Women and Birth最新文献_第2页

“The hardest 9 months of my life”: Parents’ experiences of care in pregnancies after perinatal loss in Australia “我生命中最艰难的9个月”：澳大利亚围产期流产后，父母在怀孕期间的护理经历

IF 4.1 2区医学 Q1 NURSING

Women and Birth

Pub Date : 2026-01-09 DOI: 10.1016/j.wombi.2025.102155

Siobhan A. Loughnan , Kathina Ali , Aleena M. Wojcieszek , Ida Stevia Diget , Laura Singline , Ann Lancaster , Emma Porter , Christine Andrews , Adrienne Gordon , Alexander E.P. Heazell , Susannah Hopkins Leisher , Amy Cooper , Elizabeth McCarthy , Vanessa Postle , Anne Sneddon , Barbara Vernon , Sean Seeho , Sailesh Kumar , Frances M. Boyle , Vicki Flenady , David Ellwood

Problem

Pregnancy after perinatal loss is associated with increased risks of adverse psychosocial and biomedical outcomes.

Background

Standard antenatal care often fails to meet these parents’ needs.

Aim

To explore parents’ experiences of pregnancy after perinatal loss in Australia and understand the care and support they find most meaningful.

Methods

National cross-sectional web-based survey of parents in Australia who had experienced perinatal loss and were pregnant or had completed a subsequent pregnancy in the preceding five years. Quantitative data were analysed largely descriptively; qualitative data underwent thematic analysis.

Findings

Of 332 participants (97 % mothers), most experienced adverse mental health issues at least sometimes during the subsequent pregnancy (70–98 %). Most received additional or specialised care plans (74 %) and reported elements of respectful and compassionate care most-, or all of the time (73–91 %). Participants typically rated their care favourably. Most had access to medical components of care, such as an obstetrician (89 %) and additional ultrasound scans (87 %), while few reported the involvement of a specialist midwife (17 %), bereavement counsellor (23 %) or specialist antenatal classes for pregnancy after loss (5 %). Thematic analysis identified one overarching theme: recognition of the subsequent pregnancy and previous loss; and four subthemes: trusted healthcare professional in a continuity of carer model, additional care and monitoring, emotional and mental health support, and respectful communication.

Discussion

Recognition of the subsequent pregnancy in the context of prior loss is essential.

Conclusion

Improving access to integrated, trauma-informed continuity of care models may better support parents in pregnancies after loss.

问题围产期流产后妊娠与不良社会心理和生物医学结果的风险增加有关。标准的产前保健往往不能满足这些父母的需求。目的探讨澳大利亚围产期流产后父母的怀孕经历，了解他们认为最有意义的关怀和支持。方法对澳大利亚在过去五年内经历过围产期流产并怀孕或已完成后续妊娠的父母进行全国性的基于网络的横断面调查。定量数据主要是描述性分析；对定性数据进行专题分析。在332名参与者（97% %为母亲）中，大多数人在随后的怀孕期间至少有时会出现不良的心理健康问题（70 - 98% %）。大多数人接受了额外的或专门的护理计划（74% %），大多数或所有时间（73% - 91% %）报告了尊重和同情护理的要素。参与者通常对他们的护理给予好评。大多数人可以获得医疗护理的组成部分，例如产科医生（89 %）和额外的超声波扫描（87 %），而很少有人报告有专业助产士（17 %）、丧亲辅导员（23 %）或专门的产前培训课程（5 %）。专题分析确定了一个总体主题：承认随后的怀孕和先前的损失；还有四个副主题：在护理模式的连续性中值得信赖的医疗保健专业人员，额外的护理和监测，情感和精神健康支持，以及尊重的沟通。讨论认识到在先前流产的情况下的后续妊娠是必要的。结论提高综合性、创伤知情的连续性护理模式的可及性，可以更好地支持失孕后怀孕的父母。

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引用次数: 0

Infant feeding experiences and support needs in women with severe mental illness: A qualitative study in England 患有严重精神疾病妇女的婴儿喂养经历和支持需求：英国的一项定性研究。

IF 4.1 2区医学 Q1 NURSING

Women and Birth

Pub Date : 2026-01-05 DOI: 10.1016/j.wombi.2025.102156

Natasha Baker , Claire A. Wilson , Debra Bick , Louise M. Howard , Hannah Rayment Jones , Ioannis Bakolis , Yan-Shing Chang , Tayana Soukup

Background

Breastfeeding has significant health benefits for mothers and babies. Severe mental illness (SMI) affects around 3 % of women giving birth but very little is currently known about their infant feeding experiences. Due to a paucity of evidence, support needs are largely unknown.

Aim

To explore the infant feeding experiences and supports needs of women with SMI.

Methods

Semi structured interviews were conducted online and in person from 2022 to 2023 with 20 women under care of perinatal mental health teams in England. Interviews were audio-recorded, transcribed and anonymised. Reflective thematic analysis was used to analyse the data.

Findings

Four key themes were identified; (1) The intersection between infant feeding and mental health; (2) Infant feeding support from maternity services; (3) Infant feeding preparation; and (4) Specific considerations for women with SMI. The concept of ‘collaborative practice to support infant feeding and mental health’ draws the themes together and is marked by a disconnect in collaborative care supporting both infant feeding and mental health.

Discussion

SMI can manifest itself in beliefs and emotions related to infant feeding. Experiences of support highlighted the need for better anticipatory guidance around infant feeding for women with SMI, including contexts specific to perinatal SMI like psychiatric inpatient settings, psychotropic medication use, and the challenges associated with sleep deprivation.

Conclusions

Negative experiences with infant feeding and poor support have a significant impact on women with SMI. Support should focus on the emotional and practical demands of breastfeeding and how women can manage this alongside their illness.

背景：母乳喂养对母亲和婴儿都有显著的健康益处。严重精神疾病（SMI）影响了大约3 %的分娩妇女，但目前对她们的婴儿喂养经历知之甚少。由于缺乏证据，支持需求在很大程度上是未知的。目的：探讨重度精神障碍妇女的婴儿喂养经验及支持需求。方法：从2022年到2023年，对20名在英国围产期心理健康小组护理的妇女进行了半结构化的在线和面对面访谈。采访被录音、转录和匿名。采用反思性专题分析方法分析数据。发现：确定了四个关键主题；(1)婴幼儿喂养与心理健康的交叉；(2)母婴服务对婴儿喂养的支持；(3)婴儿喂养准备；(4)重度精神障碍女性的具体注意事项。“协作实践以支持婴儿喂养和心理健康”的概念将这些主题结合在一起，其特点是在支持婴儿喂养和心理健康的协作护理方面存在脱节。讨论：重度精神障碍可以表现在与婴儿喂养有关的信念和情绪上。支持的经验强调了对重度精神障碍妇女的婴儿喂养需要更好的预期指导，包括围产期重度精神障碍的具体情况，如精神病住院环境、精神药物的使用以及与睡眠剥夺相关的挑战。结论：婴儿喂养和不良支持的负面经历对重度精神分裂症妇女有显著影响。支持应侧重于母乳喂养的情感和实际需求，以及妇女如何在疾病的同时处理这些需求。

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引用次数: 0

Midwifery student experiences in continuity and public hospital models of care: A cross-sectional survey 助产学学生在连续性和公立医院护理模式中的经历：一项横断面调查。

IF 4.1 2区医学 Q1 NURSING

Women and Birth

Pub Date : 2026-01-03 DOI: 10.1016/j.wombi.2025.102158

Deborah Davis , Amanda Carter , Nicole Hainsworth , Susannah Brady , Nikki Tickle , Lyndall Mollart , Allison Cummins

Background

Midwifery professional practice experience (MPE) is critical to student learning. Midwifery education standards in Australia prescribe that students must complete midwifery continuity of care experiences across pregnancy, birth and postnatally for ten women. Midwifery Professional Experience (MPE) can occur in partnering health facilities and in midwifery continuity of care models.

Aim

To compare the MPE experiences of midwifery students in public hospital maternity and continuity of midwifery care models using the validated Midwifery Students' Experience of Practice (MidSTEP) Tool.

Methods

Recruitment was via university learning management systems. Data were collected via REDCap using the validated MidSTEP tool. Demographics, program information and 26 Likert-style responses were included. Categorical data were analysed using descriptive statistics, Likert responses were dichotomised and compared between public hospital maternity care and midwifery continuity of care using McNemar’s test (significance 0.05). Open text questions were thematically analysed.

Findings

92 responses were received, 96.7 % MPE was in public maternity models of care and 3.3 % in a midwifery continuity of care model. Midwifery student responses to the MidSTEP scale favoured learning experiences through midwifery continuity of care. Open text responses were coded into four themes, culture, implicit values of the maternity service, support for students and experiences with midwifery continuity of care models.

Conclusion

This study demonstrates learning in MPE is optimised when students are embedded within continuity of midwifery care models. Prioritising student feedback using the MidSTEP tool aligns with midwifery philosophy and should be prioritised.

背景：助产专业实践经验（MPE）对学生学习至关重要。澳大利亚的助产教育标准规定，学生必须完成10名妇女在怀孕、分娩和产后的助产连续性护理经验。助产专业经验（MPE）可以发生在合作卫生设施和助产护理连续性模式中。目的：利用经验证的助产学生实践经验（MidSTEP）工具，比较公立医院产科助产学生的MPE体验和助产护理模式的连续性。方法：通过高校学习管理系统进行招聘。使用经过验证的MidSTEP工具通过REDCap收集数据。包括人口统计、项目信息和26份李克特式问卷。分类数据采用描述性统计进行分析，Likert反应采用二分类，公立医院产科护理和助产护理连续性的比较采用McNemar检验（显著性0.05）。对开放性文本问题进行主题分析。结果：收到92份回复，96.7 %的MPE在公共产科模式的护理中，3.3 %的MPE在助产连续性护理模式中。助产士学生对MidSTEP量表的反应倾向于通过助产士护理的连续性学习经验。开放文本回复被编码为四个主题，文化，产妇服务的隐含价值，对学生的支持和助产士护理模式连续性的经验。结论：本研究表明，当学生嵌入助产护理模式的连续性时，MPE的学习是优化的。使用MidSTEP工具优先考虑学生反馈与助产学理念一致，应该优先考虑。

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引用次数: 0

Women and health professionals’ views and experiences of reduced fetal movements in low- and middle-income countries: A scoping review 低收入和中等收入国家妇女和卫生专业人员对胎动减少的看法和经验：范围审查

IF 4.1 2区医学 Q1 NURSING

Women and Birth

Pub Date : 2026-01-02 DOI: 10.1016/j.wombi.2025.102157

Feri Anita Wijayanti , Kylie Watson , Kelly Howells , Alexander E.P. Heazell

Background

Raising awareness of reduced fetal movement (RFM) is a potential approach to prevent stillbirth. To date, research regarding fetal movements has largely been conducted in high-income countries. However, conclusions drawn from this setting may not be applicable to other settings with a higher burden of stillbirth due to differences in sociodemographic factors and healthcare systems.

Aim

To explore women’s and health professionals’ experiences regarding fetal movements, and interventions on encouraging the awareness of RFM in low- and middle-income countries.

Methods

A comprehensive search for peer-reviewed studies and grey literature in any language was conducted; the search strategy was not restricted by publication dates, and the last search was conducted in June 2025. Databases searched included: CINAHL, MEDLINE, EMBASE, AJOL, LILACS, and Garuda.

Findings

The review identified 61 papers from 17 low- and middle-income countries published between 1988 and 2025. Studies reported wide variation in women’s knowledge and perceptions about fetal movement and the time to seek help. There was limited literature on how health professionals discuss fetal movements and manage RFM in these settings. Most studies investigated fetal movement counting to raise awareness of RFM.

Conclusion

Despite variations in women’s experiences of fetal movements across different settings, studies have primarily focused on awareness of the quantity of movements. Further research that delves deeper into the knowledge and experiences of women and health professionals utilising both quantitative and qualitative approaches is needed to better inform initiatives which aim to raise awareness of RFM to prevent adverse outcomes.

背景提高对胎动减少（RFM）的认识是预防死产的一种潜在方法。迄今为止，有关胎儿运动的研究主要在高收入国家进行。然而，由于社会人口因素和卫生保健系统的差异，从这种情况下得出的结论可能不适用于死产负担较高的其他情况。目的探讨妇女和保健专业人员在胎儿运动方面的经验，以及在低收入和中等收入国家鼓励认识胎动的干预措施。方法对所有语言的同行评议研究和灰色文献进行综合检索；搜索策略不受出版日期限制，最后一次搜索是在2025年6月进行的。检索的数据库包括：CINAHL、MEDLINE、EMBASE、AJOL、LILACS和Garuda。该综述确定了来自17个低收入和中等收入国家在1988年至2025年间发表的61篇论文。研究报告称，女性对胎儿运动和寻求帮助的时间的认识和看法存在很大差异。关于卫生专业人员如何在这些环境中讨论胎儿运动和管理RFM的文献有限。大多数研究调查了胎动计数，以提高对RFM的认识。结论：尽管在不同的环境下，女性对胎儿运动的体验有所不同，但研究主要集中在对运动数量的认识上。需要利用定量和定性方法进一步研究妇女和保健专业人员的知识和经验，以便更好地为旨在提高对生殖健康管理认识以预防不良后果的举措提供信息。

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引用次数: 0

“I trust the evidence”: Why Australian midwives practice homebirth without professional indemnity insurance “我相信证据”：为什么澳大利亚助产士在没有专业赔偿保险的情况下在家分娩

IF 4.1 2区医学 Q1 NURSING

Women and Birth

Pub Date : 2025-12-31 DOI: 10.1016/j.wombi.2025.102159

Jennifer Mitchell , Carolyn Ruth Hastie , Roslyn Donnellan-Fernandez , Laura Gabriel

Background

Professional indemnity insurance (PII) has not been available for intrapartum care at home for privately practice midwives (PPMs) in Australia since 2001.

Aims

To examine the effect of the lack of professional indemnity insurance on the private practice of Australian homebirth midwives.

Methods

In this qualitative study, semi-structured interviews were conducted with midwives (n = 11), who were currently or had recently been providing homebirth services. Interpretative phenomenological analysis was used to explore how midwives navigate professional and personal risk in their practice.

Findings

Three higher-order themes were found that describe how midwives manage their private practice without PII for homebirth: I feel vulnerable without insurance, The system doesn’t support my practice, and I have my own risk management processes.

Conclusion

From 2001–30 th June 2025, Australian PPMs provided homebirth services without any PII, putting them at personal and professional risk. Australian PPMs navigate other risks such as the experience of horizontal violence upon transfer from home to hospital, blame culture in the maternity system which may result in an Ahpra notification and ethical distress when trying to provide care for women with complex needs. This research illustrates how PPMs practice in a system that doesn’t support them.

背景：自2001年以来，澳大利亚的私人执业助产士（PPMs）在家中的分娩期间护理不提供专业赔偿保险（PII）。目的探讨专业赔偿保险的缺乏对澳大利亚家庭助产士私人执业的影响。方法在本定性研究中，采用半结构化访谈的方式对目前或最近曾提供在家分娩服务的助产士（n = 11）进行访谈。解释性现象学分析用于探索助产士如何在实践中导航专业和个人风险。研究发现三个高阶主题描述了助产士在没有PII的情况下如何管理他们的私人诊所：没有保险我感到很脆弱，系统不支持我的做法，我有自己的风险管理流程。从2001-30 到2025年6月，澳大利亚的PPMs在没有任何PII的情况下提供在家分娩服务，这使他们面临个人和职业风险。澳大利亚的产妇管理人员应对其他风险，如从家转到医院时遭受横向暴力，产妇系统中的指责文化可能导致Ahpra通知，以及在试图为有复杂需求的妇女提供护理时面临道德困境。这项研究说明了PPMs是如何在一个不支持它们的系统中实践的。

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引用次数: 0

Maternal birth experience at operative vaginal birth 阴道手术分娩的产妇分娩经验。

IF 4.1 2区医学 Q1 NURSING

Women and Birth

Pub Date : 2025-12-23 DOI: 10.1016/j.wombi.2025.102149

Sasha M. Skinner , Billie Bradford , Eleanor Kippen , Peter Neil , Imogen Neesham , Ben W. Mol , Ryan J. Hodges , Daniel L. Rolnik , Arunaz Kumar

Background

Operative birth is a known risk factor for negative birth experience, yet the modifiable factors that shape these experiences remain underexplored.

Aim

This study examines factors associated with birth experience following operative second-stage birth, including operative vaginal birth (OVB) or fully dilated caesarean (FDCS).

Methods

We conducted a prospective mixed-methods study of women undergoing operative second-stage birth across four hospitals in one health network, in Melbourne Australia. A validated birth experience survey was administered, and responses were matched to clinical data. Logistic regression analysis identified factors associated with negative birth experience. Free-text survey responses were thematically analysed.

Findings

Of 2783 women who had an operative second-stage birth from July 2023 to March 2025, 402 (14.4 %) responded to the survey. Of those, 127 (31.6 %) scored < 25 indicating a negative experience. Negative experience was associated with prolonged second stage (odds ratio (OR) 2.00, 95 % confidence interval (CI) 1.26–3.20, p = 0.004), anal sphincter injury (OR 4.09, 95 % CI 1.59–11.00, p = 0.004) and postpartum haemorrhage (OR 2.01, 95 % CI 1.16–3.47, p = 0.013), while maternal age greater than 35 years (OR 0.41, 95 % CI 0.18–0.84, p = 0.020) and vacuum-assisted birth (OR 0.42 (0.22–0.77, p = 0.006) were protective.

Qualitative analysis identified six overarching themes impacting birth experience: (1) preparation and expectations, (2) communication and care, (3) empowerment and control, (4) exhaustion and pain, (5) separation of the family unit, (6) physical and emotional safety.

Discussion and conclusion

Birth satisfaction is influenced by both clinical and contextual factors. Effective communication, emotional support, shared decision-making, and high-quality antenatal education are essential to improving maternal experience during operative birth.

背景：手术分娩是已知的不良分娩经历的危险因素，但塑造这些经历的可改变因素仍未得到充分探讨。目的：本研究探讨手术二期分娩后分娩经历的相关因素，包括手术阴道分娩（OVB）或完全剖宫产（FDCS）。方法：我们在澳大利亚墨尔本的一个健康网络中的四家医院进行了一项前瞻性混合方法研究。进行了一项有效的分娩经验调查，并与临床数据相匹配。Logistic回归分析确定了负面出生经历的相关因素。对自由文本调查结果进行主题分析。研究结果：在2023年7月至2025年3月的2783例手术分娩的妇女中，402例（14.4 %）回应了调查。其中127例（31.6% %）得分。讨论与结论：分娩满意度受到临床和环境因素的双重影响。有效的沟通、情感支持、共同决策和高质量的产前教育对于改善手术分娩期间的产妇体验至关重要。

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引用次数: 0

Intrapartum experiences of gestational surrogates and intended parents in Australia: A qualitative study 澳大利亚代孕母亲和准父母的产时经历：一项定性研究

IF 4.1 2区医学 Q1 NURSING

Women and Birth

Pub Date : 2025-12-19 DOI: 10.1016/j.wombi.2025.102154

Jutharat Attawet , Leo Ng , Evie Kendal , Yunjing Qiu , Myles Ojabo , Sarah Jefford , Micah DJ Peters

Background

Gestational surrogacy is an increasingly visible, though tightly regulated, pathway to parenthood in Australia, yet intrapartum care remains under-examined. Existing maternity models are grounded in woman-centred care and offer limited guidance for births involving surrogates and intended parents within a triadic care relationship.

Objectives

To describe the intrapartum experiences of gestational surrogates and intended parents in Australia and to identify care processes that support or hinder respectful, inclusive practice.

Methods

A descriptive qualitative study was conducted with purposive sampling. Seventeen participants took part between December 2024 and May 2025, comprising nine gestational surrogates and eight intended parents who had experienced a surrogacy birth in Australia within the previous five years. Semi-structured online interviews (60–90 min) were audio-recorded, transcribed, de-identified, and verified. Data were managed in NVivo 12 and analysed using Braun and Clarke’s six-phase thematic analysis. Credibility was enhanced through independent coding, coding comparisons, analytic memos, and team review.

Findings

Birth was described as a shared, yet distinct experience shaped by ritual, recognition, and institutional preparedness. Three themes, each comprising interrelated subthemes, emerged: (1) rituals of handover marking the transition of parenthood, (2) recognition and misrecognition in clinical settings, and (3) institutional variability and inequity leading to inconsistent inclusion and added advocacy burdens.

Conclusion

Intrapartum surrogacy care requires attention to relational and clinical processes beyond conventional care. Findings support extending woman-centred care to a relationship-centred model recognising surrogates, intended parents, and infants. Clear guidelines, inclusive language, and surrogacy-aware documentation are essential for consistent, equitable, and respectful intrapartum care.

在澳大利亚，尽管受到严格监管，但妊娠代孕越来越成为一种为人父母的途径，但分娩时的护理仍未得到充分检查。现有的孕产模式是以妇女为中心的护理为基础的，在三位一体的护理关系中，对涉及代孕母亲和准父母的分娩提供有限的指导。目的描述澳大利亚代孕母亲和准父母的分娩经历，并确定支持或阻碍尊重、包容实践的护理过程。方法采用有目的抽样方法进行描述性定性研究。17名参与者在2024年12月至2025年5月期间参加了这项研究，其中包括9名代孕母亲和8名在过去五年内在澳大利亚经历过代孕分娩的准父母。半结构化的在线访谈（60-90 分钟）被录音、转录、去识别和验证。数据在NVivo 12中进行管理，并使用Braun和Clarke的六阶段主题分析进行分析。通过独立编码、编码比较、分析备忘录和团队评审，提高了可信度。出生被描述为一种由仪式、认可和制度准备形成的共同而独特的经历。出现了三个主题，每个主题都包含相互关联的子主题：(1)标志着父母身份过渡的交接仪式；(2)临床环境中的承认和错误认识；(3)制度的可变性和不公平导致不一致的包容和增加的倡导负担。结论产中代孕护理需要在常规护理的基础上注重关系和临床过程。研究结果支持将以女性为中心的护理扩展到以关系为中心的模式，包括代孕母亲、准父母和婴儿。明确的指导方针、包容性的语言和了解代孕的文件对于一致、公平和尊重的产中护理至关重要。

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引用次数: 0

Women’s experience of an Australian metropolitan publicly funded homebirth program: Respect, integrity, trust, and empowerment (RITE) 澳大利亚都市公共资助的家庭分娩项目的妇女经验：尊重、正直、信任和赋权（RITE）。

IF 4.1 2区医学 Q1 NURSING

Women and Birth

Pub Date : 2025-12-17 DOI: 10.1016/j.wombi.2025.102151

Linda SWEET , Katherine O'Driscoll , Tija Blums

Background

There is a body of research evidence that analyses why women choose to give birth at home. However, recent research is lacking on women’s experiences of a publicly funded homebirth in Australia.

Aim

To examine the experiences of women receiving care from one publicly funded homebirth service in metropolitan Melbourne, Victoria.

Methods

A qualitative descriptive study using semi-structured interviews was undertaken. Thirty-one women, with a total of 39 pregnancy experiences representative of the range of experiences (had a homebirth, transferred to hospital peripartum, or became ineligible for the program), participated. Data were audio recorded, transcribed, and analysed thematically.

Findings

Overall, women were satisfied with their experience of the program. The overarching theme was empowering women in maternity care, evident through the acronym RITE, Respect, Integrity, Trust, and Empowerment. Recommendations for improving the program include enhanced promotion, expansion to other health services, and broader, more inclusive inclusion criteria in publicly funded homebirth programs.

Conclusion

The challenge for publicly funded homebirth programs is maintaining a safe and effective service while expanding programs that are more responsive to women’s individual needs.

背景：有大量的研究证据分析了为什么女性选择在家分娩。然而，最近的研究缺乏关于澳大利亚公共资助的妇女在家分娩的经历。目的：研究在维多利亚州墨尔本大都会接受公共资助的家庭分娩服务的妇女的经历。方法：采用半结构化访谈进行定性描述性研究。31名妇女参加了这项研究，她们共有39次具有代表性的怀孕经历（在家分娩、转到医院围产期或失去参加该计划的资格）。对数据进行录音、转录和专题分析。调查结果：总体而言，女性对她们在该项目中的经历感到满意。最重要的主题是在产妇护理中赋予妇女权力，通过首字母缩略词RITE（尊重、诚信、信任和赋权）体现出来。改善该计划的建议包括加强推广，扩大到其他卫生服务，以及在公共资助的家庭分娩计划中制定更广泛、更具包容性的纳入标准。结论：公共资助的家庭分娩项目面临的挑战是，在扩大更能满足妇女个人需求的项目的同时，保持安全有效的服务。

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引用次数: 0

Public and private antenatal care access and utilisation as determinants of triple antenatal test for HIV, syphilis, and HBV: Evidence from the Indonesian Health Survey 公共和私人产前保健的获得和利用是艾滋病毒、梅毒和乙型肝炎病毒产前三重检测的决定因素：来自印度尼西亚健康调查的证据。

IF 4.1 2区医学 Q1 NURSING

Women and Birth

Pub Date : 2025-12-16 DOI: 10.1016/j.wombi.2025.102153

Gede Benny Setia Wirawan , Angela Kelly-Hanku , Rabiah Al Adawiyah , Alegra Wolter , Benjamin Hegarty , Yuyun Yuniar , Rinaldi Ridwan , Pande Putu Januraga , Heny Lestary , Luh Putu Lila Wulandari

Background

The Asia-Pacific regional roadmap for the triple elimination of mother-to-child transmission (EMTCT) of HIV, syphilis and Hepatitis B virus emphasises the importance of data-driven policymaking and private sector engagement. Utilising secondary data from a nationally representative household-based Indonesian Health Survey 2023 (IHS 2023), we examined the role of public and private sectors in the coverage of triple antenatal tests as an indicator for EMTCT.

Methods

Using data from IHS 2023, the analysis was limited to women and girls aged 10–54 years who self-reported a pregnancy with an antenatal care (ANC) visit between 2018 and 2023. Test coverage was defined as a self-reported history of antenatal testing for HIV, syphilis, and hepatitis B during their most recent pregnancy. Independent variables included access and utilisation of public & private healthcare facilities. Covariates included demographics, obstetric history, and socioeconomic status. Multivariable logistic regression models were developed using complex sample weighted analysis.

Results

Antenatal testing coverage for all three infections was 58.0 %. Unavailability of public health centres (PHCs, or puskesmas locally) (aOR=0.61, 95 %CI=0.45–0.84), hospitals (aOR=0.76, 95 %CI=0.66–0.89), laboratories (aOR=0.73, 95 %CI=65–0.83), and private providers (aOR=0.84, 95 %CI=0.75–0.94) were found as negative predictors, as was reliance on private providers for ANC compared to PHCs (aOR=0.65, 95 %CI=0.61–0.71).

Conclusion

Testing coverage of these infections among pregnant women was below both the national (100 %) and global (95 %) targets. Poor access to healthcare facilities and reliance on private providers for ANC were negative predictors of testing for HIV, syphilis and Hepatitis B, suggesting potential gaps in private sector engagement with the EMTCT effort.

背景：亚太地区三重消除艾滋病毒、梅毒和乙型肝炎病毒母婴传播（EMTCT）路线图强调了数据驱动的决策和私营部门参与的重要性。利用来自具有全国代表性的基于家庭的印度尼西亚健康调查2023 （IHS 2023）的二手数据，我们检查了公共和私营部门在产前三次检查覆盖率方面的作用，作为EMTCT的指标。方法：使用IHS 2023的数据，该分析仅限于在2018年至2023年期间自我报告怀孕的10-54岁妇女和女孩。检测覆盖率定义为最近怀孕期间自我报告的产前艾滋病毒、梅毒和乙型肝炎检测史。独立变量包括公共和私人医疗保健设施的获取和利用情况。协变量包括人口统计学、产科史和社会经济地位。采用复样本加权分析建立多变量logistic回归模型。结果：三种感染的产前检测覆盖率为58.0% %。公共卫生中心（phc，或当地puskesmas）（aOR=0.61, 95 %CI=0.45-0.84）、医院（aOR=0.76, 95 %CI=0.66-0.89）、实验室（aOR=0.73, 95 %CI=65-0.83）和私人提供者（aOR=0.84, 95 %CI=0.75-0.94）的不可用性被认为是负面预测因素，对私人提供者的ANC依赖程度也低于公立医院（aOR=0.65, 95 %CI=0.61-0.71）。结论：孕妇中这些感染的检测覆盖率低于国家（100% %）和全球（95% %）目标。难以获得卫生保健设施和依赖私营机构提供ANC是艾滋病毒、梅毒和乙型肝炎检测的负面预测因素，这表明私营部门参与EMTCT工作方面存在潜在差距。

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引用次数: 0

Hot weather, maternal health, and pregnancy experiences, impacts and responses: A systematic review of global qualitative research 炎热天气、孕产妇健康和妊娠经历、影响和反应：全球定性研究的系统综述。

IF 4.1 2区医学 Q1 NURSING

Women and Birth

Pub Date : 2025-12-15 DOI: 10.1016/j.wombi.2025.102152

Frances Grimshaw , Rishu Thakur , Aster Gebremedhin , Veronica Matthews (Quandamooka) , Brad Farrant , Carrington Shepherd , Christine Phillips , Caitlin S Wyrwoll , Supriya Mathew

Problem

Extreme heat exposure is a major global public health threat that is affecting people across the life course, including the pregnancy period.

Background

Studies have linked extreme heat with adverse pregnancy and newborn health outcomes globally.

Objective

The review aimed to: (1) investigate the health symptoms and pregnancy experiences and impacts associated with extreme heat, and (2) document adaptation strategies employed in pregnancy and factors impeding adaptive capacities in varying socio-economic and cultural contexts.

Methods

The review followed the Joanna Briggs Institute’s guidelines for qualitative systematic reviews. We searched databases such as EBSCO Medline, Web of Science, ScienceDirect, Scopus, PubMed, Google Scholar and Informit. Data were extracted using an inductive approach, where similar codes were placed into larger themes.

Findings

Three themes: heat-related health impacts, adaptation strategies, and mediating environmental, cultural, and socio-economic factors were constructed. Extreme heat had a pronounced impact on maternal health. Studies provided only a few details on adaptation to extreme heat, with half of the literature focused on African contexts.

Discussion

Environmental, cultural and socio-economic factors were crucial in mediating the exposure and management of heat. Findings underscored the need for culturally sensitive, context-specific public health interventions that address both the immediate and long-term needs of pregnant people during hot weather.

Conclusion

Greater awareness-raising and education are required at the health practitioner and community level to reduce any health risks in a changing climate. Future research should focus on capturing the heat-related lived experiences of pregnant people, which will enable the implementation of contextual solutions.

问题：极端高温暴露是一项重大的全球公共卫生威胁，影响人们的整个生命过程，包括怀孕期。背景：在全球范围内，研究已将极端高温与不良妊娠和新生儿健康结果联系起来。目的：本综述旨在：(1)调查与极端高温相关的健康症状和妊娠经历及其影响；(2)记录在不同社会经济和文化背景下怀孕时采用的适应策略和阻碍适应能力的因素。方法：本综述遵循乔安娜布里格斯研究所的定性系统综述指南。我们检索了EBSCO Medline、Web of Science、ScienceDirect、Scopus、PubMed、谷歌Scholar和Informit等数据库。使用归纳方法提取数据，将类似的代码放入更大的主题中。结果：构建了热相关健康影响、适应策略以及环境、文化和社会经济因素三个主题。极端高温对产妇健康产生了显著影响。研究只提供了一些关于适应极端高温的细节，其中一半的文献集中在非洲的背景下。讨论：环境、文化和社会经济因素在调节热量暴露和管理方面至关重要。调查结果强调，需要采取对文化敏感、针对具体情况的公共卫生干预措施，以解决炎热天气期间孕妇的眼前和长期需求。结论：需要在卫生从业人员和社区一级加强认识和教育，以减少气候变化带来的任何健康风险。未来的研究应侧重于捕捉孕妇与热相关的生活经历，这将使情境解决方案的实施成为可能。

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引用次数: 0