Midwifery最新文献

{"title":"Barriers and facilitators to pelvic floor muscle exercises among postpartum women: A meta-synthesis based on the capability, opportunity, motivation, and behavior (COM-B) model","authors":"Zhouli Gui ,&nbsp;Yingni Liang ,&nbsp;Yiqin Huang ,&nbsp;Qingyan Gu ,&nbsp;Qian Li ,&nbsp;Xixian Li ,&nbsp;Ruotong Liu ,&nbsp;Li OuYang ,&nbsp;Hongwu Liao","doi":"10.1016/j.midw.2025.104695","DOIUrl":"10.1016/j.midw.2025.104695","url":null,"abstract":"<div><h3>Background</h3><div>While pelvic floor muscle exercises (PFME) are recognized for preventing and treating pelvic floor dysfunction, optimal clinical implementation models remain unclear, and factors influencing postpartum adherence are incompletely understood.</div></div><div><h3>Objective</h3><div>This systematic review evaluated barriers and enablers to PFME adherence from the perspective of postpartum women, to inform behavioural change strategies.</div></div><div><h3>Methods</h3><div>Nine databases (CINAHL, PubMed, Web of Science, Embase, Cochrane Library, SinoMed, CNKI, Wanfang, VIP) were searched from inception to July 1, 2025. Eligible studies included qualitative and mixed-methods designs reporting qualitatively extractable data on barriers/enablers to postpartum PFME. Study quality was assessed using the Joanna Briggs Institute Qualitative Assessment Criteria. Thematic analysis mapped findings to the Capability, Opportunity, Motivation–Behaviour (COM-B) model.</div></div><div><h3>Results</h3><div>After screening 968 abstracts and 134 full texts, 9 studies were included (8 qualitative studies and 1 mixed-methods study). The research identified barriers and facilitators related to the following domains:physical capacity (e.g.pre-pregnancy exercise foundation and childbirth trauma and pain), psychological capacity (e.g.lack of knowledge about pelvic floor health, intergenerational misperceptions, and sexual stigma hindering communication), physical opportunity (e.g.time constraints, and digital tool empowerment), social opportunities (e.g.quality of healthcare services and family support networks), reflective motivation (e.g.risk perception-driven, immediate feedback reinforcement, uncertainty about exercise effectiveness), and automatic motivation (e.g.convenience of exercise behaviour, boredom during the process, body image needs, and external care and encouragement).</div></div><div><h3>Conclusion</h3><div>The study findings identified key factors influencing postpartum women's engagement in pelvic floor muscle exercises and proposed several intervention strategies. Given the paucity of existing qualitative studies on this topic, additional research is warranted to further elucidate the complex, interacting factors that affect postpartum women's adherence to pelvic floor muscle training regimens.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"153 ","pages":"Article 104695"},"PeriodicalIF":2.5,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145804972","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":"Women’s experiences of pain relief and easing intensity through vocalisations during childbirth: A qualitative study","authors":"Laura A. Zinsser ,&nbsp;Eva Marie Engebakken Flaathen","doi":"10.1016/j.midw.2025.104690","DOIUrl":"10.1016/j.midw.2025.104690","url":null,"abstract":"<div><h3>Background</h3><div>Childbirth pain is an individual and diverse experience; it differs from other pain as it is productive and purposeful. Some women do like to give birth without pharmacological pain relief. These women use diverse coping strategies and tools. One tool is vocalisations like vocal-toning, to master childbirth.</div></div><div><h3>Aim</h3><div>To explore, explain and interpret women’s experience with vocalisations to master the intensity and pain during childbirth.</div></div><div><h3>Methods</h3><div>In-depth interviews were conducted with 18 women postpartum. These women had a physiological birth free from pharmacological pain relief and vocalised. Braun and Clarke’s Reflexive Thematic Analysis was used to analyse the data.</div></div><div><h3>Results</h3><div>Four themes emerged: ‘<em>Changing the pain experience through sound’</em>, outlines the ease of pain during vocal-toning. <em>‘Balancing internal birthing intensity by using sound’</em>, describes the experienced relief of internal pressure and intensity through vocalisations. <em>‘Experiencing tricky moments while vocal-toning’</em>, provides detailed insights in moments when the pain can rise, by taking a breath or losing the ‘right’ tone. ‘<em>Mastering the childbirth process with sound as an essential element: \"the number one means of coping with pain\"’</em> portrays the experienced meaningfulness of sound work for childbirth.</div></div><div><h3>Conclusion</h3><div>Vocalisations eased the intensity and pain or made it more bearable for the participants. It were combined with other coping strategies and tools, but vocalisations were essential for nearly all participants to master childbirth. Midwives and other birth companions can support women in finding the ‘right’ tone through joined vocal-toning, indicating a deeper sound.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"153 ","pages":"Article 104690"},"PeriodicalIF":2.5,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145768509","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":"Distinct dyadic coping patterns in couples managing gestational diabetes mellitus: a latent profile analysis","authors":"Qian Xu ,&nbsp;Rong-rong Han ,&nbsp;Lei Zeng ,&nbsp;Ke Sun ,&nbsp;Pei-pei Luo ,&nbsp;Juan-juan Zhao ,&nbsp;Ling-ling Gao","doi":"10.1016/j.midw.2025.104692","DOIUrl":"10.1016/j.midw.2025.104692","url":null,"abstract":"<div><h3>Problem</h3><div>No studies have identified dyadic coping patterns in couples managing gestational diabetes mellitus (GDM).</div></div><div><h3>Background</h3><div>While male partners are often involved in GDM management, their involvement exerts mixed effects.</div></div><div><h3>Aim</h3><div>This study aims to (1) identify dyadic coping patterns among GDM couples, (2) compare self-management behaviors among identified patterns, and (3) examine potential predictors associated with each pattern.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted in Guangzhou, China, from September 2024 to January 2025. 200 GDM couples completed the Chinese version of the Couple Collaborative Management Scale and the GDM Knowledge Questionnaire. Pregnant women also completed the GDM Self-management Behavior Scale. Latent profile analysis was employed to identify subgroups of dyadic coping.</div></div><div><h3>Findings</h3><div>Three latent patterns emerged: Class 1 (low-positive/low-negative group; 20.0%), Class 2 (high-positive/high-negative group; 12.0%), and Class 3 (high-positive/low-negative group; 68.0%). Significant differences in self-management behaviors were observed across classes. History of adverse obstetric outcomes, paternal GDM knowledge, and maternal dyadic appraisal were significant predictors of class membership.</div></div><div><h3>Discussion</h3><div>The findings provide healthcare professionals with a deeper understanding of couple interactions in GDM management and how these interactions function within this context.</div></div><div><h3>Conclusion</h3><div>Approximately one-third of couples exhibited suboptimal dyadic coping patterns. To optimize GDM management, healthcare professionals are recommended to routinely screen couples for maladaptive patterns and implement tailored dyadic interventions to facilitate more functional couple interactions.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"153 ","pages":"Article 104692"},"PeriodicalIF":2.5,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145781314","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":"Maternal and neonatal waterbirth outcomes in a Brazilian freestanding birth centre: a cross-sectional study","authors":"Pamela Vicente Nakazone ,&nbsp;Nathalie Leister ,&nbsp;Thaís Trevisan Teixeira ,&nbsp;Carla Marins Silva ,&nbsp;Christine McCourt ,&nbsp;Maria Luiza Gonzalez Riesco","doi":"10.1016/j.midw.2025.104691","DOIUrl":"10.1016/j.midw.2025.104691","url":null,"abstract":"<div><div>Problem and Background: While international studies support the safety and benefits of waterbirth, this practice is still restricted in many Brazilian services, with few opportunities for birthing people to choose this option for labour and birth. Aim: To analyse maternal and neonatal outcomes in assisted waterbirths versus land births in a Brazilian freestanding birth centre. Methods: We conducted a cross-sectional study using retrospective data from 2012 to 2024. Maternal and neonatal outcomes of 919 waterbirths were compared to 2,805 land births, including perineal tear and repair, postpartum haemorrhage, retained placenta, maternal and neonatal transfers, neonatal resuscitation, and Apgar scores. Odds ratios (OR), rate ratios (RR) and adjusted odds ratios (aOR) were calculated, and multivariate analysis considered previous vaginal birth as a confounder variable. The significance level was 5 %. Findings: Waterbirth was associated with a lower likelihood of perineal tear (aOR, 0.75; 95 % CI, 0.65-0.87; P &lt; .001), perineal repair (OR, 0.73; 95 % CI, 0.62-0.86; P &lt; .001) and postpartum haemorrhage (aOR, 0.76; 95 % CI, 0.64-0.90; P &lt; .002). <em>Discussion:</em> The findings align with international evidence that associates waterbirth with reduced perineal trauma and postpartum haemorrhage. Unlike some studies that suggest increased neonatal risks, no adverse outcomes were observed in this study. Conclusion: Waterbirth was not associated with any additional risk to people with straightforward pregnancies. The results support the option of waterbirth as an informed choice for this population birthing in freestanding birth centres.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"153 ","pages":"Article 104691"},"PeriodicalIF":2.5,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145786963","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":"Understanding the use of peer support by midwives in clinical practice: A scoping review","authors":"Linda Sweet ,&nbsp;Gina Kruger","doi":"10.1016/j.midw.2025.104686","DOIUrl":"10.1016/j.midw.2025.104686","url":null,"abstract":"<div><h3>Problem</h3><div>Midwifery work is both challenging and rewarding. Midwifery is emotionally demanding, and peer support is thought to help midwives process distressing experiences such as traumatic births, perinatal loss, or professional conflict. Whilst there is evidence of preceptorship, mentoring, and clinical supervision in midwifery, the ways in which midwives give and receive peer support are not well understood.</div></div><div><h3>Aim</h3><div>To examine the evidence regarding the use of peer support by midwives and to map the evidence, focusing on knowledge gaps, to inform further research on how to best support midwives.</div></div><div><h3>Methods</h3><div>A scoping review was undertaken through four databases that index midwifery-related research. Peer-reviewed papers in English were sourced. Two midwifery researchers independently screened all titles and abstracts, then selected full texts. This was undertaken in Covidence. A thematic synthesis was undertaken in the selected papers.</div></div><div><h3>Findings</h3><div>Thirty articles met the inclusion criteria. The acronym ‘Strive’ was developed to represent the key concepts of peer support for midwives, including Setting (context), Trauma, Relationships, Institutional support, Validation (emotional support), and Engagement (team/managerial).</div></div><div><h3>Discussion</h3><div>‘STRIVE’ conveys an active, aspirational tone when the workplace setting or context is recognised, trauma may be minimised, positive relationships with the inter and intra professional team are built, institutional policies and practices support midwives, experiences perceived as stressful are validated through emotional support within the team, and the team and management are engaged in creating the positive environment and building social capital. Peer support may be enhanced if midwives are provided with education on mental health and well-being in the workplace.</div></div><div><h3>Conclusion</h3><div>Positive peer support is a necessity, not an indulgence, if we are to build a strong, resilient workforce and retain the midwifery workforce.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"153 ","pages":"Article 104686"},"PeriodicalIF":2.5,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145724514","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":"Advanced intrapartum midwifery practice: a scoping review","authors":"Grazia Martano ,&nbsp;Elisa Ambrosi ,&nbsp;Stefania Poggianella ,&nbsp;Claudia Paoli","doi":"10.1016/j.midw.2025.104687","DOIUrl":"10.1016/j.midw.2025.104687","url":null,"abstract":"<div><h3>Problem</h3><div>There is no international consensus on advanced midwifery practice in intrapartum care.</div></div><div><h3>Background</h3><div>Evidence suggests that advanced practice midwives improve maternal and neonatal clinical outcomes, access to care, resource efficiency and staff satisfaction. However, specific literature on advanced midwifery skills in intrapartum care is lacking.</div></div><div><h3>Aim</h3><div>To map advanced midwifery skills in intrapartum care.</div></div><div><h3>Methods</h3><div>A scoping review was conducted using electronic databases including Medline, Scopus, CINAHL, Cochrane Library, Google from inception to April 2022, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.</div></div><div><h3>Findings</h3><div>A systematic search of the literature identified 6932 studies, and 17 met inclusion criteria. The advanced intrapartum skills identified relate to perineal care, instrumental vaginal birth, breech vaginal birth, perineal repair, cesarean section, emergencies procedures, intrapartum ultrasound, counseling and mediation, labour techniques, advanced clinical assessment, intangible skills, external cephalic version.</div></div><div><h3>Discussion</h3><div>Two main trends emerge: the skills practiced in midwifery-led units are oriented to promote and respect the physiology of childbirth and, in more under-resourced contexts, the development of midwifery follows an overlapping path with that of medical skills. The advancement of intrapartum practice involves the exercise of technological and emotional skills. The practice of counseling skills contributes to the professional development of the whole team.</div></div><div><h3>Conclusion</h3><div>This review suggests the need to develop advanced skills in the area of birth physiology through the promotion of organisational models such as midwifery-led units. It is important to focus on how advanced profiles can be implemented and how advancement in practice affects maternal and neonatal outcomes.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"153 ","pages":"Article 104687"},"PeriodicalIF":2.5,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145733983","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":"Improving person-centred maternity care in Sri Lanka through co-creation: Utilising women's perceptions and stakeholder opinions","authors":"Mohamed Rishard ,&nbsp;Aysha Fathima Ziyad Mohamed ,&nbsp;Ashwini De Abrew ,&nbsp;Hemantha Senanayake ,&nbsp;Millawage Supun Dilara Wijesinghe ,&nbsp;Marzia Lazzerini","doi":"10.1016/j.midw.2025.104689","DOIUrl":"10.1016/j.midw.2025.104689","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;There is a lack of studies documenting the utilisation of different views of person-centred maternity care (PCMC), such as maternal perceptions, views of health professionals, and women’s advocates, to co-create interventions to improve the quality of care (QoC) in Sri Lanka.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;The study was conducted at a referral maternity care centre in Colombo. It involved 87 stakeholders in four phases. We conducted the study in phases to optimize logistics and feasibility. Therefore, it was conducted in a phase wise manner. Phase I: Perceptions of PCMC among 39 mothers who delivered vaginally were explored through focus group discussions (FGDs). Phase II: Delphi rounds with 25 healthcare providers were conducted to identify and prioritise interventions. Phase III: Intervention priorities were revised based on feedback from a group of 23 women’s advocacy group (WAG), using the Nominal Group Technique. Phase IV: the Nominal Group Technique was utilised to obtain the views and consensus of the women included in Phase I.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Phase I revealed five key topics:1) care and attention; 2) companions in labour; 3) respect, dignity, privacy, and communication; 4) awareness of autonomy; and 5) general safety and cleanliness. In Phase II, ten possible interventions to improve PCMC were identified, with improving staff communication skills and empowering women on their rights being the highest priorities. In Phase III, the WAG revised the priority list, with the top priorities being improving infrastructure and the organisation of care and appointing more staff. In Phase IV, the majority (94 %) of the women agreed that the proposed prioritised interventions would improve maternal healthcare services.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;This study revealed gaps in PCMC but demonstrated that in a setting like Sri Lanka, views of service users, healthcare providers, and advocacy groups can be successfully used to co-create context-specific interventions for improving QoC. We recommend further implementation research to obtain data on the feasibility, sustainability, and challenges of the identified interventions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;What is already known on this topic&lt;/h3&gt;&lt;div&gt;There is limited evidence documenting the utilisation of different views in improving person-centred maternity care in LMIC.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;What this study adds&lt;/h3&gt;&lt;div&gt;A participatory approach involving care seekers, WAG representing the public, and healthcare providers was useful in co-creating a list of prioritised interventions to improve the quality of maternity care services in a low-resource setting.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;How this study might affect research, practice, or policy&lt;/h3&gt;&lt;div&gt;The findings highlight the importance of further exploration and engagement with local stakeholders, including healthcare users, providers, and advocacy groups, to co-create context-specific interventions t","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"153 ","pages":"Article 104689"},"PeriodicalIF":2.5,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145733985","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":"Understanding the barriers UK midwives face in leading research: A critical discussion paper","authors":"Hannah M Brennan ,&nbsp;Christine Furber","doi":"10.1016/j.midw.2025.104688","DOIUrl":"10.1016/j.midw.2025.104688","url":null,"abstract":"<div><h3>Problem</h3><div>Midwives have a pivotal role in supporting excellence in care through research. However, in the UK, very few midwives lead research. It has been estimated that &lt;0.1 % of clinical midwives are employed in clinical academic careers, where they pursue a joint role working clinically and conducting research, and only 12 % of midwives working in academia hold a PhD.</div></div><div><h3>Background</h3><div>Increasing midwifery-led research and building research capacity for midwives has long been on the UK national agenda. Due to their experience, midwives can address clinically important questions and research solutions to problems that they have observed in their practice. However, midwives face many barriers to commencing and sustaining a career where they engage in midwife-led research.</div></div><div><h3>Aim</h3><div>This critical discussion paper aims to explore and understand the factors acting as barriers to UK midwives embarking on and maintaining a career leading research.</div></div><div><h3>Discussion</h3><div>This paper presents a critical discussion of the barriers for UK-based midwives to pursue research careers based on four main key points. The paper draws from UK-based reports and international contemporary literature. Four key barriers were identified from the literature: Lack of opportunities, awareness and knowledge of research among midwives; Lack of role models and mentorship; Lack of NHS and Approved Education Institution (AEI) organisational support; Lack of a clear pathway of progression.</div></div><div><h3>Conclusion and recommendations</h3><div>Significant barriers exist for UK midwives to engage in midwife-led research, which must be addressed to enable midwife-led research capacity to be improved and establish a workforce of leading midwifery researchers. Key recommendations have been identified to improve the accessibility of conducting midwife-led research.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"153 ","pages":"Article 104688"},"PeriodicalIF":2.5,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145733586","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":"First-time fathers’ inclusion in, and engagement with, perinatal primary care: An integrative review","authors":"Richard Pascal ,&nbsp;Fatch Kalembo ,&nbsp;Lesley Kuliukas ,&nbsp;Alka Kothari ,&nbsp;Garth Kendall ,&nbsp;Rikki Priest ,&nbsp;Mary Steen","doi":"10.1016/j.midw.2025.104685","DOIUrl":"10.1016/j.midw.2025.104685","url":null,"abstract":"<div><h3>Problem</h3><div>Research about first-time fathers’ inclusion in, and engagement with, perinatal primary care is limited.</div></div><div><h3>Background</h3><div>Globally, fathers’ engagement with perinatal healthcare services is low. First-time fathers experience more distress, have unique support needs and are more willing to engage with perinatal healthcare than experienced fathers. Yet, primary care’s role in supporting perinatal first-time fathers has received little research attention.</div></div><div><h3>Aim</h3><div>To examine first-time fathers’ inclusion in, and engagement with, perinatal primary care and the feasibility of engaging them through primary care pathways.</div></div><div><h3>Methods</h3><div>Integrative review of international peer-reviewed and grey literature.</div></div><div><h3>Findings</h3><div>Thirty-three studies (16 quantitative, 13 qualitative, 4 mixed-methods) were included, comprising 3712 first-time fathers. Almost half (46 %) of the fathers in 19 suitable studies were first-time fathers. Parents’ perceived barriers to father engagement included providers being mother-focused and fathers’ mistrust of providers. Provider barriers included father absence, perceived father disinterest, workload and low managerial support. Promising strategies for engagement included provider-initiated interactions with fathers and postnatal home visits. Systemic barriers received limited attention.</div></div><div><h3>Discussion</h3><div>The lack of complete father-specific data in several studies hindered the review process and limited the strength of conclusions. Since first-time fathers may comprise about half of fathers in perinatal primary care, universal services risk overlooking their specific needs. While strategies like postnatal home visits show promise for father engagement, limited consensus about engagement strategies and unaddressed systemic issues may limit their effectiveness.</div></div><div><h3>Conclusion</h3><div>Further research exploring parents’ and providers’ views is required to guide more effective father-inclusive care. Engaging first-time fathers in primary care must go beyond practical strategies and address deeper systemic issues.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"153 ","pages":"Article 104685"},"PeriodicalIF":2.5,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145733984","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":"Risk factors and pregnancy outcomes of hypertensive disorders of pregnancy: a case-control study","authors":"Qingyan Yu ,&nbsp;Lin Xie ,&nbsp;Wenhui Xu ,&nbsp;Shutong Chen ,&nbsp;Xue Chen ,&nbsp;Xinhong Jiang ,&nbsp;Qi Chu ,&nbsp;Haitao Yu","doi":"10.1016/j.midw.2025.104684","DOIUrl":"10.1016/j.midw.2025.104684","url":null,"abstract":"<div><h3>Objectives</h3><div>Hypertensive disorders of pregnancy (HDP) is a group of diseases that coexist with pregnancy and hypertension and it will affect the health of mothers and babies. The primary objective of this study was to identify the relevant factors for HDP and to briefly assess its impact on pregnancy outcomes.</div></div><div><h3>Methods</h3><div>660 pregnant women who gave birth in a hospital of Northeast China were included as the study subjects. The basic information of the pregnant woman was provided via the medical record system. Statistical analyses including logistic regression analysis and receiver operating characteristic (ROC) curves was used.</div></div><div><h3>Results</h3><div>The prevalence of overweight/obesity, high gestational weight gain (GWG) and diabetes was higher in HDP group (<em>P</em> &lt; 0.05), whereas multiparity and uterine fibroids was lower (<em>P</em> &lt; 0.05). Multifactorial analysis shown that overweight/obesity and high GWG might increase risk of HDP while multiparity and having uterine fibroids might reduce risk of HDP in pregnant women (<em>P</em> &lt; 0.001). The ROC curve indicated that pre-pregnancy BMI demonstrated the highest predictive value for the occurrence of HDP. A comparison of pregnancy outcomes revealed that the caesarean section was higher in HDP group than in CON group (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>The findings of this study reaffirmed overweight/obesity and high GWG as risk factors for HDP, while multiparity and uterine fibroids might be protective. HDP was strongly associated with increased caesarean section rates.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"153 ","pages":"Article 104684"},"PeriodicalIF":2.5,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145622369","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}