Women and Birth最新文献

{"title":"Editorial – 2025 Women and Birth Special Issue on midwifery education","authors":"Deborah Fox","doi":"10.1016/j.wombi.2025.101940","DOIUrl":"10.1016/j.wombi.2025.101940","url":null,"abstract":"","PeriodicalId":48868,"journal":{"name":"Women and Birth","volume":"38 4","pages":"Article 101940"},"PeriodicalIF":4.4,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144272485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Student midwives’ exposure to physiological birth practices: A cross-sectional study of 3055 births during 2020–23 in England","authors":"Claire Feeley,&nbsp;Rebecca Daley,&nbsp;Charlotte Mungeam,&nbsp;Tomasina Stacey","doi":"10.1016/j.wombi.2025.101937","DOIUrl":"10.1016/j.wombi.2025.101937","url":null,"abstract":"<div><h3>Background</h3><div>Among a range of care episodes and proficiencies UK midwifery students must complete to qualify, they need to personally facilitate 40 births. Students’ experiences of midwifery-led birth practices are dependent on their exposure within the clinical environment; however, such variation has not yet been explored.</div></div><div><h3>Aim</h3><div>The aim of this study was to analyse, describe and compare the characteristics of the 40 births personally facilitated by one cohort of 77 students within one English inner-city university.</div></div><div><h3>Methods</h3><div>Routinely collected data were extracted from 77 undergraduate student midwifery documents relating to births from 2020 to 2023. 3055 births were included. Data were analysed using descriptive and inferential statistics.</div></div><div><h3>Findings</h3><div>Most births occurred in Obstetric Unit (OU) settings (71 %). Most care was provided to birthing women/people who were multiparous at term gestation, who used at least one form of pharmacological analgesia. Most births were facilitated in either semi recumbent (45.6 %) or lithotomy birth positions (24 %) with the OU setting accounting for 91 % of these. Some birthing pool use for labour and/or birth were documented where the majority occurred in Alongside Midwifery Unit (AMU) settings. Comparisons between each student demonstrated wide variations of exposure to midwifery-led care practices.</div></div><div><h3>Conclusion</h3><div>Our findings highlighted that the students had extensive experience within OUs and with medicalised care practices but less consistent exposure to midwifery-led practices. Without exposure to midwifery-led birth practices across all settings, students qualify without the necessary experience to build their competency to optimise physiological birth processes, raising concerns for their preceptor period and beyond.</div></div>","PeriodicalId":48868,"journal":{"name":"Women and Birth","volume":"38 4","pages":"Article 101937"},"PeriodicalIF":4.4,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144255079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the impact of the induction of labour improvement initiative on clinical outcomes, women’s care satisfaction, and clinician experiences","authors":"Vidanka Vasilevski ,&nbsp;Hayley Pohatu ,&nbsp;Sara Holton ,&nbsp;Karen Wynter ,&nbsp;Linda Sweet","doi":"10.1016/j.wombi.2025.101935","DOIUrl":"10.1016/j.wombi.2025.101935","url":null,"abstract":"<div><h3>Background</h3><div>Rates of induction of labour (IOL) continue to rise globally. Clinician recommendations for IOL vary and are often driven by uncertainty or risk aversion. Evidence suggests that improving guidelines and practices may support clinician IOL decision-making, and support women to make informed choices and have positive IOL experiences. An IOL improvement initiative, including evidence-based guidelines and an IOL Liaison Midwife, was implemented at an Australian maternity hospital.</div></div><div><h3>Aims</h3><div>To evaluate the outcomes of the IOL improvement initiative by examining clinical outcomes, compliance with new IOL guidelines, women’s care satisfaction, and clinicians’ experiences.</div></div><div><h3>Methods</h3><div>A multi-method evaluation including: a retrospective audit of medical records to determine rates and reasons for IOL pre/post-initiative (n = 2676), surveys (pre IOL, n = 100) and interviews (post-birth, n = 48) with women, and clinician focus groups or interviews (n = 23).</div></div><div><h3>Findings</h3><div>The IOL rate significantly reduced by 5 % post-implementation (43.3 % vs 38.6 %; p &lt; 0.01). Indications for IOL also changed significantly, with fewer women being induced for reasons no longer being recommended in the new guidelines. The survey findings showed that over half of the women did not know why (54 %) or how (36 %) they would be having an IOL. Qualitative data indicated that discussions with the IOL Liaison Midwife improved women’s understanding and expectations of IOL. Clinician feedback highlighted the improved workflows and justification for IOL recommendations as a result of the initiative.</div></div><div><h3>Conclusions</h3><div>The initiative had a positive impact on IOL rates and reasons, and the experiences of women and clinicians. Implementation in other maternity settings is warranted.</div></div>","PeriodicalId":48868,"journal":{"name":"Women and Birth","volume":"38 4","pages":"Article 101935"},"PeriodicalIF":4.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Economic evaluation of a randomised controlled trial - An online bereavement support program for parents following perinatal death","authors":"Emily Callander ,&nbsp;Yanan Hu ,&nbsp;Claudia Bull ,&nbsp;Vicki Flenady ,&nbsp;David Ellwood ,&nbsp;Ann Lancaster ,&nbsp;Fran Boyle ,&nbsp;Siobhan Loughnan ,&nbsp;LWL Collaborative Group","doi":"10.1016/j.wombi.2025.101933","DOIUrl":"10.1016/j.wombi.2025.101933","url":null,"abstract":"<div><h3>Background</h3><div>Delivering timely, accessible, and cost-effective perinatal bereavement support to parents is essential to support their emotional and mental wellbeing. However, there is limited evidence on the economic impact of online-based support programs.</div></div><div><h3>Objective</h3><div>This study conducted a cost-utility analysis of parents who participated in a randomised controlled trial – comparing the <em>Living with Loss</em> program (LWL; eight-week online program for parents following perinatal death) with care-as-usual (CAU), from the perspective of the healthcare system.</div></div><div><h3>Methods</h3><div>A health service utilisation survey was designed to collect the hospital and out-of-hospital health services, and prescription medications accessed by participants during the study period. Total costs included costs to the governments and individuals (AUD 2023/24) over time. Utility was measured using quality-adjusted life years (QALYs) calculated based on the Assessment of Quality of Life (AQoL)-8D.</div></div><div><h3>Findings</h3><div>Among the 95 randomised parents, 52 (20 LWL, 32 CAU) completed economic assessments at baseline (week 0) and post-program (week 9). Of these 52 participants, 39 (16 LWL, 23 CAU) further completed the three-month follow up assessment (week 21).</div><div>Compared with CAU, the LWL program showed trends towards costs savings in primary care and maintained similar health outcomes at post-program (-$264.59 per participant, p = 0.47; QALY gained=-0.001, p = 0.9) and three-month follow up (-$531.52 per participant, p = 0.3; QALY gained=-0.002, p = 0.94).</div></div><div><h3>Conclusion</h3><div>This study provides preliminary evidence of potential economic benefits of the LWL Program. Future studies with larger sample sizes and adequate power are needed to fully assess the cost-effectiveness of online perinatal bereavement support services.</div></div>","PeriodicalId":48868,"journal":{"name":"Women and Birth","volume":"38 4","pages":"Article 101933"},"PeriodicalIF":4.4,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144195947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep practices and association between supine sleep position and stillbirth in a rural sample of pregnant women in Bangladesh","authors":"Stella Rose Harris ,&nbsp;Sk Masum Billah ,&nbsp;Sajia Islam ,&nbsp;S.M. Rokonuzzaman ,&nbsp;Neeloy Ashraful Alam ,&nbsp;Rashidul Azad ,&nbsp;Camille Raynes-Greenow","doi":"10.1016/j.wombi.2025.101934","DOIUrl":"10.1016/j.wombi.2025.101934","url":null,"abstract":"<div><h3>Objective</h3><div>To describe maternal sleep practices and assess the association between maternal supine sleep position and stillbirth.</div></div><div><h3>Methods</h3><div>The study was a secondary analysis of the control arm of a community-based cluster randomised controlled trial conducted in the Sherpur district of Bangladesh. A maternal sleep position questionnaire was prospectively administered to participants between May 2021 and November 2021. Pregnancy outcomes were collected by the field staff within 10 days of birth for participants. Multivariate Poisson regression model was used to evaluate the association between stillbirth and supine falling-to-sleep position, reporting both the relative risk (RR), adjusted relative risk (aRR) with 95 % confidence intervals.</div></div><div><h3>Results</h3><div>We included 799 births of the participating and eligible control women. A lateral sleep position was reported by 95.1 % of women, 4.8 % reported a supine sleep position. There were 19 stillbirths, a rate of 24 per 1000 births. Sharing the bed with others, ease of sleeping and level of comfort were not found to be associated with sleep position. There was no association between supine falling-to-sleep position and stillbirth (aRR 2.07, 95 % CI 0.59–7.28).</div></div><div><h3>Conclusion</h3><div>The study did not identify an association between supine sleep position and stillbirth, which may be due to both the low prevalence of stillbirth as an outcome of research, and the low frequency of supine sleep position. This is the largest study within a low-and-middle income country to assess sleep practices and sleep environment in pregnancy.</div></div>","PeriodicalId":48868,"journal":{"name":"Women and Birth","volume":"38 4","pages":"Article 101934"},"PeriodicalIF":4.4,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144195827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reframing birth: Social space as a humanizing lens in the Global South","authors":"Rikas Saputra ,&nbsp;Yenni Lidyawati","doi":"10.1016/j.wombi.2025.101936","DOIUrl":"10.1016/j.wombi.2025.101936","url":null,"abstract":"","PeriodicalId":48868,"journal":{"name":"Women and Birth","volume":"38 4","pages":"Article 101936"},"PeriodicalIF":4.4,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of working in continuity of care models on Australian midwives: A scoping review","authors":"Michelle B. Hobday ,&nbsp;Jennifer Fenwick ,&nbsp;Jane Reynolds ,&nbsp;Kirsten A. Small ,&nbsp;Chanelle Warton ,&nbsp;Melanie Robinson ,&nbsp;Caroline SE Homer ,&nbsp;Joanne Gray ,&nbsp;Kathleen Baird ,&nbsp;Zoe Bradfield","doi":"10.1016/j.wombi.2025.101932","DOIUrl":"10.1016/j.wombi.2025.101932","url":null,"abstract":"<div><h3>Problem</h3><div>Global and national strategy directives identify continuity of midwifery carer (CoMC) models as important priorities for workforce development. There are concerns about the impacts of working in CoMC on the midwifery workforce in Australia.</div></div><div><h3>Background</h3><div>CoMC models enable care across the childbearing continuum from a single midwife or small group of midwives known to the pregnant woman, improving perinatal outcomes. Potential impacts on midwives working in these models include work-life balance, retention, professional progression, professional satisfaction, burnout and attrition.</div></div><div><h3>Aim</h3><div>To review and synthesise research reporting the impact of working in CoMC models on midwives in Australia, and identify knowledge gaps to guide future research.</div></div><div><h3>Methods</h3><div>This review adopted the Joanna Briggs Institute methodology for scoping reviews and the PRISMA-ScR check list. A search strategy was developed using keywords relating to the midwifery profession, location (Australia) and CoMC models. Four databases were searched, relevant papers were identified, data extracted and synthesised.</div></div><div><h3>Findings</h3><div>Thirty-two papers met the inclusion criteria for this review. Impacts were identified under the following themes: positive partnerships with women, improved professional satisfaction, work-life balance, impact on professional relationships and positive psychological health and wellbeing.</div></div><div><h3>Discussion</h3><div>These impacts are mostly positive, with evidence of lower levels of intention to leave the workforce and reduced levels of burnout, compared to those working in shift-based models.</div></div><div><h3>Conclusion</h3><div>The effect of variations in on-call arrangements were identified as an aspect of work-life balance for future research. Findings are relevant for health service design reform and strategic national workforce planning.</div></div>","PeriodicalId":48868,"journal":{"name":"Women and Birth","volume":"38 4","pages":"Article 101932"},"PeriodicalIF":4.4,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing collaboration between midwives and obstetricians: A qualitative content analysis study","authors":"Liesa Beier ,&nbsp;Ans Luyben ,&nbsp;Qendresa Thaqi ,&nbsp;Rahel Naef","doi":"10.1016/j.wombi.2025.101929","DOIUrl":"10.1016/j.wombi.2025.101929","url":null,"abstract":"<div><h3>Problem</h3><div>Collaboration between midwives and obstetricians is insufficiently developed in Swiss and other healthcare systems.</div></div><div><h3>Background</h3><div>Collaboration in maternity care impacts birth outcomes. Previous studies have focused on determinants of collaboration, but it remains unclear how to promote interprofessional birthing care.</div></div><div><h3>Aim</h3><div>This study aimed to identify strategies for enhancing collaboration between midwives and obstetricians.</div></div><div><h3>Methods</h3><div>We conducted a qualitative content analysis study with midwives and obstetricians in three acute care hospitals in the German-speaking part of Switzerland. Data were collected through focus group interviews and analysed using inductive content analysis following Graneheim and Lundman.</div></div><div><h3>Findings</h3><div>Eleven midwives and nine obstetricians participated. Three strategies with seven categories emerged that might enhance collaboration between midwives and obstetricians on Swiss labour wards: (1) getting to know each other, (2) building trustful relationships, and (3) creating safe practice environments for collaborative practice.</div></div><div><h3>Discussion</h3><div>The findings highlight the need to promote early mutual understanding of professional roles, responsibilities, and care philosophies. Trust-building through open communication and shared decision-making was considered vital for effective collaboration. Early and ongoing joint opportunities for education, training, and professional development is required. Systemic, structural support is necessary, including shared workflow, established, interprofessional communication structures, and leadership that fosters psychological safety. Organisational commitment is essential to embedding collaboration in practice.</div></div><div><h3>Conclusion</h3><div>Enhancing collaboration in maternity care requires a multi-level approach. Efforts should focus on interprofessional learning, mutual understanding of roles, trust-building practices, and supportive institutional structures. Leadership that models inclusive behaviours and reduces perceived hierarchies is key to strengthening collaboration.</div></div>","PeriodicalId":48868,"journal":{"name":"Women and Birth","volume":"38 4","pages":"Article 101929"},"PeriodicalIF":4.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy and extreme heat events: A rapid review of evidence related to health outcomes, risk factors and interventions","authors":"Caroline Li-Maloney ,&nbsp;Katie E. Wagar ,&nbsp;Emily J. Tetzlaff ,&nbsp;Glen P. Kenny","doi":"10.1016/j.wombi.2025.101931","DOIUrl":"10.1016/j.wombi.2025.101931","url":null,"abstract":"<div><h3>Background</h3><div>Climate change is increasing the frequency and severity of extreme heat events (EHEs), resulting in increased morbidity and mortality for vulnerable populations. Pregnant people and fetuses are at risk for adverse pregnancy outcomes from EHEs.</div></div><div><h3>Objective</h3><div>To collate and synthesize existing evidence on the effects of EHE on pregnant people and fetuses and relevant mitigating factors and interventions to inform healthcare providers and other pregnancy-focused audiences.</div></div><div><h3>Methods</h3><div>A peer-reviewed search strategy was conducted in MEDLINE, EMBASE, Global Health, CAB Abstracts, SCOPUS, and ProQuest Public Health, for empirical studies and reviews published between 2009 and 2023 in English and French. The search strategy focused on terms related to EHEs, exposure, and pregnancy. Health outcomes, risk factors and interventions relating to EHEs (defined based on high ambient temperature thresholds) were reviewed and narratively reported.</div></div><div><h3>Findings</h3><div>Sixty-eight studies were included (<em>n</em> = 16 reviews; <em>n</em> = 52 empirical studies). Associations between both adverse fetal outcomes (e.g., pre-term birth) and maternal outcomes (e.g., severe maternal morbidities) and EHEs were identified. Pregnant people with low socioeconomic status were found to be more likely to have morbidities. Interventions such as improved clinician support have been proposed by researchers to reduce the risk of poor pregnancy outcomes.</div></div><div><h3>Conclusion</h3><div>There is an association between EHEs and the development of pregnancy-related morbidity and mortality, mediated by environmental, social and intrinsic individual factors. There are remaining knowledge gaps that have been identified that should be addressed, but more importantly, the synthesis of this evidence highlights the urgent need for interventions such as improved healthcare provider education, and policy interventions to mitigate the health riskscaused by exposure to heat in pregnant populations.</div></div>","PeriodicalId":48868,"journal":{"name":"Women and Birth","volume":"38 4","pages":"Article 101931"},"PeriodicalIF":4.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives and experiences of induction of labour: An Australian cross-sectional study","authors":"Zoe Bradfield ,&nbsp;Georgia Griffin ,&nbsp;Jennifer Wood ,&nbsp;Lorna Finley ,&nbsp;Courtney Barnes ,&nbsp;Sonya Mahoney ,&nbsp;Scott White ,&nbsp;Lindsay Kindinger","doi":"10.1016/j.wombi.2025.101927","DOIUrl":"10.1016/j.wombi.2025.101927","url":null,"abstract":"<div><h3>Problem</h3><div>Despite being the most common obstetric intervention, little is known about women’s experiences of induction of labour (IOL).</div></div><div><h3>Background</h3><div>Rates of IOL have risen by 43 % in the past decade in Australia. There is limited evidence regarding women’s experiences of IOL. Consumer experience is a key safety and quality indicator.</div></div><div><h3>Aim</h3><div>To explore women’s perspectives and experiences of IOL.</div></div><div><h3>Methods</h3><div>A cross-sectional method via anonymous online survey, recruited and collected data from consenting women who underwent IOL regardless of gestation, level of risk or model of care, at a tertiary site. Quantitative data were analysed using descriptive and inferential statistics. Qualitative data were analysed using inductive content analysis.</div></div><div><h3>Findings</h3><div>A total n = 546 women participated. Most (68.9 %) were satisfied with their care. Significant differences were found in women’s experiences by parity, model of care and for those not speaking English at home. Four key categories and corresponding concepts were identified.</div></div><div><h3>Discussion</h3><div>Findings provide novel evidence of women’s experiences of IOL; offering new evidence, critical to contemporary maternity service planning. Inclusion of women in co-designed benchmarking of experiences and outcomes is recommended.</div></div><div><h3>Conclusion</h3><div>This research provides comprehensive exploration of women’s experiences of IOL in one of Australia’s largest tertiary maternity services. Findings report common and divergent perspectives useful to support clinical care reform and service redesign. Remaining gaps in evidence are highlighted with recommendations for future research including addressing the rates of primiparous IOL, the impact of continuity of midwifery carer on IOL experience outcomes; and Aboriginal women’s IOL experiences specifically.</div></div>","PeriodicalId":48868,"journal":{"name":"Women and Birth","volume":"38 4","pages":"Article 101927"},"PeriodicalIF":4.4,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144134207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}