Women and Birth最新文献

{"title":"Midwives’ and nurses’ experiences of providing postnatal care in partnership: A cross-sectional study","authors":"Kyle Ernst ,&nbsp;Georgia Griffin ,&nbsp;Monique S. Rose ,&nbsp;Andrew Szabo ,&nbsp;Stuart Watson ,&nbsp;Zoe Bradfield","doi":"10.1016/j.wombi.2024.101851","DOIUrl":"10.1016/j.wombi.2024.101851","url":null,"abstract":"<div><h3>Problem</h3><div>It is unknown whether the deployment of registered nurses to assist midwives in the provision of postnatal care eases the burden of workforce shortages.</div></div><div><h3>Background</h3><div>The largest public maternity health service in Western Australia began employing registered nurses in 2022 to assist midwives with the provision of postnatal care on maternity wards in response to staffing shortages, exacerbated by COVID-19.</div></div><div><h3>Aim</h3><div>To explore midwives’ and registered nurses’ experiences of providing postnatal care on maternity wards together.</div></div><div><h3>Methods</h3><div>A descriptive cross-sectional design was employed. Quantitative and qualitative data were collected using a paper-based survey tool. Data were analysed using descriptive and inferential statistics. Content analysis was conducted on qualitative data.</div></div><div><h3>Results</h3><div>70 staff participated (<em>n</em>= 58 midwives, <em>n</em>=12 nurses). Only 19.2 % of participants felt positively about their workload allocation. Most participants (62.7 %) reported a usual allocation of 6–7 mother-baby dyads to care for. Significantly more midwives preferred allocation by the shift coordinator than nurses; and significantly more nurses preferred ‘team nursing’ than midwives.</div></div><div><h3>Discussion</h3><div>Strategic approaches are needed to improve recruitment and retention of midwifery workforce capable of responding to periods of acute demands across the full scope of midwifery practice. Guidance concerning nurses’ scope of practice in the postnatal setting is necessary from a professional, medico-legal, governance and safety standpoint.</div></div><div><h3>Conclusion</h3><div>The deployment of registered nurses into postnatal wards may be of some benefit to midwives in the context of workforce shortages. Parameters must be set outlining what is within nurses’ scope of practice in the postnatal care setting.</div></div>","PeriodicalId":48868,"journal":{"name":"Women and Birth","volume":"38 1","pages":"Article 101851"},"PeriodicalIF":4.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928897","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":"Embedding LGBTQIA+ health equity in midwifery education: A holistic whole-of-programme approach","authors":"George Parker ,&nbsp;Fleur Kelsey ,&nbsp;Suzanne C. Miller ,&nbsp;Christine R. Griffiths ,&nbsp;Alex Ker ,&nbsp;Sally A. Baddock","doi":"10.1016/j.wombi.2024.101850","DOIUrl":"10.1016/j.wombi.2024.101850","url":null,"abstract":"<div><div>Skilled midwifery care for LGBTQIA+ people is a human right, however LGBTQIA+ people have been under-served in perinatal care by the privileging of cisgender heterosexual endosex women as recipients of care. The education of midwives and other professionals to provide LGBTQIA+ inclusive care is a critical component of wider strategies to address LGBTQIA+ discrimination in perinatal care.</div><div>This paper responds to this challenge by discussing an innovative and holistic approach to introducing and embedding LGBTQIA+ health equity into one midwifery education programme in Aotearoa New Zealand. This approach harnesses opportunities in both the formal and informal curriculum and draws on the conceptual frameworks of cultural safety and humility, intersectionality, and Indigenous justice. These frameworks have informed an on-going process of reflection on, and unlearning of, cis-heteronormativity and other systemic injustices when providing perinatal care to diverse populations, for both midwifery educators and students.</div></div>","PeriodicalId":48868,"journal":{"name":"Women and Birth","volume":"38 1","pages":"Article 101850"},"PeriodicalIF":4.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Midwives’ experiences of receiving maternity care and predictors of their overall birth experiences.","authors":"Sharon Coulton Stoliar ,&nbsp;Hannah Dahlen ,&nbsp;Russell Thomson ,&nbsp;Athena Sheehan","doi":"10.1016/j.wombi.2024.101860","DOIUrl":"10.1016/j.wombi.2024.101860","url":null,"abstract":"<div><h3>Background</h3><div>Limited research has been conducted on midwives’ experiences of receiving maternity care. Midwives may bring a degree of their own personal lives to their work, including their own birthing experience.</div></div><div><h3>Aim</h3><div>To explore midwives’ experiences of giving birth and receiving maternity care and predictors of overall birth experience.</div></div><div><h3>Participants</h3><div>Midwives who, after completing their midwifery education, experienced their first birth within the Australian maternity care system, were female, over the age of 18, and fluent in English.</div></div><div><h3>Methods</h3><div>Data from an online national survey were analysed using descriptive statistics, multiple regression analysis, and Kendall’s tau correlation studies.</div></div><div><h3>Findings</h3><div>In total, 447 midwives’ responses were included. Overall, 85 % of midwives reported positive birth experiences, 12.5 % a negative or traumatic birth experience, and 2.5 % neither positive nor negative. Five significant predictors of overall birth experience were: having a normal vaginal birth, maternity care providers who instilled a sense of confidence in their professional competence, receiving the maternity care options of their choice, being able to use professional knowledge to question and negotiate with care providers, and having control over their care. Overall, 27.1 % of midwives reported feeling coerced at any one or more points of time. Satisfaction with postnatal care was most strongly correlated with overall birth experience.</div></div><div><h3>Discussion</h3><div>Midwives appear to experience birth as an overall positive experience, and this could be due to their high level of agency and autonomy in choosing a known and trusted individual care provider; however, knowledge of possible complications could explain high levels of reported coercion. Midwives may need to invest more in getting good postnatal support in place, as this appeared to have the greatest impact on their overall birth experience.</div></div>","PeriodicalId":48868,"journal":{"name":"Women and Birth","volume":"38 1","pages":"Article 101860"},"PeriodicalIF":4.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Culturally responsive, trauma-informed, continuity of care(r) toolkits: A scoping review","authors":"Ellen McEvoy ,&nbsp;Storm Henry ,&nbsp;Maedeh Aboutalebi Karkavandi ,&nbsp;Jillian Donnelly ,&nbsp;Madeleine Lyon ,&nbsp;Natalie Strobel ,&nbsp;Jacqui Sundbery ,&nbsp;Helen McLachlan ,&nbsp;Della Forster ,&nbsp;Thiago Melo Santos ,&nbsp;Simone Sherriff ,&nbsp;Rhonda Marriott ,&nbsp;Catherine Chamberlain ,&nbsp;for the Replanting the Birthing Trees group","doi":"10.1016/j.wombi.2024.101834","DOIUrl":"10.1016/j.wombi.2024.101834","url":null,"abstract":"<div><h3>Background</h3><div>Models of care that are culturally responsive, trauma-informed and provide continuity of care(r), are important components of care for Aboriginal and Torres Strait Islander parents during the broad perinatal period (pregnancy to 2 years after birth; first 1000 days). Many health services do aim to incorporate these concepts in care provision, but often focus on only one.</div></div><div><h3>Aim</h3><div>To identify practical toolkits that guide implementation of culturally responsive care, trauma-informed care, or continuity of care(r) in the perinatal period, and map the key elements.</div></div><div><h3>Methods</h3><div>A scoping review was conducted. Relevant databases and grey literature were searched to identify toolkits that guided implementation of any one of the aforementioned concepts in the perinatal period. Toolkit context, principles, core components and processes were extracted and synthesised.</div></div><div><h3>Findings</h3><div>Thirteen toolkits, from both Indigenous and non-Indigenous contexts, met the inclusion criteria. Six related to culturally responsive care, nine to trauma-informed care, and eight to continuity of care(r), with some overlap. Key principles included continuity of carer, collaboration, woman (or family) centred care, safety and holistic care. Individualised care, team work, having a safe service environment and continuity of care/r were highlighted as core components. Key processes related to planning, implementation, monitoring and evaluation, and sustainability.</div></div><div><h3>Discussion</h3><div>There are no available resources that support holistic implementation of all three concepts of culturally responsive, trauma-informed continuity of care(r), spanning the first 1000 days, for Aboriginal and Torres Strait Islander families. A synthesised toolkit of key principles, core components and key processes would assist implementation of this.</div></div><div><h3>Statement of significance</h3><div>Problem: Aboriginal and Torres Strait Islander families experience health inequalities and poorer perinatal outcomes due to a legacy of colonisation and ongoing discrimination.</div></div><div><h3>What is already known</h3><div>Culturally responsive care, trauma-informed care and continuity of care(r) are elements of perinatal care shown to improve outcomes and experiences.</div></div><div><h3>What this paper adds</h3><div>This review synthesises key aspects of culturally responsive, trauma-informed and continuity of care(r) models. It highlights the lack of resources to support services implementing models pertaining to these three concepts across the full First 1000 days, for Aboriginal and Torres Strait Islander families.</div></div>","PeriodicalId":48868,"journal":{"name":"Women and Birth","volume":"37 6","pages":"Article 101834"},"PeriodicalIF":4.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Midwives’ readiness for midwife-led care: a mixed-methods study","authors":"Yvonne J. Kuipers ,&nbsp;Valerie Bosmans ,&nbsp;Ellen Thaels ,&nbsp;Vanessa De Bock","doi":"10.1016/j.wombi.2024.101840","DOIUrl":"10.1016/j.wombi.2024.101840","url":null,"abstract":"<div><h3>Background/Problem</h3><div>To integrate midwife-led care in Belgian maternity services, understanding whether midwives are primed of executing the change is needed.</div></div><div><h3>Aim</h3><div>To explore Belgian midwives’ readiness for midwife-led care and understand the underlying processes.</div></div><div><h3>Methods</h3><div>A mixed-methods sequential study: 1) A survey including 414 practising midwives and 2) individual interviews with 12 (student) midwives. General linear model analysis was used to examine the trend between knowledge, self-efficacy and performance mean scores - indicators of midwife-led care readiness - proposed in a 27-item questionnaire. The Readiness Assessment Framework served as a template for qualitative thematic analysis.</div></div><div><h3>Findings</h3><div>Template analysis illustrated the underlying mechanisms of midwifery-led care readiness: Governmental and institutional steering and rule-making functions, regulation and reimbursement, awareness of midwife-led care among stakeholders, capacity to extend primary care postpartum services to antenatal and intrapartum care and healthcare professionals’ lack of awareness of available data of women’s experiences and midwife-led care efficacy in Belgium. These qualitative findings contribute to the understanding of the significant trend with decreasing function for knowledge, self-efficacy and performance mean scores of 25 midwife-led care readiness indicators, and the two non-significant indicators referring to a physiological postpartum period.</div></div><div><h3>Discussion/Conclusion</h3><div>In determining midwife readiness for midwife-led care, we observed adequate knowledge mean scores, associated with low self-efficacy and even lower midwife-led care performance mean scores. Our findings suggest limited readiness for MLC in antenatal and intrapartum care. Belgian midwives are the domain experts of postpartum services but face challenges in extending midwife-led care to antenatal and intrapartum services.</div></div>","PeriodicalId":48868,"journal":{"name":"Women and Birth","volume":"37 6","pages":"Article 101840"},"PeriodicalIF":4.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142561373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do women have a choice when it comes to fetal monitoring? Perceptions of information provided and choice of fetal monitoring in Australia: A national survey","authors":"Kate M. Levett ,&nbsp;Deborah Fox ,&nbsp;Panashe Bamhare ,&nbsp;Kerry L. Sutcliffe ,&nbsp;Rebecca Coddington ,&nbsp;Liz Newnham ,&nbsp;Vanessa Scarf","doi":"10.1016/j.wombi.2024.101837","DOIUrl":"10.1016/j.wombi.2024.101837","url":null,"abstract":"<div><h3>Intro</h3><div>In Australia, little research has examined how women and people participate in decision-making about types of fetal monitoring, or their perceptions of information provided by caregivers.</div></div><div><h3>Methods</h3><div>A national cross-sectional survey, the ‘Women’s experiences Of Monitoring Baby’ (WOMB) Study, explored women’s experiences of intrapartum fetal monitoring. This study reports on selected results.</div></div><div><h3>Results</h3><div>There were 861 responses. Of respondents, 20 % reported receiving enough information about types of fetal monitoring from care providers and childbirth education, 35 % recalled being asked for consent, and 34 % were unaware they had a choice in monitoring. Most women (86 %) obtained information via ‘other’ sources or own reading, and where monitoring was discussed, it was most likely a ‘brief discussion’ with a midwife (43 %).</div><div>Women who were monitored via wired CTG (35 %) were more likely to report facing barriers to choosing their preferred monitoring type, (p&lt;0.001). Wired CTG was significantly associated with hospital type and primiparity and 70 % indicated they would not choose it again (p&lt;0.001).</div></div><div><h3>Conclusion</h3><div>Women did not know they had a choice in the type of intrapartum monitoring received, and felt they had insufficient information to make informed decisions. While monitoring via intermittent doppler and wireless CTG was preferred, women experienced barriers to receiving these, especially in public hospitals in rural/regional areas and private metropolitan hospitals. Antenatal models of care and childbirth education are underutilised avenues for providing information however, it is incumbent on maternity systems to provide adequate information resources, access to equipment and appropriate models of woman-centred and humane care.</div></div>","PeriodicalId":48868,"journal":{"name":"Women and Birth","volume":"37 6","pages":"Article 101837"},"PeriodicalIF":4.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Keeping birth at home: Community and service provider visions for perinatal wellness and continued Inuit childbirth in Nunavik","authors":"Hilah Silver ,&nbsp;Elisapi Padlayat ,&nbsp;Pasha Saviakjuk ,&nbsp;Ivan Sarmiento ,&nbsp;Richard Budgell ,&nbsp;Anne Cockcroft ,&nbsp;Zoua M. Vang ,&nbsp;Neil Andersson","doi":"10.1016/j.wombi.2024.101839","DOIUrl":"10.1016/j.wombi.2024.101839","url":null,"abstract":"<div><h3>Problem</h3><div>Childbirth on traditional territories is unattainable for many Indigenous peoples living in remote communities in Canada.</div></div><div><h3>Background</h3><div>In Nunavik, Inuit territory in northern Quebec, rapid population growth risks exceeding local midwifery capacity. This poses challenges to community-based childbirth in a region recognized for reclaiming Inuit midwifery and local birthing.</div></div><div><h3>Aim</h3><div>To explore community views on protective factors of maternal and family perinatal wellness and continued local birthing.</div></div><div><h3>Methods</h3><div>In ten communities, Inuit families and perinatal service providers created a total of 54 fuzzy cognitive maps on protective factors for (1) birth in a good way in Nunavik, (2) maternal and family perinatal wellness, and (3) community-based birthing in Nunavik. We used fuzzy transitive closure to examine direct and indirect connections and collated individual factors into categories using inductive thematic analysis.</div></div><div><h3>Findings</h3><div>Well-equipped local medical facilities and services, community birthing centres run by Inuit midwives, and Inuit perinatal traditions had the strongest influence on experiencing <em>birth in a good way in Nunavik</em>. Inuit youth perspectives featured instrumental and emotional support for mothers and families, along with health and self-care in pregnancy as the most influential factors on <em>maternal and family perinatal wellness</em>. Prominent protective factors for <em>community birth in Nunavik</em> included maternal-infant health and wellness, local Inuit midwifery services, and well-resourced medical facilities.</div></div><div><h3>Discussion</h3><div>Fuzzy cognitive mapping was helpful in informing community visioning of local childbirth and maternal and family perinatal wellness in Nunavik.</div></div><div><h3>Conclusion</h3><div>Inuit-led midwifery services are essential to continued local childbirth in the region.</div></div>","PeriodicalId":48868,"journal":{"name":"Women and Birth","volume":"37 6","pages":"Article 101839"},"PeriodicalIF":4.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549932","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":"Exploring the attitudes and beliefs of women regarding the implementation of midwife-led care in India: A mixed methods study","authors":"Marie Therese Sangy ,&nbsp;Maria J. Duaso,&nbsp;Claire Feeley,&nbsp;Shawn Walker","doi":"10.1016/j.wombi.2024.101836","DOIUrl":"10.1016/j.wombi.2024.101836","url":null,"abstract":"<div><h3>Problem</h3><div>Despite the recent introduction of midwifery services in India to improve maternal and newborn healthcare, there is limited research on women’s perspectives on midwife-led care.</div></div><div><h3>Background</h3><div>The Government of India initiated midwifery services guidelines in 2018 to improve the quality of care for pregnant women and newborns across the country. It is important to develop evidence-based strategies which can optimise the implementation of these new midwifery services.</div></div><div><h3>Aim</h3><div>This study explored women’s attitudes and beliefs towards the implementation of midwife-led care in two southern states of India.</div></div><div><h3>Methods</h3><div>A convergent mixed methods design was employed using an online questionnaire and semi-structured online interviews. Quantitative data was analysed using descriptive statistics and qualitative analysis used a framework approach. Data from both sources were then integrated through merging techniques.</div></div><div><h3>Findings</h3><div>A total of 307 women completed the online survey, and 23 participated in in-depth interviews. The study highlighted inadequate knowledge of midwife-led care among women. Despite this, 60 % expressed optimism about its benefits. Key factors to women’s acceptance included better understanding outcomes, having trust in midwives, receiving respectful care, and having autonomy in decision-making. They also required midwife-led birthing units would be clean, accessible, and well resourced.</div></div><div><h3>Discussion</h3><div>Most participants perceived midwife-led care as beneficial, valuing its skilled, responsive and compassionate services.</div></div><div><h3>Conclusion</h3><div>Insights from this study have implications for the implementation of midwife-led care which should consider the informational needs, safety standards and cultural contexts of women and their families living in both urban and rural areas of India.</div></div>","PeriodicalId":48868,"journal":{"name":"Women and Birth","volume":"37 6","pages":"Article 101836"},"PeriodicalIF":4.4,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the roles of workload and practice climate in workforce retention across the midwifery career lifespan: A latent profile analysis of early-, mid-, and late-career US midwives","authors":"E. Brie Thumm ,&nbsp;Denise Smith ,&nbsp;Zach Giano","doi":"10.1016/j.wombi.2024.101833","DOIUrl":"10.1016/j.wombi.2024.101833","url":null,"abstract":"<div><h3>Problem</h3><div>Retention of midwives across the career lifespan is essential to address workforce shortages.</div></div><div><h3>Background</h3><div>While workplace factors are demonstrated to affect job satisfaction and turnover intention, there is little research investigating how workplace factors affect midwives at different career stages. <em>Aim:</em> To examine the effects of workload and practice climate on job satisfaction and turnover intention at different career stages.</div></div><div><h3>Methods</h3><div>In a secondary analysis, we split a sample of US midwives into early-, mid-, and late-career stages. We used latent profile analysis to create profiles (called “classes”) of workload (volume of women/individuals receiving care and acuity) and practice climate. Job dissatisfaction and turnover intention were compared between classes by career stages.</div></div><div><h3>Findings</h3><div>Across all career stages, classes with negative practice climates had significantly higher turnover intention and job dissatisfaction, regardless of patient volume or acuity. Among early career midwives, high workload was not associated with high turnover intention or job dissatisfaction in the context of positive practice climates. The highest proportion of mid- career participants were in the class with high turnover intention and job dissatisfaction, while in the early career subsample the largest proportion was in the class with low dissatisfaction and low turnover intention.</div></div><div><h3>Discussion</h3><div>Across all career stages, the practice climate was the primary driver of turnover intention and job dissatisfaction. Practice climate is particularly important for early-career midwives working in high-volume settings. Mid-career midwives are an under-studied group at risk of leaving the profession.</div></div><div><h3>Conclusion</h3><div>Efforts to retain the midwifery workforce would benefit from tailoring retention strategies to midwives at different career stages.</div></div>","PeriodicalId":48868,"journal":{"name":"Women and Birth","volume":"37 6","pages":"Article 101833"},"PeriodicalIF":4.4,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528273","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":"How does place impact intrapartum practice for midwives and obstetricians?","authors":"Christine Mellor,&nbsp;Marion Hunter,&nbsp;Elizabeth Smythe","doi":"10.1016/j.wombi.2024.101829","DOIUrl":"10.1016/j.wombi.2024.101829","url":null,"abstract":"<div><h3>Background</h3><div>Rising rates of labour and birth interventions are causing concern, having the potential to cause harm if used inappropriately. International evidence demonstrates that place itself influences birth outcomes, but evidence is limited as to how. In New Zealand there are differences in the rates of spontaneous vaginal births by place, along with differences when benchmarking uncomplicated primiparae birthing in hospital maternity facilities throughout the country.</div></div><div><h3>Aim</h3><div>To develop understanding of how place influenced midwives’ and obstetricians’ practice in relation to supporting physiological birth.</div></div><div><h3>Method</h3><div>For this Hermeneutic Phenomenological study participants were purposively selected and consisted of nine midwives (employed and self-employed) and three obstetricians, all practising in midwifery led units or hospital maternity facilities. Data was collected using semi-structured interviews. The method of analysis involved writing and rewriting to surface interpretive insights, drawing on philosophical notions from Heidegger and Gadamer.</div></div><div><h3>Findings</h3><div>The findings revealed that place influences what practitioners are attuned to, what is easier for them to achieve, and their ability to provide woman-centred care. Competing tensions and pressures within place can blur the perceived relationship between normality and risk, influencing what is considered to be safe.</div></div><div><h3>Summary</h3><div>Place is not neutral; it influences how midwives and obstetricians practise and shapes how they support physiological labour and birth. The findings of this research contribute to a deeper understanding of the barriers and enablers to supporting physiological birth within place.</div></div>","PeriodicalId":48868,"journal":{"name":"Women and Birth","volume":"37 6","pages":"Article 101829"},"PeriodicalIF":4.4,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}