Pub Date : 2023-11-02DOI: 10.12968/bjom.2023.31.11.634
Danielle Jacob
Background/Aims Postpartum haemorrhage is a global concern and is a leading cause of maternal mortality in low- and middle-income countries. Oxytocin is the preferred prophylactic uterotonic; however, it is heat sensitive and therefore may not be suitable in low- and middle-income countries, which are often warm climates. An alternative is carbetocin, which is heat stable and longer acting. Methods Literature was sourced from the EBSCO, CINAHL, Medline and Global Health databases. Studies written in English in the last 10 years, that compared carbetocin to oxytocin in management of postpartum haemorrhage were selected. An ABCDFIX mnemonic tool was used to individually critique each study. Results The key themes were postpartum haemorrhage over 500ml, postpartum haemorrhage over 1000ml, need for blood transfusion, retained placenta, haemoglobin levels and need for additional uterotonics. The use of carbetocin may reduce the risk of postpartum haemorrhage and the need for additional uterotonics in low- and middle-income countries. Conclusions The use of carbetocin, instead of oxytocin, in low- and middle-income countries may reduce the risk of postpartum haemorrhage after vaginal birth and the need for more uterotonics. However, more research is needed in these settings.
{"title":"Carbetocin vs oxytocin in third stage labour: a quantitative review of low- and middle-income countries","authors":"Danielle Jacob","doi":"10.12968/bjom.2023.31.11.634","DOIUrl":"https://doi.org/10.12968/bjom.2023.31.11.634","url":null,"abstract":"Background/Aims Postpartum haemorrhage is a global concern and is a leading cause of maternal mortality in low- and middle-income countries. Oxytocin is the preferred prophylactic uterotonic; however, it is heat sensitive and therefore may not be suitable in low- and middle-income countries, which are often warm climates. An alternative is carbetocin, which is heat stable and longer acting. Methods Literature was sourced from the EBSCO, CINAHL, Medline and Global Health databases. Studies written in English in the last 10 years, that compared carbetocin to oxytocin in management of postpartum haemorrhage were selected. An ABCDFIX mnemonic tool was used to individually critique each study. Results The key themes were postpartum haemorrhage over 500ml, postpartum haemorrhage over 1000ml, need for blood transfusion, retained placenta, haemoglobin levels and need for additional uterotonics. The use of carbetocin may reduce the risk of postpartum haemorrhage and the need for additional uterotonics in low- and middle-income countries. Conclusions The use of carbetocin, instead of oxytocin, in low- and middle-income countries may reduce the risk of postpartum haemorrhage after vaginal birth and the need for more uterotonics. However, more research is needed in these settings.","PeriodicalId":52489,"journal":{"name":"British Journal of Midwifery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135933499","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 : 2023-11-02DOI: 10.12968/bjom.2023.31.11.652
Ines Salmoral, Denise McGuinness
Ines Salmoral and Denise McGuinness reflect on whether human donor milk should be made available for healthy term infants in the maternity setting
伊内斯·萨莫勒尔和丹尼斯·麦吉尼斯反思了是否应该为健康的足月婴儿提供人类捐赠的母乳
{"title":"Human Donor Milk in Maternity","authors":"Ines Salmoral, Denise McGuinness","doi":"10.12968/bjom.2023.31.11.652","DOIUrl":"https://doi.org/10.12968/bjom.2023.31.11.652","url":null,"abstract":"Ines Salmoral and Denise McGuinness reflect on whether human donor milk should be made available for healthy term infants in the maternity setting","PeriodicalId":52489,"journal":{"name":"British Journal of Midwifery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135972905","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 : 2023-11-02DOI: 10.12968/bjom.2023.31.11.640
Martine Pringle
Universally, maternity care is particularly susceptible to risk. In England, the safety of maternity services has been the subject of many recent enquiries, leading to media scrutiny and concerns regarding safe outcomes and positive maternity experiences. During 2020–2021, an increased number of maternity units in the East of England were placed on the national Maternity Safety Support Programme, indicating that enhanced regional support was necessary. To establish exactly what support was required, both as a region and for individual maternity units, a tool was developed and launched April 2021: the ‘sixty supportive steps to safety’. This framework was intended to provide support to maternity units, so that the maternity quadrumvirate, the local maternity and neonatal system, the trust board and the integrated care board could have confidence and assurance that their maternity services had identified any required areas of improvement. Completion of the framework also enabled units to complete the tool, as well as to showcase and share best practice across the region.
{"title":"An appraisal of the East of England ‘sixty supportive steps to safety’ tool","authors":"Martine Pringle","doi":"10.12968/bjom.2023.31.11.640","DOIUrl":"https://doi.org/10.12968/bjom.2023.31.11.640","url":null,"abstract":"Universally, maternity care is particularly susceptible to risk. In England, the safety of maternity services has been the subject of many recent enquiries, leading to media scrutiny and concerns regarding safe outcomes and positive maternity experiences. During 2020–2021, an increased number of maternity units in the East of England were placed on the national Maternity Safety Support Programme, indicating that enhanced regional support was necessary. To establish exactly what support was required, both as a region and for individual maternity units, a tool was developed and launched April 2021: the ‘sixty supportive steps to safety’. This framework was intended to provide support to maternity units, so that the maternity quadrumvirate, the local maternity and neonatal system, the trust board and the integrated care board could have confidence and assurance that their maternity services had identified any required areas of improvement. Completion of the framework also enabled units to complete the tool, as well as to showcase and share best practice across the region.","PeriodicalId":52489,"journal":{"name":"British Journal of Midwifery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135933232","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 : 2023-11-02DOI: 10.12968/bjom.2023.31.11.646
Nur Syafiqah Saime, Sarena Hashim, Siti Mazidah Mohamad, Sharimawati Sharbini, Lisa McKenna, Khadizah H Abdul-Mumin
Women who experience a miscarriage have unique needs for initial supportive care. This is particularly the case when first attending healthcare facilities, prior to referral to further care pathways, especially in the emergency department. This article explores initial care for women who experience a miscarriage, and argues that while this period might be viewed as transitional, initial supportive care is crucial as it is likely that women will experience heightened emotional turbulence. Although, at times, the transition period may be brief, it is still fundamental to provide women who may be vulnerable with optimal support. The review and discussion in this article particularly reference the context in Brunei Darussalam, but also explore the context of existing international literature.
{"title":"Initial care during miscarriage in the emergency department: a discussion of international context","authors":"Nur Syafiqah Saime, Sarena Hashim, Siti Mazidah Mohamad, Sharimawati Sharbini, Lisa McKenna, Khadizah H Abdul-Mumin","doi":"10.12968/bjom.2023.31.11.646","DOIUrl":"https://doi.org/10.12968/bjom.2023.31.11.646","url":null,"abstract":"Women who experience a miscarriage have unique needs for initial supportive care. This is particularly the case when first attending healthcare facilities, prior to referral to further care pathways, especially in the emergency department. This article explores initial care for women who experience a miscarriage, and argues that while this period might be viewed as transitional, initial supportive care is crucial as it is likely that women will experience heightened emotional turbulence. Although, at times, the transition period may be brief, it is still fundamental to provide women who may be vulnerable with optimal support. The review and discussion in this article particularly reference the context in Brunei Darussalam, but also explore the context of existing international literature.","PeriodicalId":52489,"journal":{"name":"British Journal of Midwifery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135933505","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 : 2023-11-02DOI: 10.12968/bjom.2023.31.11.610
Juliet Albert, Catrin Evans, Mary Wells
Background Female genital mutilation affects an estimated 200 million women and girls worldwide. This article examines a midwife-led service that integrates health advocates and counsellors into a model of holistic woman-centred care and was the blueprint for new national clinics opened in 2019. Methods This retrospective case note review examined referral patterns, clinical findings and interventions over 11 years at a UK specialist clinic for non-pregnant women with female genital mutilation. Results More than 2000 consultations were conducted. Two thirds of women had type 3 mutilation. Most were Somali (73.4%) with 18 other ethnic backgrounds represented. Women presented with dysuria, dyspareunia/apareunia, dysmenorrhea, recurrent infections, post-traumatic stress disorder, nightmares, flashbacks and psychosexual issues. Interventions included deinfibulation under local anaesthetic (many as same day walk-in cases), clinical reports for asylum applications and trauma counselling. One in 10 attendees were healthcare professionals/carers. Nearly 5% were refugees/asylum seekers. There were 12 safeguarding referrals, three cases of mandatory reporting duty and two protection orders. Intersectional violence was frequently reported among women of West African origin. Conclusions Significant numbers of non-pregnant women require specialist help. Innovative means to publicise clinics and routine enquiry during gynaecological consultations and GP registration, could ensure earlier signposting to services. Deinfibulation can be safely performed by an expert midwife in a community or outpatient setting.
{"title":"Analysis of a specialist service for non-pregnant women with female genital mutilation: 2008–2019","authors":"Juliet Albert, Catrin Evans, Mary Wells","doi":"10.12968/bjom.2023.31.11.610","DOIUrl":"https://doi.org/10.12968/bjom.2023.31.11.610","url":null,"abstract":"Background Female genital mutilation affects an estimated 200 million women and girls worldwide. This article examines a midwife-led service that integrates health advocates and counsellors into a model of holistic woman-centred care and was the blueprint for new national clinics opened in 2019. Methods This retrospective case note review examined referral patterns, clinical findings and interventions over 11 years at a UK specialist clinic for non-pregnant women with female genital mutilation. Results More than 2000 consultations were conducted. Two thirds of women had type 3 mutilation. Most were Somali (73.4%) with 18 other ethnic backgrounds represented. Women presented with dysuria, dyspareunia/apareunia, dysmenorrhea, recurrent infections, post-traumatic stress disorder, nightmares, flashbacks and psychosexual issues. Interventions included deinfibulation under local anaesthetic (many as same day walk-in cases), clinical reports for asylum applications and trauma counselling. One in 10 attendees were healthcare professionals/carers. Nearly 5% were refugees/asylum seekers. There were 12 safeguarding referrals, three cases of mandatory reporting duty and two protection orders. Intersectional violence was frequently reported among women of West African origin. Conclusions Significant numbers of non-pregnant women require specialist help. Innovative means to publicise clinics and routine enquiry during gynaecological consultations and GP registration, could ensure earlier signposting to services. Deinfibulation can be safely performed by an expert midwife in a community or outpatient setting.","PeriodicalId":52489,"journal":{"name":"British Journal of Midwifery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135933497","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 : 2023-11-02DOI: 10.12968/bjom.2023.31.11.656
Tamara Kubba, Ilana Pizer-Mason, Isabelle Cornet, Meg Wilson
In the wake of the Ockenden report, a new initiative has been established at the Whittington Health NHS Trust, to discuss and reflect on patient safety
在奥肯登报告之后，惠廷顿健康NHS信托基金建立了一项新的倡议，以讨论和反思患者安全
{"title":"The Ockenden café initiative","authors":"Tamara Kubba, Ilana Pizer-Mason, Isabelle Cornet, Meg Wilson","doi":"10.12968/bjom.2023.31.11.656","DOIUrl":"https://doi.org/10.12968/bjom.2023.31.11.656","url":null,"abstract":"In the wake of the Ockenden report, a new initiative has been established at the Whittington Health NHS Trust, to discuss and reflect on patient safety","PeriodicalId":52489,"journal":{"name":"British Journal of Midwifery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135933500","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}
Background The maternal mortality rate in Pakistan is high, which has been attributed partly to delays in accessing healthcare for women who are pregnant and in labour. This study aimed to explore the community's perspectives of delays to use of health services in pregnancy and labour, using the ‘three delays’ model and the framework for determinants of maternal mortality. Methods An explorative-descriptive approach was used, with purposeful sampling of 382 participants selected from across Pakistan. Four groups of participants were selected: married women, married men, adolescent girls and adolescent boys. Results Several factors led to delays seeking healthcare. Women were unable to decide for themselves whether to attend a healthcare facility, there were issues reaching a facility in time and at the facility, either the resources or healthcare workers were lacking. Conclusions Women must be given education and access to healthcare in order to reduce maternal mortality and morbidity.
{"title":"Maternal mortality and morbidity in Pakistan: a situational analysis","authors":"Nimira Asif, Farzana Adnan, Shahnaz Shahid Ali, Zahid Memon, Tazeen Saeed Ali","doi":"10.12968/bjom.2023.31.11.623","DOIUrl":"https://doi.org/10.12968/bjom.2023.31.11.623","url":null,"abstract":"Background The maternal mortality rate in Pakistan is high, which has been attributed partly to delays in accessing healthcare for women who are pregnant and in labour. This study aimed to explore the community's perspectives of delays to use of health services in pregnancy and labour, using the ‘three delays’ model and the framework for determinants of maternal mortality. Methods An explorative-descriptive approach was used, with purposeful sampling of 382 participants selected from across Pakistan. Four groups of participants were selected: married women, married men, adolescent girls and adolescent boys. Results Several factors led to delays seeking healthcare. Women were unable to decide for themselves whether to attend a healthcare facility, there were issues reaching a facility in time and at the facility, either the resources or healthcare workers were lacking. Conclusions Women must be given education and access to healthcare in order to reduce maternal mortality and morbidity.","PeriodicalId":52489,"journal":{"name":"British Journal of Midwifery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135933498","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 : 2023-10-02DOI: 10.12968/bjom.2023.31.10.597
George F Winter
George F Winter discusses the prevalence of reports highlighting bullying in midwifery, and the evidence for ways to address this issue
乔治·F·温特(George F Winter)讨论了突出助产士欺凌行为的报告的普遍性，以及解决这一问题的方法的证据
{"title":"Bullying in the workplace","authors":"George F Winter","doi":"10.12968/bjom.2023.31.10.597","DOIUrl":"https://doi.org/10.12968/bjom.2023.31.10.597","url":null,"abstract":"George F Winter discusses the prevalence of reports highlighting bullying in midwifery, and the evidence for ways to address this issue","PeriodicalId":52489,"journal":{"name":"British Journal of Midwifery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135901266","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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