European Journal of Midwifery最新文献

Introduction: European countries have recently received many migrants from Ukraine. Women's life experiences and expectations shape their perception of maternity care and childbirth. Our study aimed to explore how newly arrived Ukrainian refugee women experience their maternity care in Norway.

Methods: Social media were used to recruit eight women meeting the criteria of being newly arrived Ukrainian refugee women. Semi-structured interviews, three face-to-face and five video-calls, were performed between December 2023 and January 2024. We used Braun and Clarke for thematic analysis.

Results: Three main themes were identified: healthcare in country of origin, high-quality care in the new country, and challenges as a refugee. Women reported that in their home country, the cost of maternity care had a significant impact on the quality of care they received with a tendency toward overmedicalization, as access to certain services often depended on payment. Participants described instances of feeling disrespected by healthcare staff in their home country, in contrast to their experiences in Norway. Women reported that in Norway they experienced a high level of professionalism among healthcare staff and a well-functioning healthcare system with good physical conditions. Challenges that the women struggled with were communication and barriers to accessing services.

Conclusions: Being treated professionally and with respect played a central role in creating a positive experience and mitigated the negative experiences of problems with communication and navigation in an unfamiliar healthcare system. Future research could investigate the use of written information to aid migrants in understanding the maternity services and some of the vocabulary.

Introduction: The well-being of midwives impacts the quality of care provided during labor and birth, influencing maternal and neonatal outcomes. It is crucial that newly qualified midwives (NQMs) feel confident in managing labor and childbirth, to foster positive experiences for both mother and child. This study aims to explore and understand the lived experiences of NQMs caring for women during labor and birth.

Methods: A Heideggerian hermeneutic phenomenological approach was used to explore the experiences of ten NQMs within two years post-qualification, working in the Central Delivery Suite (CDS) of Malta's main public hospital. Purposive sampling identified participants, and data were collected through one-time, semi-structured, in-depth interviews conducted in private settings with the first author (JG) between December 2021 and January 2022. The interviews followed a self-designed schedule in English (JG, RPP) and were audio-recorded. Reflective journaling was maintained throughout. Analysis was guided by van Manen's six-step method, with hermeneutic philosophy and Willian Bridges' transition model informing the interpretation.

Results: Two main themes emerged: 1) 'Baptism of fire' and 2) 'Containing the fire'. 'Baptism of fire' encapsulates the initial challenges NQMs faced, including feelings of being overwhelmed and unprepared. 'Containing the fire' highlights how NQMs developed strategies to adapt, growing more confident and effective in their roles. These experiences were shaped by their training exposure to CDS and the level of support from colleagues during their transition.

Conclusions: The findings highlight the need for supportive environments, extended CDS placements and structured guidance through preceptorship. Enhancing NQMs' transition to practice has implications for midwifery education, policy, and practice.

Introduction: During pregnancy, women rely on a variety of sources to obtain information. However, not all of these sources are equally reliable, and there is the concern that especially online information-seeking may increase pregnancy-related anxiety. This study examines to what extent different sources of pregnancy information are associated with concurrent pregnancy-related anxiety (RQ1) and changes in pregnancy-related anxiety throughout the pregnancy (RQ2).

Methods: This study was integrated into the ongoing Swedish Mom2B study (sub-study data collection: December 2022-April 2024), where women complete weekly questionnaires via a research app. Each trimester, they received questions about their use of information sources and pregnancy-related anxiety.

Results: Our sample consisted of 751 pregnant women (273 with at least two waves of data). Using the midwife (β= -0.14, p<0.001; 95% CI: -3.32 - -1.13) or social circle (β= -0.08, p<0.05; 95% CI: -2.83 - -0.07) as a source of pregnancy-and childbirth-related information was associated with lower levels of pregnancy-related anxiety. In contrast, reliance on online sources for information was associated with higher levels of anxiety (β=0.14, p<0.001; 95% CI: 1.52-5.03). Except for (e-)books, which lowered the odds of improving anxiety (OR=0.62, p<0.01; 95% CI: 0.45-0.85), none of the information sources predicted changes in pregnancy-related anxiety over time.

Conclusions: Not all information sources play an equal role in relation to pregnancy-related anxiety. Interpersonal sources in particular may help mitigate anxiety. However, future research with more nuanced methodologies and shorter measurement intervals could clarify possible causal relationships and refine our understanding of how various information sources affect pregnancy-related anxiety over time.

Introduction: Cesarean section rates continue to increase worldwide. In 2021, one in every five deliveries was delivered by cesarean section. This is particularly alarming in resource-limited countries such as Kosovo, where the rates continue to increase and vary considerably between hospitals. Understanding the underlying factors that drive the increase and variation of cesarean section rates may help to change these trends. This study investigates how emotional intelligence and emotional labor impact cesarean section decision-making among midwives and obstetricians in Kosovo, along with clinical factors.

Methods: We employed a conjoint analysis using a cross-sectional study design to assess preferences that drive decisions for cesarean section. We used the Dutch questionnaire on Emotional Labor, the Assessing Emotions Scale, and the Quality of Decision-making questionnaire, and designed a conjoint questionnaire with 28 hypothetical scenarios. We invited all midwives and obstetricians employed at the Gynecology and Obstetrics Clinic of the University Clinical Centre of Kosovo to participate in the study. The data were collected from January to the end of March 2023. Stata 18 BE was used for statistical computing and data visualization.

Results: A gestational age of 42 weeks decreased CS likelihood among midwives (OR=0.75; 95% CI: 0.62-0.90, p=0.002). Previous cesarean sections (OR=1.42; 95% CI: 1.11-1.81, p=0.005) and hypertension (OR=1.23; 95% CI: 1.01-1.51, p=0.042) raised CS odds for midwives. A pelvic size of 8 cm significantly increased CS likelihood for midwives (OR=1.70; 95% CI: 1.37-2.09, p<0.001), while a size of 11 cm was protective for both groups (midwives: OR=0.73; 95% CI: 0.57-0.93, p=0.010; obstetricians: OR=0.70; 95% CI: 0.52-0.94, p=0.019). Maternal age of 40 years was significant only for obstetricians (OR=1.43; 95% CI: 1.00-2.06, p=0.052), and university education was significant for midwives (OR=1.19; 95% CI: 1.03-1.37, p=0.020). Non-clinical factors and emotional measures showed no significant or consistent trends in either group.

Conclusions: Various clinical and non-clinical factors shape the decision to recommend a cesarean section, with obstetricians and midwives prioritizing these factors differently. These findings underscore the importance of implementing evidence-based practices to enhance maternal and newborn health outcomes in Kosovo and similar settings, while optimizing cesarean decision-making.

[This corrects the article DOI: 10.18332/ejm/195830.].

[This corrects the article DOI: 10.18332/ejm/195831.].

Introduction: Pregnancy is a critical period marked by vast changes, with a pivotal role in healthcare. The Mothers on Respect (MOR) index measures and ensures respect in maternal care, impacting health-seeking behaviors and postpartum outcomes vital for individual and healthcare system well-being. This study aims to validate the Greek version of the MOR index to enhance respectful maternity care and contribute to positive childbirth experiences.

Methods: A retrospective, cross-sectional, descriptive, and analytical online survey collected data from Greek women with home childbirth experience. We utilized a self-administered questionnaire and the Greek version of the Mothers on Respect (MOR) index.

Results: The MOR index, assessing knowledge and awareness, showed a median score of 78 points, with a significant association between higher scores and living in Attica or being a healthcare professional (p=0.027 and p=0.024, respectively). Confirmatory factor analysis indicated the questionnaire had an acceptable fit, and reliability was confirmed with Cronbach's α exceeding 0.7 across all dimensions.

Conclusions: The Greek MOR index validation advances respectful maternity care, enhances maternal health in Greece, and contributes to regional efforts for positive childbirth experiences.

Introduction: Maternity care professionals need to guide women through an increasing number of decision-making processes during pregnancy. Professionals tend to focus more on providing information than on decision support. According to the self-determination theory (SDT), professionals could help women make their own choices by fulfilling their three basic psychological needs: autonomy, competence, and relatedness through autonomy-supportive interactions. This study aimed to quantify autonomy-supportive and autonomy-thwarting interactions that professionals use during prenatal consultations and their association with women's perceptions of the healthcare climate during consultations.

Methods: A quantitative observation study with a cross-sectional design was conducted in the Netherlands from March to October 2020. Twenty-three maternity care professionals in 2 hospitals and 16 midwifery practices were purposefully sampled. During 104 prenatal consultations, professional interactions were audiotaped and coded using the Coding and Observing Need-Supportive Consultation in Maternity Care Consultations. The woman's perceived healthcare climate was assessed using the Healthcare Climate Questionnaire.

Results: We observed that professionals derive their autonomy-supportive interactions from a small repertoire. They tend to use more autonomy-supportive interactions (mean=2.31, SD=0.58) that give room to the woman than interactions that stimulate active engagement (mean=1.41, SD=0.80). During structuring interactions, they tend to use more informative (mean=1.81, SD=0.59) than supportive interactions (mean=0.94, SD=0.55). Women generally perceived the healthcare climate as positive.

Conclusions: Women were rarely stimulated to be actively engaged in the consultations, while active woman engagement is vital in offering women-centered decision-making support. Professionals could improve their autonomy-supportive consultation climate by paying explicit attention to interactions involving women and offering structure.

Introduction: High-risk pregnancies require special attention in maternal and child health services, given the high potential for complications that can affect maternal and fetal health. The continuity of care (COC) approach is expected to increase family independence and prevent pregnancy complications. This study aims to analyze the effectiveness of COC in improving the family independence of high-risk pregnant women in preventing pregnancy complications.

Methods: This study used a quasi-experimental design with a pretest-posttest approach without a control group, involving 134 high-risk pregnant women, in the target area at the Wonoayu Community Health Centre, Sidoarjo, Indonesia from February to May 2024, who were selected through purposive sampling. Data were collected through structured questionnaires before and after the COC intervention, which included assessing knowledge and family roles in supporting pregnant women's health. The COC mentoring program was implemented for three months, with a focus on family education and involvement in maternal healthcare. A validated questionnaire measured family self-reliance before and after the intervention.

Results: The study showed a significant increase in family self-reliance, with a p<0.001 in all aspects measured, including fulfilment of physiological and psychological needs, preparation for labor, the postpartum period, and preparation after the baby is born. This increase suggests that the COC intervention is effective in empowering families to support high-risk pregnant women. Before the intervention, the mean score for physiological and psychological needs fulfilment was 17.45, which increased to 36.42 after the intervention (p<0.001). In addition, labor preparation also showed a significant increase from 11.40 to 24.38, as well as postpartum preparation from 13.00 to 28.79, and preparation after the baby is born from 13.25 to 28.75 (all p<0.001).

Conclusions: The consistent improvement in all measured aspects, indicated that the COC intervention not only improved families' knowledge and skills, but also contributed to their preparedness in supporting pregnant women during and after pregnancy.