Women and Birth最新文献

{"title":"‘What do you need?’ An observational, cross-sectional study of the holistic healthcare needs of culturally and linguistically diverse Australian women with Gestational Diabetes Mellitus","authors":"Haneefa Alliu ,&nbsp;Mei Ying Boon ,&nbsp;Marjorie Atchan ,&nbsp;Natasha Jojo ,&nbsp;Mary-Ellen Hooper ,&nbsp;Maryam Bazargan ,&nbsp;Cathy Knight Agarwal ,&nbsp;Nicola Irwin ,&nbsp;Deborah Davis","doi":"10.1016/j.wombi.2025.102147","DOIUrl":"10.1016/j.wombi.2025.102147","url":null,"abstract":"<div><h3>Background</h3><div>Gestational Diabetes Mellitus (GDM) is the most rapidly rising type of diabetes in Australia. Women of certain ethnic backgrounds are disproportionately affected, experiencing poorer health outcomes. The holistic healthcare needs of these women are not well understood</div></div><div><h3>Aim</h3><div>To compare the GDM Holistic Healthcare Needs Scale results between women who primarily speak English and those speaking another language at home.</div></div><div><h3>Methods</h3><div>All pregnant women with GDM, residing in Australia and registered with the National Diabetes Services Scheme were invited to participate in this observational, cross-sectional study. Participation involved completing the web-based GDM Holistic Healthcare Needs Scale, from 4 May 2023. Results are presented as simple proportions, with the Chi-square test for independence comparing needs between the two groups.</div></div><div><h3>Findings</h3><div>Of the 342 participants, 282 (82.5 %) primarily spoke English and 60 (17.5 %) spoke mainly another language at home. Women speaking other languages had a significantly higher need for ‘information about managing GDM that takes account of your culture’ (P &lt; 0.001) and ‘information provided in a language or words that you can understand’ (P = 0.03). Conversely, primarily English-speaking women reported a significantly higher need for ‘consistent information and advice from different healthcare providers’ (P = 0.04), and ‘not always feeling ‘high risk’’ (P = 0.05).</div></div><div><h3>Discussion</h3><div>Resources for women with GDM should be comprehensive and culturally appropriate, using words and language that can be easily understood. The GDM Holistic Healthcare Needs Scale is a useful instrument for measuring holistic healthcare needs of women from diverse backgrounds.</div></div><div><h3>Conclusion</h3><div>The holistic healthcare needs of women with GDM should be considered throughout service and care planning to promote optimal outcomes for women and babies.</div></div>","PeriodicalId":48868,"journal":{"name":"Women and Birth","volume":"39 1","pages":"Article 102147"},"PeriodicalIF":4.1,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145624570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Setting the frame: How midwives balance professional accountability with birth autonomy in Germany. A grounded theory study","authors":"Marie Tallarek ,&nbsp;Julia Leinweber ,&nbsp;Annemarie Jost ,&nbsp;Jacob Spallek","doi":"10.1016/j.wombi.2025.102143","DOIUrl":"10.1016/j.wombi.2025.102143","url":null,"abstract":"<div><h3>Introduction</h3><div>Promoting birthing persons’ autonomy is essential to woman-centred maternity care and associated with birthing persons’ positive birth experiences. Although midwives play a crucial role in promoting or hindering birth autonomy, little is known about how they navigate birth autonomy in Germany. This study aimed to identify midwives’ experiences and strategies of engaging with birthing persons’ autonomy in different German settings.</div></div><div><h3>Material and methodology</h3><div>Semi-structured interviews were conducted with 12 midwives from hospitals, birth centres, and home birth environments in Germany. The interviews were recorded, transcribed verbatim, and analysed according to Grounded Theory Methodology (GTM) developed by Strauss &amp; Corbin. In total, 2944 codes were grouped into five categories (“Phenomenon”, “Causal conditions”, “Context”, “Action strategies”, and “Consequences”) and integrated into one model. Elements of Reflexive GTM facilitated the reflection on researcher positionality.</div></div><div><h3>Results</h3><div>Midwives continuously balance multiple, often competing, demands, among them the need to define a framework that gives them confidence to stand behind every aspect of the care they provide. The midwives achieve this by interpreting various contextual conditions, prioritising them, defining their professional boundaries and options, and matching maternal preferences with these. Throughout the birth process, they monitor changes and dynamically adjust established boundaries as needed.</div></div><div><h3>Discussion</h3><div>The study results enhance our understanding of the evolving and context-sensitive process of decision-making during childbirth. Discourses around birth autonomy would benefit from adequate terminology that reflects this complexity. In sum, this study contributes to current discourses on midwifery practice, education, and policy.</div></div>","PeriodicalId":48868,"journal":{"name":"Women and Birth","volume":"39 1","pages":"Article 102143"},"PeriodicalIF":4.1,"publicationDate":"2025-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145608119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women’s experiences of community-based midwifery continuity of care in South London: A longitudinal intersectional study","authors":"Zahra A. Khan ,&nbsp;Cristina Fernandez Turienzo ,&nbsp;Hannah Rayment-Jones ,&nbsp;Zoë Vowles ,&nbsp;Seeromanie Harding ,&nbsp;Jane Sandall","doi":"10.1016/j.wombi.2025.102137","DOIUrl":"10.1016/j.wombi.2025.102137","url":null,"abstract":"<div><h3>Problem</h3><div>Women from ethnic minority groups and those living in deprived areas are disproportionately at risks of adverse perinatal outcomes, including stillbirth, preterm birth, and poor-quality care. Despite growing policy attention, it remains unclear which interventions are most effective in addressing these inequalities.</div></div><div><h3>Background</h3><div>In the United Kingdom, a national inequalities strategy called NHS CORE20PLUS5 prioritises midwife continuity of care as a targeted intervention for women from Black, Asian and Minority Ethnic backgrounds and those living in the most deprived areas. An intersectional lens offers critical insight into overlapping systems of inequality.</div></div><div><h3>Aim</h3><div>To explore whether a place-based midwifery continuity model can improve care experiences for women living in an ethnically diverse and socially deprived area of South London</div></div><div><h3>Methods</h3><div>A longitudinal qualitative study was conducted with fifteen women who received care through a community-based continuity model. Semi-structured interviews were carried out across three timepoints: third trimester, 0–3 months postpartum, and 9–12 months postpartum. Narrative analysis informed by intersectionality explored temporal experiences across settings.</div></div><div><h3>Findings</h3><div>Two narrative themes were identified: organisational power and interpersonal power. Organisational power reflected systemic constraints, institutional fragmentation, and women’s marginalisation in standard maternity pathways which can contribute to inequity. In contrast, interpersonal power, particularly relationships with named midwives, enabled continuity, trust and engagement.</div></div><div><h3>Conclusion</h3><div>This study shows how community-based continuity models can redistribute power and enhance relational care in ways that matter to women. Findings strengthen the evidence for continuity as a protective intervention and inform future policy and service design to address perinatal inequalities.</div></div>","PeriodicalId":48868,"journal":{"name":"Women and Birth","volume":"39 1","pages":"Article 102137"},"PeriodicalIF":4.1,"publicationDate":"2025-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145590611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of Twinning up North: A qualitative exploration among Icelandic and Dutch midwives","authors":"Liselotte Kweekel ,&nbsp;Edythe L. Mangindin ,&nbsp;Franka Cadee ,&nbsp;Marianne J. Nieuwenhuijze","doi":"10.1016/j.wombi.2025.102125","DOIUrl":"10.1016/j.wombi.2025.102125","url":null,"abstract":"<div><h3>Problem</h3><div>Globally, midwives are underrepresented in leadership roles and excluded from critical decision-making processes, meaning they cannot adequately influence policy or provide high quality care and ensure women’s sexual and reproductive health and rights.</div></div><div><h3>Background</h3><div>Twinning is defined as a cross-cultural reciprocal process where two groups of people work together to achieve joint goals. Research shows that twinning between groups of midwives contributes to leadership capacity and can increase the power of midwives. In the Twinning up North project, midwives from Iceland and the Netherlands worked together to achieve joined goals.</div></div><div><h3>Aim</h3><div>The aim of this study was to explore the impact of Twinning up North on the participant midwives’ personal and professional growth.</div></div><div><h3>Methods</h3><div>Data were collected using the Most Significant Change methodology, collecting participants’ stories on the impact of the project, and subsequently conducting two focus groups to deeper explore their responses.</div></div><div><h3>Findings</h3><div>Taking part in the Twinning up North project made most participants 1. Feel inspired by other twins; 2. Feel like a leader; 3. Communicate more confidently with other professionals; 4. Promote the physiology of birth; and 5. Make midwifery visible in their communities. The basic condition for growth to occur was a positive group interaction expressed by the feeling of belonging, peer support, and building trustful relationships.</div></div><div><h3>Conclusion</h3><div>Twinning is a complex and dynamic process where growth does not occur in a linear way. However, the twinning programme can be used to promote personal and professional growth to encourage midwives to take on leadership roles.</div></div>","PeriodicalId":48868,"journal":{"name":"Women and Birth","volume":"39 1","pages":"Article 102125"},"PeriodicalIF":4.1,"publicationDate":"2025-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Ngarrama maternity service on maternal and neonatal health outcomes for First Nations women in three maternity services: a retrospective cohort study in Australia","authors":"Sonia Pervin ,&nbsp;Lauren Kearney ,&nbsp;Tara Denaro ,&nbsp;Sherry Holzapfel ,&nbsp;Jodi Dyer ,&nbsp;Phillipa E. Cole ,&nbsp;Sonita Giudice ,&nbsp;Leonie Callaway","doi":"10.1016/j.wombi.2025.102132","DOIUrl":"10.1016/j.wombi.2025.102132","url":null,"abstract":"<div><h3>Problem</h3><div>First Nations women experience health inequities that can increase the risk of adverse health outcomes. Culturally safe continuity of midwifery care is associated with improved pregnancy outcomes, yet First Nations women have had limited access to such models. In 2011, the Ngarrama Maternity Service (hereafter called Ngarrama) was established within Metro North Health, Brisbane, Queensland to provide maternity services for First Nations women and their families. However, the outcomes of the model have not been robustly evaluated.</div></div><div><h3>Aims</h3><div>This study aims to evaluate the pregnancy and birth outcomes of First Nations women and babies receiving care through Ngarrama.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was undertaken. Mothers of First Nations babies who received care from Ngarrama in urban Brisbane, between 2020 and 2021, were included. Outcomes assessed included preterm birth, birth weight, newborn morbidity, neonatal unit admission, antenatal visits, active resuscitation after birth, smoking after 20 weeks of gestation, and breastfeeding 24 h before discharge from hospital.</div></div><div><h3>Results</h3><div>1009 First Nations babies were included in the analyses: 522 in the Standard Care group and 487 in the Ngarrama care. Women receiving care within Ngarrama were less likely to give birth to a preterm baby than women receiving standard care (7.1 % compared to 11.2 %). After controlling for confounders, the Ngarrama care significantly reduced the odds of having a preterm birth (OR=0.58, 95 % CI 0.43, 0.78, p &lt; 0.001); smoking after 20 weeks of gestation (OR=0.69, 95 % CI 0.61, 0.77, p &lt; 0.001); and lower neonatal morbidity before discharge (OR=0.58, 95 % CI 0.47, 0.72, p &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>The care provided within the Ngarrama Maternity Service reduced preterm birth, smoking during pregnancy, and neonatal morbidity, confirming the effectiveness of a hospital-based continuity of midwifery care model working with community. Increased access and rollout of services of this kind are urgently needed.</div></div>","PeriodicalId":48868,"journal":{"name":"Women and Birth","volume":"39 1","pages":"Article 102132"},"PeriodicalIF":4.1,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145552339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Mid-Tech survey: Midwives’ views about the influence of intrapartum fetal surveillance technologies upon supporting women’s bodily autonomy","authors":"Rachael Woodworth ,&nbsp;Vanessa Scarf ,&nbsp;Rebecca Coddington ,&nbsp;Kate Levett ,&nbsp;Kris Rogers ,&nbsp;Deborah Fox","doi":"10.1016/j.wombi.2025.102135","DOIUrl":"10.1016/j.wombi.2025.102135","url":null,"abstract":"<div><h3>Background</h3><div>Bodily autonomy is central to respectful, woman centred care. Midwives must facilitate informed decision-making, including choices about intrapartum fetal surveillance, and uphold women’s instinctive movement and positioning.</div></div><div><h3>Aim</h3><div>To explore midwives’ perceptions of how different intrapartum fetal surveillance technologies affect their ability to support bodily autonomy.</div></div><div><h3>Methods</h3><div>The 2024 Mid-Tech survey was completed online by 396 Australian midwives. Descriptive statistics summarised responses. Adjusted logistic regression analyses examined associations between technology access and: (1) use of intermittent auscultation, and (2) perceptions of woman centred care when using continuous electronic fetal monitoring.</div></div><div><h3>Results</h3><div>Wired cardiotocography was perceived as most restrictive to mobility, followed by wireless telemetry. Fetal scalp electrodes and beltless patches were perceived as less restrictive; handheld dopplers, the least. One in four midwives reported inconsistent access to intermittent auscultation equipment (e.g., handheld doppler), only 64.6 % had adequate access to wireless continuous electronic fetal monitoring technologies. Intermittent auscultation use was low but higher among midwives with consistent equipment access (OR:3.84;95 % CI:2.21–6.68;p &lt; 0.001), and with adequate pre-registration (OR: 2.25;95 % CI:1.30–3.89;p &lt; 0.01) and post-registration training (OR:2.26;95 % CI:1.45–3.50;p &lt; 0.001). Less than 15 % of midwives believed that women being continuously monitored received woman centred care, this was more likely when access to wireless continuous electronic fetal monitoring technologies were adequate (OR:2.96;95 % CI:1.42–6.15;p &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>Consistent access to wireless continuous electronic fetal monitoring supports midwives in upholding bodily autonomy. Improving access to and education in intermittent auscultation may increase its use. Given less restrictive alternatives, wired cardiotocography devices may no longer be fit for purpose.</div></div>","PeriodicalId":48868,"journal":{"name":"Women and Birth","volume":"39 1","pages":"Article 102135"},"PeriodicalIF":4.1,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145552430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"It is mentally challenging – Understanding breastfeeding grief during the postpartum period: A qualitative descriptive study","authors":"Tumilara Aderibigbe","doi":"10.1016/j.wombi.2025.102136","DOIUrl":"10.1016/j.wombi.2025.102136","url":null,"abstract":"<div><h3>Background</h3><div>African American women are less likely to meet their breastfeeding goals compared to Non-Hispanic White women. Women who do not meet their breastfeeding goals may experience breastfeeding grief which negatively impacts their mental health. Providing therapeutic care and support to these women is likely to be difficult if their experiences of breastfeeding grief are not fully understood.</div></div><div><h3>Aim</h3><div>To explore African American women’s experiences of breastfeeding grief.</div></div><div><h3>Methods</h3><div>Using a qualitative descriptive design, individual semi-structured interviews were conducted on Zoom with a purposive sample of 16 African American women who believed they had experienced breastfeeding grief in the United States. Interviews were audio and video recorded and transcribed verbatim. Transcripts were uploaded to Dedoose and analysed using reflexive thematic analysis.</div></div><div><h3>Findings</h3><div>Participants’ mean age was 29.5 years. Five meaning-based themes of breastfeeding grief were generated. In the first theme, ‘<em>breastfeeding did not go as planned’,</em> women expressed reluctantly ceasing breastfeeding. The ‘<em>so we grieve’</em> theme encompassed breastfeeding grief emotions; sadness being the most common. In the third theme, ‘<em>because we grieve’,</em> decisions made due to, and the health impact of breastfeeding grief were discussed. The ‘<em>we want to understand</em>’ theme focused on knowing why women did not meet their breastfeeding goals. Lastly, recommendations to manage breastfeeding challenges and breastfeeding grief were summarised in the ‘<em>additional perceptions’</em> theme.</div></div><div><h3>Conclusion</h3><div>Breastfeeding grief presents with profound sadness and a sense of failure that negatively impacts maternal emotional health. If unaddressed, breastfeeding grief may continue for several years postpartum. Further research is needed to address breastfeeding grief.</div></div>","PeriodicalId":48868,"journal":{"name":"Women and Birth","volume":"39 1","pages":"Article 102136"},"PeriodicalIF":4.1,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145552391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“I often wonder if it was all worth it” – Exploring the experiences of financial hardship for Australian midwifery students","authors":"Lynnelle Moran ,&nbsp;Tanya Capper ,&nbsp;Kate Dawson ,&nbsp;Lois McKellar","doi":"10.1016/j.wombi.2025.102133","DOIUrl":"10.1016/j.wombi.2025.102133","url":null,"abstract":"<div><h3>Problem</h3><div>The need to grow the Australian midwifery workforce is well established and increasing graduate numbers is essential. Midwifery students face several challenges during their studies, one of which is financial hardship.</div></div><div><h3>Background</h3><div>Mandatory midwifery practice experiences undertaken in the clinical environment are a pre-registration requirement for Australian midwifery students. Financial hardship associated with these requirements are wide ranging and cause significant challenges for students.</div></div><div><h3>Aim</h3><div>To understand the experiences of financial hardship for midwifery students enrolled in Australian entry to practice programs.</div></div><div><h3>Methods</h3><div>An explanatory sequential mixed method design comprising two stages. For stage one, a national online survey of Australian midwifery students gathered baseline economic data and perceived causes of financial hardship. This consisted of closed and Likert scale questions with two open ended questions. Stage two involved semi-structured interviews with study participants. This paper reports on findings from stage one.</div></div><div><h3>Findings</h3><div>The survey was completed by 113 midwifery students representing most states across Australia. Thirteen percent reported annual household incomes below the poverty line and almost half indicated that financial hardship impacted their ability to complete their studies. Clinical placement was challenging, with 83 % indicating major to severe hardship during this time. While most students funded this through personal savings (77 %) many relied on family support. Responses to open-ended questions revealed seven themes, representing the multifaceted impact of financial hardship, encompassing both the students own personal experiences and broader consequences.</div></div><div><h3>Discussion</h3><div>Midwifery students face significant financial hardship exacerbated by demanding clinical requirements and limited support. Wide ranging consequences include disruption to educational progress, reduced psychological wellbeing, personal sacrifices and in some cases, loss of financial independence. Critically, students recognised the risk to the midwifery profession.</div></div><div><h3>Conclusion</h3><div>Significant financial pressures exist, requiring prompt and effective action to reduce the vulnerabilities and barriers faced by midwifery students in Australia.</div></div>","PeriodicalId":48868,"journal":{"name":"Women and Birth","volume":"39 1","pages":"Article 102133"},"PeriodicalIF":4.1,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of the Rebozo in second stage labour to reduce the incidence of assisted vaginal births for nulliparous women: A pilot randomised controlled trial","authors":"Kathy L. Hillier ,&nbsp;Victoria Eley ,&nbsp;Tracy Humphrey ,&nbsp;Emma Ballard ,&nbsp;Nigel Lee","doi":"10.1016/j.wombi.2025.102134","DOIUrl":"10.1016/j.wombi.2025.102134","url":null,"abstract":"<div><h3>Background</h3><div>Nulliparous women utilising epidural analgesia are more likely to experience fetal malposition, leading to assisted vaginal births. Current methods reducing this risk appear largely ineffective. Anecdotal reports suggest some midwives using Rebozo, a gentle rocking movement, helps prevent and correct fetal malposition, however evidence from randomised trials is lacking. Complex clinical trials require pilot testing of design feasibility to be successful.</div></div><div><h3>Aim</h3><div>To test feasibility of recruitment, retention, data collection and analysis for a fully powered randomised controlled trial of Rebozo.</div></div><div><h3>Methods</h3><div>Unblinded parallel 1:1 pilot randomised controlled trial was undertaken at two sites in Southeast Queensland. Nulliparous women with a term, singleton cephalic pregnancy using epidural analgesia were randomised to Rebozo or standard care. Primary feasibility outcomes were assessed against progression criteria.</div></div><div><h3>Results</h3><div>Three of five feasibility criteria were not met. Of 73 women eligible for participation, 65.8 % (n = 48) (&gt;80.0 % target) provided consent. Of these, 43.8 % (n = 21) became ineligible prior to randomisation at second stage labour. Completed data forms (44.0 % with target of &gt;80.0 %) and withdrawals (7.4 % with target of &lt;5 %) also failed feasibility criteria. Protocol compliance and absence of adverse events met targets.</div></div><div><h3>Discussion/Conclusion</h3><div>Effective strategies to improve recruitment, attrition and study fidelity would be required for a successful trial examining the efficacy of Rebozo in reducing assisted vaginal births for nulliparous women utilising epidural analgesia. Funding for dedicated research midwives may assist in addressing most feasibility issues.</div></div>","PeriodicalId":48868,"journal":{"name":"Women and Birth","volume":"39 1","pages":"Article 102134"},"PeriodicalIF":4.1,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women’s insights into choice, empowerment, and control in a subsequent pregnancy following a negative birth experience: A multimethod study","authors":"Deborah Pidd ,&nbsp;Catina Adams ,&nbsp;Michelle Newton ,&nbsp;Christine East","doi":"10.1016/j.wombi.2025.102124","DOIUrl":"10.1016/j.wombi.2025.102124","url":null,"abstract":"<div><h3>Background</h3><div>Lack of control and choice contributes to women experiencing birth as negative or distressing. Wanting a different experience in a subsequent pregnancy following a negative experience is invariably uppermost in women’s minds. A woman-centred approach is associated with a more positive maternity care experience.</div></div><div><h3>Aim</h3><div>To establish women’s agreement on elements of care that place them at the centre of their maternity care, following a negative birth experience and to identify enablers and constraints influencing perception of woman-centred care</div></div><div><h3>Methods</h3><div>This multimethod study combined quantitative and qualitative approaches to explore women’s perspectives on aspects of woman-centred care. Fifty-seven multiparous pregnant women with a history of negative maternity experiences and/or fear of birth completed a survey assessing eleven co-designed elements of care identified in a modified Delphi study. Fourteen of these women participated in semi-structured interviews about their current maternity care. Quantitative data were analysed using descriptive statistics, and qualitative data using content and thematic analysis.</div></div><div><h3>Findings</h3><div>Women valued acknowledgment of previous experiences and comprehensive information supporting informed decision-making and control. Holistic care from known caregivers enhanced these outcomes, although some women felt centred in their care when supported by unknown clinicians who adopted woman-centred practices.</div></div><div><h3>Conclusion</h3><div>Meeting women's values, preferences, and informational needs promotes a sense of control and empowerment. Continuity of care enhances woman-centred approaches, though relational care can also be provided within fragmented systems. Continuity during pregnancy should be prioritised for women who have experienced a negative birth experience and have a current fear of birth.</div></div>","PeriodicalId":48868,"journal":{"name":"Women and Birth","volume":"39 1","pages":"Article 102124"},"PeriodicalIF":4.1,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145442526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}