Midwifery最新文献

{"title":"Factors influencing the implementation of the woman-centred care model for pregnant women in a hospital setting: an integrative review","authors":"Alessia Migliarini ,&nbsp;Patrizia Di Giacomo ,&nbsp;Daniele Zama ,&nbsp;Mara Mattioli","doi":"10.1016/j.midw.2025.104650","DOIUrl":"10.1016/j.midw.2025.104650","url":null,"abstract":"<div><h3>Background</h3><div>The term “Woman-Centred Care” focuses on the individual needs, aspirations and expectations of the woman herself rather than the needs of the healthcare system or professionals. The principles on which this model of care is based, are the control, choice, and continuity of care for women.</div></div><div><h3>Objective</h3><div>The objective of this review would like to explore and summarise the evidence currently available on the factors which influence the implementation of the care model for pregnant women in a hospital setting.</div></div><div><h3>Methods</h3><div>An integrative review was conducted using the method of Whittemore and Knafl and the PICOT search strategy. The Medline, PubMed and CINAHL databases were examined to identify primary studies that, between 2013 and July 2024, investigated factors influencing the implementation of women-centred care models in hospital settings. The inclusion/exclusion process and reporting followed the PRISMA 2020 guidelines. The qualitỳ of the studies was assessed according to the criteria of the Mixed Method appraisal tool.</div></div><div><h3>Findings</h3><div>411 studies were eligible and 16 of those included. A total of 16 records were included. Four themes and four sub-themes influencing the implementation of Woman-Centred Care were identified: the perspective of the midwives; the care model; communication and collaboration (relationships with colleagues; relationship with women and empowerment) and, resources and support (organisation and stakeholders; management).</div></div><div><h3>Discussion</h3><div>The implementation of the “Woman-Centred Care\" model is strongly influenced by organizational policies and midwives' awareness of their role as guarantors of \"natural\" childbirth.</div></div><div><h3>Conclusion</h3><div>The lack of a shared understanding of what Woman-Centred Care actually means can contribute to the confusion and definition with which it is proposed.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"152 ","pages":"Article 104650"},"PeriodicalIF":2.5,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145420187","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":"Addressing socioeconomic inequalities in perinatal outcomes in the UK: a critical discussion","authors":"Dr Chiamaka Elumogo,&nbsp;Dr Hannah Rayment-Jones","doi":"10.1016/j.midw.2025.104649","DOIUrl":"10.1016/j.midw.2025.104649","url":null,"abstract":"","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"152 ","pages":"Article 104649"},"PeriodicalIF":2.5,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145438558","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":"Weight-inclusive maternity care: An approach to reduce weight stigma and improve pregnancy and birth outcomes","authors":"Briony Hill ,&nbsp;Haimanot Hailu ,&nbsp;Pragya Kandel ,&nbsp;Lauren Kearney ,&nbsp;Bec Jenkinson ,&nbsp;Anita Maepioh ,&nbsp;Rachael Nugent ,&nbsp;Leonie Callaway ,&nbsp;Ahlia Griffiths ,&nbsp;Tina Siale ,&nbsp;Renee Tome ,&nbsp;Helen Skouteris","doi":"10.1016/j.midw.2025.104648","DOIUrl":"10.1016/j.midw.2025.104648","url":null,"abstract":"","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"152 ","pages":"Article 104648"},"PeriodicalIF":2.5,"publicationDate":"2025-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145452398","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":"Midwife-led birth debrief: A concept analysis","authors":"Kate Buchanan ,&nbsp;Elliesha O’Reilly ,&nbsp;Georgia Wilcox ,&nbsp;Sara Bayes ,&nbsp;Lauren Kearney ,&nbsp;Linda Sweet ,&nbsp;Hazel Keedle","doi":"10.1016/j.midw.2025.104647","DOIUrl":"10.1016/j.midw.2025.104647","url":null,"abstract":"<div><h3>Background</h3><div>Psychological birth trauma (PBT) affects approximately 19 % of postnatal women, making its prevention a global priority. Midwives are responsible for providing psychosocial care during the postnatal period to foster the mother-infant relationship, provide education and screening and support positive transitions to parenting. However, the specific attributes of a birth debrief and the role of the midwife in a supporting a woman to review their birth experience is less well documented in regulatory frameworks or scientific literature. This has created significant ambiguity in both clinical practice among health professionals and in research contexts. The lack of a clear understanding of what constitutes a birth debrief and how it differs from other psychological interventions may impact the service provided to birthing people.</div></div><div><h3>Aim</h3><div>The aim of this concept analysis was to develop a conceptual definition of a midwife-led birth debrief</div></div><div><h3>Design</h3><div>The Rogers evolutionary approach was used for this concept analysis.</div></div><div><h3>Data sources</h3><div>A Systematic search was conducted of databases CINAHL, PubMed/MEDLINE, and PsycINFO, as they index maternity-related research. The search was conducted December 2024, and again in April 2025.</div></div><div><h3>Results</h3><div>The review included twenty peer -reviewed empirical studies. From these, the attributes, antecedents and consequences of midwife-led birth debriefing were identified, forming the basis for a conceptual definition. A midwife-led birth debrief provides a woman-led, emotionally safe environment, facilitated by therapeutic communication and midwifery expertise, to help women reflect and find meaning in their birth experiences.</div></div><div><h3>Conclusion</h3><div>The conceptual definition of birth debrief provides the foundation for evaluating its effectiveness in research, guide policy development and position midwives as critical to psychosocial support in the early postnatal period.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"151 ","pages":"Article 104647"},"PeriodicalIF":2.5,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145390705","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":"Overdiagnosis in screening for gestational diabetes: A scoping review","authors":"Sara Karentius ,&nbsp;John Brandt Brodersen ,&nbsp;Mille Falk Bjørch ,&nbsp;Eva Rydahl ,&nbsp;Emma Grundtvig Gram","doi":"10.1016/j.midw.2025.104646","DOIUrl":"10.1016/j.midw.2025.104646","url":null,"abstract":"<div><h3>Background</h3><div>Screening for gestational diabetes mellitus (GDM) in healthy pregnancies is disputed, and rising GDM incidence calls for an investigation into the potential for overdiagnosis.</div></div><div><h3>Aim</h3><div>To identify and map empirical evidence on overdiagnosis in GDM screening and explore how different screening strategies impact overdiagnosis.</div></div><div><h3>Methods</h3><div>This review adheres to the JBI Manual and PRISMA-ScR guidelines. Systematic searches were performed on September 10th, 2024, without date, language, or geography restrictions, in Medline, Embase, CINAHL, Cochrane Library, and Web of Science. One search targeted studies explicitly addressing overdiagnosis through primary empirical analyses, while a second search included RCTs evaluating GDM screening programmes. Evidence screening and selection were carried out independently by two authors.</div></div><div><h3>Findings</h3><div>We included ten studies with varying designs in Search 1 and nine RCTs in Search 2. In Search 1, only one study defined overdiagnosis. In Search 2, seven of nine RCTs show an increased incidence with intensified screening. Of these, six evaluated universal screening and showed no accompanying benefits, suggesting overdiagnosis. Variations in strategies and outcomes complicate comparisons. Additionally, no RCTs compare screening to no screening or risk-based to universal screening, raising uncertainties about the effects of different screening programmes and practices.</div></div><div><h3>Discussion</h3><div>Our analysis of RCT data demonstrates that intensifying screening led to increased incidence without corresponding beneficial effects, indicating overdiagnosis. Few studies have assessed overdiagnosis empirically, and no established framework currently guides the definition or operationalisation of overdiagnosis in GDM screening research.</div></div><div><h3>Conclusion</h3><div>Data from RCTs indicate overdiagnosis in universal GDM screening.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"153 ","pages":"Article 104646"},"PeriodicalIF":2.5,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145691347","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":"The mediating role of psychological birth trauma in association between childbirth satisfaction and the desire to avoid pregnancy among Iranian postpartum women","authors":"Sajedeh Hasani ,&nbsp;Nasim Bahrami ,&nbsp;Solmaz Heidarifard ,&nbsp;Zainab Alimoardi","doi":"10.1016/j.midw.2025.104636","DOIUrl":"10.1016/j.midw.2025.104636","url":null,"abstract":"<div><h3>Objective</h3><div>Iran's declining fertility rate is a major demographic concern. The desire to avoid pregnancy (DAP) is a key predictor of future fertility. While dissatisfaction with childbirth care and psychological birth trauma are known to negatively impact future fertility decisions, their specific pathways to influencing the desire to avoid future pregnancy remain unclear. This study therefore aimed to examine the relationship between mothers' satisfaction with childbirth care and their desire to avoid subsequent pregnancy, while investigating the mediating effect of childbirth-related psychological trauma.</div></div><div><h3>Design</h3><div>Cross-sectional study</div></div><div><h3>Setting</h3><div>Urban comprehensive health centers in Qazvin, Iran.</div></div><div><h3>Participants</h3><div>350 married women, with a mean age of 31.83 years, within six months postpartum.</div></div><div><h3>Measurements</h3><div>Validated scales including the Birth Satisfaction Scale-Revised (BSS-R), the City Birth Trauma Scale, and the Desire to Avoid Pregnancy (DAP) scale.</div></div><div><h3>Findings:</h3><div>The final path analysis model demonstrated an excellent fit (CFI=1.000, RMSEA=0.000), explaining 35.4% of the variance in DAP. Psychological birth trauma functioned as a complete mediator. Regarding childbirth care satisfaction, the ‘women's personal attributes’ subscale of the BSS-R exerted both a direct effect on DAP (<em>β=0.20, p</em> <em>&lt;</em> <em>0.001</em>) and an indirect effect via psychological birth trauma (<em>β=0.11, p</em> <em>&lt;</em> <em>0.001</em>). Reproductive history showed strong associations with DAP: a higher number of pregnancies (<em>β=0.47</em> for ≥4 pregnancies, <em>p</em> <em>&lt;</em> <em>0.001</em>) increased DAP, while a larger desired family size (<em>β=−0.53</em> for ≥3 children, <em>p</em> <em>&lt;</em> <em>0.001</em>) and a history of abortion (<em>β=−0.12, p</em> <em>=</em> <em>0.013</em>) decreased DAP</div></div><div><h3>Key conclusions and implications for practice</h3><div>Psychological birth trauma was demonstrated to be a complete mediator in the relationship between childbirth care satisfaction and subsequent pregnancy avoidance. Interventions designed to improve respectful, supportive maternity care and provide trauma-informed support are not only crucial for maternal well-being but may also be essential for addressing Iran's low fertility rate by mitigating a key barrier to future childbearing.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"151 ","pages":"Article 104636"},"PeriodicalIF":2.5,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145364367","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":"Validation in China of the Quality Maternal and Newborn Care Framework index","authors":"Jie Tao ,&nbsp;Shiying Wang ,&nbsp;Chunquan Ou ,&nbsp;Xueheng Wen ,&nbsp;Jinyi Li ,&nbsp;Mingdi Zhao ,&nbsp;Andrew Symon ,&nbsp;Jinguo Zhai","doi":"10.1016/j.midw.2025.104634","DOIUrl":"10.1016/j.midw.2025.104634","url":null,"abstract":"<div><div>Problem: Despite progress in maternal and newborn health, China still lacks a validated and multidimensional tool to monitor care quality and guide improvements.</div><div>Background: The Quality Maternal and Newborn Care Framework index (QMNCFi) is a novel but comprehensive and globally developed tool for assessing maternity care quality from the service user’s perspective, offering huge potential for assessing care quality in China.</div><div>Aim: This study aimed to validate the Chinese version of the QMNCFi and report initial findings from economically diverse settings.</div><div>Methods: An online survey was conducted in five hospitals in five provinces in China among women between 6 weeks to 1 year postpartum. Construct validity was assessed using confirmatory factor analysis. Reliability was evaluated through internal consistency and test–retest reliability. Inferential statistics were used to analyze score differences across sub-groups.</div><div>Findings: 547 mothers completed the survey. Confirmatory factor analysis indicated that the construct of the Chinese version aligned with the original version. The Cronbach’s α for the survey’s 13 sections ranged from 0.629 to 0.975, and the Intraclass Correlation Coefficient of test-retest ranged from 0.620 to 0.926. There is a modest correlation between regional economic level and QMNCFi scores at all time periods (<em>p</em> &lt; 0.05). Pregnancy sub-index scores were slightly higher among women in rural areas compared to urban areas (<em>p</em> &lt; 0.05).</div><div>Conclusion: The Chinese version of the QMNCFi is feasible to obtain service user perceptions of the quality of care at scale in China.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"152 ","pages":"Article 104634"},"PeriodicalIF":2.5,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145426635","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":"‘Making birth better: bringing together evidence, knowledge and experience’ international labour and birth research conference 2025","authors":"","doi":"10.1016/j.midw.2025.104628","DOIUrl":"10.1016/j.midw.2025.104628","url":null,"abstract":"","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104628"},"PeriodicalIF":2.5,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145358270","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":"The association of maternal sedentary behaviour before and during pregnancy and offspring health outcomes: A systematic review and meta-analysis","authors":"Jia Wang ,&nbsp;Rui Dong ,&nbsp;Sen Qu ,&nbsp;Dongchun Chang ,&nbsp;Mengxia Hong ,&nbsp;Yu Wang ,&nbsp;Wen Zhong ,&nbsp;Zhenqing Ren ,&nbsp;Jie Wang","doi":"10.1016/j.midw.2025.104633","DOIUrl":"10.1016/j.midw.2025.104633","url":null,"abstract":"<div><h3>Background</h3><div>Sedentary behaviour is prevalent and associated with adverse maternal outcomes. However, conflicting results exist regarding the relationship between maternal sedentary behaviour before or during pregnancy and the consequences for offspring.</div></div><div><h3>Aim</h3><div>The present systematic review and meta-analysis aimed to quantitatively and qualitatively synthesise the existing evidence on the associations of maternal sedentary behaviour before or during pregnancy with offspring health outcomes.</div></div><div><h3>Methods</h3><div>Studies were obtained by searching relevant literature using seven databases from inception to February 4, 2025. Two independent reviewers screened the literature, assessed study eligibility, and extracted data. The quality of included studies was evaluated using the Newcastle-Ottawa Scale. A meta-analysis was conducted for a minimum of two comparable studies; otherwise, a narrative synthesis was employed.</div></div><div><h3>Findings</h3><div>Nine studies were included in this review. Outcome variables were birth outcomes (<em>n</em> = 8) and infant weight at 12 months (<em>n</em> = 1). Meta-analysis of two studies showed no statistically significant association between maternal sedentary time during pregnancy and low birth weight (odds ratio = 1.68, 95 % confidence intervals = 0.63–4.50). In the narrative synthesis, three studies found an association between maternal sedentary time during pregnancy and birth outcomes. Maternal sedentary time before pregnancy was associated with non-cardiac birth defects but not with birth weight or small for gestational age.</div></div><div><h3>Conclusions</h3><div>Although there is some evidence that mothers’ sedentary behaviour before or during pregnancy may be associated with the health of offspring, more high-quality studies are needed to confirm these findings and determine the impact on long-term offspring outcomes.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"151 ","pages":"Article 104633"},"PeriodicalIF":2.5,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318564","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":"Parity as a predictor of functional limitations and sick leave in pregnancy-related low back and pelvic pain: A Danish cross-sectional study","authors":"Kristian P. Frausing ,&nbsp;Eva E. Simonsen ,&nbsp;Helen N. Madsen ,&nbsp;Dorthe Sørensen ,&nbsp;Jesper Dahlgaard ,&nbsp;Rikke D. Maimburg","doi":"10.1016/j.midw.2025.104631","DOIUrl":"10.1016/j.midw.2025.104631","url":null,"abstract":"<div><h3>Background</h3><div>Parity has been reported as a risk factor for pregnancy-related low back and pelvic girdle pain (LBPP), but evidence is often based on retrospective self-report data from late pregnancy or the postpartum period. Less is known about whether parity influences pain severity once LBPP is present, and how it affects daily functioning and work participation.</div></div><div><h3>Aim</h3><div>To compare nulliparous and parous participants with clinically validated LBPP at mid- and later pregnancy, focusing on pain severity, functional limitations, and sick leave.</div></div><div><h3>Methods</h3><div>In a cross-sectional design, 222 pregnant women with LBPP completed questionnaires at routine antenatal consultations in gestational weeks 18 and 28. Pain was assessed on six numerical rating scales (0–10), and functional limitations on ten daily activities. Pain diagnoses were validated through clinical examination. Linear and ordinal regression models with robust standard errors were fitted, adjusting for age, job demands, and prior pain. Multiplicity was controlled using false discovery rate (FDR) correction.</div></div><div><h3>Findings</h3><div>Parous women reported higher pain scores across consultations, however differences were small and non-significant after FDR correction. In contrast, they consistently reported greater functional limitations in more demanding daily activities, particularly later in pregnancy. Parous participants were also substantially more likely to be on sick leave. This association remained robust after adjustment for covariates.</div></div><div><h3>Conclusions</h3><div>Among women with clinically defined LBPP, parity was not a strong predictor of pain severity but was associated with greater functional limitations and sick leave. These findings suggest that parity may be particularly relevant for the consequences of LBPP.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"151 ","pages":"Article 104631"},"PeriodicalIF":2.5,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145301957","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}