Midwifery最新文献

{"title":"Strengthening Philippine midwifery curricula with planetary health competencies: A call for action","authors":"Artemio M. Gonzales Jr., Arnold Jann L. Cariaso","doi":"10.1016/j.midw.2025.104619","DOIUrl":"10.1016/j.midw.2025.104619","url":null,"abstract":"","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104619"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212983","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":"2025-11-01","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":"Development and pilot test of a CTG skills test for midwives","authors":"Maija Männistö ,&nbsp;Kristiina Heinonen ,&nbsp;Marja Härkänen ,&nbsp;Reeta Lamminpää","doi":"10.1016/j.midw.2025.104614","DOIUrl":"10.1016/j.midw.2025.104614","url":null,"abstract":"<div><h3>Background</h3><div>High-quality obstetric care promotes maternal safety and fetal well-being. Modern cardiotocography (CTG) interpretation emphasises fetal physiology rather than isolated heart rate patterns, aiming to reduce unnecessary interventions and improve outcomes. Misinterpretation of CTG remains a key contributor to substandard perinatal care. Assessing interpretation skills is essential for evaluating competence and measuring the effects of training. Regular assessment supports clinical proficiency, identifies educational needs, and ultimately enhances the quality and safety of childbirth.</div></div><div><h3>Aim</h3><div>This study aimed to develop and pilot a CTG skills test to assess midwives' interpretation skills.</div></div><div><h3>Methods</h3><div>The skills test was constructed based on the existing literature and the content validity was evaluated by an expert panel (<em>n</em> = 8) through two rounds of online surveys. The pilot test was conducted at one birthing unit with midwives (<em>n</em> = 12) to assess the feasibility of the test. Data were analysed with inductive content analysis and quantitative methods, including the content validity index and descriptive statistics.</div></div><div><h3>Results</h3><div>The CTG skills test was validated through expert review and a pilot study. It showed excellent content validity (S-CVI/Ave = 0.94). Experts and midwives found it relevant but challenging, especially in fetal physiology. Revisions made to the test improved the clarity and usability of the test. The skills test is suitable for assessing CTG competence and identifying training needs.</div></div><div><h3>Conclusions</h3><div>CTG interpretation is crucial for safe childbirth, making midwives' competence and training essential for quality obstetric care. This validated skills test helps to assess CTG skills, identify training needs, and enhance delivery safety.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104614"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145119398","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":"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":"2025-11-01","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":"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":"2025-11-01","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":"Multidimensional sleep health and breastfeeding self-efficacy: A cross-sectional study","authors":"Sha Li ,&nbsp;Xianyan Hao ,&nbsp;Yanzhe Wang ,&nbsp;Xingchen Shang ,&nbsp;Qingyu Wang ,&nbsp;Jiayin Ruan","doi":"10.1016/j.midw.2025.104618","DOIUrl":"10.1016/j.midw.2025.104618","url":null,"abstract":"<div><h3>Background</h3><div>Breastfeeding is recommended for new mothers. However, the rate of breastfeeding is far below the recommendation, and researchers have devoted themselves to exploring the associated factors to promote breastfeeding.</div></div><div><h3>Aim</h3><div>To explore the association between maternal multidimensional sleep health and prenatal breastfeeding self-efficacy.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted among pregnant women attending obstetrics departments at three hospitals in Jiangsu, China. The RU_SATED 2.0, Prenatal Breastfeeding Self-efficacy Scale, Maternity Social Support Scale, 7-item Generalized Anxiety Disorder Scale, and 9-item Patient Health Questionnaire were administered to evaluate multidimensional sleep health, prenatal breastfeeding self-efficacy, social support, and anxiety and depression symptoms of pregnant women, respectively. Independent t-tests and multiple linear regression were applied to explore the association between multidimensional sleep health and prenatal breastfeeding self-efficacy.</div></div><div><h3>Findings</h3><div>A total of 349 pregnant women completed the survey, with a mean age of 30.59 years (SD=3.96, Range: 20–45). The scores of sleep health and prenatal breastfeeding self-efficacy were 15.07±3.65 and 56.96±15.31, respectively. Independent t-tests revealed that pregnant women with better sleep health demonstrated significantly higher scores in prenatal breastfeeding self-efficacy, including the skills and needs and information acquisition domains (Cohen’s d ranging from 0.330 to 0.435). Moreover, the linear regression model showed that better sleep health (B=0.58, P=0.011), more social support (B=0.65, P=0.022), and current children (B=14.05, P&lt;0.001) were associated with higher prenatal breastfeeding self-efficacy, while gestational age was negatively associated with prenatal breastfeeding self-efficacy (B=−0.21, P=0.027) after adjusting for covariates.</div></div><div><h3>Conclusion</h3><div>Optimal multidimensional sleep health is associated with better prenatal breastfeeding self-efficacy, and targeted sleep health interventions should be implemented to enhance maternal sleep health and promote better breastfeeding outcomes.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104618"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154909","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":"Bridging communities and classrooms: citizen involvement in midwifery education","authors":"Sandra Patrícia Souto ,&nbsp;Sónia Brandão ,&nbsp;Andreia Soares Goncalves ,&nbsp;Rosa Silva","doi":"10.1016/j.midw.2025.104602","DOIUrl":"10.1016/j.midw.2025.104602","url":null,"abstract":"","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104602"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the maternal perception of neonatal jaundice: Insights from a hospital in Uruguay","authors":"Pablo Lores ,&nbsp;Victoria Beñarán ,&nbsp;Agustina Dodino ,&nbsp;Guadalupe Gonçalves ,&nbsp;Antonela Pigazzini ,&nbsp;Teresa Freire","doi":"10.1016/j.midw.2025.104607","DOIUrl":"10.1016/j.midw.2025.104607","url":null,"abstract":"<div><h3>Background</h3><div>Neonatal jaundice (NJ) is a common condition affecting new-borns worldwide. Despite its high prevalence, misconceptions about its causes, severity, and treatment persist among mothers, influencing the recognition and management. In Uruguay, no studies have previously assessed maternal knowledge and perceptions of NJ.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate maternal understanding of NJ, identify sociodemographic, obstetric and gynecological factors influencing perception, and assess sources of information.</div></div><div><h3>Methods</h3><div>A descriptive, cross-sectional study was conducted at the Pereira Rossell Hospital Centre in Uruguay. A total of 201 postpartum mothers were surveyed using structured interviews and self-administered questionnaires. Data were collected on sociodemographic factors, prior exposure to NJ, general knowledge, and maternal attitudes towards its recognition and management.</div></div><div><h3>Results</h3><div>While most participants had heard about NJ, only 31 % believed they knew what it was. The overall accuracy rate for knowledge-based questions was 25 %, with a high frequency of \"I don't know\" responses. Medical appointments were the primary source of information, yet considerable knowledge gaps remained. Notably, 98 % of mothers stated they would seek medical attention if their new-born exhibited signs of NJ, but misconceptions regarding severity and treatment remained.</div></div><div><h3>Conclusion</h3><div>This study highlights substantial deficiencies in maternal knowledge and awareness of NJ in Uruguay. Despite high healthcare access, inadequate guidance was evident across all sociodemographic groups. Enhancing perinatal education and implementing targeted awareness initiatives are crucial for improving the early recognition and management of NJ.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104607"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women’s choices and preferences for subsequent mode of birth following an obstetric anal sphincter injury (OASI): A scoping review","authors":"Christine Murray ,&nbsp;Marcia George,&nbsp;Jenny Davis,&nbsp;Kristina Edvardsson","doi":"10.1016/j.midw.2025.104588","DOIUrl":"10.1016/j.midw.2025.104588","url":null,"abstract":"<div><h3>Background</h3><div>Obstetric anal sphincter injury (OASI) may result in physical and psychological maternal health consequences. Women’s choice or preference for mode of birth following OASI has not been extensively researched.</div></div><div><h3>Objectives</h3><div>The scoping review aimed to identify, appraise and synthesise published literature.</div></div><div><h3>Eligibility criteria</h3><div>All study designs, primary peer-reviewed research publications, publications with explicit mention of maternal choice or preference for mode of birth in a subsequent birth following a previous OASI.</div></div><div><h3>Sources of evidence</h3><div>A systematic search of CINAHL, Medline and Web of Science databases was conducted.</div></div><div><h3>Charting methods</h3><div>Primary research, English language publications with explicit mention of maternal choice or preference for mode of birth following OASI were included. No date limits were set. Quality appraisal was performed, and results synthesised.</div></div><div><h3>Results</h3><div>Of 1031 records screened, 63 full-text publications were assessed against inclusion criteria, resulting in 10 publications identified. Two additional publications were identified through reference list checks of included studies. Of 12 included publications, 11 used quantitative and one qualitative approach. Common themes such as mode of birth, faecal or urinary incontinence, guidance/counselling, risk of recurrence, OASI classification and sexual function were identified.</div></div><div><h3>Conclusions</h3><div>Preference or choice of mode of birth is multifactorial. There is minimal evidence containing participant voices identified in the published literature on this topic. More qualitative research is needed to ascertain what preferences women have and why they make the choices that they do in relation to mode of birth in subsequent pregnancy.</div></div><div><h3>Structured Statement of significance</h3><div>Obstetric anal sphincter injury can be a serious, life altering and devastating injury occurring during childbirth. Despite the impact of OASI, limited research has been undertaken regarding women’s preferences and decisions surrounding subsequent mode of birth following OASI. Existing published literature has been predominantly quantitative in nature, with a notable lack of qualitative research found. This paper summarises the current body of research literature on this important women’s health topic, and identifies the need for further qualitative research on this topic, allowing the voices of women to be heard regarding their lived experiences</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104588"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145027209","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":"Then they’re not there. Women’s experiences following admission of their newborn to a neonatal intensive care unit","authors":"Laura Stedman ,&nbsp;Catherine Angell ,&nbsp;Vanora A Hundley","doi":"10.1016/j.midw.2025.104587","DOIUrl":"10.1016/j.midw.2025.104587","url":null,"abstract":"<div><h3>Background</h3><div>Gestational diabetes mellitus (GDM) is a complication of pregnancy associated with neonatal morbidities including admission to Neonatal Intensive Care Units (NICU). Previous research highlights a lack of birth satisfaction and trauma for women following admission of their baby. Previously, research has focussed on a pre-term population. This study aimed to explore the experiences of women, diagnosed with GDM, whose babies were admitted to NICU at any gestation.</div></div><div><h3>Methods</h3><div>A 24-item, fully qualitative online survey was launched through JISC on 28th July 2023, shared through social media and online platforms. Inclusion criteria specified women who had been diagnosed with GDM, lived and received care in the UK and whose baby was admitted to NICU at or shortly after birth. Ethical approval was granted by Bournemouth University.</div></div><div><h3>Results</h3><div>18 women participated in the survey. Two primary themes were identified: ‘experience’ and ‘understanding’, further separated into five and three sub-themes respectively. A lack of understanding and knowledge was identified, with calls for enhanced education and joint decision making. Women recalled feelings of grief, isolation and stress as a result of the admission. For many, this experience was traumatic with lasting effects. For babies born at term, feelings of surprise and separation were paramount, in contrast to those born pre-term.</div></div><div><h3>Conclusion</h3><div>There is need to increase education and improve current material to support women who find themselves facing this outcome. Future research should also focus on reducing the incidence of admission to NICU for women who have received a diagnosis of GDM.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104587"},"PeriodicalIF":2.5,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145046771","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}