Australian Midwifery最新文献

The purpose of this paper is to evaluate the quality and significance of contemporary Australian midwifery research as reported in the Australian Midwifery Journal 2002–2004. The evaluation involved grading the research. The ultimate aim is to recommend some research strategies and areas of focus for our discipline over the next five to 10 years. The average score for quantitative research was 2.3 out of a possible 4 (with 4 being the highest possible). The average grades for significance as evidence for practice were calculated with 1 being the highest possible grade and 5 being the lowest possible. For qualitative research, the average grade was undesirably high at 4.2 and for quantitative research it was 4.4.

The grading exercise demonstrated that our current research output is, with some exceptions, not of high enough quality to be able to create evidence for practice. Thus, our first step must be to improve the quality of both our qualitative and quantitative research. Multi-site, team based, programmatic research is recommended as a multi-pronged strategy to improve the quality of our research, enhance our research training and become successful in funding applications. A limitation of the study is that the exercise would be strengthened if two or more reviewers had completed the reviews independently.

It is conservatively estimated that 1:3 Australian women leak urine following childbirth, an often unacknowledged, invisible and under-reported outcome. A framework for midwifery practice arose from the findings of a prospective, longitudinal study aimed to improve bladder outcomes for childbearing women (Stainton et al. 2005). This longitudinal study included bladder history and function as well as pregnancy, birth and postpartum factors of 124 women from first trimester through the first year postpartum. The identification of women who leak before their first pregnancy as being 4.14 times (p=0.02) more at risk for postpartum incontinence has significant implications for the provision of antenatal care that includes a history of bladder function. A pattern of urine leakage from early pregnancy through the first postnatal year provides a template for the timing of appropriate education, intervention, preventative care and referral. The language used is the key to midwives engaging women in discussing bladder health issues.

This study investigated fathers' functional status following the birth of a baby. Of the men who attended a variety of postnatal services within one regional centre in Queensland, Australia, 165 were surveyed at six weeks postpartum using the Inventory of Functional Status — Fathers (Tulman et al. 1993). Both first time and experienced fathers participated and all had fathered a healthy full-term infant. Results indicate that the fathers' functional status was highest in the areas of household, child-care and work related activities and lowest for infant care, personal and social activities. Although 83% of the fathers continued to work regular or increased hours outside the home, almost 30% managed to increase their involvement in activities involving home and family. Clearly most fathers appeared to engage in a balancing act that required them to relinquish some personal activities in order to be an involved parent. Practitioners should encourage new fathers to discuss their expectations of parenting and investigate the variety of leave options available to them to enable greater participation in activities at home.

The print and other forms of media offer significant amounts of information to women about pregnancy, parenthood and the birth process, but much less information exists about postnatal depression and how to cope with the frequently painful realities involved in childbirth and parenting — especially when debilitated by postnatal depression (PND).

Even less information exists about such women's reactions to interventions by health professionals, which is the subject of my Ph.D study in progress. This article reviews current literature about the clinical presentation of postnatal depression, the three major types of mood disorders following childbirth, the risk factors for postnatal depression, detection and treatment of postnatal depression and the need for further research on treatment outcomes for women with PND.

This study aimed to evaluate dinoprostone gel induction of labour. A prospective observational study was conducted over six months in 2001. Themes explored include predictive indicators within the Modified Bishop's Score, timing between doses, timing of administration and number of doses administered.

Labouring after one dose of dinoprostone gel is significantly related to a Modified Bishop's Score of >4 (p=0.005) and position of the cervix (p=0.031) for all women, and for multiparous women cervical dilatation (p=0.014). Timing of administration will not affect timing of delivery. There is no benefit in waiting more than six to eight hours between doses.

Assessing fetal heart and thus fetal wellbeing during labour and childbith is an important if contentious, clinical practice. There is debate and concern about optimal methods of fetal monitoring during low risk childbirth. This paper reports on the findings of a qualitative study that investigated current midwives' practices. Data from focus groups conducted with midwives practising in Queensland was subject to a qualitative content analysis. While the ideal method of monitoring the fetal heart in low-risk labour is intermittent auscultation this analysis highlights not only the range of methods but also the rationales, contexts and factors motivating and influencing midwives' practice choices. In the current complex care environment midwives face a range of challenges to practice that facilitate the provision of consistent woman-centered care.