Midwifery最新文献

Problem: Little is known about mothers' experiences and preferences for maternity services in Singapore. A more nuanced understanding would identify areas for improvement in perinatal care, reducing the burden on healthcare providers in supporting maternity services.

Background: Expecting mothers are typically referred to hospital-based antenatal and postnatal services in Singapore. In recent years, Singapore has made maternity services available in primary care community settings called polyclinics, to improve accessibility of such services.

Aim: To explore the experiences and preferences of Singaporean mothers in receiving maternity services in acute hospitals and polyclinics.

Methods: A descriptive qualitative study design was adopted, and data were collected from September to October 2023. In total, 13 mothers were recruited from a maternity care hospital in Singapore. Individual semi-structured audio-recorded interviews were conducted, and data were analysed using thematic analysis.

Findings: Three themes were identified: (1) Considerations when seeking maternity care, (2) Differing preferences and satisfaction levels, (3) Hopes for better perinatal care for mothers and babies.

Discussion: Most mothers preferred seeking hospital-based antenatal care and were more inclined to do postnatal follow-ups in polyclinics. Factors like accessibility, cost and perceived expertise of healthcare providers influenced the decision-making. Maternal satisfaction with care services also fluctuated based on interpersonal factors and whether their informational needs were met.

Conclusion: Overall, mothers' perceptions of maternity services were positive. Findings suggest the possibility of further expanding maternity services in community settings to increase professional support for mothers. Future research is needed to ascertain these findings in non-English speaking and non-subsidized settings.

Background: Ultrasound technology has become integral in antenatal care for its diagnostic effectiveness and potential to improve maternal and neonatal outcomes. Despite its proven benefits, challenges persist in its widespread adoption, particularly in low-resource settings like Kenya.

Aim: The aim of this study was to explore the perspectives of healthcare providers regarding the integration of obstetric point-of-care ultrasound into routine maternal services in low-level facilities Kenya.

Methods: Using a descriptive qualitative study embedded in a large scale implementation study 76 healthcare providers who had undergone obstetric point-ofcare ultrasound training and were providing maternal services were purposively sampled from healthcare facilities across eight counties. Data was collected using structured audiotaped interviews, which were transcribed, and analyzed using thematic analysis.

Results: Five main themes with several subthemes emerged from the analysis: (1) Clinical Decision-Making (2) Quality of Services, (3) Training, (4)Technology Issues, and (5) Sustainability.

Discussion: Findings from this study suggest that use of obstetric Point-of-Care Ultrasound in resource-limited primary care settings, can enhance clinical decision making and influence patient management, ultimately resulting in significant health outcomes.

Conclusion: Equipping health care providers with skills to conduct obstetric point of care ultrasound can lead to better-informed clinical decisions and ultimately contribute to improved health outcomes in underserved populations.

Problem: For health care providers to ensure appropriate decision-making in clinical settings during childbirth, facilitators and barriers must be identified.

Background: Women who experience a sense of control by participating in the decision-making process, are more likely to have a positive birth experience. However, decision-making may involve hierarchies of close observation and control.

Aim: The aim of the scoping review was to map and summarise existing literature on the process of clinical decision-making during childbirth from the perspective of labouring women, relatives and health care providers.

Methods: We carried out a scoping review in line with Joanna Briggs Institute scoping review methodology. The search identified studies in Scandinavian or English languages from 2010 - Jan 2023 comprising evidence at different levels of the pyramid, resulting in 18.227 hits. Following the PRISMA checklist, the final inclusion comprised 62 papers.

Findings: Four main categories summarized the importance of the following factors: 1) Woman-caregiver relationship, with sub-categories The importance of communication and Midwifery care, 2) Consent and legal issues, 3) Organization, with sub-categories Medicalization, Working atmosphere, and Complexity, and 4) Decision-making tools and models, with sub-categories Shared decision-making, and Other tools and models for decision-making.

Conclusion: Balancing intuition and expertise of caregivers with evidence-based practices, is crucial to ensure women's participation in decision-making. Furthermore, a trusting relationship between the mother, partner, and health care provider is of utmost importance. Shared decision-making, which appeared to be the primary model for clinical decision-making regardless context, requires reflective practice and is a communication strategy.