European Journal of Midwifery最新文献

Introduction: Despite national efforts, inequalities in maternal and infant health persist. Black, Asian and other ethnic minority, along with those in deprived areas, face disproportionately high complication and mortality rates. Prioritizing research is crucial for improving care experiences for women and families.

Methods: By adopting a qualitative ethnographic approach, we explored priority areas for research regarding Black, Asian, and ethnic minority mothers accessing healthcare in the UK. Data were gathered through focus groups and analyzed inductively and thematically using NVivo. The study sample comprised 55 women from various ethnic backgrounds, with the largest groups identifying as Black African, Arab, and Asian Pakistani.

Results: Women outlined key research priorities stemming from significant challenges in accessing maternity care. These included: 1) Communication barriers such as language difficulties, understanding each other and health literacy; 2) Emotional and psychological support, highlighting a need for further research. Women underscored the value of safe spaces for peer support and social interaction; 3) Participants stressed the importance of comprehensive perinatal education, particularly during the transition to parenthood, along with a strong desire for digital resources, information sharing, and networking; 4) High-quality, compassionate, and well-coordinated maternity care remained a primary concern; and 5) Socioeconomic support, including financial assistance, childcare, and resources for essential postnatal needs.

Conclusions: To tackle these issues, research at both community and individual levels should be commissioned to ensure women's priority concerns are comprehensively addressed. These findings provide valuable insights that can help shape national efforts to improve maternity care and reduce disparities, by informing policy and improving professional training.

Introduction: Optimal fetal positioning is essential for ensuring that labor progresses efficiently and reducing the need for interventions. The aim of this study was to evaluate the potential role of the Spinning Babies^® approach to facilitate fetal head rotation.

Methods: This retrospective study was based on data collected by midwifery students, supervised by experienced midwifery tutors, using digital partograms. The fetal position was recorded at several stages of labor, particularly at the labor onset and at the delivery. For the current analysis, only women with an occiput-posterior or occiput-transverse fetal position were included. The Spinning Babies^® approach was compared with a control group. The association between anterior head rotation and the use of the Spinning Babies^® techniques was evaluated using a log-binomial model.

Results: A total of 244 partograms were identified. Of these, 60 women underwent the Spinning Babies^® approach, while the remaining 184 did not (control group). At first, in the Spinning Babies^® group, 40.0% were left occiput-posterior, 43.3% were right occiput-posterior, and 16.7% were occiput-transverse. In the control group the corresponding proportions were: 33.2%, 56.0%, and 10.9%. At the delivery, the fetal head rotated from posterior (or transverse) to anterior in 93.3% of women who underwent Spinning Babies^® techniques, compared to 63.6% of controls. The use of Spinning Babies^® techniques was associated with a 45% increased likelihood of achieving anterior position (RR=1.45; 95% CI: 1.23-1.72).

Conclusions: Optimal fetal positioning may be facilitated using Spinning Babies^® approach. To confirm these findings, further research using more standardized protocols and objective measures is needed.

Introduction: The study aim was to examine mother-infant bonding, feeding practices, and postnatal care experiences of mothers diagnosed with COVID-19 in hospital settings from 2020 to 2022.

Methods: A mixed-methods research design was conducted, involving 117 participants in a cross-sectional online survey and 11 phone interviews. The study was conducted among mothers diagnosed with COVID-19 by PCR test and admitted to four maternity facilities in Qatar from 1 May 2020 to 16 January 2022. The Postnatal Bonding Questionnaire was used to examine mother-baby bonding, and interviews were conducted to gain a deeper understanding of the overall postnatal experience. Descriptive statistics, t-tests, and ANOVA were applied to analyze associations between postnatal bonding scores and various factors.

Results: Participants had a postnatal bonding mean score of ≥12, which indicated impaired bonding (mean=12.0, SD=4.7). Mode of birth and postnatal bonding scores were correlated, especially those with instrumental deliveries (mean=30.2, SD=12.0, p<0.001). Five themes emerged illustrating the respondents' adaptive strategies and the build-up of impaired bonding during the pandemic. These themes underscored the need for support in enhancing mothers' coping and resilience to the challenges during the pandemic.

Conclusions: The pandemic has significantly impacted maternal-infant bonding, as evidenced by increased reports of maternal stress, reduced physical contact, and limitations on partner support. Midwives and other healthcare professionals play a pivotal role in supporting, educating, and reassuring women about providing safe, high-quality care during the crisis. Further research is essential to develop evidence-based guidelines and to examine the long-term consequences of disrupted bonding on infant development.

Introduction: Japanese midwives support lactating women to continue breastfeeding. However, midwives often learn breast care methods through practical experience. This study investigated how midwives acquire knowledge about mastitis and breast cancer.

Methods: This cross-sectional study was conducted in Japan over two months. The study participants were midwives with breast care experience. The questionnaire was sent to 800 midwifery facilities for recruitment. The questions covered learning and diagnostic methods for general breast care, bacterial mastitis, severe mastitis, and breast cancer during lactation. The analysis method involved descriptive statistics. An Ethical Review Committee approved this study.

Results: The survey return rate was 27.50% (n=200). The valid response rate was 87.27% (n=192). Although the learning method that helped midwives most regarding mastitis, in general, was breast care experience (38.0%), knowledge about bacterial mastitis and severe mastitis came from advice from doctors or senior midwives (33.3%, 42.4%). However, knowledge about breast cancer during lactation was mostly learned during formal education (29.5%); many had never learned about it (10.5%). The most common method used by midwives to make breast care decisions was subjective judgment.

Conclusions: Most midwives learned a great deal by observing and palpating actual breasts in clinical settings. Some midwives had learned very little about breast cancer. Most midwives did not use medical equipment for breast evaluations. This suggests that Japanese midwives have high breast care skills. However, there is room for improving midwives' skills in using medical equipment.

Introduction: Somali women represent a significant proportion of the non-Western migrant population in Europe. Language barriers and cultural differences can hinder these women from having a positive childbirth experience. This study aims to explore how Somali women with limited language proficiency experience childbirth in Norway.

Methods: Social media and snowball method was used to recruit eight Somali women with limited Norwegian language skills who had given birth in Norway within the past three years. Semi-structured, face-to-face interviews were performed during December 2023-January 2024. Thematic analysis according to Braun and Clarke was used.

Results: The study identified three themes: communication and language challenges, relationships with midwives, and cultural differences and health literacy. Communication difficulties, mainly due to language barriers, contributed to feelings of insecurity among the women. Non-verbal communication and husbands acting as interpreters were important for understanding, especially since there were insufficient professional interpreters available. While many women mentioned feeling safe and supported by midwives, some felt alienated and faced stereotypical attitudes. Religious beliefs significantly shaped birthing experiences, leading to a preference for female doctors for both religious and cultural reasons. Limited health literacy contributed to misunderstandings regarding perineal tears and their severity.

Conclusions: Culturally sensitive care and personalized communication are crucial in preventing misunderstandings and ensuring that vital information is clearly communicated. By enhancing midwives' cultural awareness and multicultural competence, they can offer more tailored and effective support, fostering a positive childbirth experience for women from diverse backgrounds. This approach ultimately leads to improved outcomes and strengthens trust between women and healthcare professionals.

Introduction: Allowing freedom of movement and positions during labor facilitates safe progression, improves maternal and neonatal outcomes, and contributes to a positive birth experience for women and their partners. Childbirth preparation aims to empower women by equipping them with skills and confidence to manage labor actively and knowledgeably. However, in many hospital settings, women's mobility remains restricted. This study explores expert perspectives on the core components of an intervention designed to promote women's autonomy and active participation during labor, to be implemented by nurse-midwives within Childbirth Preparation Programs in primary healthcare.

Methods: A qualitative study was conducted in February 2024 in Portugal, using a focus group composed of ten nurse-midwives recognized as experts in childbirth preparation. The session was recorded and analyzed through content analysis, guided by the Theory of Emancipated Decision-Making in Women's Healthcare.

Results: Nine women and one man participated, aged 34-64 years, representing primary healthcare, hospitals, and academia. Six key themes emerged from the analysis: the intentionality behind the intervention; understanding the meanings and expectations women hold about their birth experience; empowering women by providing knowledge and skills; raising awareness of social norms that may influence women's decisions and actions; encouraging women to reflect on their options; and fostering woman-centered care.

Conclusions: The experts emphasized the importance of promoting mobility during labor to enhance perinatal outcomes and the childbirth experience. Empowering women through experiential learning, fostering reflection, supporting informed choices, and ensuring continuity of care through collaborative professional practices were identified as essential strategies for effective intervention.

Introduction: Midwives frequently encounter adverse events, potentially leading to the Second Victim Phenomenon (SVP), a condition marked by emotional distress, self-doubt, and psychological symptoms. This study investigates the prevalence, key triggers, symptom severity, and support needs of midwives in Austria affected by SVP.

Methods: A cross-sectional survey was conducted among Austrian midwives (n=487) using the SeViD-questionnaire. Descriptive statistics were applied to assess SVP prevalence, symptoms, and support measures. Binary logistic regression analyses examined predictors of SVP occurrence and symptom severity, while the Mann-Whitney U test compared support preferences between affected and non-affected midwives.

Results: SVP prevalence was 94.3%, with self-doubt (52.5%), guilt (47.0%), and flashbacks (41.8%) as the most pronounced symptoms. Work experience and workload did not predict SVP occurrence. However, events involving patient harm (OR=1.92; 95% CI: 1.11-3.31, p=0.02) and higher neuroticism scores (OR=1.62; 95% CI: 1.24-2.11, p<0.01) significantly predicted high symptom severity. Affected midwives rated professional counseling as less helpful than non-affected peers (p=0.03, r=0.02).

Conclusions: The high prevalence of SVP underscores the need for comprehensive, accessible support for Austrian midwives. Peer support programs should be central, alongside preventive and reactive measures. Support must be inclusive of self-employed midwives. Targeted interventions can enhance mental well-being, improve patient safety, and strengthen healthcare quality.

Introduction: Early labor is critical in shaping birth experiences, and women seek midwifery care to manage challenges during this stage. A salutogenic attitude, focusing on positive experiences and health promotion, is needed instead of the current pathogenic maternity model. This study aimed to understand how midwives support women's positive early labor experience and to identify key elements contributing to salutogenic midwifery care practices during early labor.

Methods: We employed a qualitative study design, conducting nine focus group discussions (FGDs) with 39 women in Denmark, Sweden, and Switzerland. First, data were analyzed thematically using an inductive approach to capture codes. Second, a salutogenic best-fit framework guided the analysis, structuring the data into three domains: comprehensibility, manageability, and meaningfulness. Within domains, sub-themes were identified to elucidate how midwifery care might contribute to positive early labor experiences.

Results: Comprehensibility was achieved when women trusted midwives to provide accessible, high-quality care tailored to individual needs to help them comprehend the maternity system. Manageability was experienced when midwives guided women through the uncertainties of early labor and provided plans when needed. Meaningfulness was created through availability, accessibility, and emotional support. Continuity of care was an underlying foundation for a positive experience of all three domains.

Conclusions: A salutogenic midwifery approach, centering on flexibility and individualization, was essential to women's positive experiences cross-nationally. Salutogenic midwifery care during early labor reduced anxiety and enhanced emotional resilience. Our findings underscore the importance of salutogenic midwifery care for women in early labor, which should be recognized and implemented in maternity care settings.

Introduction: Traumatic events experienced during midwifery internships can have a significant impact on students, leading to emotional distress and doubts about continuing their studies. The aim of this study was to explore whether the experience of traumatic events influences motivation to continue studying and affects the professional expectations associated with the role of the midwife.

Methods: A qualitative descriptive phenomenological approach was used, focusing on the lived experiences of midwifery students in Italy. Data were collected through open-ended questionnaires administered to 36 third-year students from a midwifery Bachelor's degree program during the 2023-2024 academic year. Thematic analysis, following the Braun and Clarke six-step framework, was used to identify and interpret patterns in the data.

Results: The analysis revealed 21 codes, eight subthemes, and three main themes: 'Discovering the elements that shape the perception of the event', 'Suffer the consequences of the event', and 'Engage in a dynamic process to acquire the professional dimension'. Students described the factors that shape their perception of events, such as inadequate preparation, emergencies, and negative professional behaviors. Emotional consequences included fear, frustration, and doubts about their professional abilities. Despite these challenges, students showed resilience, often seeking support from mentors and external resources, ultimately reaffirming their commitment to the profession of midwifery.

Conclusions: Traumatic events during internships significantly impact the experiences of midwifery students. Effective clinical tutoring and emotional support are crucial to mitigate negative effects and foster professional growth. Understanding these dynamics can help educators better prepare students for the emotional demands of the profession.