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Associations between birth experience and postpartum depression – A Cross-Sectional study 分娩经历与产后抑郁之间的关系-一项横断面研究。

IF 1.7 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2025-12-01 DOI: 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.

目的：出生经历是一个多维度的概念，可以影响出生后的生活，包括心理健康。它可能会导致产后抑郁症（PPD）的发展，这是一种常见的产后疾病。本研究旨在探讨在控制背景变量的情况下，出生经历与PPD症状之间是否存在独立的相关性。此外，还分析了与PPD症状相关的社会人口学和临床因素。方法：这项横断面研究包括参与前6-16周在瑞典南部五家医院分娩的参与者。从2021年9月到2022年1月，通过网络调查收集数据，包括社会人口统计学和临床变量、爱丁堡产后抑郁量表和修订后的分娩经历问卷。多元线性回归用于检验出生经历与抑郁症状之间的关系，控制潜在的混杂因素。结果：对505份已完成调查的分析显示了独立的负相关，其中较好的分娩经历与较少的产后抑郁症状相关（β = -2.87, p）。结论：积极的分娩经历与较少的产后抑郁症状独立相关，而较低的分娩支持、较年轻、少数民族身份和其他背景因素与PPD风险增加相关。这些发现强调了促进支持性和积极分娩体验的产妇护理的必要性，特别关注PPD风险较高的群体。

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引用次数: 0

The epistemic injustice of racialised maternal care 种族化产妇护理的认知不公。

IF 1.7 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2025-12-01 DOI: 10.1016/j.srhc.2025.101162

Fatumo Osman , Elin Ternström , Maja Bodin , Sarah Hamed

引用次数: 0

Key influences on women’s decisions for vaginal birth following a previous caesarean section: A qualitative study 对先前剖腹产后妇女决定顺产的关键影响：一项定性研究

IF 1.7 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2025-11-17 DOI: 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.

全球剖宫产率仍在稳步上升，从撒哈拉以南非洲的5%到加勒比和拉丁美洲的42.8%。阴道分娩后CS （VBAC）是一个证明的方式，以增加正常分娩的大多数妇女。本研究旨在探讨影响女性既往CS后VBAC决策的因素。方法采用定性设计。所有之前有过一次CS经验的女性都被邀请参加VBAC。本研究的数据是在2023年3月至9月期间通过Zoom对10名女性进行半结构化的个人访谈，并获得口头和书面同意。本研究采用主题分析，并根据福柯的权力/知识理论对研究结果进行讨论。研究结果影响女性决策的因素分为两个主题——“自决”和“自信”。“知识、坚强的意志、以往的经验，以及产后对自我感觉良好的追求，都有助于女性做出自己的决定。”自信和护理人员的支持对妇女的信心有影响。大多数参与者对他们的决定表现出一种控制感和满足感，无论他们后来的出生方式如何。结论研究结果强调了知识与权力之间的内在联系，以及这些构念在决策中的作用。因此，妇女需要充分了解情况，并感到有权在以前剖腹产后决定自己的分娩方式。

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引用次数: 0

Preserving professional distinction: The risk of merging nurses and midwives and the imperative to strengthen both professions – A commentary 保留专业区别：合并护士和助产士的风险以及加强这两个职业的必要性-评论。

IF 1.7 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2025-11-13 DOI: 10.1016/j.srhc.2025.101167

Malin Bogren , Alison McFadden , Paridhi Jha , Kerstin Erlandsson

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.

护士和助产士是韧性卫生系统和实现全民健康覆盖的基础，但全球政策往往未能反映其独特的能力、监管框架和贡献。随着国际职业标准分类（ISCO）的修订，一个拟议的子类别——助产士专业人员下的“护士-助产士”——有可能将这两个职业混为一谈。本评论认为，这种分类威胁到卫生人力数据的完整性，破坏了助产士主导的护理模式，并损害了实现性健康、生殖健康、孕产妇健康、新生儿健康和青少年健康全球目标的努力。根据最新的《世界护理和助产状况报告》，我们展示了错误的分类是如何夸大助产覆盖估计并掩盖持续的短缺的。此外，合并职业可能会削弱助产的自主性和独特理念，促进过度医疗化护理，转移关键资源。我们呼吁保留护理和助产作为不同的、同等重要的职业——每个职业都应该得到单独的投资、监管和认可。只有通过准确的分类，我们才能确保负责任的人力资源规划，保护助产的独特贡献，并在全世界推进以人为本、性别平等的卫生系统。

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引用次数: 0

An exploration of midwives’ perceptions of the Ockenden review: a qualitative study 助产士对Ockenden评论的看法的探索：一项定性研究

IF 1.7 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2025-11-12 DOI: 10.1016/j.srhc.2025.101166

Caitlin Foley, Christine McCourt, Cassandra Yuill

Aim

This study aims to understand midwives’ perceptions of the Ockenden report.

Background

The Ockenden report was published following an inquiry into maternity services at Shrewsbury and Telford Hospitals NHS Trust. It reports multiple failings endemic at the Trust and concludes with 15 ‘Immediate and Essential Actions’ to be enacted across English maternity services. The report and its recommendations have resulted in changes to maternity practice throughout the UK.

Method

An exploratory qualitative study design, comprising semi-structured interviews with nine midwives between May and July 2023.

Results

Two overarching themes were identified; the context of the report, and the impact of the report, and within them five subthemes. These were: “We’ve seen it all before”; Change is complicated; A tool for change; Perception of midwifery; and Fuelling the obstetric paradigm. Midwives recognised the importance of the report and many of the concerns it raised and agreed there are significant problems within UK maternity care. However, there was also an expression of concern regarding the lack of evidence supporting some of the recommendations and how the report was impacting practice.

Conclusions

There are significant problems present in maternity practice in the UK. Inquiries may lead to important recommendations; however, they can be difficult to enact and may have unintended consequences. More research is needed looking into why meaningful change is difficult to achieve and how perinatal professionals interact with policy change.

目的本研究旨在了解助产士对Ockenden报告的看法。奥肯登报告是在对什鲁斯伯里和特尔福德NHS信托医院的产科服务进行调查后发表的。它报告了该信托基金普遍存在的多个缺陷，并在英国产科服务中制定了15项“立即和必要的行动”。该报告及其建议导致了整个英国产妇实践的变化。方法采用探索性定性研究设计，于2023年5月至7月对9名助产士进行半结构化访谈。结果确定了两个总体主题；报告的背景和报告的影响，以及其中的五个分主题。这些是：“我们以前都见过了”；改变是复杂的；变革的工具；对助产的认识；推动产科模式。助产士认识到该报告的重要性，以及它提出的许多担忧，并同意英国产科护理存在重大问题。然而，也有人对缺乏证据支持某些建议以及报告如何影响实践表示关切。结论在英国产科实践中存在着重大问题。调查可能导致重要的建议；然而，它们可能难以实施，并可能产生意想不到的后果。需要更多的研究来探讨为什么有意义的改变很难实现，以及围产期专业人员如何与政策变化相互作用。

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引用次数: 0

Reforming professional identity: experiences of internationally educated midwives in a Swedish bridging program – A qualitative study 改革的专业身份：经验的国际教育助产士在瑞典衔接程序-定性研究。

IF 1.7 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2025-11-12 DOI: 10.1016/j.srhc.2025.101165

Emma Barkeling , Elin Nässén , Sofia Alsing , Helena Lindgren

Background

The first bridging program for midwives in Sweden started in 2018. This made it possible for midwives educated outside of the EU/EES and Switzerland to obtain a Swedish midwifery license and become familiar with the Swedish healthcare system within a year.

Aim

To describe midwives, who have obtained their midwifery education outside of the EU/EES and Switzerland, experiences obtaining a Swedish midwifery license through the bridging program at Karolinska Institutet.

Method

A qualitative study was conducted utilizing semi-structured interviews with nine midwives who had completed the bridging program. Content analysis was used.

Results

From the analysis, one theme emerged: Reforming professional identity. This theme encompassed four categories: A bridging program as a way of reaching the goal, experience of support, becoming familiar with a new healthcare system and learning while using a new language.

Conclusion

The necessity for a bridging program became apparent as the midwives encountered differences in healthcare systems and diverse approaches to interacting with birthing women. Acquiring the skill to provide consistent support was challenging, demanding proficient communication skills, with casual conversation being the greatest obstacle.

背景：瑞典的第一个助产士衔接项目于2018年启动。这使得在欧盟/EES和瑞士以外接受教育的助产士有可能获得瑞典助产执照，并在一年内熟悉瑞典医疗保健系统。目的：描述在欧盟/EES和瑞士以外获得助产教育的助产士，通过卡罗林斯卡学院的衔接课程获得瑞典助产执照的经验。方法：采用半结构化访谈对9名完成衔接课程的助产士进行定性研究。采用内容分析法。结果：从分析中得出一个主题：重塑职业认同。该主题包括四个类别：作为实现目标方式的桥梁项目、支持体验、熟悉新的医疗系统以及在使用新语言的同时学习。结论：当助产士遇到医疗保健系统的差异和与分娩妇女互动的不同方法时，桥接计划的必要性变得明显。获得提供持续支持的技能是具有挑战性的，需要熟练的沟通技巧，随意的交谈是最大的障碍。

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引用次数: 0

‘Just not enough time’ – Under-resourced and low prioritization for postpartum care in Australia continues to impact breastfeeding support and success for women “只是没有足够的时间”——在澳大利亚，资源不足和产后护理的低优先级继续影响着母乳喂养对妇女的支持和成功。

IF 1.7 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2025-11-09 DOI: 10.1016/j.srhc.2025.101164

Chloe A Mora Garces, Liz McNeill, Megan Cooper, Annette Briley

Background

Postnatal care is the cornerstone of successful parenting and long-term health. Midwives face barriers when supporting and educating postpartum women. Breastfeeding is an important component of postpartum care that is likely impacted when under-resourced.

Aims

To examine the facilitators and barriers faced by midwives in providing effective breastfeeding support within the early postnatal context.

Methods

An online survey for midwives in Australia, advertised on social media. Open-ended questions generated qualitative data that were thematically analysed and demographic data were analysed to provide descriptive statistics.

Findings

After removal of incomplete responses, 113 were analysed. The respondents were Australian residents. Participants highlighted how evidence based and high-quality breastfeeding “Knowledge facilitates preparedness” for postpartum women. Conversely, “Just not enough time” was expressed as a key barrier to providing effective, quality support to postpartum women.

Discussion

Women desire individualised and timely support from midwives, however, experience the postnatal ward as chaotic. The participants concur that there is “Just not enough time” to provide individualised support women desire around breastfeeding. Improving midwife: woman ratios and counting the babies, as announced in Queensland, Australia in 2023, and ensuring midwives are cognisant in lactogenesis will improve women’s confidence and promote long term breastfeeding.

Conclusion

Continued under-resourcing of postpartum care is impacting midwives’ ability to provide the individualized and timely education and support women desire and require for long term breastfeeding. Exploration of alleviating strategies that better equip midwives to support women and the longevity of their breastfeeding journeys, is urgently needed.

背景：产后护理是成功养育子女和长期健康的基石。助产士在支持和教育产后妇女时面临障碍。母乳喂养是产后护理的一个重要组成部分，在资源不足时可能会受到影响。目的：研究助产士在产后早期提供有效母乳喂养支持时面临的促进因素和障碍。方法：对澳大利亚助产士进行在线调查，并在社交媒体上做广告。开放式问题产生定性数据，对这些数据进行主题分析，对人口数据进行分析，提供描述性统计数据。结果：剔除不完全反应后，对113例进行了分析。受访者都是澳大利亚居民。与会者强调了如何以证据为基础的高质量母乳喂养“知识促进产后妇女的准备”。相反，“只是没有足够的时间”被认为是为产后妇女提供有效、高质量支持的主要障碍。讨论：妇女渴望从助产士那里得到个性化和及时的支持，然而，产后病房却是混乱的。与会者一致认为，“只是没有足够的时间”来为母乳喂养妇女提供个性化的支持。改善助产士：正如澳大利亚昆士兰州在2023年宣布的那样，女性比例和计算婴儿数量，并确保助产士认识到母乳生成，将提高女性的信心，促进长期母乳喂养。结论：持续的产后护理资源不足影响了助产士提供个性化和及时的教育以及支持妇女长期母乳喂养的愿望和需求的能力。迫切需要探索缓解战略，使助产士更好地为妇女提供支持，延长她们的母乳喂养旅程。

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引用次数: 0

Exploring Australian midwives’ approaches to labour pain and workplace realities: Philosophies in practice 探索澳大利亚助产士对分娩疼痛和工作场所现实的方法：实践中的哲学

IF 1.7 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2025-11-08 DOI: 10.1016/j.srhc.2025.101163

Kate Dawson , Elizabeth Newnham , Lester Jones , Christine East , Laura Whitburn

Objective

This study explored midwives’ views and experiences of supporting women to manage labour pain. This paper specifically examines midwives’ philosophical underpinnings and the organisational factors that influence their ability to enact these approaches in practice.

Methods

A national cross-sectional survey of Australian midwives was undertaken, incorporating both open- and closed-ended questions. Closed-ended questions were analysed using descriptive analysis, while open-ended responses were examined through thematic analysis.

Results

Of the 557 respondents, the majority reported a ‘working with pain’ philosophy in their approach to supporting women during labour. Perceived workplace support for practicing, in alignment with this philosophy, was more likely when working in a continuity of care model. Workplace context and structural positioning were critical to feeling supported. Many midwives described healthcare settings as constraining, often requiring them to relinquish their philosophical approach due to systemic factors – an experience that was frequently associated with distress.

Conclusion

Midwives commonly prefer to support women to work with pain during labour, aligning with a philosophy that honours the physiological process of birth. However, system factors, particularly fragmented models of care, high intervention rates, and a culture that prioritises pain relief, pose significant barriers to practising in this way. Enhancing access to tools to facilitate birth physiology, as well as addressing unhelpful cultural beliefs surrounding labour pain, may not only improve women’s birth experiences but also contribute to greater midwifery job satisfaction and retention.

目的探讨助产士支持产妇处理阵痛的观点和经验。本文专门检查助产士的哲学基础和组织因素，影响他们的能力制定这些方法在实践中。方法对澳大利亚助产士进行全国性横断面调查，包括开放式和封闭式问题。使用描述性分析分析封闭式问题，而通过专题分析检查开放式回答。结果在557名受访者中，大多数人在支持女性分娩时采用了“忍受痛苦”的理念。在连续性护理模式下工作时，与这一理念一致的工作场所对实践的支持更有可能。工作环境和结构定位对感觉支持至关重要。许多助产士将医疗环境描述为限制，通常要求他们放弃他们的哲学方法，由于系统因素-一种经常与痛苦相关的经历。结论助产士通常更愿意支持妇女在分娩过程中忍受疼痛，这与尊重分娩生理过程的理念相一致。然而，系统因素，特别是分散的护理模式、高干预率和优先缓解疼痛的文化，对以这种方式进行实践构成了重大障碍。增加获得分娩生理学工具的机会，以及解决围绕分娩疼痛的无益文化信仰，不仅可以改善妇女的分娩体验，还有助于提高助产士的工作满意度和留任率。

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引用次数: 0

Female sexual health: the use of videos in Brazilian sign language (Libras) to make knowledge accessible for deaf women 女性性健康：使用巴西手语（Libras）视频，使失聪妇女能够获得知识。

IF 1.7 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2025-11-01 DOI: 10.1016/j.srhc.2025.101161

Juliana Maria Teobaldo Martins , Regiane da Silva Barbosa , Marli Teresinha Cassamassino Duarte , Vera Lúcia Messias Fialho Capellini

This article addresses the development and validation of an informational video on female sexual health for deaf women. Given the communication barriers between healthcare professionals and deaf patients, and considering the detrimental effects of misinformation on ensuring the right to health for deaf women, this study aims to develop and validate an educational video in Brazilian Sign Language (Libras) on female anatomy, menstruation, and hygiene care, to be used in clinical settings with deaf women. Through a methodological study, a video in Libras on female sexual health was created, which was initially validated through the Delphi technique by Libras specialists and deaf women. The resulting audiovisual material proved to be a powerful Assistive Technology tool for informing and enhancing communication between healthcare professionals and deaf patients.

这篇文章讨论了一个关于女性性健康的信息视频的开发和验证。鉴于医护人员与耳聋患者之间的沟通障碍，并考虑到错误信息对确保耳聋女性健康权的不利影响，本研究旨在制作和验证巴西手语（Libras）的女性解剖学，月经和卫生保健教育视频，用于耳聋女性的临床设置。通过方法学研究，制作了一部关于女性性健康的天秤座视频，并由天秤座专家和聋哑妇女通过德尔菲技术初步验证。由此产生的视听材料被证明是一个强大的辅助技术工具，为医护人员和失聪患者提供信息和加强沟通。

引用次数: 0

We’re guessing: The data crisis in maternal mortality research in the United States 我们猜测：美国孕产妇死亡率研究中的数据危机。

IF 1.7 3区医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Sexual & Reproductive Healthcare

Pub Date : 2025-10-27 DOI: 10.1016/j.srhc.2025.101159

Cassie Joy Sistoso

引用次数: 0