriodicalId":32920,"journal":{"name":"European Journal of Midwifery","volume":"13 12","pages":""},"PeriodicalIF":1.9,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138592512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interprofessional survey on knowledge and attitudes of midwives regarding oral health, in France.","authors":"Abid Bossouf, Céline Sabourin, Florent Fuchs, Nicolas Giraudeau, Camille Inquimbert","doi":"10.18332/ejm/172881","DOIUrl":"10.18332/ejm/172881","url":null,"abstract":"<p><strong>Introduction: </strong>Oral health is essential for psychosocial well-being and general health. For expectant mothers, pregnancy increases the risk of oral diseases and has a subsequent impact on the oral health of a child once born. Midwives are in charge of pregnancy monitoring, childbirth and newborns' first days of life. They could have an important role in prevention. However, limited studies evaluating the knowledge, attitudes and practices on oral health among midwives have been conducted in Europe.</p><p><strong>Methods: </strong>We performed a cross-sectional study using a self-administered questionnaire. Two local midwifery associations sent out the questionnaire by email and social media networks to all registered midwives and practicing in the department of Herault (n=613), between April and May 2022. Statistical analyses on quantitative data and descriptive analyses of qualitative free-text responses were performed.</p><p><strong>Results: </strong>In total, 167 midwives were included. We found a lack of knowledge on many oral health topics and this was stated as the main reason that only 29% of midwives provided oral health information to their patients. Only 30% of the midwives had a training module on oral health during their initial training, and less than half of them considered the training adequate. To improve their lack of knowledge, participants expressed a preference for digital communication methods for themselves; however, they favored in-person interaction for public interventions.</p><p><strong>Conclusions: </strong>This study showed a lack of training and knowledge about oral health among midwives and a lack of oral health discussion with expectant mothers who are a high-risk population for oral diseases.</p>","PeriodicalId":32920,"journal":{"name":"European Journal of Midwifery","volume":"7 ","pages":"37"},"PeriodicalIF":1.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10690821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138478751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Normal childbirth: The natural, non-medical, alternative approaches to the most common medical interventions in labor.","authors":"Dimitrios Papoutsis, Angeliki Antonakou","doi":"10.18332/ejm/174525","DOIUrl":"10.18332/ejm/174525","url":null,"abstract":"","PeriodicalId":32920,"journal":{"name":"European Journal of Midwifery","volume":"7 ","pages":"36"},"PeriodicalIF":1.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10690818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138478752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Midwives' experiences with aortic compression for postpartum hemorrhage: A qualitative study.","authors":"Sonja Kalsvik, Mirjam Lukasse, Enid L Myhre","doi":"10.18332/ejm/172880","DOIUrl":"https://doi.org/10.18332/ejm/172880","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to examine midwives' firsthand experience with aortic compression during postpartum hemorrhage. Severe postpartum hemorrhage is a critical complication during childbirth and the leading cause of maternal morbidity and mortality. Active management of the third stage of labor, combined with standard treatment, has reduced the incidence. However, these measures occasionally fall short, and there is a global need for easy, effective alternative methods. Aortic compression, though not widely recognized, is employed intermittently and lacks substantial scientific backing.</p><p><strong>Methods: </strong>This qualitative study comprised interviews with midwives from various healthcare settings across Norway. Over a two-month period in 2022, we conducted seven individual semi-structured interviews. Interview transcripts were thematically analyzed using Braun and Clarke's six-step process.</p><p><strong>Results: </strong>Four prominent themes emerged from the analysis, reflecting midwives' experiences with aortic compression in managing postpartum hemorrhage (PPH). In their experiences with aortic compression, midwives uncovered its dual qualities of being both easy and effective. Their utilization of the technique was experience-based only, shaped by personal experience rather than formal training. Nevertheless, aortic compression was perceived as the first-line response to suspected postpartum hemorrhage, preventing escalation, and offering a clearer view of the situation to facilitate timely treatment. Most significantly, midwives recognized aortic compression as a crucial intervention that reduces blood loss and improves health.</p><p><strong>Conclusions: </strong>Postpartum hemorrhage is a feared situation in the delivery room. The participants consider that aortic compression may affect maternal health and mortality. However, further research is necessary.</p>","PeriodicalId":32920,"journal":{"name":"European Journal of Midwifery","volume":"7 ","pages":"35"},"PeriodicalIF":1.9,"publicationDate":"2023-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10665914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138463019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Midwives' work-related fear and anxiety and its impact on their wellbeing and performance. A qualitative study of perceived anxiety in community midwives.","authors":"Davita H van den Heuvel, Liesbeth E Kool, Tamar L Nelson, Esther I Feijen-de Jong","doi":"10.18332/ejm/172574","DOIUrl":"https://doi.org/10.18332/ejm/172574","url":null,"abstract":"<p><strong>Introduction: </strong>Working with acute situations is usually part of midwifery practice. In the Netherlands the community midwives work in a context where they are mostly the sole decision-makers and policymakers and often do not have the support of a multidisciplinary team during a birth. How Dutch community midwives maintain their emotional hygiene is not known. This study aims to explore how Dutch midwives perceive fear and its influence on their performance.</p><p><strong>Methods: </strong>This is a qualitative study with semi-structured interviews of 19 Dutch community midwives between October 2018 and January 2019.</p><p><strong>Results: </strong>Four themes were identified: 1) midwives' perceptions of fear and anxiety, 2) how years of experience affect fear and anxiety, 3) influence of the work content; and 4) implications for performance. Midwives perceived fear in acute situations where maternal and/or fetal complications were imminent. Participants perceived anxiety either as helpful or a hindrance. Awareness of these feelings helps them to regulate whether or not to give in to these feelings.</p><p><strong>Conclusions: </strong>Our findings suggest similar perspectives on fear in Dutch community midwives compared to previous outcomes. In the Netherlands, midwives seem reluctant to talk about fear and anxiety in the profession. The awareness of these emotions occurring while working is essential for the wellbeing of midwives, as well as the importance of knowing how to act on fear and anxiety.</p>","PeriodicalId":32920,"journal":{"name":"European Journal of Midwifery","volume":"7 ","pages":"34"},"PeriodicalIF":1.9,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10658298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138463020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women's experiences and views of outpatient and inpatient induction of labor with oral misoprostol: A secondary qualitative study.","authors":"Hanne A Hægeland, Marianne G Moi, Fride E Austad, Hanna Oommen, Janne Rossen, Mirjam Lukasse","doi":"10.18332/ejm/172651","DOIUrl":"https://doi.org/10.18332/ejm/172651","url":null,"abstract":"<p><strong>Introduction: </strong>As labor induction rates continue to increase, so has the interest in performing induction in an outpatient setting for pregnancies defined as low-risk. Twenty women participated in the pilot study of a Randomized Controlled Trial (RCT) comparing inpatient and outpatient labor induction with oral misoprostol. This study aimed to explore women's experiences of outpatient induction of labor and their views on this as an alternative method to inpatient labor induction.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted, from November 2021 to January 2022 with eight women randomized to outpatient induction and four women randomized to inpatient induction. Verbatim transcribed interviews were analyzed using Graneheim and Lundman's content analysis.</p><p><strong>Results: </strong>Three main categories emerged: the required framework around outpatient labor induction, what felt better at home and what felt safer at the hospital. To feel secure at home, women needed sufficient information, close follow-up while at home, and an easy-to-administer induction method. Outpatient labor induction gave women the opportunity of constant support from the partner and increased freedom of movement and self-expression. Some expressed relief over being randomized to inpatient labor induction, because of easy access to health providers, fetal monitoring, and not risking giving birth before arrival to the hospital. Women stressed the importance of being given a choice.</p><p><strong>Conclusions: </strong>Outpatient labor induction contributed to a positive birth experience and should be considered as an alternative for women with low-risk pregnancies. Shared decision-making, including the opportunity for women to change their mind, is essential as induction and early labor affects women's whole childbirth experience.</p>","PeriodicalId":32920,"journal":{"name":"European Journal of Midwifery","volume":"7 ","pages":"33"},"PeriodicalIF":1.9,"publicationDate":"2023-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10655146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138463067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}