Tokophobia is a mild to extreme fear of pregnancy and/or childbirth that may cause a woman to avoid giving birth. It is a common obstetrical problem that affects women's health. Some studies have found that fear of childbirth is common in East African countries. However, there was inconsistency across those studies, and no study was undertaken to report the pooled prevalence of fear of childbirth and its associated factors. As a result, the purpose of this systematic review and meta-analysis is to identify the pooled prevalence of fear of childbirth and its associated factors in Eastern Africa.
Methods
We conducted a systematic review and meta-analysis of studies on the prevalence and associated factors of childbirth fear using Pub Med, Hinari, Google Scholar, and East African University archives. Data were extracted using a data extraction format developed in Microsoft Excel, and the analysis was carried out with STATA 14 statistical software. Each article's quality was assessed using the Joanna Briggs Institute's critical appraisal tool for prevalence studies. The Cochrane Q statistics and I2 test were used to examine heterogeneity between studies. Subgroup analysis was done by country and sample size. To assess publication bias, a funnel plot, and Egger's regression test were used.
Results
This systematic review and meta-analysis included eleven studies. The pooled prevalence of the fear of childbirth among pregnant women in East Africa was 27.86 %. A history of labor and delivery complications (OR = 5.41, 95 %CI = 2.20, 8.63), poor social support (OR = 4.50, 95 %CI = 1.70, 11.92), primiparity (OR = 1.91, 95 %CI = 1.17, 3.12), no ANC follow-up (AOR=2.65, 95 %CI=1.48, 4.74), and unplanned pregnancy (AOR=4.88, 95 %CI=1.23, 19.31) were statistically associated with the fear of childbirth.
Conclusion
The pooled prevalence of fear of childbirth was high. Previous labor and delivery complications, poor social support, primiparity, a lack of antenatal care follow-up, and unplanned pregnancy were all statistically associated with fear of childbirth. To address this, healthcare providers should focus on individualized psychological support for pregnant women who experience tokophobia. Furthermore, encouraging comprehensive antenatal care and strengthening social networks can reduce the fear of childbirth and promote maternal well-being.
{"title":"Fear of childbirth and its associated factors among pregnant women in East Africa: Systematic review and meta-analysis","authors":"Mesfin Abebe , Tsion Mulat Tebeje , Nebiha Yimer , Tesfahun Simon , Abel Belete , Getnet Melaku , Habtamu Endashaw Hareru","doi":"10.1016/j.midw.2024.104191","DOIUrl":"10.1016/j.midw.2024.104191","url":null,"abstract":"<div><h3>Background</h3><div>Tokophobia is a mild to extreme fear of pregnancy and/or childbirth that may cause a woman to avoid giving birth. It is a common obstetrical problem that affects women's health. Some studies have found that fear of childbirth is common in East African countries. However, there was inconsistency across those studies, and no study was undertaken to report the pooled prevalence of fear of childbirth and its associated factors. As a result, the purpose of this systematic review and meta-analysis is to identify the pooled prevalence of fear of childbirth and its associated factors in Eastern Africa.</div></div><div><h3>Methods</h3><div>We conducted a systematic review and meta-analysis of studies on the prevalence and associated factors of childbirth fear using Pub Med, Hinari, Google Scholar, and East African University archives. Data were extracted using a data extraction format developed in Microsoft Excel, and the analysis was carried out with STATA 14 statistical software. Each article's quality was assessed using the Joanna Briggs Institute's critical appraisal tool for prevalence studies. The Cochrane Q statistics and I<sup>2</sup> test were used to examine heterogeneity between studies. Subgroup analysis was done by country and sample size. To assess publication bias, a funnel plot, and Egger's regression test were used.</div></div><div><h3>Results</h3><div>This systematic review and meta-analysis included eleven studies. The pooled prevalence of the fear of childbirth among pregnant women in East Africa was 27.86 %. A history of labor and delivery complications (OR = 5.41, 95 %CI = 2.20, 8.63), poor social support (OR = 4.50, 95 %CI = 1.70, 11.92), primiparity (OR = 1.91, 95 %CI = 1.17, 3.12), no ANC follow-up (AOR=2.65, 95 %CI=1.48, 4.74), and unplanned pregnancy (AOR=4.88, 95 %CI=1.23, 19.31) were statistically associated with the fear of childbirth.</div></div><div><h3>Conclusion</h3><div>The pooled prevalence of fear of childbirth was high. Previous labor and delivery complications, poor social support, primiparity, a lack of antenatal care follow-up, and unplanned pregnancy were all statistically associated with fear of childbirth. To address this, healthcare providers should focus on individualized psychological support for pregnant women who experience tokophobia. Furthermore, encouraging comprehensive antenatal care and strengthening social networks can reduce the fear of childbirth and promote maternal well-being.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"139 ","pages":"Article 104191"},"PeriodicalIF":2.6,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349774","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 : 2024-09-21DOI: 10.1016/j.midw.2024.104189
Maiken F. Damm , Stina Lou , Puk Sandager , Ida Vogel , Christina Prinds , Dorte Hvidtjoern
Termination of pregnancy due to a fetal anomaly is a challenging and mentally stressful experience, associated with trauma-related stress, depression and symptoms of complicated grief. It differs from other types of pregnancy loss because of the role of active decision-making. Expectant parents depend on caring and experienced staff to guide them during a time full of ambiguity and contrasting emotions.
This study examines how expectant parents experience the process of birth with termination of pregnancy due to fetal anomaly at a specialised unit for prenatal loss.
Data was generated from semi-structured interviews with 11 women and 9 male partners, one to five months after termination of pregnancy.
Three themes were identified 1) Suspended time/space bubble; the unit for prenatal loss was described as a time-space bubble, that promoted a sense of meaning, a feeling of togetherness and an awareness of parallel worlds, 2) The midwife matters; participants emphasised midwives’ 'invisible', chronological and individualised practice, making it possible to be present and in the process, and 3) Meeting and spending time with the fetus/baby; participants’ responses and relation to the fetus were very different, with most of them embracing the fetus as a baby, grateful for the opportunity to have time together.
The findings from this study suggest a need for specialised midwives dedicated to prenatal loss, in units designed as private and protected spaces to accommodate the requirements of parents undergoing termination of pregnancy due to fetal anomaly.
{"title":"A time/space bubble: Expectant parents’ experience of birth after termination of pregnancy due to fetal anomaly in a midwifery-led, obstetric unit for prenatal loss","authors":"Maiken F. Damm , Stina Lou , Puk Sandager , Ida Vogel , Christina Prinds , Dorte Hvidtjoern","doi":"10.1016/j.midw.2024.104189","DOIUrl":"10.1016/j.midw.2024.104189","url":null,"abstract":"<div><div>Termination of pregnancy due to a fetal anomaly is a challenging and mentally stressful experience, associated with trauma-related stress, depression and symptoms of complicated grief. It differs from other types of pregnancy loss because of the role of active decision-making. Expectant parents depend on caring and experienced staff to guide them during a time full of ambiguity and contrasting emotions.</div><div>This study examines how expectant parents experience the process of birth with termination of pregnancy due to fetal anomaly at a specialised unit for prenatal loss.</div><div>Data was generated from semi-structured interviews with 11 women and 9 male partners, one to five months after termination of pregnancy.</div><div>Three themes were identified 1) <em>Suspended time/space bubble</em>; the unit for prenatal loss was described as a time-space bubble, that promoted a sense of meaning, a feeling of togetherness and an awareness of parallel worlds, 2) <em>The midwife matters</em>; participants emphasised midwives’ 'invisible', chronological and individualised practice, making it possible to be present and in the process, and 3) <em>Meeting and spending time with the fetus/baby</em>; participants’ responses and relation to the fetus were very different, with most of them embracing the fetus as a baby, grateful for the opportunity to have time together.</div><div>The findings from this study suggest a need for specialised midwives dedicated to prenatal loss, in units designed as private and protected spaces to accommodate the requirements of parents undergoing termination of pregnancy due to fetal anomaly.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"140 ","pages":"Article 104189"},"PeriodicalIF":2.6,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391715","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 : 2024-09-18DOI: 10.1016/j.midw.2024.104187
Jun Huang , Yiyang Lin , Yanqing Fu , Zelin Xu , Huilan Hong , Rachel Arbing , Wei-Ti Chen , Anni Wang , Feifei Huang
<div><h3>Objective</h3><div>Few studies have applied a health ecological model to understand perinatal depression among high-risk women, and existing research remains primarily cross-sectional in nature. This study aimed to explore the interplay among family function, perceived stress, insomnia symptoms, cognitive reactivity subscales (such as hopelessness/suicidality, aggression, control/perfectionism, avoidant coping, and acceptance/coping), mindfulness subscales (including attention, present focus, awareness, and acceptance), physiological indicators (e.g., hgb, 25-hydroxyvitamin D, and HbA1C), and depressive symptoms in Chinese high-risk women during the perinatal period.</div></div><div><h3>Design</h3><div>This was a longitudinal population-based cohort study.</div></div><div><h3>Setting</h3><div>This two-wave prospective study was conducted in Fujian Province, China, from December 2021 to January 2023.</div></div><div><h3>Participants</h3><div>We used convenience sampling to enroll 368 pregnant patients from obstetrical clinics and inpatient departments of three tertiary hospitals (level 3) in Fuzhou and Quanzhou City, Fujian Province, China.</div></div><div><h3>Measurements and findings</h3><div>In the statistical analysis, cross-sectional data were analyzed via the contemporaneous network method, and longitudinal data were analyzed via the cross-lagged panel network method. The core symptoms in the depression-related symptom network during the third trimester and three months postpartum were identified as attention (ATT) (strength = 1.02) and acceptance/coping (ACC) (strength = 1.19). All bridge symptoms were shown as depression (EPDS) (bridging strength = 0.07 and 0.09). A comparison between the first and second survey networks showed a reduced edge weight for the association between depressive symptoms and insomnia symptoms (to 0 in the second survey network, diff = -0.18, <em>P</em> < 0.001). Conversely, the association between depressive symptoms and control/perfectionism increased to 0.252 (diff = 0.25, <em>P</em> < 0.001). Through cross-lagged panel network analysis, the EPDS (out strength = 3.68, OEI =3.60) was identified as the most influential symptom and the most predictable symptom (R² = 0.76). Perceived stress (PSS) (in strength = 2.49) and hopelessness/suicidality (HOP) (IEI = 1.96) were identified as the most susceptible symptoms.</div></div><div><h3>Key conclusions</h3><div>Cross-sectional network analysis combined with longitudinal network analysis revealed the mechanism of action between symptoms. Attention (ATT) and acceptance/coping (ACC) were identified as the core symptoms in the network of depression-related symptoms during the third trimester and three months postpartum, and the bridge symptoms were both depression (EPDS). In the dynamic network, depression (EPDS) was identified as the most influential and predictable symptom, and perceived stress (PSS) and hopelessness/suicidality (HOP) were identified as the
{"title":"A longitudinal network analysis of interaction factors among Chinese women at high risk for perinatal depression","authors":"Jun Huang , Yiyang Lin , Yanqing Fu , Zelin Xu , Huilan Hong , Rachel Arbing , Wei-Ti Chen , Anni Wang , Feifei Huang","doi":"10.1016/j.midw.2024.104187","DOIUrl":"10.1016/j.midw.2024.104187","url":null,"abstract":"<div><h3>Objective</h3><div>Few studies have applied a health ecological model to understand perinatal depression among high-risk women, and existing research remains primarily cross-sectional in nature. This study aimed to explore the interplay among family function, perceived stress, insomnia symptoms, cognitive reactivity subscales (such as hopelessness/suicidality, aggression, control/perfectionism, avoidant coping, and acceptance/coping), mindfulness subscales (including attention, present focus, awareness, and acceptance), physiological indicators (e.g., hgb, 25-hydroxyvitamin D, and HbA1C), and depressive symptoms in Chinese high-risk women during the perinatal period.</div></div><div><h3>Design</h3><div>This was a longitudinal population-based cohort study.</div></div><div><h3>Setting</h3><div>This two-wave prospective study was conducted in Fujian Province, China, from December 2021 to January 2023.</div></div><div><h3>Participants</h3><div>We used convenience sampling to enroll 368 pregnant patients from obstetrical clinics and inpatient departments of three tertiary hospitals (level 3) in Fuzhou and Quanzhou City, Fujian Province, China.</div></div><div><h3>Measurements and findings</h3><div>In the statistical analysis, cross-sectional data were analyzed via the contemporaneous network method, and longitudinal data were analyzed via the cross-lagged panel network method. The core symptoms in the depression-related symptom network during the third trimester and three months postpartum were identified as attention (ATT) (strength = 1.02) and acceptance/coping (ACC) (strength = 1.19). All bridge symptoms were shown as depression (EPDS) (bridging strength = 0.07 and 0.09). A comparison between the first and second survey networks showed a reduced edge weight for the association between depressive symptoms and insomnia symptoms (to 0 in the second survey network, diff = -0.18, <em>P</em> < 0.001). Conversely, the association between depressive symptoms and control/perfectionism increased to 0.252 (diff = 0.25, <em>P</em> < 0.001). Through cross-lagged panel network analysis, the EPDS (out strength = 3.68, OEI =3.60) was identified as the most influential symptom and the most predictable symptom (R² = 0.76). Perceived stress (PSS) (in strength = 2.49) and hopelessness/suicidality (HOP) (IEI = 1.96) were identified as the most susceptible symptoms.</div></div><div><h3>Key conclusions</h3><div>Cross-sectional network analysis combined with longitudinal network analysis revealed the mechanism of action between symptoms. Attention (ATT) and acceptance/coping (ACC) were identified as the core symptoms in the network of depression-related symptoms during the third trimester and three months postpartum, and the bridge symptoms were both depression (EPDS). In the dynamic network, depression (EPDS) was identified as the most influential and predictable symptom, and perceived stress (PSS) and hopelessness/suicidality (HOP) were identified as the","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"139 ","pages":"Article 104187"},"PeriodicalIF":2.6,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142315053","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 : 2024-09-17DOI: 10.1016/j.midw.2024.104183
Cath Grimley, Jo Parsons
{"title":"To vaccinate or not to vaccinate? The dilemma of pregnant women","authors":"Cath Grimley, Jo Parsons","doi":"10.1016/j.midw.2024.104183","DOIUrl":"10.1016/j.midw.2024.104183","url":null,"abstract":"","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"139 ","pages":"Article 104183"},"PeriodicalIF":2.6,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0266613824002663/pdfft?md5=a1d3b44188f35d689c6b18df29901063&pid=1-s2.0-S0266613824002663-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142311505","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 : 2024-09-12DOI: 10.1016/j.midw.2024.104188
Johanna Blomgren , Helena Lindgren , Dinah Amongin , Kerstin Erlandsson , Christina Lundberg , Annette E. Kanyunyuzi , Sarah Muwanguzi , Victoria M. Babyrie , Ketty Ogwang , Dinnah Aineomugasho , Namutosi Catherine , Michael B. Wells
Background
Addressing the evidence-to-practice gap in midwifery is vital for improving maternal and newborn health outcomes. Despite the potential of involving midwives in quality improvement interventions to address this gap, such interventions are understudied. In a Ugandan urban hospital, midwifery practices with a significant evidence-to-practice gap have been identified as areas for clinical improvement.
Objectives
The primary objective of the Quality Improvement was to increase the uptake of identified and essential midwifery practices through a quality improvement approach led by midwives.
Participants
We enrolled 703 women aged 18 years and older with uncomplicated full-term pregnancies (between 37+0 and 42+0 weeks) who gave birth at the facility.
Intervention
The intervention focused on evidence-based practices with an identified evidence-to-practice gap: dynamic birth position, including women's involvement in birth position decision-making, perineal protection and intrapartum support. A team of midwives led a seven-month co-created quality improvement intervention. The intervention used Plan–Do–Study–Act (PDSA) cycles, following the Model for Improvement and included a train-the-trainer approach and weekly online support meetings.
Data collection
In this single-case prospective observational study, we compared pre-, during and post-intervention uptake of evidence-based practices. Trained research assistants collected data through interviews and observations.
Results
We observed improvements in the uptake of all clinical improvement areas. Dynamic birth positions increased from 0 % to 79 %, decision-making of birth positions from 0 % to 75 %, perineal protection measures from 62 % to 92 % and intrapartum support from 7 % to 67 %.
Conclusion
A multifactorial midwife-led Quality Improvement resulted in significant and sustained improvements in the uptake of evidence-based practices in maternal and newborn healthcare. If given the mandate and time, midwives can successfully lead Quality Improvements, which enhance the quality of care and close the evidence-to-practice gaps in maternal and newborn health. The study's results underscore the significance of developing effective strategies to enhance care quality and promote the adoption of evidence-based midwifery practices.
{"title":"Midwife-led quality improvement: Increasing the use of evidence-based birth practices in Uganda","authors":"Johanna Blomgren , Helena Lindgren , Dinah Amongin , Kerstin Erlandsson , Christina Lundberg , Annette E. Kanyunyuzi , Sarah Muwanguzi , Victoria M. Babyrie , Ketty Ogwang , Dinnah Aineomugasho , Namutosi Catherine , Michael B. Wells","doi":"10.1016/j.midw.2024.104188","DOIUrl":"10.1016/j.midw.2024.104188","url":null,"abstract":"<div><h3>Background</h3><p>Addressing the evidence-to-practice gap in midwifery is vital for improving maternal and newborn health outcomes. Despite the potential of involving midwives in quality improvement interventions to address this gap, such interventions are understudied. In a Ugandan urban hospital, midwifery practices with a significant evidence-to-practice gap have been identified as areas for clinical improvement.</p></div><div><h3>Objectives</h3><p>The primary objective of the Quality Improvement was to increase the uptake of identified and essential midwifery practices through a quality improvement approach led by midwives.</p></div><div><h3>Participants</h3><p>We enrolled 703 women aged 18 years and older with uncomplicated full-term pregnancies (between 37+0 and 42+0 weeks) who gave birth at the facility.</p></div><div><h3>Intervention</h3><p>The intervention focused on evidence-based practices with an identified evidence-to-practice gap: dynamic birth position, including women's involvement in birth position decision-making, perineal protection and intrapartum support. A team of midwives led a seven-month co-created quality improvement intervention. The intervention used Plan–Do–Study–Act (PDSA) cycles, following the Model for Improvement and included a train-the-trainer approach and weekly online support meetings.</p></div><div><h3>Data collection</h3><p>In this single-case prospective observational study, we compared pre-, during and post-intervention uptake of evidence-based practices. Trained research assistants collected data through interviews and observations.</p></div><div><h3>Results</h3><p>We observed improvements in the uptake of all clinical improvement areas. Dynamic birth positions increased from 0 % to 79 %, decision-making of birth positions from 0 % to 75 %, perineal protection measures from 62 % to 92 % and intrapartum support from 7 % to 67 %.</p></div><div><h3>Conclusion</h3><p>A multifactorial midwife-led Quality Improvement resulted in significant and sustained improvements in the uptake of evidence-based practices in maternal and newborn healthcare. If given the mandate and time, midwives can successfully lead Quality Improvements, which enhance the quality of care and close the evidence-to-practice gaps in maternal and newborn health. The study's results underscore the significance of developing effective strategies to enhance care quality and promote the adoption of evidence-based midwifery practices.</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"139 ","pages":"Article 104188"},"PeriodicalIF":2.6,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0266613824002717/pdfft?md5=884886ea8f1865440cef0392f558900d&pid=1-s2.0-S0266613824002717-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142272848","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 : 2024-09-12DOI: 10.1016/j.midw.2024.104185
Gill Thomson, Rebecca Nowland
Problem
Currently there is a lack of clear guidance to underpin postnatal listening services for women who have had a traumatic or difficult birth.
Background
Postnatal listening (or birth reflections) services are important to help women review their birth and ask questions about their care, but currently there is no clear guidance on how these services should be provided.
Aim
To synthesise existing evidence on postnatal listening services for women following a traumatic or negative childbirth experience.
Methods
A rapid evidence review using four databases (PsycINFO, CINAHL, Medline, Web of Science), backward and forward chaining, and hand searches of previous systematic reviews. The Mixed Methods Appraisal tool was used to appraise the studies. Quantitative and qualitative data were synthesised into descriptive themes.
Findings
Database searches (n = 9,459 hits), backward and forward chaining and hand searching identified 27 articles for inclusion. Nineteen different services are described, evaluated as part of controlled trials (n = 16) or using quantitative and/or qualitative data (n = 8); three studies are audits of UK services. Findings are reported in 5 themes, ‘Who provides the service?’, ‘Types and quality of care’, ‘Targeting the support’, ‘Timing and location’, and ‘Training and experiences of maternity staff’.
Discussion
The findings identify who, how, when, where and what should be provided within postnatal listening services. Services should be flexibly provided by trained maternity staff via active listening, empathy, and a non-judgmental approach.
Conclusion
Further work is needed to develop an optimum training programme, to identify key components of effectiveness, and to ensure these services are culturally relevant.
{"title":"A rapid evidence review of postnatal listening services for women following a traumatic or negative childbirth experience","authors":"Gill Thomson, Rebecca Nowland","doi":"10.1016/j.midw.2024.104185","DOIUrl":"10.1016/j.midw.2024.104185","url":null,"abstract":"<div><h3>Problem</h3><p>Currently there is a lack of clear guidance to underpin postnatal listening services for women who have had a traumatic or difficult birth.</p></div><div><h3>Background</h3><p>Postnatal listening (or birth reflections) services are important to help women review their birth and ask questions about their care, but currently there is no clear guidance on how these services should be provided.</p></div><div><h3>Aim</h3><p>To synthesise existing evidence on postnatal listening services for women following a traumatic or negative childbirth experience.</p></div><div><h3>Methods</h3><p>A rapid evidence review using four databases (PsycINFO, CINAHL, Medline, Web of Science), backward and forward chaining, and hand searches of previous systematic reviews. The Mixed Methods Appraisal tool was used to appraise the studies. Quantitative and qualitative data were synthesised into descriptive themes.</p></div><div><h3>Findings</h3><p>Database searches (<em>n</em> = 9,459 hits), backward and forward chaining and hand searching identified 27 articles for inclusion. Nineteen different services are described, evaluated as part of controlled trials (<em>n</em> = 16) or using quantitative and/or qualitative data (<em>n</em> = 8); three studies are audits of UK services. Findings are reported in 5 themes, <em>‘Who provides the service?’, ‘Types and quality of care’, ‘Targeting the support’, ‘Timing and location’,</em> and <em>‘Training and experiences of maternity staff’</em>.</p></div><div><h3>Discussion</h3><p>The findings identify who, how, when, where and what should be provided within postnatal listening services. Services should be flexibly provided by trained maternity staff via active listening, empathy, and a non-judgmental approach.</p></div><div><h3>Conclusion</h3><p>Further work is needed to develop an optimum training programme, to identify key components of effectiveness, and to ensure these services are culturally relevant.</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"139 ","pages":"Article 104185"},"PeriodicalIF":2.6,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0266613824002687/pdfft?md5=98421794c2d9e1587d6a86d4088103e4&pid=1-s2.0-S0266613824002687-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142272849","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 : 2024-09-11DOI: 10.1016/j.midw.2024.104181
Elizabeth McCarthy, Jan de Vries, Louise Gallagher
Background
Breastfeeding Support Groups are deemed effective in promoting breastfeeding initiation and duration, but few studies have addressed the mothers’ perspectives.
Research aim
To investigate the role and impact of Breastfeeding Support Groups on breastfeeding mothers in Ireland from the women's perspective. Specific objectives included the assessment over time of breastfeeding self-efficacy knowledge, use, and limitations of BSGs and whether they contributed towards women achieving their breastfeeding goals.
Methods
An online survey using an established, validated Breastfeeding Self-Efficacy tool and custom-designed questions was administered at two time points as part of a larger sequential explanatory mixed methods’ design. Cultural Historical Activity Theory was used as the theoretical framework.
Results
Majority of respondents at Phase 1 (N = 978) were multiparous, urban dwellers, and breastfeeding more than twelve months. Mothers first attend Breastfeeding Support Groups primarily to meet other breastfeeding mothers with many attending multiple types of group formats weekly. Qualities considered extremely important in breastfeeding supporters were: personal breastfeeding experience breastfeeding knowledge empathy understanding and listening skills There was no statistical difference in breastfeeding self-efficacy over time (z = -1.296, p = .195, r = -0.06).
Conclusions
Participants attend Breastfeeding Support Groups to ‘meet other mothers’ in a convenient and local location, and not necessarily for a problem. Breastfeeding Support Groups normalise breastfeeding through social support, with breastfeeding supporters providing knowledge, empathy, understanding listening, and personal breastfeeding experience. Breastfeeding self-efficacy was high and did not increase over time, suggesting mothers need to be highly efficacious in this cohort to breastfeed.
{"title":"Women's perspectives on the role and impact of breastfeeding support groups in Ireland","authors":"Elizabeth McCarthy, Jan de Vries, Louise Gallagher","doi":"10.1016/j.midw.2024.104181","DOIUrl":"10.1016/j.midw.2024.104181","url":null,"abstract":"<div><h3>Background</h3><div>Breastfeeding Support Groups are deemed effective in promoting breastfeeding initiation and duration, but few studies have addressed the mothers’ perspectives.</div></div><div><h3>Research aim</h3><div>To investigate the role and impact of Breastfeeding Support Groups on breastfeeding mothers in Ireland from the women's perspective. Specific objectives included the assessment over time of breastfeeding self-efficacy knowledge, use, and limitations of BSGs and whether they contributed towards women achieving their breastfeeding goals.</div></div><div><h3>Methods</h3><div>An online survey using an established, validated Breastfeeding Self-Efficacy tool and custom-designed questions was administered at two time points as part of a larger sequential explanatory mixed methods’ design. Cultural Historical Activity Theory was used as the theoretical framework.</div></div><div><h3>Results</h3><div>Majority of respondents at Phase 1 (<em>N</em> = 978) were multiparous, urban dwellers, and breastfeeding more than twelve months. Mothers first attend Breastfeeding Support Groups primarily to meet other breastfeeding mothers with many attending multiple types of group formats weekly. Qualities considered extremely important in breastfeeding supporters were: personal breastfeeding experience breastfeeding knowledge empathy understanding and listening skills There was no statistical difference in breastfeeding self-efficacy over time (<em>z</em> = -1.296, <em>p</em> = .195, <em>r</em> = -0.06).</div></div><div><h3>Conclusions</h3><div>Participants attend Breastfeeding Support Groups to ‘meet other mothers’ in a convenient and local location, and not necessarily for a problem. Breastfeeding Support Groups normalise breastfeeding through social support, with breastfeeding supporters providing knowledge, empathy, understanding listening, and personal breastfeeding experience. Breastfeeding self-efficacy was high and did not increase over time, suggesting mothers need to be highly efficacious in this cohort to breastfeed.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"139 ","pages":"Article 104181"},"PeriodicalIF":2.6,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S026661382400264X/pdfft?md5=a9780459429ef6a445fdc677281ecce8&pid=1-s2.0-S026661382400264X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142315052","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 : 2024-09-11DOI: 10.1016/j.midw.2024.104184
Yu Xuan Ng , Chengting Chang , Chin Yue Tan , Hong-Gu He
Background
Childbearing women often resort to pharmacotherapies for pain and anxiety management during childbirth, despite their adverse effects. Virtual reality has emerged as an alternative, but a comprehensive synthesis of women's experiences with virtual reality during labor is lacking, hindering validation of its perceived effects.
Aim
To synthesize the best available evidence of women's perceptions of the use of virtual reality during childbirth.
Methods
From the beginning until December 31, 2023, a comprehensive search was conducted across nine databases (PubMed, Embase, Cochrane Library, CINAHL, MEDLINE, PsycINFO, Web of Science, Scopus, and ProQuest Dissertations and Theses Global), with no restrictions on publication year but limited to English language only. Qualitative findings focusing on women's experiences with virtual reality during childbirth were included. Two reviewers independently screened studies, extracted data, and appraised quality. Data synthesis followed the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis and thematic analysis framework, with evidence assessed through GRADE-CERQual.
Results
Eight studies were included, revealing a central theme: "The Journey of Childbirth through the Lens of Virtual Reality", supported by four themes: collective experiences and sentiments; labor pain and anxiety mitigation; Contentment and enthusiasm for subsequent utilization; and preferences and improvements.
Conclusion
This qualitative systematic review explored women's unique experiences with virtual reality during childbirth. It highlighted the need for ongoing research and collaborative efforts in healthcare to enhance virtual reality interventions, ensuring their efficacy in obstetrics for competent childbirth management.
背景育龄妇女在分娩过程中通常会采用药物疗法来控制疼痛和焦虑，尽管这些疗法会产生不良影响。目的综合妇女对分娩期间使用虚拟现实技术的看法的现有最佳证据。方法从开始到 2023 年 12 月 31 日，我们对九个数据库（PubMed、Embase、Cochrane Library、CINAHL、MEDLINE、PsycINFO、Web of Science、Scopus 和 ProQuest Dissertations and Theses Global）进行了全面检索，对出版年份没有限制，但仅限于英语。研究纳入了关注妇女在分娩过程中使用虚拟现实体验的定性研究成果。两名审稿人独立筛选研究、提取数据并评估质量。数据综合遵循了乔安娜-布里格斯研究所（JBI）的《证据综合手册》和主题分析框架，并通过 GRADE-CERQual 对证据进行了评估：结果纳入了八项研究，揭示了一个中心主题："虚拟现实镜头下的分娩之旅"，并辅以四个主题：集体体验和情感；减轻分娩疼痛和焦虑；对后续使用的满足感和热情；以及偏好和改进。结论本定性系统综述探讨了妇女在分娩过程中使用虚拟现实技术的独特体验。它强调了在医疗保健领域进行持续研究和合作的必要性，以加强虚拟现实干预措施，确保其在产科中的有效性，从而实现有效的分娩管理。
{"title":"Women's perceptions of the use of virtual reality during childbirth: A qualitative systematic review and meta-synthesis","authors":"Yu Xuan Ng , Chengting Chang , Chin Yue Tan , Hong-Gu He","doi":"10.1016/j.midw.2024.104184","DOIUrl":"10.1016/j.midw.2024.104184","url":null,"abstract":"<div><h3>Background</h3><div>Childbearing women often resort to pharmacotherapies for pain and anxiety management during childbirth, despite their adverse effects. Virtual reality has emerged as an alternative, but a comprehensive synthesis of women's experiences with virtual reality during labor is lacking, hindering validation of its perceived effects.</div></div><div><h3>Aim</h3><div>To synthesize the best available evidence of women's perceptions of the use of virtual reality during childbirth.</div></div><div><h3>Methods</h3><div>From the beginning until December 31, 2023, a comprehensive search was conducted across nine databases (PubMed, Embase, Cochrane Library, CINAHL, MEDLINE, PsycINFO, Web of Science, Scopus, and ProQuest Dissertations and Theses Global), with no restrictions on publication year but limited to English language only. Qualitative findings focusing on women's experiences with virtual reality during childbirth were included. Two reviewers independently screened studies, extracted data, and appraised quality. Data synthesis followed the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis and thematic analysis framework, with evidence assessed through GRADE-CERQual.</div></div><div><h3>Results</h3><div>Eight studies were included, revealing a central theme: \"The Journey of Childbirth through the Lens of Virtual Reality\", supported by four themes: collective experiences and sentiments; labor pain and anxiety mitigation; Contentment and enthusiasm for subsequent utilization; and preferences and improvements.</div></div><div><h3>Conclusion</h3><div>This qualitative systematic review explored women's unique experiences with virtual reality during childbirth. It highlighted the need for ongoing research and collaborative efforts in healthcare to enhance virtual reality interventions, ensuring their efficacy in obstetrics for competent childbirth management.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"139 ","pages":"Article 104184"},"PeriodicalIF":2.6,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142311504","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 : 2024-09-10DOI: 10.1016/j.midw.2024.104186
Aaron A. Funa
Understanding the experiences of student midwives during clinical training is crucial amid evolving midwifery practices in the Philippines. This training is a vital component of their education, offering real-world experience in hospital and community settings. Although existing literature covers various aspects of midwifery training, detailed accounts of the specific challenges and opportunities faced by Filipino student midwives are limited. This study explores the experiences of student midwives across different levels of training in public and private institutions, focusing on the opportunities and challenges they encountered. A qualitative descriptive research design was conducted with 26 purposively selected student midwives. Data collected through in-depth interviews were analyzed to identify recurring themes. Key themes included the importance of a supportive learning environment, exposure to diverse cases, and the acquisition of practical skills. Challenges such as hierarchical barriers and communication challenges, role confusion, resource limitations and adaptation struggles, balancing autonomy and supervision, emotional toll of challenging situations and limited community experiences were highlighted. The findings stress the need for a more supportive and resourceful training environment. Addressing these challenges through targeted interventions could enhance the learning experience and better prepare student midwives for their professional roles. Collaborative efforts with other healthcare professionals and continuous learning opportunities are also essential for their development. This study offers valuable insights for educators and healthcare institutions to optimize midwifery training programs, ultimately fostering the holistic growth of future midwives.
{"title":"Exploring clinical practice education for student midwives: Hospital and community opportunities and challenges","authors":"Aaron A. Funa","doi":"10.1016/j.midw.2024.104186","DOIUrl":"10.1016/j.midw.2024.104186","url":null,"abstract":"<div><p>Understanding the experiences of student midwives during clinical training is crucial amid evolving midwifery practices in the Philippines. This training is a vital component of their education, offering real-world experience in hospital and community settings. Although existing literature covers various aspects of midwifery training, detailed accounts of the specific challenges and opportunities faced by Filipino student midwives are limited. This study explores the experiences of student midwives across different levels of training in public and private institutions, focusing on the opportunities and challenges they encountered. A qualitative descriptive research design was conducted with 26 purposively selected student midwives. Data collected through in-depth interviews were analyzed to identify recurring themes. Key themes included the importance of a supportive learning environment, exposure to diverse cases, and the acquisition of practical skills. Challenges such as hierarchical barriers and communication challenges, role confusion, resource limitations and adaptation struggles, balancing autonomy and supervision, emotional toll of challenging situations and limited community experiences were highlighted. The findings stress the need for a more supportive and resourceful training environment. Addressing these challenges through targeted interventions could enhance the learning experience and better prepare student midwives for their professional roles. Collaborative efforts with other healthcare professionals and continuous learning opportunities are also essential for their development. This study offers valuable insights for educators and healthcare institutions to optimize midwifery training programs, ultimately fostering the holistic growth of future midwives.</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"139 ","pages":"Article 104186"},"PeriodicalIF":2.6,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142232963","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 : 2024-09-08DOI: 10.1016/j.midw.2024.104182
Mega Hasanul Huda , Yeni Rustina , Fajar Tri Waluyanti , Cindy-Lee Dennis , Shu-Yu Kuo
Background
Fathers play a significant role in supporting sustaining exclusive breastfeeding. It is crucial to assess paternal confidence in assisting mothers during breastfeeding.
Research aim
This study evaluated the psychometric properties of the Paternal Breastfeeding Self-Efficacy Scale- Short Form among Indonesian fathers.
Methods
A cross-sectional study was conducted among 462 fathers whose wives gave birth to the baby in public hospitals in Indonesia. The internal consistency and test-retest reliability were examined using Cronbach's alpha and intraclass correlation coefficient. We evaluated the convergent, divergent, predictive, and construct validity.
Results
Confirmatory factor analysis demonstrated a one-factor structure model with satisfactory fit indices. The Cronbach's alpha (0.96), McDonald's Omega coefficient (0.97), and intraclass correlation coefficient (0.99) indicated an excellent reliability of the scale. The father's breastfeeding self-efficacy was positively correlated with the mother's breastfeeding self-efficacy (r= 0.251, p < .001), and negatively associated with symptoms of depression (r = -0.150, p < .01) and anxiety (r = -0.314, p < .001). We also found a positive correlation between BSES-SF and exclusive breastfeeding at two weeks postpartum (r = 0.538, p < .001). Fathers who were employed and their partner was multipara, had a vaginal birth, practiced skin-to-skin contact and rooming-in, and exclusive breastfeeding were more confident to support their partner's breastfeeding.
Conclusions
The Indonesian version of the paternal Breastfeeding Self-Efficacy Scale- Short Form is a reliable and valid tool for screening and assessing fathers’ confidence in assisting mothers in breastfeeding.
{"title":"Psychometric evaluation of the Indonesian version of paternal breastfeeding self-efficacy scale- short form: A confirmatory factor analysis","authors":"Mega Hasanul Huda , Yeni Rustina , Fajar Tri Waluyanti , Cindy-Lee Dennis , Shu-Yu Kuo","doi":"10.1016/j.midw.2024.104182","DOIUrl":"10.1016/j.midw.2024.104182","url":null,"abstract":"<div><h3>Background</h3><p>Fathers play a significant role in supporting sustaining exclusive breastfeeding. It is crucial to assess paternal confidence in assisting mothers during breastfeeding.</p></div><div><h3>Research aim</h3><p>This study evaluated the psychometric properties of the Paternal Breastfeeding Self-Efficacy Scale- Short Form among Indonesian fathers.</p></div><div><h3>Methods</h3><p>A cross-sectional study was conducted among 462 fathers whose wives gave birth to the baby in public hospitals in Indonesia. The internal consistency and test-retest reliability were examined using Cronbach's alpha and intraclass correlation coefficient. We evaluated the convergent, divergent, predictive, and construct validity.</p></div><div><h3>Results</h3><p>Confirmatory factor analysis demonstrated a one-factor structure model with satisfactory fit indices. The Cronbach's alpha (0.96), McDonald's Omega coefficient (0.97), and intraclass correlation coefficient (0.99) indicated an excellent reliability of the scale. The father's breastfeeding self-efficacy was positively correlated with the mother's breastfeeding self-efficacy (<em>r</em>= 0.251, <em>p</em> < .001), and negatively associated with symptoms of depression (<em>r</em> = -0.150, <em>p</em> < .01) and anxiety (<em>r</em> = -0.314, <em>p</em> < .001). We also found a positive correlation between BSES-SF and exclusive breastfeeding at two weeks postpartum (<em>r</em> = 0.538, <em>p</em> < .001). Fathers who were employed and their partner was multipara, had a vaginal birth, practiced skin-to-skin contact and rooming-in, and exclusive breastfeeding were more confident to support their partner's breastfeeding.</p></div><div><h3>Conclusions</h3><p>The Indonesian version of the paternal Breastfeeding Self-Efficacy Scale- Short Form is a reliable and valid tool for screening and assessing fathers’ confidence in assisting mothers in breastfeeding.</p></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"139 ","pages":"Article 104182"},"PeriodicalIF":2.6,"publicationDate":"2024-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142232964","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}
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