Midwifery最新文献

{"title":"A qualitative analysis of postpartum women’s experiences with urinary incontinence and physical activity","authors":"Lisa VanWiel ,&nbsp;Olivia Butler ,&nbsp;Lucas J. Carr ,&nbsp;Jessica Gorzelitz ,&nbsp;William T. Story ,&nbsp;Kara M. Whitaker","doi":"10.1016/j.midw.2025.104591","DOIUrl":"10.1016/j.midw.2025.104591","url":null,"abstract":"<div><h3>Problem</h3><div>The postpartum period is associated with low physical activity, and increased risk of activity-related adverse health conditions.</div></div><div><h3>Background</h3><div>Urinary incontinence (UI) is a prevalent postpartum condition associated with low physical activity which protects against many adverse postpartum health conditions. However, little is known about how postpartum women experience UI and physical activity.</div></div><div><h3>Study Aims</h3><div>Thematically analyse <em>how</em> and <em>why</em> UI is associated with postpartum physical activity.</div></div><div><h3>Methods</h3><div>A purposive sample of postpartum participants with UI (n=30) were recruited from a larger study. Semi-structured in-depth interviews were conducted to understand postpartum women’s experiences with UI and activity. Interview transcripts were dual-coded using Dedoose qualitative software and thematically analysed using an interpretive phenomenology framework.</div></div><div><h3>Findings</h3><div>Six themes emerged: 1) Physical activity decreases in the postpartum period; 2) UI is one of many influences on postpartum activity; 3) Postpartum women stop activity, decrease intensity, or use compensatory strategies in response to UI; 4) UI is a threat to women’s identity, mental health, and social health; 5) Women with UI have unmet needs; and 6) Postpartum women with UI want activity interventions designed by qualified health professionals.</div></div><div><h3>Discussion</h3><div>Postpartum women should be screened for UI and low physical activity. More work is needed to develop interventions within and outside of the healthcare system aimed at addressing UI and low physical activity in the postpartum period.</div></div><div><h3>Conclusions</h3><div>UI negatively influences physical activity in the postpartum period and impacts postpartum mental health. Interventions are desired to treat UI and improve postpartum physical activity.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104591"},"PeriodicalIF":2.5,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144997539","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":"Response to comments on Paz et al. (2025) midwifery theories: A scoping review","authors":"Sara D.C. Paz ,&nbsp;Andreia S. Goncalves ,&nbsp;Filipa Sampaio ,&nbsp;Ana Paula Prata","doi":"10.1016/j.midw.2025.104589","DOIUrl":"10.1016/j.midw.2025.104589","url":null,"abstract":"","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104589"},"PeriodicalIF":2.5,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145046774","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":"2025-09-02","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":"International news October 2025","authors":"Elizabeth Duff (International News Editor)","doi":"10.1016/j.midw.2025.104586","DOIUrl":"10.1016/j.midw.2025.104586","url":null,"abstract":"","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"149 ","pages":"Article 104586"},"PeriodicalIF":2.5,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145026797","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 \"Epidural or water immersion? A prospective cohort study of maternal and neonatal outcomes in a tertiary hospital\" [Midwifery 146 (2025)104392].","authors":"Soledad Carregui-Vilar, Eva M Moya-Artuñedo, Ricardo Chalmeta, Lucia Rocca-Ihenacho, Eladio J Collado-Boira","doi":"10.1016/j.midw.2025.104505","DOIUrl":"10.1016/j.midw.2025.104505","url":null,"abstract":"","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":" ","pages":"104505"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575841","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":"Midwives' perceived knowledge, perceptions, and experiences of managing paternal postnatal depression in Tanzania: A qualitative descriptive study.","authors":"Paul Shidende, Randi Bates, Gary Dick, Rebecca Lee","doi":"10.1016/j.midw.2025.104299","DOIUrl":"10.1016/j.midw.2025.104299","url":null,"abstract":"<p><strong>Background: </strong>Paternal postnatal depression (PPND) is an under-recognized condition that affects new fathers' psychological and emotional well-being, which may impact family dynamics, work performance, and childcare. Despite its significance, there is limited awareness and understanding of its management and implications among midwives, especially in Africa.</p><p><strong>Aims: </strong>To explore midwives' experiences of managing PPND in Tanzania.</p><p><strong>Methods: </strong>A qualitative descriptive study explored Tanzanian midwives' perceived knowledge, perceptions, and experience in PPND. Twenty-two midwives were purposively sampled from two hospitals in Dar-es-Salaam, Tanzania, to participate in two focus group discussions. Following Elo and Kyngäs' (2008) framework, qualitative content analysis was employed to identify and interpret patterns in the data.</p><p><strong>Results: </strong>The midwives acknowledged PPND as significant and frequently encountered but overlooked. They identified risk factors like family health, socioeconomic status, and economic issues alongside emotional, physical, and behavioral symptoms in fathers. Challenges in managing PPND among midwives stem from insufficient resources, systemic obstacles, and societal stigma. Further, societal misconceptions could worsen PPND. To treat PPND, midwives used strategies including interprofessional collaboration, counseling, and education, though they emphasized the need for better training and resources.</p><p><strong>Conclusion: </strong>While midwives in Tanzania recognized PPND and its impact, there was a pressing need for specialized training and systemic changes to better support affected fathers. Enhancing midwives' knowledge and skills, addressing cultural and societal stigmas, and improving healthcare infrastructure were crucial to effectively managing PPND.</p>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":" ","pages":"104299"},"PeriodicalIF":2.5,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046785","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":"Sleep, physical activity, and pregnancy symptoms: Factors associated with cognitive performance in early pregnancy","authors":"Virginia R. Nuckols ,&nbsp;Kristen G. Davis ,&nbsp;Gary L. Pierce ,&nbsp;Karin F Hoth ,&nbsp;Mark K Santillan ,&nbsp;Bethany Barone Gibbs ,&nbsp;Kara M. Whitaker","doi":"10.1016/j.midw.2025.104585","DOIUrl":"10.1016/j.midw.2025.104585","url":null,"abstract":"<div><h3>Background</h3><div>Women often report disruptions in cognitive performance during pregnancy. Though substantiated by objective assessments, findings have been inconsistent and potential contributing factors are not well understood.</div></div><div><h3>Aim</h3><div>The objective of this study was to examine the cross-sectional associations between maternal mood, stress, pregnancy-related symptoms and device measured 24-hour activity behaviors with cognitive performance in the first trimester of pregnancy.</div></div><div><h3>Methods</h3><div>Pregnant women (N=90) were assessed in the first trimester. Non-pregnant controls (N=73) were assessed 1-5 years after pregnancy. Depressive symptoms, (Center for Epidemiological Studies Depression Scale), stress (Perceived Stress Scale), and pregnancy-specific health related quality of life (Nausea and Vomiting during Pregnancy Health-Related Quality of Life) were evaluated using validated questionnaires, and 24-hour activity measured via actigraphy (activPAL, Actiwatch Spectrum Plus). Cognitive performance was evaluated using tests of memory, processing speed, and executive function.</div></div><div><h3>Findings</h3><div>Pregnant women performed lower on memory tests compared with non-pregnant women. Neither depressive symptoms nor stress were associated with lower cognitive performance in pregnancy. Physical symptoms of pregnancy (e.g., nausea, vomiting) were related to lower memory scores (β=0.32, P=0.02). Longer sleep duration was associated with better executive function performance (β=1.4, P=0.03).</div></div><div><h3>Conclusion</h3><div>This study demonstrates lower memory performance in the first trimester of pregnancy compared with non-pregnant controls and indicates that pregnancy symptoms and shorter sleep duration may be contributing factors.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104585"},"PeriodicalIF":2.5,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144933634","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 the self-reported experience of the 10 steps to successful breastfeeding and sociodemographic characteristics with breastfeeding self-efficacy","authors":"Mary Economou ,&nbsp;Ourania Kolokotroni ,&nbsp;Irene Paphiti-Demetriou ,&nbsp;Christiana Kouta ,&nbsp;Ekaterini Lambrinou ,&nbsp;Eleni Hadjigeorgiou ,&nbsp;Vasiliki Hadjiona ,&nbsp;Nicos Middleton","doi":"10.1016/j.midw.2025.104584","DOIUrl":"10.1016/j.midw.2025.104584","url":null,"abstract":"<div><h3>Background</h3><div>The effect of Breastfeeding Self-efficacy (BFSE) and the Baby-Friendly Hospital Initiative’s (BFHI) 10 Steps on breastfeeding initiation, continuation and exclusivity, is well established. However, direct evidence about the association between the experience of the 10 steps and self-efficacy is limited.</div></div><div><h3>Objective</h3><div>To assess the association between adherence to the 'Ten Steps to Successful Breastfeeding', sociodemographic factors and other predictors with breastfeeding self-efficacy (BFSE) at 48 hours and at one month postpartum.</div></div><div><h3>Methods</h3><div>Implementation of the 10 Steps was assessed based on the self-reported experience on of a consecutive sample of 568 mothers’ across all public (N=5) and 29 (of 35) private maternity clinics. Data were collected within the first 24-48 hours after birth using the WHO/UNICEF Baby Friendly Hospital Initiative questionnaire (Section 4), Sociodemographic information of the participants was also gathered at baseline. BFSE was assessed within 48 hours and at 1^st month postpartum based on the BFSE-SF scale. Associations of the 10 Steps with BFSE were explored in stepwise linear regression models, examining individual questionnaire items as well as the level of implementation (no, partial or full) of each step except for Step 6 (exclusivity).</div></div><div><h3>Results</h3><div>Rooming-in emerged as the maternity practice most consistently associated with BFSE both within the first 48 hours (β-coeff= 0.38 95% CI: 0.22, 0.54) and at 1^st month (β-coeff= 0.30 95% CI: 0.12, 0.48). Step 4 (early initiation of BF) and Step 10 (guidance to community support) showed associations with BFSE only within 48 hours after birth. Furthemore, mothers who experienced Step 8 (feeding on demand) and Step 9 (no use of a pacifier) were more likely to exhibit higher BFSE levels in the 1st month. Intention to EBF during the first six months and previous breastfeeding experience were identified as significant predictors of BFSE at both 48 hours and one month postpartum.</div></div><div><h3>Conclusion</h3><div>Baby Friendly hospital’s “10 Steps” have varying influence on breastfeeding self-efficacy. Given the role of BFSE in breastfeeding continuation and exclusivity, understanding which practices most enhance it is vital. However, the bi-directional nature of the association should be further explored, as women with higher self-efficacy may also be more likely to seek or advocate for these practices.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"150 ","pages":"Article 104584"},"PeriodicalIF":2.5,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144997538","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":"Spatial variation of short birth interval in the Asia-Pacific region","authors":"Catherine Chojenta ,&nbsp;Desalegn Markos Shifti ,&nbsp;Tesfalidet Beyene ,&nbsp;Tanmay Bagade ,&nbsp;Nuruzzaman Khan ,&nbsp;Jessica Botfield ,&nbsp;Janet Dzator ,&nbsp;Melissa Harris","doi":"10.1016/j.midw.2025.104583","DOIUrl":"10.1016/j.midw.2025.104583","url":null,"abstract":"<div><h3>Background</h3><div>Most countries in the Asia-Pacific region experience high rates of adverse maternal and child health outcomes, including maternal and child mortality. A significant proportion of these adverse outcomes are related to short birth intervals (SBI), which the World Health Organization defines as &lt;33 months between two subsequent live births. Understanding the country-specific geographical variation of SBI in the Asia-Pacific region will enable the implementation of targeted interventions in higher-risk areas. Therefore, we aimed to explore the spatial variation of SBI across the Asia-Pacific region.</div></div><div><h3>Methods</h3><div>We used data from Demographic and Health Surveys (DHS) of eight countries in the Asia-Pacific region: Bangladesh, Cambodia, India, Myanmar, Nepal, Pakistan, Philippines, and Timor-Leste, as these countries have location data available (i.e., latitude/longitude) along with the standard DHS data. The degree of spatial autocorrelation was identified using Global Moran’s I statistics, and the degree of clustering of SBI was measured using Getis-Ord General G statistics. Getis-Ord Gi* was used to identify SBI hot spots.</div></div><div><h3>Results</h3><div>The prevalence of SBI in the Asia-Pacific region varied from 21.3 % in Bangladesh to 60.7 % in Pakistan. SBI hot spots were identified in Bangladesh, India, Myanmar, Nepal, Pakistan, the Philippines, and Timor-Leste.</div></div><div><h3>Conclusion</h3><div>This study revealed significant spatial variation in SBI across the Asia-Pacific region, with hotspots in several countries. These findings highlight the importance of bolstering targeted family planning services and raising awareness around optimal birth intervals.</div></div><div><h3>Statement of significance</h3><div><strong>Problem or Issue -</strong></div><div>SBI is associated with an increased risk of adverse maternal and child health outcomes such as gestational diabetes and maternal anemia, preterm birth and low birth weight.</div><div><strong>What is already known? -</strong></div><div>Previous studies have investigated spatial variations in SBI within specific countries in the Asia-Pacific region. However, they do not provide data on broader geographical areas across the region.</div><div><strong>What this paper adds? -</strong></div><div>Using nationally representative data, our study conducted a comprehensive spatial analysis of SBI in eight Asia-Pacific countries. The findings reveal wide-ranging geographical variations in SBI, helping policymakers implement targeted interventions and prioritise high-risk areas.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"149 ","pages":"Article 104583"},"PeriodicalIF":2.5,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144916970","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":"Global perspectives of midwifery ethics: Crucial features for practice via an international Delphi study","authors":"Kate BUCHANAN ,&nbsp;Sara BAYES ,&nbsp;Elizabeth NEWNHAM ,&nbsp;Mavis KIRKHAM ,&nbsp;Marianne NIEUWENHUIJZE","doi":"10.1016/j.midw.2025.104582","DOIUrl":"10.1016/j.midw.2025.104582","url":null,"abstract":"<div><h3>Background</h3><div>Practising ethically as a midwife is essential for providing high quality care during pregnancy, childbirth, and the postpartum period. Whilst midwives may have theoretical knowledge of ethics, applying ethical care in practice may be challenging. There is a gap in the literature that describes how midwives themselves conceptualise, interpret, and apply ethics in their practice.</div></div><div><h3>Aim</h3><div>To describe midwives’ perceptions, and experiences of ethics in midwifery practice, and to determine the crucial features of midwifery ethics.</div></div><div><h3>Methods</h3><div>Fifty participants from 21 countries participated in the study. A two-round Delphi approach was employed. Round Two required participants to enter the REDCap portal to rank and comment on statements about midwifery ethics that were derived from qualitative data collected and thematically analysed in Round One.</div></div><div><h3>Finding</h3><div>Fourteen characteristics captured in four domains were developed from the study that describe what midwives perceive ethical midwifery and maternity care to be. The four domains are: Midwifery ethics are founded in midwifery philosophy, Midwifery ethics as relational Care, Midwifery ethics are embodied (lived or intrinsic), Midwifery ethics demonstrate advocacy.</div></div><div><h3>Conclusion</h3><div>The domains and characteristics of midwifery ethics provide insights into midwives' unique ethical practices and represent foundational information to inform the practical application of midwifery ethics. The participants’ perceptions and experiences demonstrate a deeply rooted desire for a midwifery ethics construct that is underpinned by midwifery philosophy, focused on reproductive justice, and is aligned to and demonstrates solidarity with women’s autonomy in childbearing and more broadly.</div></div>","PeriodicalId":18495,"journal":{"name":"Midwifery","volume":"149 ","pages":"Article 104582"},"PeriodicalIF":2.5,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144896302","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}