Pub Date : 2025-12-10DOI: 10.1016/j.srhc.2025.101175
Solomon Hailemeskel Beshah , Kerstin Erlandsson , Tesfanesh Lemma , Esther Lloyd , Hana Nigussie Teshome , Helena Lindgren
Background
Midwifery models of Care (MiMoC) is not standardized in in low-resourced settings, limiting the ability to evaluate the feasibility and effective in improving maternal and neonatal health outcomes compared to a standard care model.
Methods and trial
This article describes and discusses rationale, study protocol, and randomisation process for a study that will randomly allocate 1,654 pregnant women to receive or not receive MiMoC in four selected health facilities in Debre Berhan town, Ethiopia. Women will be randomly assigned to either the MiMoC group (Group A) or the standard care model (Group B) using a computer-generated randomisation scheme. In the MiMoC arm (intervention group), women will receive care during pregnancy, labour and birth, and immediate postnatal care from a single midwife or backup midwifes. Conversely, the standard care arm will involve care from various staff members at different times. To evaluate the effect of continuity of midwifery care, the principal maternal health outcome of the study will be the proportion of women having a spontaneous vaginal birth. The primary neonatal health outcome will be the proportion of neonates born preterm. In February 2025, we began recruiting women for the main study. The intervention group will be compared with the control group using an intention-to-treat analysis. Ors and 95% CIs will be estimated. The study was approved by Debre Berhan University’s Institutional Review Board and the Swedish National Ethical Review Authority.
{"title":"Remodeling maternal health care: evaluating the impact of implementing the midwifery model of care on maternal and neonatal health outcomes in Ethiopia: The MiMoC project","authors":"Solomon Hailemeskel Beshah , Kerstin Erlandsson , Tesfanesh Lemma , Esther Lloyd , Hana Nigussie Teshome , Helena Lindgren","doi":"10.1016/j.srhc.2025.101175","DOIUrl":"10.1016/j.srhc.2025.101175","url":null,"abstract":"<div><h3>Background</h3><div>Midwifery models of Care (MiMoC) is not standardized in in low-resourced settings, limiting the ability to evaluate the feasibility and effective in improving maternal and neonatal health outcomes compared to a standard care model.</div></div><div><h3>Methods and trial</h3><div>This article describes and discusses rationale, study protocol, and randomisation process for a study that will randomly allocate 1,654 pregnant women to receive or not receive MiMoC in four selected health facilities in Debre Berhan town, Ethiopia. Women will be randomly assigned to either the MiMoC group (Group A) or the standard care model (Group B) using a computer-generated randomisation scheme. In the MiMoC arm (intervention group), women will receive care during pregnancy, labour and birth, and immediate postnatal care from a single midwife or backup midwifes. Conversely, the standard care arm will involve care from various staff members at different times. To evaluate the effect of continuity of midwifery care, the principal maternal health outcome of the study will be the proportion of women having a spontaneous vaginal birth. The primary neonatal health outcome will be the proportion of neonates born preterm. In February 2025, we began recruiting women for the main study. The intervention group will be compared with the control group using an intention-to-treat analysis. Ors and 95% CIs will be estimated. The study was approved by Debre Berhan University’s Institutional Review Board and the Swedish National Ethical Review Authority.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"47 ","pages":"Article 101175"},"PeriodicalIF":1.7,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-05DOI: 10.1016/j.srhc.2025.101173
Márcia Conceição , Ana Sofia Ferreira , Rita Seabra , Maria Conceição Freitas , Juan Miguel Martinez-Galiano , Bruno Magalhães
Background
Persistent inequalities shape women’s access to and experiences of contraceptive care. Improving care quality requires a clearer understanding of women-provider interactions. This study aimed to synthesise women’s and healthcare providers’ experiences of contraceptive counselling.
Methods
This qualitative systematic review with inductive thematic synthesis followed the JBI methodology. Eligible studies in English, Portuguese, or Spanish published from database inception to 16 June 2025 were identified in CINAHL Ultimate, MedicLatina, MEDLINE Ultimate, the Psychology and Behavioral Sciences Collection, and Scopus. An initial limited search, development of search terms, and comprehensive database searches were undertaken; the PRISMA flow diagram summarised study selection. Two reviewers independently appraised quality using the JBI Critical Appraisal Checklist for Qualitative Research, and extracted data on study objectives, design, setting, participants, and main themes using a standardised form.
Results
Nine studies met the inclusion criteria. Six explored women’s experiences, two examined healthcare providers’ experiences, and one addressed both. Three overarching themes emerged: Contraceptive Engagement, Woman-Provider Relationship, and Decision-Making Process. Women and healthcare providers identified economic constraints, religious beliefs, and information gaps as common obstacles to contraceptive engagement.
Healthcare providers emphasised woman-centred care, aligning with women’s preference for non-judgemental, proactive, and respectful counselling. The decision-making process was the most prominent theme, with informed and respected decisions serving as central facilitators.
Conclusion
High-quality counselling requires recognising women’s needs and adopting empowerment strategies. Integrating these insights into services and expanding counselling delivered by trained healthcare providers are essential to improve access and quality. Further research should inform education and training programmes.
背景：持续的不平等影响了妇女获得避孕护理的机会和经验。提高护理质量需要更清楚地了解妇女与提供者之间的相互作用。这项研究的目的是综合妇女和保健提供者的避孕咨询经验。方法：采用JBI方法，采用归纳主题综合法进行定性系统评价。从数据库建立到2025年6月16日，在CINAHL Ultimate、MedicLatina、MEDLINE Ultimate、psychological and Behavioral Sciences Collection和Scopus中确定了符合条件的英语、葡萄牙语或西班牙语研究。进行了最初的有限搜索、搜索术语的开发和全面的数据库搜索；PRISMA流程图总结了研究选择。两位审稿人使用JBI定性研究关键评估清单独立评估质量，并使用标准化表格提取有关研究目标、设计、设置、参与者和主题的数据。结果：9项研究符合纳入标准。其中六篇研究了女性的经历，两篇研究了医疗服务提供者的经历，一篇研究了两者。出现了三个主要主题：避孕参与、妇女与提供者的关系和决策过程。妇女和卫生保健提供者认为经济限制、宗教信仰和信息差距是避孕措施实施的常见障碍。医疗保健提供者强调以妇女为中心的护理，这符合妇女对非评判性、前瞻性和尊重性咨询的偏好。决策过程是最突出的主题，知情和受尊重的决定是主要的促进因素。结论：高质量的咨询需要认识到妇女的需求并采取赋权策略。将这些见解纳入服务并扩大由训练有素的保健提供者提供的咨询，对于改善获取和质量至关重要。进一步的研究应为教育和培训方案提供信息。
{"title":"Women’s and healthcare providers’ experiences of contraceptive counselling: a qualitative systematic review","authors":"Márcia Conceição , Ana Sofia Ferreira , Rita Seabra , Maria Conceição Freitas , Juan Miguel Martinez-Galiano , Bruno Magalhães","doi":"10.1016/j.srhc.2025.101173","DOIUrl":"10.1016/j.srhc.2025.101173","url":null,"abstract":"<div><h3>Background</h3><div>Persistent inequalities shape women’s access to and experiences of contraceptive care. Improving care quality requires a clearer understanding of women-provider interactions. This study aimed to synthesise women’s and healthcare providers’ experiences of contraceptive counselling.</div></div><div><h3>Methods</h3><div>This qualitative systematic review with inductive thematic synthesis followed the JBI methodology. Eligible studies in English, Portuguese, or Spanish published from database inception to 16 June 2025 were identified in CINAHL Ultimate, MedicLatina, MEDLINE Ultimate, the Psychology and Behavioral Sciences Collection, and Scopus. An initial limited search, development of search terms, and comprehensive database searches were undertaken; the PRISMA flow diagram summarised study selection. Two reviewers independently appraised quality using the JBI Critical Appraisal Checklist for Qualitative Research, and extracted data on study objectives, design, setting, participants, and main themes using a standardised form.</div></div><div><h3>Results</h3><div>Nine studies met the inclusion criteria. Six explored women’s experiences, two examined healthcare providers’ experiences, and one addressed both. Three overarching themes emerged: Contraceptive Engagement, Woman-Provider Relationship, and Decision-Making Process. Women and healthcare providers identified economic constraints, religious beliefs, and information gaps as common obstacles to contraceptive engagement.</div><div>Healthcare providers emphasised woman-centred care, aligning with women’s preference for non-judgemental, proactive, and respectful counselling. The decision-making process was the most prominent theme, with informed and respected decisions serving as central facilitators.</div></div><div><h3>Conclusion</h3><div>High-quality counselling requires recognising women’s needs and adopting empowerment strategies. Integrating these insights into services and expanding counselling delivered by trained healthcare providers are essential to improve access and quality. Further research should inform education and training programmes.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"47 ","pages":"Article 101173"},"PeriodicalIF":1.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146004749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pregnancy with Type 2 Diabetes Mellitus (T2DM) requires intensified medical management and self-care. However, little is known about how women experience pregnancy while living with T2DM.
Aim
To explore the pregnancy experiences of women living with T2DM.
Methods
A qualitative interview study was conducted at a specialist antenatal clinic in a university hospital in Sweden. Eleven women with a pre-pregnancy diagnosis of T2DM participated in semi-structured interviews. Data were analysed inductively using Braun and Clarke’s reflexive thematic analysis.
Findings
One overarching theme was identified: Pushed to the limit, driven by love, supported by four sub-themes. (1) A familiar diagnosis, but an unfamiliar experience described how women felt unprepared for the physical and emotional demands of pregnancy. (2) Blood glucose levels: intense monitoring and inconsistent communication highlighted how continuous monitoring was both supportive and overwhelming, with conflicting advice contributing to uncertainty. (3) When medical care outweighs emotional support captured mixed care experiences, including instances of weight stigma and lack of holistic support. (4) Pregnancy as a mental and physical trial reflected the strain of managing T2DM, while also showing the women’s determination, fueled by their care for the unborn child.
Discussion
The findings show that women with T2DM navigate a complex pregnancy experience marked by clinical intensity, emotional pressure, and inconsistent support. Despite this, their motivation to protect their babies helped them persevere.
Conclusion
Antenatal care for women with T2DM should be adapted to their specific needs, with emphasis on routine preconception counselling, coherent care pathways, and empathetic, person-centred communication.
{"title":"Pushed to the limit, driven by love: A qualitative study of women’s experiences of pregnancy with type 2 diabetes mellitus","authors":"Karolina Linden , Karolina Ericson , Anneli Törnroos , Malin Bogren","doi":"10.1016/j.srhc.2025.101174","DOIUrl":"10.1016/j.srhc.2025.101174","url":null,"abstract":"<div><h3>Background</h3><div>Pregnancy with Type 2 Diabetes Mellitus (T2DM) requires intensified medical management and self-care. However, little is known about how women experience pregnancy while living with T2DM.</div></div><div><h3>Aim</h3><div>To explore the pregnancy experiences of women living with T2DM.</div></div><div><h3>Methods</h3><div>A qualitative interview study was conducted at a specialist antenatal clinic in a university hospital in Sweden. Eleven women with a pre-pregnancy diagnosis of T2DM participated in semi-structured interviews. Data were analysed inductively using Braun and Clarke’s reflexive thematic analysis.</div></div><div><h3>Findings</h3><div>One overarching theme was identified: <em>Pushed to the limit, driven by love</em>, supported by four sub-themes. <em>(1) A familiar diagnosis, but an unfamiliar experience</em> described how women felt unprepared for the physical and emotional demands of pregnancy. <em>(2) Blood glucose levels: intense monitoring and inconsistent communication</em> highlighted how continuous monitoring was both supportive and overwhelming, with conflicting advice contributing to uncertainty. <em>(3) When medical care outweighs emotional support</em> captured mixed care experiences, including instances of weight stigma and lack of holistic support. <em>(4) Pregnancy as a mental and physical trial</em> reflected the strain of managing T2DM, while also showing the women’s determination, fueled by their care for the unborn child.</div></div><div><h3>Discussion</h3><div>The findings show that women with T2DM navigate a complex pregnancy experience marked by clinical intensity, emotional pressure, and inconsistent support. Despite this, their motivation to protect their babies helped them persevere.</div></div><div><h3>Conclusion</h3><div>Antenatal care for women with T2DM should be adapted to their specific needs, with emphasis on routine preconception counselling, coherent care pathways, and empathetic, person-centred communication.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"47 ","pages":"Article 101174"},"PeriodicalIF":1.7,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145694618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.srhc.2025.101171
Caesar Agula , Ayaga A. Bawah , Nathalie Kapp , Jamie L. Menzel , Samuel K. Antobam , Elisabeth Eckersberger , Erin E. Pearson
Objectives
This study examined contraceptive use before pregnancy and after medication abortion (MA) among clinic and pharmacy clients in Ghana, and factors linked to modern contraceptive uptake post-MA.
Methods
Data were drawn from a non-inferiority, prospective study of 1,974 women who obtained MA with misoprostol and mifepristone from pharmacies (n = 929) and clinics (n = 1,045) in Ghana. Descriptive statistics were generated to assess contraceptive use before pregnancy and after MA, whereas binary logistic regressions were fitted to examine the factors associated with modern contraceptive uptake post-MA.
Results
Overall, non-use of contraception increased from 57 % before pregnancy (n = 1123) to 66 % post-MA (n = 1293), a trend driven by pharmacy clients. While 55 % (n = 344) of the clinic clients who were not using any contraceptive method before pregnancy remained non-method users post-MA, 86 % (n = 434) was the case for the pharmacy group. Additionally, of the non-method users who switched to any contraceptive method after MA, a higher share of the clinic group (n = 274, 44 %) used modern contraceptive methods compared to the pharmacy group (n = 58, 12 %). The regression results revealed that receiving information on contraception and accessing MA from clinics significantly increased the odds of adopting modern contraception after MA.
Conclusions
A relatively greater share of women who accessed MA in pharmacies did not use any contraceptive method following the abortion. Additionally, receiving contraception information enhanced modern contraception adoption after MA. Findings highlight the need to develop programmes and strategies to expand the provision of contraception information to women seeking MA, including those using the pharmacy route.
{"title":"Trajectories of contraception before pregnancy and after medication abortion among women accessing clinic vs pharmacy services in Ghana","authors":"Caesar Agula , Ayaga A. Bawah , Nathalie Kapp , Jamie L. Menzel , Samuel K. Antobam , Elisabeth Eckersberger , Erin E. Pearson","doi":"10.1016/j.srhc.2025.101171","DOIUrl":"10.1016/j.srhc.2025.101171","url":null,"abstract":"<div><h3>Objectives</h3><div>This study examined contraceptive use before pregnancy and after medication abortion (MA) among clinic and pharmacy clients in Ghana, and factors linked to modern contraceptive uptake post-MA.</div></div><div><h3>Methods</h3><div>Data were drawn from a non-inferiority, prospective study of 1,974 women who obtained MA with misoprostol and mifepristone from pharmacies (n = 929) and clinics (n = 1,045) in Ghana. Descriptive statistics were generated to assess contraceptive use before pregnancy and after MA, whereas binary logistic regressions were fitted to examine the factors associated with modern contraceptive uptake post-MA.</div></div><div><h3>Results</h3><div>Overall, non-use of contraception increased from 57 % before pregnancy (n = 1123) to 66 % post-MA (n = 1293), a trend driven by pharmacy clients. While 55 % (n = 344) of the clinic clients who were not using any contraceptive method before pregnancy remained non-method users post-MA, 86 % (n = 434) was the case for the pharmacy group. Additionally, of the non-method users who switched to any contraceptive method after MA, a higher share of the clinic group (n = 274, 44 %) used modern contraceptive methods compared to the pharmacy group (n = 58, 12 %). The regression results revealed that receiving information on contraception and accessing MA from clinics significantly increased the odds of adopting modern contraception after MA.</div></div><div><h3>Conclusions</h3><div>A relatively greater share of women who accessed MA in pharmacies did not use any contraceptive method following the abortion. Additionally, receiving contraception information enhanced modern contraception adoption after MA. Findings highlight the need to develop programmes and strategies to expand the provision of contraception information to women seeking MA, including those using the pharmacy route.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"46 ","pages":"Article 101171"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145623798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To evaluate the acceptability and feasibility of a complex midwifery intervention, developed in line with the MRC Framework, designed to promote active labour and support informed decision-making.
Methods
A qualitative study was conducted within community-based childbirth preparation programmes. The intervention was delivered by nurse-midwives in primary care. Semi-structured interviews with participating women and nurse-midwives were retrospectively analysed to explore perceptions of acceptability and feasibility.
Results
Women generally perceived the intervention as highly acceptable, valuing the group format, experiential and reflective elements, and the sense of preparation and confidence gained. Many described enhanced self-efficacy and agency, often reinforced by partner support. However, some reported frustration when strategies could not be applied during labour, highlighting the limits of antenatal programmes in restrictive medical contexts. Midwives also considered the programme acceptable, recognising its innovative methodology, contribution to professional development, and positive impact on women. Feasibility was reflected in women’s accounts of experiential learning, scenario-based reflection, and printed materials as mediators of practice, with reported outcomes including mobility, autonomy, and more meaningful birth experiences, though institutional constraints sometimes limited active strategies. Midwives emphasised feasibility through strong motivation, the intervention’s low cost, and its integration into routine care, while also noting challenges such as limited space, large groups, and ambivalence towards the decision-making component.
Conclusion
The intervention was acceptable to women and midwives and feasible for integration into childbirth preparation. Divergent perspectives revealed areas for refinement, underscoring the limits of antenatal programmes in medicalised contexts while highlighting the potential of context-sensitive, evidence-based interventions to strengthen women’s autonomy.
{"title":"Acceptability and feasibility of a midwifery intervention to promote active labour and decision-making: a qualitative study with women and nurse-midwives","authors":"Marlene Isabel Lopes , Margarida Vieira , Alexandrina Cardoso","doi":"10.1016/j.srhc.2025.101172","DOIUrl":"10.1016/j.srhc.2025.101172","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the acceptability and feasibility of a complex midwifery intervention, developed in line with the MRC Framework, designed to promote active labour and support informed decision-making.</div></div><div><h3>Methods</h3><div>A qualitative study was conducted within community-based childbirth preparation programmes. The intervention was delivered by nurse-midwives in primary care. Semi-structured interviews with participating women and nurse-midwives were retrospectively analysed to explore perceptions of acceptability and feasibility.</div></div><div><h3>Results</h3><div>Women generally perceived the intervention as highly acceptable, valuing the group format, experiential and reflective elements, and the sense of preparation and confidence gained. Many described enhanced self-efficacy and agency, often reinforced by partner support. However, some reported frustration when strategies could not be applied during labour, highlighting the limits of antenatal programmes in restrictive medical contexts. Midwives also considered the programme acceptable, recognising its innovative methodology, contribution to professional development, and positive impact on women. Feasibility was reflected in women’s accounts of experiential learning, scenario-based reflection, and printed materials as mediators of practice, with reported outcomes including mobility, autonomy, and more meaningful birth experiences, though institutional constraints sometimes limited active strategies. Midwives emphasised feasibility through strong motivation, the intervention’s low cost, and its integration into routine care, while also noting challenges such as limited space, large groups, and ambivalence towards the decision-making component.</div></div><div><h3>Conclusion</h3><div>The intervention was acceptable to women and midwives and feasible for integration into childbirth preparation. Divergent perspectives revealed areas for refinement, underscoring the limits of antenatal programmes in medicalised contexts while highlighting the potential of context-sensitive, evidence-based interventions to strengthen women’s autonomy.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"47 ","pages":"Article 101172"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145665532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.srhc.2025.101168
Caroline René , Isabelle Landry , Francine de Montigny
Background
Infertility affects around one in six people worldwide. Technological advances and changes in legislation in medically assisted reproduction (MAR) are helping more people achieve parenthood after a journey marked by infertility. Yet the unique experience of women who become pregnant after MAR, and of their partners, remains little known.
Aim
To describe the experience of pregnant women and their partners during a pregnancy resulting from infertility-related MAR by examining their emotions throughout the pregnancy, their parental identity construction, and transformations experienced in various spheres of their life.
Methods
We conducted an integrated case study using a descriptive qualitative approach. Semi-structured interviews were conducted with 21 participants from Quebec (Canada), including 13 pregnant women and eight partners (five men, three women) who had conceived by infertility-related MAR. The data were analysed abductively.
Findings
The pregnant women and their partners experienced intense emotions throughout the pregnancy, oscillating between joy, fear, and relief. Parental identity construction was marked by expectation, hope, and a transition centred on pregnancy and infertility. They also transformed their relationships, adapting as a couple, redefining family and social ties, and entering a new normal with healthcare professionals.
Conclusion
For pregnant women and their partners, pregnancy after infertility-related MAR is fraught with paradoxical emotions and marked by challenging parental identity construction. Social and family recognition of their journey influences how they navigate the transitional period of pregnancy and project themselves into their parental role. Personalised, empathetic support from healthcare professionals is essential to support them during pregnancy and facilitate their transition to parenthood.
{"title":"Expecting a child conceived by medically assisted reproduction in the context of infertility: A qualitative case study of the experience of pregnant women and their partners","authors":"Caroline René , Isabelle Landry , Francine de Montigny","doi":"10.1016/j.srhc.2025.101168","DOIUrl":"10.1016/j.srhc.2025.101168","url":null,"abstract":"<div><h3>Background</h3><div>Infertility affects around one in six people worldwide. Technological advances and changes in legislation in medically assisted reproduction (MAR) are helping more people achieve parenthood after a journey marked by infertility. Yet the unique experience of women who become pregnant after MAR, and of their partners, remains little known.</div></div><div><h3>Aim</h3><div>To describe the experience of pregnant women and their partners during a pregnancy resulting from infertility-related MAR by examining their emotions throughout the pregnancy, their parental identity construction, and transformations experienced in various spheres of their life.</div></div><div><h3>Methods</h3><div>We conducted an integrated case study using a descriptive qualitative approach. Semi-structured interviews were conducted with 21 participants from Quebec (Canada), including 13 pregnant women and eight partners (five men, three women) who had conceived by infertility-related MAR. The data were analysed abductively.</div></div><div><h3>Findings</h3><div>The pregnant women and their partners experienced intense emotions throughout the pregnancy, oscillating between joy, fear, and relief. Parental identity construction was marked by expectation, hope, and a transition centred on pregnancy and infertility. They also transformed their relationships, adapting as a couple, redefining family and social ties, and entering a new normal with healthcare professionals.</div></div><div><h3>Conclusion</h3><div>For pregnant women and their partners, pregnancy after infertility-related MAR is fraught with paradoxical emotions and marked by challenging parental identity construction. Social and family recognition of their journey influences how they navigate the transitional period of pregnancy and project themselves into their parental role. Personalised, empathetic support from healthcare professionals is essential to support them during pregnancy and facilitate their transition to parenthood.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"46 ","pages":"Article 101168"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.srhc.2025.101170
Annika Wilzén , My Foucard , Katri Nieminen , Anna Malmquist , Hanna Grundström
Objective
Birth experience is a multidimensional concept that can impact life after birth, including mental health. It may contribute to the development of postpartum depression (PPD), a common postpartum condition. This study aimed to investigate whether there is an independent correlation between birth experience and PPD symptoms, while controlling for background variables. Additionally, sociodemographic and clinical factors associated with PPD symptoms were analyzed.
Methods
This cross-sectional study included participants who gave birth 6–16 weeks prior to participation, at five hospitals in southern Sweden. Data was collected via a web-based survey from September 2021 to January 2022, covering sociodemographic and clinical variables, the Edinburgh Postnatal Depression Scale, and the revised Childbirth Experience Questionnaire. Multiple linear regression was used to examine the relationship between birth experience and depressive symptoms, controlling for potential confounders.
Results
An analysis of 505 completed surveys revealed an independent negative correlation, where a better birth experience was linked to less symptoms of PPD (β = -2.87, p < 0.001). Significant predictors of more PPD symptoms included ethnic minority status, past or current mental health issues, previous trauma, premature labour, younger age and lower birth support.
Conclusion
A positive birth experience was independently associated with fewer postpartum depression symptoms, whereas lower birth support, younger age, minority status, and other background factors were linked to increased risk for PPD. These findings highlight the need for maternity care that promotes supportive and positive birth experiences, with particular attention to groups at higher risk of PPD.
{"title":"Associations between birth experience and postpartum depression – A Cross-Sectional study","authors":"Annika Wilzén , My Foucard , Katri Nieminen , Anna Malmquist , Hanna Grundström","doi":"10.1016/j.srhc.2025.101170","DOIUrl":"10.1016/j.srhc.2025.101170","url":null,"abstract":"<div><h3>Objective</h3><div>Birth experience is a multidimensional concept that can impact life after birth, including mental health. It may contribute to the development of postpartum depression (PPD), a common postpartum condition. This study aimed to investigate whether there is an independent correlation between birth experience and PPD symptoms, while controlling for background variables. Additionally, sociodemographic and clinical factors associated with PPD symptoms were analyzed.</div></div><div><h3>Methods</h3><div>This cross-sectional study included participants who gave birth 6–16 weeks prior to participation, at five hospitals in southern Sweden. Data was collected via a web-based survey from September 2021 to January 2022, covering sociodemographic and clinical variables, the Edinburgh Postnatal Depression Scale, and the revised Childbirth Experience Questionnaire. Multiple linear regression was used to examine the relationship between birth experience and depressive symptoms, controlling for potential confounders.</div></div><div><h3>Results</h3><div>An analysis of 505 completed surveys revealed an independent negative correlation, where a better birth experience was linked to less symptoms of PPD (β = -2.87, p < 0.001). Significant predictors of more PPD symptoms included ethnic minority status, past or current mental health issues, previous trauma, premature labour, younger age and lower birth support.</div></div><div><h3>Conclusion</h3><div>A positive birth experience was independently associated with fewer postpartum depression symptoms, whereas lower birth support, younger age, minority status, and other background factors were linked to increased risk for PPD. These findings highlight the need for maternity care that promotes supportive and positive birth experiences, with particular attention to groups at higher risk of PPD.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"46 ","pages":"Article 101170"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145607486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-17DOI: 10.1016/j.srhc.2025.101169
Ms Marcella Gavin , Magdalena Ohaja , Linda Biesty
Background
There remains a steady increase in the caesarean section (CS) rate globally ranging from 5% in sub-Saharan Africa to 42.8% in the Caribbean and Latin America. Vaginal birth after CS (VBAC) is a proven way of increasing normality in childbirth for most women. This study aimed to explore the factors that influence women’s decision-making for VBAC after previous CS.
Method
A qualitative design was used. All women with experience of one previous CS, and eligible for VBAC were invited to participate in the study. Data for this study were collected using semi-structured individual interview with 10 women via Zoom following verbal and written consent between March and September 2023. Thematic analysis was employed, and the discussion of the findings was informed by Foucault’s theory of power/knowledge.
Findings
Factors that influence women’s decision-making are presented under two main themes – ‘Self-determination,’ and ‘Self-confidence.’ Knowledge, strong will, previous experience, and quest to feel better after birth contributed to women’s determination to be in control of their decision. Self–belief, and support from the care providers had impact on women’s confidence. Most of the participants demonstrated a sense of control and satisfaction with their decision regardless of subsequent mode of birth.
Conclusion
The findings highlight the intrinsic link between knowledge and power and the role of these constructs in decision-making. Therefore, women need to be well informed and feel empowered to take control of the decision about their mode of birth following previous caesarean section.
{"title":"Key influences on women’s decisions for vaginal birth following a previous caesarean section: A qualitative study","authors":"Ms Marcella Gavin , Magdalena Ohaja , Linda Biesty","doi":"10.1016/j.srhc.2025.101169","DOIUrl":"10.1016/j.srhc.2025.101169","url":null,"abstract":"<div><h3>Background</h3><div>There remains a steady increase in the caesarean section (CS) rate globally ranging from 5% in sub-Saharan Africa to 42.8% in the Caribbean and Latin America. Vaginal birth after CS (VBAC) is a proven way of increasing normality in childbirth for most women. This study aimed to explore the factors that influence women’s decision-making for VBAC after previous CS.</div></div><div><h3>Method</h3><div>A qualitative design was used. All women with experience of one previous CS, and eligible for VBAC were invited to participate in the study. Data for this study were collected using semi-structured individual interview with 10 women via Zoom following verbal and written consent between March and September 2023. Thematic analysis was employed, and the discussion of the findings was informed by Foucault’s theory of power/knowledge.</div></div><div><h3>Findings</h3><div>Factors that influence women’s decision-making are presented under two main themes – ‘Self-determination,’ and ‘Self-confidence.’ Knowledge, strong will, previous experience, and quest to feel better after birth contributed to women’s determination to be in control of their decision. Self–belief, and support from the care providers had impact on women’s confidence. Most of the participants demonstrated a sense of control and satisfaction with their decision regardless of subsequent mode of birth.</div></div><div><h3>Conclusion</h3><div>The findings highlight the intrinsic link between knowledge and power and the role of these constructs in decision-making. Therefore, women need to be well informed and feel empowered to take control of the decision about their mode of birth following previous caesarean section.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"46 ","pages":"Article 101169"},"PeriodicalIF":1.7,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145578676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nurses and midwives are foundational to resilient health systems and achieving Universal Health Coverage, yet global policies often fail to reflect their distinct competencies, regulatory frameworks, and contributions. As the International Standard Classification of Occupations (ISCO) undergoes revision, a proposed sub-category—“nurse-midwives” under Midwifery Professionals—risks conflating these two professions. This commentary argues that such a classification threatens the integrity of health workforce data, undermines midwifery-led models of care, and compromises efforts to meet global targets for sexual, reproductive, maternal, newborn, and adolescent health. Drawing on the latest State of the World’s Nursing and Midwifery reports, we demonstrate how misclassification inflates midwifery coverage estimates and obscures persistent shortages. Furthermore, merging professions risks diminishing the autonomy and unique philosophy of midwifery, promoting over-medicalised care and diverting critical resources. We call for the preservation of nursing and midwifery as distinct, equally essential professions—each deserving of separate investment, regulation, and recognition. Only through accurate classification can we ensure accountable workforce planning, protect midwifery’s unique contributions, and advance person-centered, gender-equitable health systems worldwide.
{"title":"Preserving professional distinction: The risk of merging nurses and midwives and the imperative to strengthen both professions – A commentary","authors":"Malin Bogren , Alison McFadden , Paridhi Jha , Kerstin Erlandsson","doi":"10.1016/j.srhc.2025.101167","DOIUrl":"10.1016/j.srhc.2025.101167","url":null,"abstract":"<div><div>Nurses and midwives are foundational to resilient health systems and achieving Universal Health Coverage, yet global policies often fail to reflect their distinct competencies, regulatory frameworks, and contributions. As the International Standard Classification of Occupations (ISCO) undergoes revision, a proposed sub-category—“nurse-midwives” under Midwifery Professionals—risks conflating these two professions. This commentary argues that such a classification threatens the integrity of health workforce data, undermines midwifery-led models of care, and compromises efforts to meet global targets for sexual, reproductive, maternal, newborn, and adolescent health. Drawing on the latest State of the World’s Nursing and Midwifery reports, we demonstrate how misclassification inflates midwifery coverage estimates and obscures persistent shortages. Furthermore, merging professions risks diminishing the autonomy and unique philosophy of midwifery, promoting over-medicalised care and diverting critical resources. We call for the preservation of nursing and midwifery as distinct, equally essential professions—each deserving of separate investment, regulation, and recognition. Only through accurate classification can we ensure accountable workforce planning, protect midwifery’s unique contributions, and advance person-centered, gender-equitable health systems worldwide.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"46 ","pages":"Article 101167"},"PeriodicalIF":1.7,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145544183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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