Midwifery最新文献

{"title":"Socioeconomic deprivation as a risk factor for stillbirth: A case-control study","authors":"Jessica V. Keane ,&nbsp;Paul Corcoran ,&nbsp;Sara Leitao ,&nbsp;Joye McKernan ,&nbsp;Edel Manning ,&nbsp;Keelin O’Donoghue ,&nbsp;Richard A. Greene","doi":"10.1016/j.midw.2025.104615","DOIUrl":"10.1016/j.midw.2025.104615","url":null,"abstract":"<div><h3>Background</h3><div>Stillbirth is a devastating outcome for families. Identifying and addressing risk factors is of crucial importance. Level of deprivation has been linked to adverse perinatal outcomes, including stillbirth.</div></div><div><h3>Methods</h3><div>An observational case-control study was conducted, matching cases of stillbirth (<em>n</em> = 127) with a control cohort of live births (<em>n</em> = 266, ratio 2:1). Retrospective data on maternal characteristics, pregnancy details and neonatal outcomes from 2018–2021 was collected from a tertiary maternity unit in the Republic of Ireland. The Pobal HP Deprivation Index was used to categorise small areas into levels of deprivation. Maternal age, parity, BMI, booking visit gestation were considered potential confounding factors. Statistical analysis using SPSS, included: descriptive statistics, Chi-squared tests, T-tests. Logistic regression for crude and multivariate analysis, including odds ratio calculations, were used to identify differences in risk of stillbirth across the deprivation levels and categories of confounding factors.</div></div><div><h3>Results</h3><div>The results demonstrated no statistically significant correlation between level of deprivation and risk of having a stillbirth (<em>p</em> = 0.288) in this sample. When readjusted into quintiles of deprivation, a slightly higher representation of stillbirth was noted in the more deprived levels, though not statistically significant. When examining by cause of death, there was a significant association between deprivation and placental causes of death (<em>p</em> = 0.048). High BMI was consistently associated with stillbirth, while late booking visit gestation and advanced maternal age also showed associations.</div></div><div><h3>Conclusions</h3><div>This study found no clear link between deprivation and stillbirth but observed higher placental-related stillbirth in deprived quintiles, emphasising the need for further national research.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104615"},"PeriodicalIF":2.5,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145096736","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":"Postnatal bedsharing advice, risk and exploitation: a feminist analysis","authors":"Anna Melamed","doi":"10.1016/j.midw.2025.104612","DOIUrl":"10.1016/j.midw.2025.104612","url":null,"abstract":"<div><h3>Problem</h3><div>Breastfeeding is beneficial to babies and mothers. Postnatal bedsharing is evidenced to support breastfeeding and maternal wellbeing. Advice against bedsharing creates a barrier to breastfeeding. It also frames women as an inherent risk to their baby, something statistically untrue in the absence of known risk factors. Women are advised to both breastfeed, and to not bedshare, which sets up a contradiction. Telling mothers they are simultaneously a risk to, and a resource for, the baby, can lead to exhaustion, shame, confusion and difficulties breastfeeding.</div></div><div><h3>Discussion</h3><div>To investigate this seeming contradiction in UK breastfeeding and bedsharing advice I examine the risk discourse and Douglas’ conception of risk and pollution. To explain why women’s bodies are a site of contestation, and why some risks (overlaying) are amplified over others (lower breastfeeding rates or maternal exhaustion) I use radical materialist feminism. I argue that risk discourses and taboos around bedsharing are part of a patriarchal ontology of the sovereign individual which denies the intrinsic interdependence and relationality. Denying the centrality of the mother-baby dyad as a relation is part of the mechanism of exploitation of women. The bedsharing advice reduces the woman’s subjectivity and agency, which is to the detriment of mothers and babies because their wellbeing is interdependent.</div></div><div><h3>Conclusion</h3><div>The prevalence of bedsharing advice is explained by an ontology in which individuals are imagined as a risk and/or a resource to one another. The driving force is not the wellbeing and support of the dyad, but exploitation of women and re-enforcement of patriarchal logic. Women-centred feminist postnatal advice would better support the dyad.</div></div><div><h3>Tweetable abstract</h3><div>Advice against postnatal bedsharing positions women as a risk and resource, to the detriment of the mother-baby dyad and breastfeeding, and in service of patriarchal exploitation of women as a resource.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104612"},"PeriodicalIF":2.5,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145109223","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":"Corrigendum to “Witnessing a loss and the lived experiences of physicians, nurses, and midwives providing care in perinatal loss in Turkey: A phenomenological study” [Midwifery 149 (2025) 104577]","authors":"Gül Büşra Altunay ,&nbsp;Merve Yazar Renkyorgancı ,&nbsp;Emel Ege ,&nbsp;Şerife Didem Kaya","doi":"10.1016/j.midw.2025.104599","DOIUrl":"10.1016/j.midw.2025.104599","url":null,"abstract":"","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104599"},"PeriodicalIF":2.5,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075571","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":"Food adaptations and challenges during early pregnancy: A qualitative exploration of women’s experience","authors":"Cindy Chevalley Gerber ,&nbsp;Isabelle Carrard ,&nbsp;Marielle Schmied ,&nbsp;Raphaël Hammer","doi":"10.1016/j.midw.2025.104609","DOIUrl":"10.1016/j.midw.2025.104609","url":null,"abstract":"<div><h3>Background</h3><div>Maternal nutrition is a significant factor influencing both fetal and maternal health. Barriers to healthy eating during pregnancy have been mostly investigated in terms of nutritional awareness and compliance with nutritional guidelines. However, little is known about women’s experiences of changing dietary practices in the first trimester of pregnancy specifically.</div></div><div><h3>Aim</h3><div>To explore women’s experiences of food adaptation in the context of daily life in early pregnancy, focusing on challenges and strategies to deal with them.</div></div><div><h3>Methods</h3><div>Face-to-face semi-structured interviews were conducted with a purposeful sample of 20 pregnant women after 16 weeks’ gestation in Switzerland. Data analysis followed the principles of thematic analysis.</div></div><div><h3>Findings</h3><div>We produced three core themes – “navigating the information jungle”, “handling pregnancy symptoms”, “keeping pregnancy secret and social norms around meals” – reflecting three significant challenges women faced in early pregnancy, and eight strategies they used to deal with these challenges.</div></div><div><h3>Conclusion</h3><div>Our findings highlight that food adaptations in early pregnancy lie at the intersection of bodily, cognitive, emotional, and psychosocial dimensions of eating. The absence of consultation with a perinatal health professional characterises early pregnancy, fostering women’s anxiety and uncertainty in relation to nutritional recommendations. Pregnant women should be entitled to an earlier reimbursed follow-up appointment during the first trimester. A consultation with a midwife or a dietitian would be particularly well-suited to provide them with reassurance and to help them achieve healthy diet despite the challenges they encounter.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104609"},"PeriodicalIF":2.5,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145096735","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":"Implementation of the clinical practice guideline on intrapartum care for low-risk births in Belgium","authors":"Yvonne J Kuipers ,&nbsp;Roxanne Bleijenbergh ,&nbsp;Eveline Mestdagh","doi":"10.1016/j.midw.2025.104606","DOIUrl":"10.1016/j.midw.2025.104606","url":null,"abstract":"<div><h3>Background</h3><div>The newest Belgian clinical practice guideline on intrapartum care for low-risk births requires support to facilitate its implementation, as merely presenting guidelines does not guarantee adoption by end-users.</div></div><div><h3>Aim</h3><div>To systematically identify and prioritise clinical questions that need greater implementation support, understand the context of barriers and facilitators to implementation, and define a set of healthcare behavioural implementation activities for Belgian maternity services.</div></div><div><h3>Methods</h3><div>We employed an integrated knowledge translation approach, combining the Knowledge-To-Action and Intervention Mapping frameworks. This approach involves identifying clinical questions that require enhanced implementation support, analysing barriers within the context, and defining change and performance objectives. Feedback from a Belgian multi-stakeholder consulting group and Advisory Board informed the process.</div></div><div><h3>Findings</h3><div>Two clinical questions require greater support for implementation: (1) initial clinical investigations during labour and (2) ongoing investigations and interventions during a low-risk birth. Barriers to applying the recommendations include individual healthcare professional factors and professional interactions. Implementation demands healthcare professionals recognise the physiological aspects of labour and birth, stay updated on the evidence, accept the evidence supporting the management of low-risk births, and involve shared decision-making while seeking the woman’s consent. Achieving behavioural change consists of shifting attitudes, intentions, knowledge, social norms, and skills.</div></div><div><h3>Discussion</h3><div>The identified barriers to implementing recommendations emphasise the crucial role of interpersonal dynamics in successful guideline implementation. Therefore, policies should tackle structural challenges within Belgian maternity care.</div></div><div><h3>Conclusion</h3><div>To enhance maternity care services, communication, collaboration, and mutual understanding across professional boundaries are needed.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104606"},"PeriodicalIF":2.5,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092060","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":"Deserts of disparity: Social vulnerability’s role in maternity care gaps","authors":"Angelo Cadiente ,&nbsp;Jamie Chen ,&nbsp;Bryan Pilkington","doi":"10.1016/j.midw.2025.104608","DOIUrl":"10.1016/j.midw.2025.104608","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the relationship between maternity care deserts and social vulnerability.</div></div><div><h3>Study Design</h3><div>1084 counties from the March of Dimes (2019–2021) and the CDC/ATSDR Social Vulnerability Index (SVI, 2020) across 11 U.S. states were assessed. Linear regression models analyzed the relationships between social vulnerability, obstetric providers, and uninsured women.</div></div><div><h3>Results</h3><div>SVI did not bear any statistical influence on maternity care desert classifications (<em>r</em> = -0.050, <em>p</em> = 0.101). However, higher SVI was correlated with fewer obstetric providers (β = -0.524, <em>p</em> &lt; 0.001) and higher uninsured rates (β = 0.151, <em>p</em> &lt; 0.001). Socioeconomic vulnerability (<em>r</em> = -0.143, <em>p</em> &lt; 0.001) and household characteristics (<em>r</em> = -0.146, <em>p</em> &lt; 0.001) were associated with reduced maternity care access, while racial and ethnic minority status (<em>r</em> = 0.064, <em>p</em> = 0.036) and housing type and transportation (<em>r</em> = 0.165, <em>p</em> &lt; 0.001) were associated with greater access.</div></div><div><h3>Discussion</h3><div>Counties with greater vulnerability in socioeconomic status and household characteristics tended to have fewer obstetric providers available and higher proportions of uninsured women, indicating a double burden of social risk and limited medical infrastructure. Counties with greater vulnerability in racial and ethnic minority status and housing type and transportation were paradoxically associated with greater availability of maternity care resources, suggesting that despite diverse communities experiencing poor outcomes, they have the medical means available.</div></div><div><h3>Conclusions</h3><div>Our findings suggest that barriers to maternity care extend beyond resource availability, requiring efforts that address systemic barriers and equitable resource allocation.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104608"},"PeriodicalIF":2.5,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145119397","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":"Perception of empowerment in Spanish midwives: A cross-sectional study","authors":"Zaida Rodríguez-Puente ,&nbsp;Agustín Rodríguez-Esteban ,&nbsp;Francisco Javier Pérez-Rivera ,&nbsp;Olga Arias-Gundín ,&nbsp;Elena Andina-Díaz","doi":"10.1016/j.midw.2025.104611","DOIUrl":"10.1016/j.midw.2025.104611","url":null,"abstract":"<div><h3>Introduction</h3><div>Empowerment of midwives is an important issue worldwide and lack of empowerment in midwives is associated with a decrease in job satisfaction and consequently a higher probability of job desertion. Given the international shortage of professionals, it is necessary to explore the key aspects of increasing their job satisfaction. The aim of this paper was to investigate perceptions of empowerment in Spanish midwives’ practice through the Perceptions of Empowerment in Midwifery Scale (PEMS).</div></div><div><h3>Methods</h3><div>A cross-sectional survey using a national sample of midwives in Spain from January to June 2023. 504 midwives were recruited from the Spanish Federation of midwives’ associations in 2023. Data were collected using the revised version of the Perception of Empowerment Scale (PEMS) translated into Spanish.</div></div><div><h3>Results</h3><div>The PEMS scale exhibited suitable validity. The exploratory factor analyses identified three subescales: <em>Professional Recognition, Autonomy and Manager,Support,Skills &amp; Resources</em> and <em>Autonomy.</em> The PEMS-R-IT had good internal consistency for each proposed dimension. 54.3 % of the participants reported having autonomy in their work. There were significant differences between primary care midwives and special care midwives in the Professional recognition dimension <em>p</em> = .016*. Midwives working in primary care felt more recognized professionally.</div></div><div><h3>Conclusions</h3><div>The perception of empowerment and autonomy of Spanish midwives in maternity and postnatal wards was lower than in the primary care setting. Years of experience were not significant in feeling more autonomous. More research is needed to assess the perceptions of empowerment of midwives in Spain. This study support the psychometric quality of PEMS.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104611"},"PeriodicalIF":2.5,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145096779","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":"Perceptions of care providers on the implementation of an antenatal psychosocial clinical decision support system: the Born in Belgium Professionals platform","authors":"Amuli Kelly ,&nbsp;Decabooter Kim ,&nbsp;Germanes Caroline ,&nbsp;Van Parys An-Sofie ,&nbsp;Verschelde Sabine ,&nbsp;Saey Emilie ,&nbsp;Moulin Manon ,&nbsp;Cornu Pieter ,&nbsp;Delvaux Nicolas ,&nbsp;Van den Berghe Steven ,&nbsp;Feijen-de Jong Esther ,&nbsp;Beeckman Katrien","doi":"10.1016/j.midw.2025.104610","DOIUrl":"10.1016/j.midw.2025.104610","url":null,"abstract":"<div><h3>Background</h3><div>Clinical decision support systems (CDSS) can enhance care processes and clinical outcomes. Adoption depends not only on perceived usefulness but also on contextual human, organisational, and technical factors. Understanding care providers’ perception and how these factors influence adoption is essential for implementing systems that can be embedded in routine perinatal practice.</div></div><div><h3>Aim</h3><div>To examine the real-world adoption (or uptake) of the Born in Belgium Professionals antenatal psychosocial decision-support platform, describing how and why care providers use it and identifying facilitators and barriers to sustained implementation.</div></div><div><h3>Methods</h3><div>A cross-sectional survey of all active users (March–July 2024) captured frequency of use, motivations, and perceptions. Frequent versus non-frequent users were compared with chi-square and Mann–Whitney tests (p &lt; .05).</div></div><div><h3>Findings</h3><div>Of 313 users, 127 responded; most were midwives working in large organisations. About 46% were frequent users. Motivators were the psychosocial questionnaire, continuity of care and preventive benefit. Frequent users more often attended training (64.4% vs 30.9%; p &lt; 0.001), perceived greater patient benefit (median 4.5 vs 4.0; p = .046) and rated the platform’s integration in electronic health record (EHR) higher (median 5.5 vs 5.0; p = .002). Non-frequent users cited time pressure and interoperability issues.</div></div><div><h3>Discussion</h3><div>Positive perceptions of benefits, adequate training, and seamless workflow integration promote sustained use. Organisational support and robust interoperability further facilitate uptake, whereas time pressures and suboptimal EHR embedding hinder regular use.</div></div><div><h3>Conclusion</h3><div>Implementation strategies that emphasise training, interoperability, and alignment with existing workflows are essential to optimise adoption of antenatal psychosocial decision-support systems.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"151 ","pages":"Article 104610"},"PeriodicalIF":2.5,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145248048","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":"Perceptions of fear of childbirth and the needs for mindfulness-based intervention among Chinese women planned for normal birth: A qualitative study","authors":"Ruohan Wang ,&nbsp;Yue Huang ,&nbsp;Junyan Zhou ,&nbsp;Ka Ming Chow","doi":"10.1016/j.midw.2025.104604","DOIUrl":"10.1016/j.midw.2025.104604","url":null,"abstract":"<div><h3>Background</h3><div>Fear of childbirth (FOC) is a common experience for pregnant women, leading to both physiological and psychological consequences. Mindfulness-based intervention is a potential approach to addressing FOC, yet the perceptions and needs of Chinese women regarding this intervention remain unexplored.</div></div><div><h3>Aim</h3><div>To explore Chinese women’s perceptions of FOC, and the needs for developing mindfulness-based interventions.</div></div><div><h3>Methods</h3><div>A descriptive qualitative approach was employed. Semi-structured interviews were conducted with women in their third trimester or within six weeks postpartum, all were planning for or had a normal birth. Thematic analysis was conducted using NVivo version 12 for data management and analysis.</div></div><div><h3>Findings</h3><div>Thirty participants, including 15 antenatal and 15 postnatal women, were recruited. Overall, FOC was common among pregnant women, with labour-related pain being the primary source. Due to FOC, some women hold catastrophic beliefs about normal birth and express a preference for caesarean section without medical indication or request an epidural analgesia before experiencing the pain, indicating the needs to address FOC. Regarding mindfulness-based intervention, limited knowledge has emerged as the primary barrier to adoption. All four participants who were familiar with mindfulness expressed positive attitudes towards the intervention.</div></div><div><h3>Conclusion</h3><div>This study highlights the substantial needs for mindfulness-based interventions to address FOC, thereby improving women’s overall childbirth experience. Future interventions should be developed to address these needs.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104604"},"PeriodicalIF":2.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080949","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":"Motivations, challenges, and practices of pelvic floor rehabilitation in postpartum women with urinary incontinence under China’s proactive health framework: a qualitative research","authors":"Shuxian Li ,&nbsp;Jiarong Xu ,&nbsp;Zhentong Zhong ,&nbsp;Jie Li ,&nbsp;Wenjun Tang ,&nbsp;Wenzhi Cai","doi":"10.1016/j.midw.2025.104605","DOIUrl":"10.1016/j.midw.2025.104605","url":null,"abstract":"<div><h3>Background</h3><div>Urinary incontinence is a common form of pelvic floor dysfunction among postpartum women worldwide, imposing significant physical, psychological, and socioeconomic burdens. Current research primarily focuses on clinical interventions while giving insufficient attention to integrated care models combining medical treatment with self-management strategies. The emerging literature underscores the importance of proactive health behaviours. Within China's Proactive Health framework, the mechanisms through which postpartum women engage in comprehensive rehabilitation remain underexplored.</div></div><div><h3>Introduction and hypothesis</h3><div>This qualitative study explores the motivations, challenges, and practices of postpartum women with urinary incontinence as they engage in proactive pelvic floor rehabilitation.</div></div><div><h3>Methods</h3><div>A descriptive, qualitative design was employed in this study. Face-to-face semi-structured interviews were conducted with postpartum women with urinary incontinence in a treatment room between September and October 2024. Participant interviews were transcribed verbatim and analysed thematically using NVivo software, which is widely used for qualitative data analysis.</div></div><div><h3>Results</h3><div>Postpartum women with urinary incontinence (<em>n</em> = 22) were interviewed by trained interviewers to investigate the motivations, challenges, and practices of proactive pelvic floor rehabilitation under China’s Proactive Health framework. The motivations included three subthemes: seeking pelvic recovery, reducing life impact, and social-family effects; The challenges included four subthemes: health competency demands, limited postpartum care, parenting load, and financial burdens; The practices encompassed four main domains: health literacy, healthy lifestyle, initiative healthcare engagement, social support acquisition.</div></div><div><h3>Conclusions</h3><div>This study identifies key motivations and challenges of postpartum women’s engagement in proactive pelvic floor rehabilitation and documents the diverse practices they adopt in daily life. These findings offer theoretical and practical insights for healthcare providers and multi-sectoral collaborations targeting postpartum rehabilitation improvement and pelvic floor health promotion within China’s Proactive Health framework.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104605"},"PeriodicalIF":2.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086422","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}