Birth-Issues in Perinatal Care最新文献

{"title":"Birthing parent postpartum acute care use: Multilevel opportunities for strengthening healthcare","authors":"Clara E. Busse PhD, MPH,&nbsp;Alison M. Stuebe MD, MSc,&nbsp;Katherine Tumlinson PhD,&nbsp;Christine Tucker PhD,&nbsp;Catherine J. Vladutiu PhD,&nbsp;Brian Pence PhD,&nbsp;Kristin P. Tully PhD","doi":"10.1111/birt.12860","DOIUrl":"10.1111/birt.12860","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Two-thirds of pregnancy-related deaths occur from 1 day to 1 year after birth, and medical complications frequently occur after birth. Postpartum health concerns are often urgent, requiring timely medical care, which may contribute to a reliance on acute care. One approach to improving postpartum health is to investigate birthing parents' accounts of acute care use in the months after birth, which is what we did in this study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This mixed-methods study included questionnaire responses, semi-structured interviews, and chart review of 18 English-speaking individuals who used acute care in the 90 days after birth in the southeastern United States. Interviews were conducted remotely, recorded, and professionally transcribed. Qualitative data were inductively coded to iteratively develop categories and themes with respect to contributors and barriers to postpartum acute care use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Birthing parents engaged in complex decision-making processes to decide where and when to seek postpartum acute care in response to their urgent health concerns. Many described fear and uncertainty about their postpartum health. Most participants contacted a healthcare practitioner before using acute care, followed their guidance, and were treated or otherwise reassured at the acute care visit.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>These findings suggest multilevel opportunities for strengthening healthcare systems, including better-preparing individuals for the postpartum period and structuring care to accommodate birthing parents and include their support systems. The insights from this study can inform multilevel strategies for strengthening healthcare so that birthing parents are safe and well postpartum.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"51 4","pages":"843-854"},"PeriodicalIF":2.8,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142115004","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":"Experiences of attending prenatal ultrasounds during the COVID-19 pandemic in Australia: A cross-sectional survey","authors":"Helen J. Nightingale MMid,&nbsp;Christina Watts PhD,&nbsp;Kim Pham MD","doi":"10.1111/birt.12867","DOIUrl":"10.1111/birt.12867","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Prenatal ultrasounds form an important part of routine maternity care in Australia and indeed internationally. The COVID-19 pandemic necessitated rapid changes in society and healthcare to curb transmission, with evidence demonstrating detrimental impacts on childbearing women associated with these restrictions. However, experiences with pandemic restrictions for prenatal ultrasounds in relation to distress, patient expectations, and satisfaction are largely unknown. This study aimed to explore the experiences of pregnant women attending prenatal ultrasound during the pandemic in Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional online survey of people in Australia who had undergone at least one prenatal ultrasound during the period of maternity care restrictions was performed. The survey included validated tools for assessing post-traumatic stress, satisfaction, and expectations with maternity care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1280 responses were obtained. Almost 37% of respondents returned a PCL-C score consistent with probable post-traumatic stress disorder. Unexpected ultrasound findings or a high PCL-C score were more likely to have higher expectations and lower levels of satisfaction with their maternity care experience. Having an ultrasound for pregnancy loss, fetal abnormality, and/or a prior post-traumatic stress disorder diagnosis were the strongest factors correlating with a high PCL-C score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The prevalence of post-traumatic stress symptoms in the study population is concerning and elucidates the distress experienced in association with prenatal ultrasounds during pandemic restrictions in Australia. Maternity services should acknowledge the high levels of service consumers with post-trauma symptoms and consider trauma-responsive maternity care adaptations in response to adverse perinatal outcomes for those afflicted with post-trauma and distress-related symptoms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 1","pages":"100-111"},"PeriodicalIF":2.8,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12867","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037784","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":"The First Baby Study: What women would like to have known about first childbirth. A mixed-methods study","authors":"Kate M. Levett PhD,&nbsp;Kerry L. Sutcliffe PhD, MPhil,&nbsp;Jennifer Vanderlaan PhD,&nbsp;Kristen H. Kjerulff PhD","doi":"10.1111/birt.12854","DOIUrl":"10.1111/birt.12854","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although prenatal care providers aim to prepare women for first childbirth, little research has explored retrospectively what birthing people would like to have known before first childbirth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To describe women's reports of what they would like to have known before first childbirth but feel they were not told.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a secondary analysis of the First Baby Study, a large prospective cohort study conducted in Pennsylvania, USA. Telephone interviews were conducted with 3006 women 1 month after their first childbirth. Women were first asked: “Was there anything that you would have liked to have known before your delivery that you were not told?”. If “yes” they were asked a second question: “Please tell me what you would have liked to have known before your delivery”.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Analysis</h3>\u0000 \u0000 <p>A convergent mixed-methods analysis including descriptive analytics to compare characteristics of women by answers to the first question, and qualitative content analysis of women's open-ended answers to the second question.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>A total of 441 women (14.7%) reported there was something they would like to have known before their first childbirth. Women described that communication with care providers was their main concern. They would have liked a better understanding of their options before birth, more agency in decision-making, and more information about the topics of their body, their birth, their baby, and what to expect beyond birth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Results highlight important topics for childbirth education, and the impact of gaps in shared decision-making, patient–provider communication, and supportive care practices for first childbirth, especially where women have identified vulnerabilities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"51 4","pages":"795-805"},"PeriodicalIF":2.8,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12854","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019669","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":"Domestic and family violence and associated maternal and perinatal outcomes: A population-based retrospective cohort study","authors":"Kathleen Marion Baird PhD,&nbsp;Hala Phipps PhD,&nbsp;Nasrin Javid PhD,&nbsp;Bradley, Stephen de Vries PhD","doi":"10.1111/birt.12863","DOIUrl":"10.1111/birt.12863","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Domestic family violence (DFV) is a global health concern affecting one in three women worldwide. Women are vulnerable to DFV throughout their life; however, pregnancy introduces an increased risk of experiencing DFV for millions of women and birthing people.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Routinely collected data from two hospitals in one local health district in New South Wales, Australia, were examined to determine the prevalence of DFV from 2010 to 2019. Demographics and outcome factors were compared by a reported history of DFV. Multivariable logistic regression was used to assess for predictors of DFV and to assess DFV as a predictor of adverse maternal and perinatal outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One percent of women (538/52,469) experienced DFV in the past year. Women experiencing domestic violence were more likely to be younger and have previous children, and had higher Edinburgh Depression Scores. These women were more likely to experience stillbirth (1.5% vs. 0.6%, <i>p</i> = 0.005). Maternal age &lt; 25 years, cigarette smoking, alcohol use in pregnancy, mental health issues, and place of birth were associated with a recent history of DFV after adjusting for confounders. Recent DFV was associated with preterm birth and mental health issues but was not associated with admission to the neonatal nursery, small-for-gestational-age birthweight, or caesarean section after adjusting for confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There was a relationship between DFV and poorer health outcomes for both women and their babies. This study highlighted that stillbirth is high among the population of women who experience DFV when compared to women who do not experience DFV.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 1","pages":"89-99"},"PeriodicalIF":2.8,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12863","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005982","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":"How well can the fetal heart rate baseline be assessed by intrapartum intermittent auscultation? An interrater reliability and agreement study","authors":"Christina Hernandez Engelhart MMid,&nbsp;Sophie Vanbelle PhD,&nbsp;Pål Øian MD, PhD,&nbsp;Aase Serine Devold Pay PhD,&nbsp;Anne Kaasen PhD,&nbsp;Ellen Blix PhD","doi":"10.1111/birt.12858","DOIUrl":"10.1111/birt.12858","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We aimed to examine the inter-reliability and agreement among midwives when assessing the fetal heart rate (FHR) using the handheld Doppler. The primary aim was to measure the reliability and agreement of FHR baseline (baseline) as beats per minute (bpm). The secondary aims were to measure fluctuations from the baseline, defined as increases and decreases, and classifications (normal or abnormal) of FHR soundtracks. This is the first interrater reliability and agreement study on intermittent auscultation (IA) to our knowledge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The participant population consisted of 154 women in labor, from a mixed-risk population and admitted to hospital for intrapartum care. The rater population were 16 midwives from various maternity care settings in Norway. A total of 154 soundtracks were recorded with a handheld Doppler device, and the 16 raters assessed 1-min soundtracks once, through an online survey (Nettskjema). They assessed the baseline, FHR increase or decrease, and the FHR classification. The primary outcome, baseline, was measured with intraclass correlation coefficient (ICC). The secondary outcomes were measured with kappa and proportion of agreement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The interrater reliability for the baseline (bpm) was ICC(A,1) 0.74 (95% CI 0.69–0.78). On average, an absolute difference of 7.9 bpm (95% CI 7.3–8.5 bpm) was observed between pairs of raters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our results demonstrate an acceptable level of reliability and agreement in assessing the baseline using a handheld Doppler.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"51 4","pages":"835-842"},"PeriodicalIF":2.8,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12858","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009978","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":"Unveiling injustice: Disrupting child removal policies and upholding breastfeeding: An emancipatory framework","authors":"Amanda Peek BMid (Hon), IBCLC,&nbsp;Sharynne Hamilton PhD, BA, BWomSt, ADJPROF,&nbsp;Marjorie Atchan PhD, BN, MEd/Wrk,&nbsp;Natasha Jojo PhD, MSc (MHN). BSC(N),&nbsp;Holly Northam OAM, PhD, MCritCareNurs, RN, RM, Churchill Fellow, SFHEA","doi":"10.1111/birt.12852","DOIUrl":"10.1111/birt.12852","url":null,"abstract":"<p>Before colonization, Aboriginal and Torres Strait Islander communities had nurturing, holistic, and communitarian approaches that promoted extended and healthy lives for their children. Colonization, marked by policies of genocide and assimilation, has resulted in an alarming overrepresentation of Aboriginal and Torres Strait Islander children under the care of child protection agencies, resulting in compromised health outcomes and reduced life expectancies. We are conducting a study designed to enhance positive developmental outcomes for Aboriginal and Torres Strait Islander children by articulating and enabling the rights of mothers and children to breastfeed in the context of a child protection intervention and child removal. To understand and address this problem, it is critical to implement culturally safe, de-colonized, emancipatory research that is guided by and benefits Aboriginal and Torres Strait Islander communities. This article presents an emancipatory framework that we are applying to our study using an Aboriginal participatory action research approach, that serves as a guide for non-Indigenous researchers seeking to conduct research with Indigenous communities. We emphasize the importance of incorporating an Aboriginal participatory action research framework, using community consultation and codesign; culturally secure data collection methods, and paying attention to Indigenous data sovereignty. Developing trusting respectful relationships is conducive to knowledge acquisition, exchange, and use, when research approaches deeply rooted in community involvement are applied. A call to action by the critical midwifery studies collective, urges non-Indigenous researchers to become accountable allies that demonstrates respect for community leadership while actively striving to ensure research does not perpetuate further harm, and produces effective change. This article provides an overview of ways to conduct ethical emancipatory research with Indigenous participants, that is, of benefit to midwifery practitioners and is applicable to many areas of research, policy, and practice.</p>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 3","pages":"448-456"},"PeriodicalIF":2.5,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12852","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989557","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":"Parents' and healthcare providers' perceptions, experiences, knowledge of, and attitudes toward kangaroo care of preterm babies in hospital settings: Mixed-methods systematic review","authors":"Amal Almutairi RN, AC-PNP,&nbsp;Anna Gavine PhD,&nbsp;Alison McFadden PhD","doi":"10.1111/birt.12859","DOIUrl":"10.1111/birt.12859","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Kangaroo care is an effective intervention to increase survival and improve the health and development of preterm infants. Despite this, implementation of kangaroo care globally remains low. The objectives of this review were to: (a) synthesize evidence on parents' and healthcare practitioners' perceptions, experiences, knowledge of, and attitudes toward kangaroo care of preterm babies in hospital settings; and (b) establish parents' satisfaction with kangaroo care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Studies of any design were included if they focused on parents' or healthcare practitioners' perceptions, experiences, knowledge of, and attitudes to kangaroo care of preterm babies, or reported parents' satisfaction, and were conducted in hospital settings. The search of seven electronic databases, African Journals Online, World Health Organization regional databases, and a gray literature search was conducted in April/May 2020, and updated in January 2024. Study selection was undertaken by two independent reviewers. Quality assessment using the Mixed Method Appraisal Tool and data extraction were completed by one reviewer with a 10% check by a second reviewer. Data were synthesized narratively using a parallel results convergent integrated design.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-seven studies, 19 quantitative, 16 qualitative, and 2 mixed methods, were included. The findings suggested that while healthcare practitioners generally demonstrated knowledge about kangaroo care, there was a notable minority with insufficient understanding among those who received training. Parents' knowledge, particularly among fathers, was limited. Both healthcare practitioners and parents appeared to have positive attitudes to kangaroo care. Little is known about parental satisfaction with kangaroo care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Most healthcare practitioners were knowledgeable about kangaroo care, but parents had limited knowledge. This review findings suggest a need to enhance parental knowledge of kangaroo care before neonatal unit admission, and training is needed for HCPs to implement kangaroo care consistently.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"51 4","pages":"690-707"},"PeriodicalIF":2.8,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977262","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":"Assessing patient autonomy in the context of TeamBirth, a quality improvement intervention to improve shared decision-making during labor and birth","authors":"Vanessa L. Neergheen MPH,&nbsp;Lynn El Chaer MPH,&nbsp;Avery Plough MPH,&nbsp;Elizabeth Curtis RN,&nbsp;Victoria J. Paterson MPH,&nbsp;Trisha Short RN,&nbsp;Amani Bright BS,&nbsp;Stuart Lipsitz ScD,&nbsp;Aizpea Murphy BA,&nbsp;Kate Miller PhD,&nbsp;Laura Subramanian MS,&nbsp;Evelyn Radichel MSN,&nbsp;John Ervin MD,&nbsp;Lindsay Castleman RN,&nbsp;Erin Brown DO,&nbsp;Tracy Yeboah BS,&nbsp;Tiffany Moore Simas MD, MPH, MEd,&nbsp;Daniel Terk MD,&nbsp;Saraswathi Vedam CNM, MSN, RM,&nbsp;Neel Shah MD,&nbsp;Amber Weiseth DNP","doi":"10.1111/birt.12857","DOIUrl":"10.1111/birt.12857","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Respectful maternity care includes shared decision-making (SDM). However, research on SDM is lacking from the intrapartum period and instruments to measure it have only recently been developed. TeamBirth is a quality improvement initiative that uses team huddles to improve SDM during labor and birth. Team huddles are structured meetings including the patient and full care team when the patient's preferences, care plans, and expectations for when the next huddle will occur are reviewed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used patient survey data (<i>n</i> = 1253) from a prospective observational study at four U.S. hospitals to examine the relationship between TeamBirth huddles and SDM. We measured SDM using the Mother's Autonomy in Decision-Making (MADM) scale. Linear regression models were used to assess the association between any exposure to huddles and the MADM score and between the number of huddles and the MADM score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In our multivariable model, experiencing a huddle was significantly associated with a 3.13-point higher MADM score. When compared with receiving one huddle, experiencing 6+ huddles yielded a 3.64-point higher MADM score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Patients reporting at least one TeamBirth huddle experienced significantly higher SDM, as measured by the MADM scale. Our findings align with prior research that found actively involving the patient in their care by creating structured opportunities to discuss preferences and choices enables SDM. We also demonstrated that MADM is sensitive to hospital-based quality improvement, suggesting that future labor and birth interventions might adopt MADM as a patient-reported experience measure.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"51 4","pages":"855-866"},"PeriodicalIF":2.8,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977336","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":"Toward a semiotics of midwifery: Multimodal communication's effects on accessibility, equity, and power dynamics","authors":"Jane Celeste PhD, HBCE","doi":"10.1111/birt.12853","DOIUrl":"10.1111/birt.12853","url":null,"abstract":"<p>According to semiotics, we live in a world of signs, where almost anything can act as a signifier and convey meaning. But what of the semiotic landscape of midwifery? What signs are present within a client's multi-sensory experience of their midwifery care? How are these signs functioning to increase equity and accessibility? Or worse, how might certain aspects of the client's experience communicate unjust power dynamics? Semiotics allows us to examine a wide communicative and educational environment. By paying particular attention to the multivalent meanings of different signs—be they written, visual, oral, or even physical—we can start to see how multimodal communication plays a vital role in a client's perception of equity and power. One way to improve client experience is by approaching education and semiotic experience from the same place as trauma-informed care. A more health-literate sensitive approach viewed through the lens of semiotics assumes all clients have little previous knowledge or comfort within a care setting. This hyperawareness and criticality of the semiotic environment would allow midwives to acknowledge various sensory and communicative biases and intentionally redesign the entire client experience. The semiotic landscape is then curated to meet the needs of the most important audience—those marginalized and discriminated against whether that is because of education, finances, race, gender, or any other intersectional identity. We must acknowledge the fact that all sign systems can either reinforce abusive power relations or work to improve them. For what is at stake here is not just a client's overall comfort, but their full understanding of the care they are receiving, the options they have, and their autonomy within their entire perinatal experience.</p>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 3","pages":"457-461"},"PeriodicalIF":2.5,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972365","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":"The impact of relationship factors on antenatal depression in the context of the COVID-19 pandemic","authors":"Chloe Pekarsky BHSc,&nbsp;Janice Skiffington MSc,&nbsp;Kathleen Chaput PhD,&nbsp;Donna Slater PhD,&nbsp;Lara M. Leijser MSc, MD, PhD,&nbsp;Amy Metcalfe PhD","doi":"10.1111/birt.12862","DOIUrl":"10.1111/birt.12862","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Antenatal depression is the most prevalent pregnancy-associated mental health disorder. Previous studies have identified several risk factors for antenatal depression, including partner support. However, during the COVID-19 pandemic, many relationship dynamics changed. This study examined the extent to which relationship factors had an impact on antenatal depression in comparison with other well-researched factors in the context of the pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A secondary analysis was conducted using data from the P3 Cohort in Calgary, a longitudinal cohort study based in Alberta, Canada. Pregnant people (<i>n</i> = 872) completed self-report questionnaires and validated scales about sociodemographic, psychological, and relationship characteristics. Antenatal depression was assessed using the Edinburgh Postnatal Depression Scale (EPDS). Logistic regression was used to assess the impact of reported characteristics on antenatal depression. Tests of model fit were used to examine whether the inclusion of variables related to relationship quality improved model fit after accounting for other known risk factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 18.23% of participants experienced antenatal depression. Relationship factors including relationship unhappiness (OR = 1.98 [95% CI: 1.06–3.69]), having an upsetting partner (OR = 2.00 [95% CI: 1.17–3.40]), and having a lower quality of relationships with close friends and family (OR = 1.76 [95% CI: 1.14–2.73]) were associated with antenatal depression; however, inclusion of these relationship factors did not improve model fit after accounting for other known predictors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Overall, relationship factors were not associated with antenatal depression during the pandemic after accounting for other known risk factors. Stress and anxiety caused by the pandemic may have overshadowed the impact of relationship factors, or relationship factors may have contributed to higher levels of stress and anxiety more generally within our sample.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 1","pages":"78-88"},"PeriodicalIF":2.8,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12862","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972364","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}