A significant proportion of women worldwide experience childbirth as a traumatic event, which may result in enduring consequences for themselves, their partners and their children. Healthcare professionals have a key role in supporting women with psychological birth trauma and birth related post-traumatic stress disorder through prevention, early detection and supportive practices but evidence indicates that these phenomena, are not recognised by practitioners.
Design
This integrative review followed Whittemore and Knafl's five-stage framework as it facilitates the inclusion of different methodological approaches into an overall synthesis of the evidence. A systematic search of four electronic databases CINAHL, MEDLINE, EMBASE and PsycINFO was conducted between 2003 and 2024, with no geographical limits set due to the paucity of research published in this area.
Findings
Eight studies met the inclusion criteria and were synthesised using thematic synthesis. Two main themes plus sub-themes were identified: (1) Knowledge and Skills (sub-themes: Communication; Clinical skills) and (2) Challenges (sub-themes: Attitudes; Resources).
Conclusions
Knowledge and skill deficits contribute to the difficulties healthcare professionals face when providing care to women with psychological birth trauma and birth related PTSD. A lack of referral pathways for women to receive the specialised support and treatment they require is also evidenced. This study is the first to our knowledge to examine healthcare professionals experiences of caring for women with psychological birth trauma and birth related post-traumatic stress disorder and make recommendations on how to prevent, identify and support affected women within the perinatal setting.
{"title":"An integrative review of healthcare professionals’ experiences in caring for women who have experienced psychological birth trauma or birth related Post Traumatic Stress Disorder","authors":"Aoife O'Donoghue , Carmel Bradshaw , Annmarie Grealish","doi":"10.1016/j.midw.2025.104336","DOIUrl":"10.1016/j.midw.2025.104336","url":null,"abstract":"<div><h3>Background</h3><div>A significant proportion of women worldwide experience childbirth as a traumatic event, which may result in enduring consequences for themselves, their partners and their children. Healthcare professionals have a key role in supporting women with psychological birth trauma and birth related post-traumatic stress disorder through prevention, early detection and supportive practices but evidence indicates that these phenomena, are not recognised by practitioners.</div></div><div><h3>Design</h3><div>This integrative review followed Whittemore and Knafl's five-stage framework as it facilitates the inclusion of different methodological approaches into an overall synthesis of the evidence. A systematic search of four electronic databases CINAHL, MEDLINE, EMBASE and PsycINFO was conducted between 2003 and 2024, with no geographical limits set due to the paucity of research published in this area.</div></div><div><h3>Findings</h3><div>Eight studies met the inclusion criteria and were synthesised using thematic synthesis. Two main themes plus sub-themes were identified: (1) Knowledge and Skills (sub-themes: Communication; Clinical skills) and (2) Challenges (sub-themes: Attitudes; Resources).</div></div><div><h3>Conclusions</h3><div>Knowledge and skill deficits contribute to the difficulties healthcare professionals face when providing care to women with psychological birth trauma and birth related PTSD. A lack of referral pathways for women to receive the specialised support and treatment they require is also evidenced. This study is the first to our knowledge to examine healthcare professionals experiences of caring for women with psychological birth trauma and birth related post-traumatic stress disorder and make recommendations on how to prevent, identify and support affected women within the perinatal setting.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"144 ","pages":"Article 104336"},"PeriodicalIF":2.6,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143421984","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}
Pub Date : 2025-02-10DOI: 10.1016/j.midw.2025.104333
Taylor M. Guthrie , Lauren Kearney , Kahlee Snape , Linda Sweet , Vidanka Vasilevski , Susan de Jersey
Problem
The rate of pregnancy following bariatric surgery is rising globally and is associated with health benefits but also increased risk of micronutrient deficiency, preterm birth and small for gestational age offspring. Bariatric surgery may limit women's ability to meet the nutrient demands of pregnancy, necessitating individualised nutrition therapy. However, little is known about women's experiences of, and preferences for nutrition-related care during pregnancy after bariatric surgery.
Aim
To describe women's experiences of pregnancy after bariatric surgery, focussing on nutrition-related care.
Methods
This qualitative study interviewed women across Australia with a history of any bariatric surgery. Semi-structured telephone interviews were conducted after 36-weeks gestation and before childbirth. Data were analysed using reflexive thematic analysis.
Findings
Thirteen women aged 26–37 participated. Three themes were generated: navigating healthcare, the personal toll of pregnancy after bariatric surgery, and women's agency. Despite a strong desire for specialised nutrition care, women encountered several barriers to accessing this. When care was available, it often did not meet women's needs due to healthcare professionals’ limited understanding of the nutrition challenges faced in pregnancies following bariatric surgery. This compelled women to seek information outside their maternity care team and advocate for themselves during care.
Discussion
These findings highlight the need to address barriers to accessing nutrition care for pregnant women following bariatric surgery. Improved understanding of pregnancy and post-operative symptoms may enable enhanced woman-centred care.
Conclusion
Greater awareness of bariatric surgery among all maternity care professionals is needed to improve opportunities for informed, shared decision-making with pregnant women.
{"title":"Pregnant women's experiences of nutrition care after previous bariatric surgery","authors":"Taylor M. Guthrie , Lauren Kearney , Kahlee Snape , Linda Sweet , Vidanka Vasilevski , Susan de Jersey","doi":"10.1016/j.midw.2025.104333","DOIUrl":"10.1016/j.midw.2025.104333","url":null,"abstract":"<div><h3>Problem</h3><div>The rate of pregnancy following bariatric surgery is rising globally and is associated with health benefits but also increased risk of micronutrient deficiency, preterm birth and small for gestational age offspring. Bariatric surgery may limit women's ability to meet the nutrient demands of pregnancy, necessitating individualised nutrition therapy. However, little is known about women's experiences of, and preferences for nutrition-related care during pregnancy after bariatric surgery.</div></div><div><h3>Aim</h3><div>To describe women's experiences of pregnancy after bariatric surgery, focussing on nutrition-related care.</div></div><div><h3>Methods</h3><div>This qualitative study interviewed women across Australia with a history of any bariatric surgery. Semi-structured telephone interviews were conducted after 36-weeks gestation and before childbirth. Data were analysed using reflexive thematic analysis.</div></div><div><h3>Findings</h3><div>Thirteen women aged 26–37 participated. Three themes were generated: navigating healthcare, the personal toll of pregnancy after bariatric surgery, and women's agency. Despite a strong desire for specialised nutrition care, women encountered several barriers to accessing this. When care was available, it often did not meet women's needs due to healthcare professionals’ limited understanding of the nutrition challenges faced in pregnancies following bariatric surgery. This compelled women to seek information outside their maternity care team and advocate for themselves during care.</div></div><div><h3>Discussion</h3><div>These findings highlight the need to address barriers to accessing nutrition care for pregnant women following bariatric surgery. Improved understanding of pregnancy and post-operative symptoms may enable enhanced woman-centred care.</div></div><div><h3>Conclusion</h3><div>Greater awareness of bariatric surgery among all maternity care professionals is needed to improve opportunities for informed, shared decision-making with pregnant women.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"143 ","pages":"Article 104333"},"PeriodicalIF":2.6,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143403737","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}
While there are many studies on women's childbirth experiences globally, there is limited studies on childbirth experiences in Ghana especially in the North East Region.
Background
The environment where women give birth is important, influences the birth process and outcomes of mother and neonate. Current understanding of influence birth environment and childbirth experiences in the northern parts of Ghana has not been fully explored.
Study aim
Our study aimed at exploring the birth environment and mothers’ childbirth experiences in North-East Region, Ghana.
Methods
An exploratory-descriptive qualitative (EDQ) study involving thirteen (Tzeng et al., 2017) purposefully selected postnatal mothers in Nalerigu was conducted. Using a semi-structured interview guide, individual face-to-face in-depth tape-recorded interviews were conducted until data saturation. Interviews were transcribed verbatim and analysed using thematic analysis. Two (Afulani et al., 2019) main and 5 sub-themes emerged.
Findings
The findings of the study revealed that birthing environment had an influence on mothers’ experiences with regards to comfort, and privacy. However, mothers reported that the environment did not offer options for choice to alternative birthing positions. It was observed that these environmental factors had both positive and negative effects on mothers during childbirth.
Discussion & Conclusion
Study findings showed that the birth environment is associated with comfort, privacy, service provision satisfaction and desire for facility delivery and limited involvement in the choice of birth position. Though most of the participants indicated favourable birth environment and satisfactory services, it is important to address the concerns of the few who had negative experiences during labour to promote respectful maternity care. Antenatal education on birth positions is recommended.
{"title":"Birth environment experiences of postnatal mothers; An exploratory qualitative study in Nalerigu, Ghana","authors":"Justina Atogichiga Alechana , Evelyn Asamoah Ampofo , Adiza Atoko Mumuni , Edem Kojo Dzantor , Jonathan Gbene","doi":"10.1016/j.midw.2025.104335","DOIUrl":"10.1016/j.midw.2025.104335","url":null,"abstract":"<div><h3>Problem</h3><div>While there are many studies on women's childbirth experiences globally, there is limited studies on childbirth experiences in Ghana especially in the North East Region.</div></div><div><h3>Background</h3><div>The environment where women give birth is important, influences the birth process and outcomes of mother and neonate. Current understanding of influence birth environment and childbirth experiences in the northern parts of Ghana has not been fully explored.</div></div><div><h3>Study aim</h3><div>Our study aimed at exploring the birth environment and mothers’ childbirth experiences in North-East Region, Ghana.</div></div><div><h3>Methods</h3><div>An exploratory-descriptive qualitative (EDQ) study involving thirteen (Tzeng et al., 2017) purposefully selected postnatal mothers in Nalerigu was conducted. Using a semi-structured interview guide, individual face-to-face in-depth tape-recorded interviews were conducted until data saturation. Interviews were transcribed verbatim and analysed using thematic analysis. Two (Afulani et al., 2019) main and 5 sub-themes emerged.</div></div><div><h3>Findings</h3><div>The findings of the study revealed that birthing environment had an influence on mothers’ experiences with regards to comfort, and privacy. However, mothers reported that the environment did not offer options for choice to alternative birthing positions. It was observed that these environmental factors had both positive and negative effects on mothers during childbirth.</div></div><div><h3>Discussion & Conclusion</h3><div>Study findings showed that the birth environment is associated with comfort, privacy, service provision satisfaction and desire for facility delivery and limited involvement in the choice of birth position. Though most of the participants indicated favourable birth environment and satisfactory services, it is important to address the concerns of the few who had negative experiences during labour to promote respectful maternity care. Antenatal education on birth positions is recommended.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"143 ","pages":"Article 104335"},"PeriodicalIF":2.6,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143422313","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}
Pub Date : 2025-02-10DOI: 10.1016/j.midw.2025.104334
Patrícia Fagundes , Bruna O. de Vargas , Bruna L. Holand , Marcela Medina , Vera L. Bosa , Michele Drehmer
Objective
Childbirth is a natural process, and according to the World Health Organization, oral intake is recommended for patients at usual risk. However, due to rare cases of pulmonary aspiration (known as Mendelson's syndrome) during general anesthesia and the limited evidence supporting its benefits, this practice remains controversial. This systematic review summarizes evidence on interventions that recommend oral intake during labor compared to fasting, focusing on labor duration and perinatal complications.
Sources
A literature search across PubMed, EMBASE, Lilacs, and Scielo identified randomized clinical trials involving habitual-risk patients, nulliparous women receiving oral diet interventions during labor. The RoB 2.0 tool was used to assess bias.
Summary of the findings
Six studies (3,333 patients) were included, with three showing low risk of bias. Patients in the intervention group were allowed to eat, while the control group only had access to water, ice chips, and non-energy drinks. Food intake was found to correlate with significantly shorter labor duration in one study (P < 0.01), while no significant differences were observed in the others. No outcome variations (such as epidural anesthesia, lower Apgar scores, vomiting, or nausea) or cases of aspiration or Mendelson's syndrome were reported.
Conclusions
Only one study found a significant difference in labor duration when offering a diet during labor to patients at usual risk compared to fasting. No differences were observed in other perinatal outcomes between the intervention and control groups.
{"title":"Less restrictive food consumption during labor in nulliparous habitual risk patients and obstetric outcomes: A systematic review","authors":"Patrícia Fagundes , Bruna O. de Vargas , Bruna L. Holand , Marcela Medina , Vera L. Bosa , Michele Drehmer","doi":"10.1016/j.midw.2025.104334","DOIUrl":"10.1016/j.midw.2025.104334","url":null,"abstract":"<div><h3>Objective</h3><div>Childbirth is a natural process, and according to the World Health Organization, oral intake is recommended for patients at usual risk. However, due to rare cases of pulmonary aspiration (known as Mendelson's syndrome) during general anesthesia and the limited evidence supporting its benefits, this practice remains controversial. This systematic review summarizes evidence on interventions that recommend oral intake during labor compared to fasting, focusing on labor duration and perinatal complications.</div></div><div><h3>Sources</h3><div>A literature search across PubMed, EMBASE, Lilacs, and Scielo identified randomized clinical trials involving habitual-risk patients, nulliparous women receiving oral diet interventions during labor. The RoB 2.0 tool was used to assess bias.</div></div><div><h3>Summary of the findings</h3><div>Six studies (3,333 patients) were included, with three showing low risk of bias. Patients in the intervention group were allowed to eat, while the control group only had access to water, ice chips, and non-energy drinks. Food intake was found to correlate with significantly shorter labor duration in one study (<em>P</em> < 0.01), while no significant differences were observed in the others. No outcome variations (such as epidural anesthesia, lower Apgar scores, vomiting, or nausea) or cases of aspiration or Mendelson's syndrome were reported.</div></div><div><h3>Conclusions</h3><div>Only one study found a significant difference in labor duration when offering a diet during labor to patients at usual risk compared to fasting. No differences were observed in other perinatal outcomes between the intervention and control groups.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"143 ","pages":"Article 104334"},"PeriodicalIF":2.6,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143422312","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}
Pub Date : 2025-02-06DOI: 10.1016/j.midw.2025.104329
Hyunjeong Shin , Songi Jeon , Inhae Cho
Problem
According to systematic literature reviews, most studies measured pregnant women's quality of life using generic measures.
Background
Condition-specific questionnaires are more sensitive and responsive than generic questionnaires. There is a great need to establish specific measures for assessing pregnant women's health-related quality of life considering their unique experiences of pregnancy.
Aim
To develop and test psychometric properties of the PregQOL, a health-related quality of life measure specific to pregnant women.
Methods
To construct the items of the PregQOL, we conducted semi-structured face-to-face interviews with five pregnant women in addition to an extensive literature review. For psychometric testing, data were collected with a convenience sample of 411 pregnant women. Construct validity was assessed via exploratory and confirmatory factor analyses. Convergent and known-groups validity were evaluated. Internal consistency reliability was studied using Cronbach's alpha and McDonald's omega. Test-retest reliability was examined.
Findings
After evaluation of content validity and exploratory/confirmatory factor analysis, the 24-item PregQOL was developed with four dimensions: daily functioning, supportive conditions, adaptation to pregnancy, and psychological well-being. It demonstrated convergent validity with relations to a quality of life measure for general population. Known-groups validity was supported by significant differences between the depressed and non-depressed groups. The scale demonstrated adequate internal consistency and test-retest reliability. It also showed good reliability across three trimesters of pregnancy.
Discussion
The newly developed PregQOL demonstrated good psychometric properties across three trimesters of pregnancy.
Conclusion
The PregQOL might be useful for helping midwives and other healthcare providers understand the overall well-being of pregnant women.
{"title":"Health-related quality of life scale specific to pregnant women (PregQOL): Development and psychometric evaluation","authors":"Hyunjeong Shin , Songi Jeon , Inhae Cho","doi":"10.1016/j.midw.2025.104329","DOIUrl":"10.1016/j.midw.2025.104329","url":null,"abstract":"<div><h3>Problem</h3><div>According to systematic literature reviews, most studies measured pregnant women's quality of life using generic measures.</div></div><div><h3>Background</h3><div>Condition-specific questionnaires are more sensitive and responsive than generic questionnaires. There is a great need to establish specific measures for assessing pregnant women's health-related quality of life considering their unique experiences of pregnancy.</div></div><div><h3>Aim</h3><div>To develop and test psychometric properties of the PregQOL, a health-related quality of life measure specific to pregnant women.</div></div><div><h3>Methods</h3><div>To construct the items of the PregQOL, we conducted semi-structured face-to-face interviews with five pregnant women in addition to an extensive literature review. For psychometric testing, data were collected with a convenience sample of 411 pregnant women. Construct validity was assessed via exploratory and confirmatory factor analyses. Convergent and known-groups validity were evaluated. Internal consistency reliability was studied using Cronbach's alpha and McDonald's omega. Test-retest reliability was examined.</div></div><div><h3>Findings</h3><div>After evaluation of content validity and exploratory/confirmatory factor analysis, the 24-item PregQOL was developed with four dimensions: <em>daily functioning, supportive conditions, adaptation to pregnancy, and psychological well-being.</em> It demonstrated convergent validity with relations to a quality of life measure for general population. Known-groups validity was supported by significant differences between the depressed and non-depressed groups. The scale demonstrated adequate internal consistency and test-retest reliability. It also showed good reliability across three trimesters of pregnancy.</div></div><div><h3>Discussion</h3><div>The newly developed PregQOL demonstrated good psychometric properties across three trimesters of pregnancy.</div></div><div><h3>Conclusion</h3><div>The PregQOL might be useful for helping midwives and other healthcare providers understand the overall well-being of pregnant women.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"143 ","pages":"Article 104329"},"PeriodicalIF":2.6,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143369807","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}
Pub Date : 2025-02-03DOI: 10.1016/j.midw.2025.104318
Elizabeth Duff (International NewsEditor)
{"title":"International News March 2025","authors":"Elizabeth Duff (International NewsEditor)","doi":"10.1016/j.midw.2025.104318","DOIUrl":"10.1016/j.midw.2025.104318","url":null,"abstract":"","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"142 ","pages":"Article 104318"},"PeriodicalIF":2.6,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143176059","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}
Pub Date : 2025-02-01DOI: 10.1016/j.midw.2024.104266
Aimee Grant , Catrin Griffiths , Kathryn Williams , Amy E. Brown
Background
Around 3 % of people are Autistic; women may be under-diagnosed. Autistic people report lack of staff understanding, stigma and environmental barriers to using midwifery services. It is not known if these issues are present in perinatal loss services.
Aim
To understand Autistic people's experiences of care for perinatal loss.
Methods
An online survey for Autistic adults in the United Kingdom who had been pregnant, using closed and open questions. Data were analysed descriptively, using Kruskal-Wallis tests and thematically.
Results
The majority of losses appeared to be early in pregnancy. Among 67 participants, over half (58.2 %, n = 39) always sought healthcare during a perinatal loss, but 28.4 % (n = 19) never accessed care. Of those who received healthcare (n = 48; 71.6 %), over half (n = 27; 56.3 %) did not know they were Autistic at the time, and just one person told health professionals that they were Autistic. Four participants identified instances where staff were supportive or kind, but the majority of experiences were negative, with reported issues focused on communication, the way support was provided, inadequate pain relief and the hospital environment. We generated one overarching theme: “trauma”.
Conclusion
Autistic people from the UK identified significant Disability-related access issues with perinatal loss care in addition to issues reported by a general population. UK Perinatal loss services need urgent investment to be able to provide person-centred care to all. Staff supporting perinatal loss should receive neurodiversity-affirming Autism training and be aware that many Autistic people experiencing perinatal loss may not have or share a diagnosis.
{"title":"“I felt belittled and ridiculed for being in pain”: An online survey of Autistic people's experience of care for pregnancy loss (perinatal loss) in the United Kingdom✰","authors":"Aimee Grant , Catrin Griffiths , Kathryn Williams , Amy E. Brown","doi":"10.1016/j.midw.2024.104266","DOIUrl":"10.1016/j.midw.2024.104266","url":null,"abstract":"<div><h3>Background</h3><div>Around 3 % of people are Autistic; women may be under-diagnosed. Autistic people report lack of staff understanding, stigma and environmental barriers to using midwifery services. It is not known if these issues are present in perinatal loss services.</div></div><div><h3>Aim</h3><div>To understand Autistic people's experiences of care for perinatal loss.</div></div><div><h3>Methods</h3><div>An online survey for Autistic adults in the United Kingdom who had been pregnant, using closed and open questions. Data were analysed descriptively, using Kruskal-Wallis tests and thematically.</div></div><div><h3>Results</h3><div>The majority of losses appeared to be early in pregnancy. Among 67 participants, over half (58.2 %, <em>n</em> = 39) always sought healthcare during a perinatal loss, but 28.4 % (<em>n</em> = 19) never accessed care. Of those who received healthcare (<em>n</em> = 48; 71.6 %), over half (<em>n</em> = 27; 56.3 %) did not know they were Autistic at the time, and just one person told health professionals that they were Autistic. Four participants identified instances where staff were supportive or kind, but the majority of experiences were negative, with reported issues focused on communication, the way support was provided, inadequate pain relief and the hospital environment. We generated one overarching theme: “trauma”.</div></div><div><h3>Conclusion</h3><div>Autistic people from the UK identified significant Disability-related access issues with perinatal loss care in addition to issues reported by a general population. UK Perinatal loss services need urgent investment to be able to provide person-centred care to all. Staff supporting perinatal loss should receive neurodiversity-affirming Autism training and be aware that many Autistic people experiencing perinatal loss may not have or share a diagnosis.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"141 ","pages":"Article 104266"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872545","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}
Pub Date : 2025-02-01DOI: 10.1016/j.midw.2024.104253
Ida Dayyani , Ingrid Jepsen , Saraswathi Vedam , Rikke Damkjær Maimburg
Objective
Decision-making is important in user-involved maternity care and patient experience instruments Mothers Autonomy in Decision Making scale (MADM) and Mothers on Respect index (MORi) are used internationally to measure the user involvement quality and users’ experiences of autonomy and respect. This study aimed to translate and qualitatively adapt the original MADM and MORi instruments to the Danish language and culture.
Methods
A forward and backward translation using a standard guideline. Subsequently, qualitative interviews to refine the translation and cultural adaptation by pilot testing the scales.
Results
The translation process showed cultural differences linked to linguistic variations between Danish and English. Cognitive interviews with 14 diverse pregnant women revealed challenges in women's understanding of decision-making in maternity care. Changes in wording and assisting descriptive texts were made. Further, the order of the MADM items was changed to improve the understanding of decision-making.
Discussion
Primarily, the discussion concerns how decision-making can be understood in the context of maternity care and why women's understanding of decision-making in Danish maternity care in the MADM scale items was challenged.
Conclusion
The qualitative pilot test using cognitive interviews after translation of the instruments was a valuable method for cultural adaptation providing important knowledge on women's understanding and perceptions of item contents. The cognitive interviews provided a comprehensive understanding of decision-making and contributed to a thoroughly worked Danish version of the MADM and MORi instruments.
{"title":"Measuring autonomy and respect: A qualitative, cross-cultural adaptation of the Mothers Autonomy in decision making scale and mothers on respect index instruments in Danish","authors":"Ida Dayyani , Ingrid Jepsen , Saraswathi Vedam , Rikke Damkjær Maimburg","doi":"10.1016/j.midw.2024.104253","DOIUrl":"10.1016/j.midw.2024.104253","url":null,"abstract":"<div><h3>Objective</h3><div>Decision-making is important in user-involved maternity care and patient experience instruments Mothers Autonomy in Decision Making scale (MADM) and Mothers on Respect index (MORi) are used internationally to measure the user involvement quality and users’ experiences of autonomy and respect. This study aimed to translate and qualitatively adapt the original MADM and MORi instruments to the Danish language and culture.</div></div><div><h3>Methods</h3><div>A forward and backward translation using a standard guideline. Subsequently, qualitative interviews to refine the translation and cultural adaptation by pilot testing the scales.</div></div><div><h3>Results</h3><div>The translation process showed cultural differences linked to linguistic variations between Danish and English. Cognitive interviews with 14 diverse pregnant women revealed challenges in women's understanding of decision-making in maternity care. Changes in wording and assisting descriptive texts were made. Further, the order of the MADM items was changed to improve the understanding of decision-making.</div></div><div><h3>Discussion</h3><div>Primarily, the discussion concerns how decision-making can be understood in the context of maternity care and why women's understanding of decision-making in Danish maternity care in the MADM scale items was challenged.</div></div><div><h3>Conclusion</h3><div>The qualitative pilot test using cognitive interviews after translation of the instruments was a valuable method for cultural adaptation providing important knowledge on women's understanding and perceptions of item contents. The cognitive interviews provided a comprehensive understanding of decision-making and contributed to a thoroughly worked Danish version of the MADM and MORi instruments.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"141 ","pages":"Article 104253"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142807022","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}
Pub Date : 2025-02-01DOI: 10.1016/j.midw.2024.104270
Sarah Lang , Jennifer G. McIntosh , Joanne Enticott , Rebecca Goldstein , Susanne Baker , Margaret McGowan , Shamil Cooray , Lan Du , Anjana Reddy , Cheryce L. Harrison , Eleanor Thong , Kushan De Silva , Helena Teede , Lisa J. Moran , Siew Lim
Problem/ Background
The acceptability of providing women with personalised cardiometabolic risk information using risk prediction tools early in pregnancy is not well understood.
Aim
To explore women's and healthcare professionals’ perspectives of the acceptability of a prognostic, composite risk prediction tool for cardiometabolic risk (gestational diabetes and/or hypertensive disorders of pregnancy) for use in early pregnancy.
Methods
Semi-structured interviews were conducted to explore the acceptability of cardiometabolic risk prediction tools, preferences for risk communication and considerations for implementation into antenatal care. The Theoretical Framework of Acceptability informed interview questions. Transcripts were thematically analysed.
Findings
Women ≤24 weeks’ gestation (n = 13) and healthcare professionals (n = 8), including midwives (n = 2), general practitioners (n = 2), obstetricians (n = 2), an endocrinologist (n = 1) and cardiologist (n = 1) participated. Participants indicated that providing personalised risk information is only appropriate when preventative measures can be initiated to mitigate risks. Differentiating the risk for each condition (single risk outputs) was often preferred to composite risk outputs to enable targeted monitoring and management. Defining conditions and risks to mother/baby, visually depicting personalised risk scores, and providing clear, patient-centred clinical management plans were recommended. Supportive clinical policy changes, staff engagement/training, and integration into electronic health records were suggested to facilitate uptake into routine antenatal care.
Conclusion
Women and healthcare professionals suggested that early pregnancy cardiometabolic risk prediction tools may be acceptable when preventative interventions are available to reduce risks. Risk prediction tools with integrated patient-centred education materials may promote timely access and engagement with preventative interventions to optimise women's current and future health.
{"title":"Exploring the acceptability of a risk prediction tool for cardiometabolic risk (gestational diabetes and hypertensive disorders of pregnancy) for use in early pregnancy: A qualitative study","authors":"Sarah Lang , Jennifer G. McIntosh , Joanne Enticott , Rebecca Goldstein , Susanne Baker , Margaret McGowan , Shamil Cooray , Lan Du , Anjana Reddy , Cheryce L. Harrison , Eleanor Thong , Kushan De Silva , Helena Teede , Lisa J. Moran , Siew Lim","doi":"10.1016/j.midw.2024.104270","DOIUrl":"10.1016/j.midw.2024.104270","url":null,"abstract":"<div><h3>Problem/ Background</h3><div>The acceptability of providing women with personalised cardiometabolic risk information using risk prediction tools early in pregnancy is not well understood.</div></div><div><h3>Aim</h3><div>To explore women's and healthcare professionals’ perspectives of the acceptability of a prognostic, composite risk prediction tool for cardiometabolic risk (gestational diabetes and/or hypertensive disorders of pregnancy) for use in early pregnancy.</div></div><div><h3>Methods</h3><div>Semi-structured interviews were conducted to explore the acceptability of cardiometabolic risk prediction tools, preferences for risk communication and considerations for implementation into antenatal care. The Theoretical Framework of Acceptability informed interview questions. Transcripts were thematically analysed.</div></div><div><h3>Findings</h3><div>Women ≤24 weeks’ gestation (<em>n</em> = 13) and healthcare professionals (<em>n</em> = 8), including midwives (<em>n</em> = 2), general practitioners (<em>n</em> = 2), obstetricians (<em>n</em> = 2), an endocrinologist (<em>n</em> = 1) and cardiologist (<em>n</em> = 1) participated. Participants indicated that providing personalised risk information is only appropriate when preventative measures can be initiated to mitigate risks. Differentiating the risk for each condition (single risk outputs) was often preferred to composite risk outputs to enable targeted monitoring and management. Defining conditions and risks to mother/baby, visually depicting personalised risk scores, and providing clear, patient-centred clinical management plans were recommended. Supportive clinical policy changes, staff engagement/training, and integration into electronic health records were suggested to facilitate uptake into routine antenatal care.</div></div><div><h3>Conclusion</h3><div>Women and healthcare professionals suggested that early pregnancy cardiometabolic risk prediction tools may be acceptable when preventative interventions are available to reduce risks. Risk prediction tools with integrated patient-centred education materials may promote timely access and engagement with preventative interventions to optimise women's current and future health.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"141 ","pages":"Article 104270"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927176","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}
Pub Date : 2025-02-01DOI: 10.1016/j.midw.2024.104277
Emily R Bowden , Maree R Toombs , Anne B Chang , Gabrielle B McCallum , Robyn L Williams
Problem/Background
Australian First Nations people experience disproportionate burdens of poor outcomes compared to non-First Nations people. Further, women living in remote communities face more barriers to care-seeking in pregnancy. Despite work being done in some remote communities, there is limited data exploring women's experiences of pregnancy care, thus a limited understanding of specific barriers and enablers to care-seeking for these women.
Aim
This study aimed to identify barriers and enablers to care-seeking during pregnancy for Australian First Nations women living in several remote communities in the Northern Territory, by listening to their stories.
Methods
Yarning, highly regarded and rigorous qualitative approach developed by and for First Nations peoples, was undertaken in several settings with women living in remote First Nations communities. Using purposive sampling, nine women participated.
Findings
Two themes emerged: (1) the importance of family and community for women's emotional wellbeing; (2). ways healthcare providers and services build trust with pregnant women.
Discussion
Women identified various family and community members as significant sources of support in community and while hospitalised, including having companions while away from home. Further, reduced access to community life impacted emotional wellbeing.
Continuity-of-care throughout pregnancy was essential for building trust, as was responsive, clear communication. Intentional connection building by care providers enabled development of trust.
Conclusion
Providing culturally safe care will likely facilitate enablers and reduce barriers to care-seeking in pregnancy in remote communities. It requires ongoing and sustained efforts to ensure true partnership and collaboration between First Nations peoples and health services.
{"title":"‘Walking the journey’ with pregnant and birthing women from remote Australian First Nations communities: A qualitative study in the Top End of the Northern Territory","authors":"Emily R Bowden , Maree R Toombs , Anne B Chang , Gabrielle B McCallum , Robyn L Williams","doi":"10.1016/j.midw.2024.104277","DOIUrl":"10.1016/j.midw.2024.104277","url":null,"abstract":"<div><h3>Problem/Background</h3><div>Australian First Nations people experience disproportionate burdens of poor outcomes compared to non-First Nations people. Further, women living in remote communities face more barriers to care-seeking in pregnancy. Despite work being done in some remote communities, there is limited data exploring women's experiences of pregnancy care, thus a limited understanding of specific barriers and enablers to care-seeking for these women.</div></div><div><h3>Aim</h3><div>This study aimed to identify barriers and enablers to care-seeking during pregnancy for Australian First Nations women living in several remote communities in the Northern Territory, by listening to their stories.</div></div><div><h3>Methods</h3><div>Yarning, highly regarded and rigorous qualitative approach developed by and for First Nations peoples, was undertaken in several settings with women living in remote First Nations communities. Using purposive sampling, nine women participated.</div></div><div><h3>Findings</h3><div>Two themes emerged: (1) the importance of family and community for women's emotional wellbeing; (2). ways healthcare providers and services build trust with pregnant women.</div></div><div><h3>Discussion</h3><div>Women identified various family and community members as significant sources of support in community and while hospitalised, including having companions while away from home. Further, reduced access to community life impacted emotional wellbeing.</div><div>Continuity-of-care throughout pregnancy was essential for building trust, as was responsive, clear communication. Intentional connection building by care providers enabled development of trust.</div></div><div><h3>Conclusion</h3><div>Providing culturally safe care will likely facilitate enablers and reduce barriers to care-seeking in pregnancy in remote communities. It requires ongoing and sustained efforts to ensure true partnership and collaboration between First Nations peoples and health services.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"141 ","pages":"Article 104277"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932123","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}
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