Midwifery最新文献

Introduction: Globally, an increase in facility-based childbirth is associated with provision of care that may not align with the expectations of women. The study was conducted to explore expectations of women regarding intrapartum care and whether these expectations aligned with their experiences of care during a facility-based childbirth.

Methods: A qualitative descriptive study was conducted among women who had given birth. We conducted 18 in-depth interviews to explore women's expectations, and preferences during childbirth. Women were also interviewed to explore their childbirth experiences, especially to determine whether their experience of care matched their expectations.

Results: We identified two themes: 1) What women want during intrapartum care and 2) What women received during intrapartum care. Most women prioritised maternal and neonatal survival during intrapartum care. Secondly, women wanted services to be available during childbirth. These included availability of adequate medicines, supplies, and healthcare providers. Thirdly, women who were scheduled for caesarean sections yearned for labour pain relief and postoperative pain relief after birth. Lastly, women wanted respectful maternity care and to give birth in clean facilities. Women who desired for positive birth outcomes including normal births noted that those expectations were met even among those who had caesarean births. Participants noted that medicines and supplies were available for them except for some supplies that were required for caesarean section. Women were surprised to receive respectful care despite hearsay stories of mistreatment in facilities, while the facilities were seen to be clean and hygienic. Although women desired pain relief for labour and postoperative pain, they perceived inadequate pain relief during and after operation.

Conclusion: Women had low expectations of care. Women's expectations were focussed on the bare minimum of maternal and neonatal survival. Women's expectations for availability of medicines, and optimal pain relief were not adequately met during childbirth. Addressing all the expectations of women during childbirth may promote positive childbirth experience, satisfaction and skilled birth attendance.

Problem: In remote Papua New Guinea there are few midwives or functioning health facilities, and high perinatal mortality. Indigenous traditional birth attendants carry the burden of caring for women and newborns.

Background: Midwives training and developing traditional birth attendants rely on ad-hoc approaches to the education they provide, drawing from their own knowledge and skills.

Aim: Develop a culturally sensitive conceptual educational framework as a guide for midwives to train and supervise traditional birth attendants in low-resource settings.

Methods: Seven-step approach: 1) Establish trust and respect; 2) Identification of the need; 3) Ethical considerations; 4) Needs analysis; 5) Contextual considerations; 6) Theoretical framework; 7) Practice standards.

Findings: The Yamen Traditional Birth Attendant Conceptual Educational Framework guides midwives to train and supervise traditional birth attendants to strengthen maternal and newborn healthcare in low-resource settings through pre-service education and community development. Four adult, cross-cultural learning principles were identified: cultural sensitivity, strategic issues, previous experience, evidence-based practice. Expected outcomes include increased knowledge, skills, attitudes, and critical thinking of traditional birth attendants.

Discussion: Training and supervision of traditional birth attendants by midwives is recommended for low-resource settings of Papua New Guinea to foster strong partnerships between communities and health facilities and improve perinatal safety.

Conclusion: A co-designed, culturally sensitive education framework is presented with the potential to strengthen maternal and newborn services in low-resource settings by linking traditional birth attendants to midwives in formal health services. Further research is needed to articulate the role, scope of work and key learning competencies.

Background: Breastfeeding is essential health behavior for the health of the mother and child. The duration of breastfeeding often affects the likelihood of overlapping between breastfeeding and subsequent pregnancies.

Aim: This meta-analysis evaluated the effects of breastfeeding during pregnancy on maternal and newborn health outcomes and the composition of breast milk based on previous studies.

Methods: The study protocol was developed, and the article was written following the PRISMA guidelines. The screening was conducted in September 2024, and the study was registered with PROSPERO. A comprehensive search was performed using PubMed, Google Scholar, the Cochrane Library, EBSCO, Embase, the National Thesis Center, and the TR Index. The methodological quality of the included studies was assessed using the JBI quality assessment tools. Data were pooled through meta-analysis, and a GRADE evidence profile was generated.

Findings: The meta-analysis revealed that breastfeeding during pregnancy did not significantly affect birth weight, the incidence of miscarriage, preterm labor, or pregnancy complications. However, it was associated with an increased incidence of low birth weight and intrauterine growth retardation. Regarding breast milk composition, breastfeeding during pregnancy did not change the total protein or lactose content but resulted in a reduction in fat content. Subgroup analyses indicated that the effects of breastfeeding during pregnancy on maternal and newborn health were influenced by the level of development of the country in which the studies were conducted.

Key conclusions: Breastfeeding during pregnancy may impact breast milk composition and maternal and neonatal health.