Pub Date : 2024-05-02DOI: 10.12968/bjom.2024.32.5.226
Roisin Lennon
‘Labour hopscotch’ is a visual tool that encourages activity during pregnancy and childbirth. It has been used in one advanced midwife practitioner service since 2017 and more widely across in Ireland since 2020. The biomechanics for birth toolkit was added to advanced midwife practitioner care in 2022. This study's aim was to ascertain if the biomechanics for birth toolkit impacted gestation of spontaneous onset of labour rates and birth outcomes. A retrospective study of onset of labour and birth outcomes was conducted for women before (n=155) and after (n=154) the biomechanics for birth toolkit was incorporated into care. Before the toolkit was included, there was a 57.2% spontaneous onset of labour rate, with 33.2% birthing before 41 weeks. After the kit's inclusion, there was a 72.2% spontaneous onset of labour, with 91.8% birthing before 41 weeks. Induction rates dropped from 42.8% to 27.8%, with emergency caesarean section rates following induction dropping from 33.1% to 23.8%. Using the biomechanics for birth toolkit alongside the labour hopscotch tool could increase spontaneous onset of labour rates, optimise physiological birth, reduce inductions and emergency caesarean section following induction.
{"title":"Bouncing your way to labour and birth using biomechanics and fetal optimal positioning","authors":"Roisin Lennon","doi":"10.12968/bjom.2024.32.5.226","DOIUrl":"https://doi.org/10.12968/bjom.2024.32.5.226","url":null,"abstract":"‘Labour hopscotch’ is a visual tool that encourages activity during pregnancy and childbirth. It has been used in one advanced midwife practitioner service since 2017 and more widely across in Ireland since 2020. The biomechanics for birth toolkit was added to advanced midwife practitioner care in 2022. This study's aim was to ascertain if the biomechanics for birth toolkit impacted gestation of spontaneous onset of labour rates and birth outcomes. A retrospective study of onset of labour and birth outcomes was conducted for women before (n=155) and after (n=154) the biomechanics for birth toolkit was incorporated into care. Before the toolkit was included, there was a 57.2% spontaneous onset of labour rate, with 33.2% birthing before 41 weeks. After the kit's inclusion, there was a 72.2% spontaneous onset of labour, with 91.8% birthing before 41 weeks. Induction rates dropped from 42.8% to 27.8%, with emergency caesarean section rates following induction dropping from 33.1% to 23.8%. Using the biomechanics for birth toolkit alongside the labour hopscotch tool could increase spontaneous onset of labour rates, optimise physiological birth, reduce inductions and emergency caesarean section following induction.","PeriodicalId":52489,"journal":{"name":"British Journal of Midwifery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141022313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-02DOI: 10.12968/bjom.2024.32.5.270
Juliet Albert
Juliet Albert explores a new project, ACERS-UK, which is currently underway and aiming to improve specialist service provision for survivors of female genital mutilation
{"title":"Improving specialist services for FGM","authors":"Juliet Albert","doi":"10.12968/bjom.2024.32.5.270","DOIUrl":"https://doi.org/10.12968/bjom.2024.32.5.270","url":null,"abstract":"Juliet Albert explores a new project, ACERS-UK, which is currently underway and aiming to improve specialist service provision for survivors of female genital mutilation","PeriodicalId":52489,"journal":{"name":"British Journal of Midwifery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141019583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-02DOI: 10.12968/bjom.2024.32.5.258
Linda J Deys, Valerie Wilson, Sara Bayes, Shahla Meedya
How a woman experiences birth is influenced by how she is treated, and who has power and control in the birthing environment. Focus on ‘delivery’ of an infant disregards the transformative event for the woman, with poorer physical and psychological outcomes. New evidence is needed to understand how to prevent trauma and improve maternal wellbeing. This paper presents a feminist methodology to view the lived experience of caesarean birth. Feminist birthing theories integrated with a phenomenological perspective provide insight for those working in maternity care and create a novel framework for researchers considering the position of women in a medicalised healthcare system. Feminist phenomenology with a theoretical feminist overlay refreshes the methodological framework for a new understanding of how this perinatal event impacts women.
{"title":"Using a novel approach to explore women's caesarean birth experience","authors":"Linda J Deys, Valerie Wilson, Sara Bayes, Shahla Meedya","doi":"10.12968/bjom.2024.32.5.258","DOIUrl":"https://doi.org/10.12968/bjom.2024.32.5.258","url":null,"abstract":"How a woman experiences birth is influenced by how she is treated, and who has power and control in the birthing environment. Focus on ‘delivery’ of an infant disregards the transformative event for the woman, with poorer physical and psychological outcomes. New evidence is needed to understand how to prevent trauma and improve maternal wellbeing. This paper presents a feminist methodology to view the lived experience of caesarean birth. Feminist birthing theories integrated with a phenomenological perspective provide insight for those working in maternity care and create a novel framework for researchers considering the position of women in a medicalised healthcare system. Feminist phenomenology with a theoretical feminist overlay refreshes the methodological framework for a new understanding of how this perinatal event impacts women.","PeriodicalId":52489,"journal":{"name":"British Journal of Midwifery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141019614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-02DOI: 10.12968/bjom.2024.32.5.233
Lynn Jones
Patient experience is needed to understand if a service is meeting the needs of the population it serves. In rural areas, accessing maternity services can be challenging for women. Local provision should be explored and consistently reviewed to adapt to changing social requirements and expectations. The aim of this study was to examine a rural midwifery-led ultrasound service 5 years after implementation and post COVID-19, to ascertain if the service provides a positive service user experience. A qualitative service evaluation was carried out using semi-structured interviews with four service users. Data were analysed using content analysis. Positive aspects of the service included continuity of care, communication, time to care, financial benefits and inclusivity in care and care decisions. It was noted that the ultrasound service was in the opposite direction from their homes to the obstetric service if participants needed to be referred for consultant opinion the same day. The significant underlying theme was the positive impact on mental wellbeing and patient experience in pregnancy when attending the service. There was a high level of satisfaction with the service. Engagement of a broader spectrum of women would provide deeper insight into the service and robust evidence for any service development.
{"title":"Qualitative service evaluation of a rural midwife-led ultrasound service: listening to women","authors":"Lynn Jones","doi":"10.12968/bjom.2024.32.5.233","DOIUrl":"https://doi.org/10.12968/bjom.2024.32.5.233","url":null,"abstract":"Patient experience is needed to understand if a service is meeting the needs of the population it serves. In rural areas, accessing maternity services can be challenging for women. Local provision should be explored and consistently reviewed to adapt to changing social requirements and expectations. The aim of this study was to examine a rural midwifery-led ultrasound service 5 years after implementation and post COVID-19, to ascertain if the service provides a positive service user experience. A qualitative service evaluation was carried out using semi-structured interviews with four service users. Data were analysed using content analysis. Positive aspects of the service included continuity of care, communication, time to care, financial benefits and inclusivity in care and care decisions. It was noted that the ultrasound service was in the opposite direction from their homes to the obstetric service if participants needed to be referred for consultant opinion the same day. The significant underlying theme was the positive impact on mental wellbeing and patient experience in pregnancy when attending the service. There was a high level of satisfaction with the service. Engagement of a broader spectrum of women would provide deeper insight into the service and robust evidence for any service development.","PeriodicalId":52489,"journal":{"name":"British Journal of Midwifery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141018428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Support for antenatal screening","authors":"Katy MacWard","doi":"10.12968/bjom.2024.32.5.222","DOIUrl":"https://doi.org/10.12968/bjom.2024.32.5.222","url":null,"abstract":"Katy MacWard, from Antenatal Results and Choices, discusses the charity's work to support parents throughout antenatal screening and diagnosis.","PeriodicalId":52489,"journal":{"name":"British Journal of Midwifery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141020361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Learning from bereaved parents","authors":"Mehali Patel, Julia Clark","doi":"10.12968/bjom.2024.32.4.170","DOIUrl":"https://doi.org/10.12968/bjom.2024.32.4.170","url":null,"abstract":"Mehali Patel and Julia Clark discuss the Sands Listening Project, and what was learnt from the experiences of Black and Asian bereaved parents","PeriodicalId":52489,"journal":{"name":"British Journal of Midwifery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140352444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-02DOI: 10.12968/bjom.2024.32.4.202
Sam Chenery-Morris, Jo Divers
This series of six articles is inspired by themes arising from the Royal College of Midwives State of Midwifery Education report. The series explores the current landscape and challenges in educating the future midwifery workforce, particularly those that pertain to the higher education workforce. This second article highlights some of the inequalities experienced by the majority female midwifery education workforce and their impact, exploring how these inequalities are symptomatic of many of the inequalities women experience more generally within patriarchal structures. The article examines if midwifery education is ‘women's work’, and how this can work to impede progression in leadership, research and scholarship for midwifery academics. How midwifery curricula can influence the future academic workforce in dismantling inequality is also considered.
{"title":"The gender debate: is midwifery education ‘women's work’?","authors":"Sam Chenery-Morris, Jo Divers","doi":"10.12968/bjom.2024.32.4.202","DOIUrl":"https://doi.org/10.12968/bjom.2024.32.4.202","url":null,"abstract":"This series of six articles is inspired by themes arising from the Royal College of Midwives State of Midwifery Education report. The series explores the current landscape and challenges in educating the future midwifery workforce, particularly those that pertain to the higher education workforce. This second article highlights some of the inequalities experienced by the majority female midwifery education workforce and their impact, exploring how these inequalities are symptomatic of many of the inequalities women experience more generally within patriarchal structures. The article examines if midwifery education is ‘women's work’, and how this can work to impede progression in leadership, research and scholarship for midwifery academics. How midwifery curricula can influence the future academic workforce in dismantling inequality is also considered.","PeriodicalId":52489,"journal":{"name":"British Journal of Midwifery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140352553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-02DOI: 10.12968/bjom.2024.32.4.180
Vikki Stuart, Ellen Kitson-Reynolds
Autism is a neurodevelopmental disability affecting interpersonal communication and interaction, and has a prevalence of more than 1% of the population. This review aimed to identify what midwives in England can learn from studies exploring the experiences of autistic women in the antenatal, intrapartum and early postnatal periods. A systematic literature search was conducted using seven electronic databases. Thematic analysis was performed, based on Braun and Clarke. Three themes were found: autism diagnosis and disclosure, communication and interaction with healthcare professionals, babies and groups, and sensory difficulties. Autistic women experience many challenges during the antenatal, intrapartum and early postnatal periods, and it is clear that midwives in England should treat all women as an individual, asking about their specific needs and any adjustments that can be made to provide inclusive care.
{"title":"Autistic women's experiences of the antenatal, intrapartum and early postnatal periods","authors":"Vikki Stuart, Ellen Kitson-Reynolds","doi":"10.12968/bjom.2024.32.4.180","DOIUrl":"https://doi.org/10.12968/bjom.2024.32.4.180","url":null,"abstract":"Autism is a neurodevelopmental disability affecting interpersonal communication and interaction, and has a prevalence of more than 1% of the population. This review aimed to identify what midwives in England can learn from studies exploring the experiences of autistic women in the antenatal, intrapartum and early postnatal periods. A systematic literature search was conducted using seven electronic databases. Thematic analysis was performed, based on Braun and Clarke. Three themes were found: autism diagnosis and disclosure, communication and interaction with healthcare professionals, babies and groups, and sensory difficulties. Autistic women experience many challenges during the antenatal, intrapartum and early postnatal periods, and it is clear that midwives in England should treat all women as an individual, asking about their specific needs and any adjustments that can be made to provide inclusive care.","PeriodicalId":52489,"journal":{"name":"British Journal of Midwifery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140352655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-04-02DOI: 10.12968/bjom.2024.32.4.190
Thuan Phan, Andrew D Weeks
With increasing global rates of postpartum haemorrhage, recent developments aim to ensure that birthing women are safe. This focused review will discuss developments in prediction of postpartum haemorrhage, blood loss measurement, uterotonic use and the thromboelastogram, aiming to improve prevention and treatment of postpartum haemorrhage. The unpredictable nature of postpartum haemorrhage is a significant hurdle, as all women must be considered at risk, imposing a heavy burden on healthcare services. Evidence-based tools have shown promise in improving prediction and management strategies. However, the lack of consensus and agreement on risk factors presents obstacles to developing accurate models. Ongoing research is exploring the development of an individual postpartum haemorrhage risk index, providing personalised care to pregnant women. Accurate blood loss quantification is essential for prompt postpartum haemorrhage diagnosis and appropriate interventions, but challenging in busy clinical settings. Recent advancements in prophylaxis and treatment using medication (uterotonics and tranexamic acid), as well as in monitoring using thromboelastograms, emphasise the need for effective prediction and management strategies. This critical review underscores the need for further research to enhance prediction tools, refine management protocols and address existing challenges to improve maternal outcomes.
{"title":"Postpartum haemorrhage: latest developments in prediction, drug treatment and monitoring","authors":"Thuan Phan, Andrew D Weeks","doi":"10.12968/bjom.2024.32.4.190","DOIUrl":"https://doi.org/10.12968/bjom.2024.32.4.190","url":null,"abstract":"With increasing global rates of postpartum haemorrhage, recent developments aim to ensure that birthing women are safe. This focused review will discuss developments in prediction of postpartum haemorrhage, blood loss measurement, uterotonic use and the thromboelastogram, aiming to improve prevention and treatment of postpartum haemorrhage. The unpredictable nature of postpartum haemorrhage is a significant hurdle, as all women must be considered at risk, imposing a heavy burden on healthcare services. Evidence-based tools have shown promise in improving prediction and management strategies. However, the lack of consensus and agreement on risk factors presents obstacles to developing accurate models. Ongoing research is exploring the development of an individual postpartum haemorrhage risk index, providing personalised care to pregnant women. Accurate blood loss quantification is essential for prompt postpartum haemorrhage diagnosis and appropriate interventions, but challenging in busy clinical settings. Recent advancements in prophylaxis and treatment using medication (uterotonics and tranexamic acid), as well as in monitoring using thromboelastograms, emphasise the need for effective prediction and management strategies. This critical review underscores the need for further research to enhance prediction tools, refine management protocols and address existing challenges to improve maternal outcomes.","PeriodicalId":52489,"journal":{"name":"British Journal of Midwifery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140352416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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