Sexual & Reproductive Healthcare最新文献_第4页

Combining the antenatal risk questionnaire and the Edinburgh Postnatal depression scale as a psychosocial risk assessment tool in Danish antenatal care. A descriptive study 结合产前风险问卷和爱丁堡产后抑郁量表作为心理社会风险评估工具在丹麦产前护理。描述性研究

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

Sexual & Reproductive Healthcare

Pub Date : 2025-12-01 Epub Date: 2025-08-26 DOI: 10.1016/j.srhc.2025.101141

Lotte Broberg , Katrine Røhder , Jane Marie Bendix , Ellen Løkkegaard , Mette Væver , Helle Johnsen , Mette Juhl , Vibeke de Lichtenberg , Michaela Schiøtz

Objectives

To evaluate the Antenatal Risk Questionnaire (ANRQ) and the Edinburgh Postnatal Depression Scale (EPDS) as part of an integrated psychosocial risk assessment aiming to enhance triage for pregnant women needing extended care. Further, to examine differences in sociodemographic and psychosocial characteristics of the population.

Methods

This descriptive study was conducted at Department of Gynecology and Obstetrics, Copenhagen University Hospital – North Zealand, Denmark.

Participants

Pregnant women at antenatal care level 1 or 2 at the North Zealand Hospital were invited to the study at their first-trimester ultrasound scan. The participants received an online questionnaire consisting of the ANRQ and the EPDS in gestational weeks 12–14, followed by an online questionnaire in 37–38 weeks of gestation, which included items related to sociodemographic characteristics and maternal mental health.

Results

N = 774 pregnant women were invited to participate, of whom 424 (55 %) answered the ANRQ/EPDS questionnaire. Among them, n = 88 (21 %) had an ANRQ score ≥ 23, and n = 60 (14 %) scored ≥ 11 on the EPDS. A total of 17 (4 %) women were referred to extended care. Women with low scores on the ANRQ and the EPDS (ANRQ < 23, EPDS < 11) were more often highly educated. A history of mental problems was more strongly associated with a high ANRQ than a high EPDS.

Conclusion

We identified women at increased risk of mental health problems who were not identified by the current triage process. Combining ANRQ and EPDS assessment may be an important part of a model for early identification of pregnant women with special needs.

目的评价产前风险问卷（ANRQ）和爱丁堡产后抑郁量表（EPDS）作为综合心理社会风险评估的一部分，旨在加强对需要延长护理的孕妇的分诊。进一步，检查人口的社会人口学和心理社会特征的差异。方法本描述性研究在丹麦哥本哈根大学医院妇产科进行。在新西兰医院接受1级或2级产前护理的孕妇在妊娠早期进行超声波扫描时被邀请参加这项研究。参与者在妊娠12-14周收到一份由ANRQ和EPDS组成的在线问卷，随后在妊娠37-38周收到一份在线问卷，其中包括与社会人口统计学特征和孕产妇心理健康相关的项目。结果共邀请774名孕妇参与调查，其中424人（55%）回答了ANRQ/EPDS问卷。其中，ANRQ评分≥23的有88例（21%），EPDS评分≥11的有60例（14%）。共有17名（4%）妇女被转介到延长护理。在ANRQ和EPDS （ANRQ < 23, EPDS < 11）上得分较低的女性往往受过高等教育。精神病史与高ANRQ的关系比与高EPDS的关系更强。结论：我们发现了在目前的分诊过程中未发现的精神健康问题风险增加的妇女。结合ANRQ和EPDS评估可能是早期识别有特殊需要孕妇模型的重要组成部分。

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引用次数: 0

“The Best of Both Worlds” a content analysis of midwives’ perspectives on using ultrasound for labour progress assessment “两全其美”内容分析助产士对使用超声波进行产程评估的观点

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

Sexual & Reproductive Healthcare

Pub Date : 2025-12-01 Epub Date: 2025-09-02 DOI: 10.1016/j.srhc.2025.101142

Elsa Ruth Gylfadóttir , Hulda Hjartardóttir , Valgerður Lísa Sigurðardóttir

Background

Midwives in labour wards at high-tech hospitals have witnessed significant technological advancements. Ultrasound devices for assessing labour progress may offer advantages over traditional vaginal examinations. However, it is important to examine the views of care providers before introducing this new technology.

Aim

The aim is to examine the views of midwives working in a hospital labour ward regarding the use of ultrasound devices in assessing the progress of labour and explore their views of implementing such a technology to improve care for women during labour.

Method

A qualitative study was conducted, using three semi structured focus groups interviews with 16 midwives from the hospital labour ward. A purposive sample was used to capture diverse backgrounds and experiences. Content analysis was used to identify key categories and subcategories.

Results

Two main categories emerged: 1) “Art of midwifery and technology,” including a debate between clinical skills and technology, midwives’ openness to learning, and their desire to control implementation; 2) “Women and babies come first,” highlighting the importance of options, safety, and the connection with the woman.

Conclusion

Midwives support evidence-based technological advancements that benefit clients without increasing unnecessary interventions. They believe ultrasound complements traditional vaginal exams and is a valuable option for certain groups of women. Midwives need to be involved in the implementation of new methods to ensure client well-being. Further research is needed to evaluate the benefits of using ultrasound for labour progress assessment.

高科技医院产房的助产士见证了重大的技术进步。用于评估产程的超声设备可能比传统的阴道检查更有优势。然而，在引入这项新技术之前，检查护理提供者的观点是很重要的。目的调查医院产房助产士对使用超声波设备评估分娩进展的看法，并探讨她们对采用这种技术以改善产妇分娩护理的看法。方法采用三个半结构化的焦点小组访谈，对医院产房的16名助产士进行定性研究。一个有目的的样本被用来捕捉不同的背景和经历。内容分析用于确定关键类别和子类别。结果出现了两个主要类别：1)“助产艺术与技术”，包括临床技能与技术之间的辩论，助产士对学习的开放程度，以及他们控制实施的愿望；2)“女人和孩子是第一位的”，强调选择、安全以及与女人联系的重要性。结论助产士支持基于证据的技术进步，在不增加不必要干预的情况下使客户受益。他们认为超声波是传统阴道检查的补充，对某些女性群体来说是一个有价值的选择。助产士需要参与新方法的实施，以确保客户的福祉。需要进一步的研究来评估使用超声进行产程评估的好处。

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引用次数: 0

Maternity care providers’ attitudes and beliefs toward weight and body size during pregnancy: A cross-sectional survey 产科护理人员对孕期体重和体型的态度和信念：一项横断面调查

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

Sexual & Reproductive Healthcare

Pub Date : 2025-12-01 Epub Date: 2025-09-08 DOI: 10.1016/j.srhc.2025.101145

Lauren Kearney , Bec Jenkinson , Anna Robins , Leonie Callaway , Jessica van den Heuvel , Melanie Roussin , Briony Hill

Background

Weight stigma is pervasive in society and negatively affects the quality of maternity care for women with larger bodies. Healthcare providers’ attitudes and beliefs about weight and larger bodied people contribute to experiences of weight stigma, yet the extent of weight stigma attitudes and beliefs in Australian maternity care providers is not known.

Objective

This study aimed to explore maternity care providers’ attitudes and beliefs regarding weight and body size during pregnancy.

Methods

A cross-sectional survey with Australian maternity care providers, using the Fat Attitudes Assessment Toolkit (FAAT), with an open-ended ‘any other comments’ text response, was undertaken. Quantitative responses were analysed using descriptive statistics and qualitative inductive content analysis.

Results

Maternity care providers (n = 243) from across Australia responded to the survey. Responses indicated a strong emphasis on empathy towards larger bodied pregnant women, with providers acknowledging the socioeconomic and societal impact on the complexity of weight and body size. Responses also highlighted providers’ internalised weight stigma. Free-text responses reflected mixed views on the balance between addressing health risks and avoiding weight stigma, with a need for more resources and education on weight-inclusive care.

Conclusion

Maternity care providers are aware of the complexities of caring for larger bodied women. Tailored interventions that promote empathy and reduce weight-based discrimination are recommended.

社会上普遍存在对体重的耻辱感，这对体型较大的女性的产科护理质量产生了负面影响。医疗保健提供者对体重和体型较大的人的态度和信念有助于体重耻辱的经历，但澳大利亚产妇保健提供者的体重耻辱态度和信念的程度尚不清楚。目的探讨产科护理人员对孕期体重和体型的态度和信念。方法采用“肥胖态度评估工具包”（FAAT）对澳大利亚产科护理提供者进行横断面调查，并采用开放式的“任何其他评论”文本回复。定量分析采用描述性统计和定性归纳内容分析。结果来自澳大利亚各地的产妇护理提供者（n = 243）对调查做出了回应。回应表明，医生们强烈强调对体型较大的孕妇的同情，并承认体重和体型的复杂性对社会经济和社会的影响。回应还强调了医疗服务提供者对体重的内在偏见。自由文本答复反映了对解决健康风险和避免体重污名之间的平衡的不同看法，需要更多的资源和关于体重包容性护理的教育。结论产科护理人员意识到照顾体型较大的妇女的复杂性。建议采取量身定制的干预措施，促进同理心，减少基于体重的歧视。

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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 : 2025-12-01 Epub 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

Trajectories of contraception before pregnancy and after medication abortion among women accessing clinic vs pharmacy services in Ghana 加纳接受诊所和药房服务的妇女怀孕前和药物流产后的避孕轨迹

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

Sexual & Reproductive Healthcare

Pub Date : 2025-12-01 Epub Date: 2025-11-24 DOI: 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.

目的本研究调查了加纳诊所和药房客户在怀孕前和药物流产（MA）后的避孕药使用情况，以及与MA后现代避孕药摄取相关的因素。方法数据来自一项非劣效性前瞻性研究，该研究纳入了1974名在加纳药店（n = 929）和诊所（n = 1045）接受米索前列醇和米非司酮治疗的妇女。产生描述性统计来评估怀孕前和MA后的避孕使用情况，而二元logistic回归则用于检查MA后现代避孕药摄取相关因素。结果总体而言，未采取避孕措施的比例从妊娠前的57% （n = 1123）上升至妊娠后的66% (n = 1293)，这一趋势是由药房客户推动的。而55% （n = 344）在怀孕前未使用任何避孕方法的临床客户在ma后仍未使用任何避孕方法，86% （n = 434）是药房组的情况。此外，在MA后改用任何避孕方法的非方法使用者中，临床组（n = 274,44%）使用现代避孕方法的比例高于药房组（n = 58,12%）。回归结果显示，接受避孕信息和从诊所获得避孕信息显著增加了MA后采取现代避孕措施的几率。结论在药店获得MA的妇女流产后未采取任何避孕措施的比例相对较高。此外，避孕信息的获取促进了MA后现代避孕的采用。研究结果强调需要制定规划和战略，扩大向寻求MA的妇女提供避孕信息，包括那些使用药房途径的妇女。

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引用次数: 0

Quality of couple relationship among first-time mothers and partners, during pregnancy and the following eight years after childbirth 在怀孕期间和分娩后的八年里，第一次母亲和伴侣之间的夫妻关系质量

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

Sexual & Reproductive Healthcare

Pub Date : 2025-12-01 Epub Date: 2025-10-16 DOI: 10.1016/j.srhc.2025.101155

Angelica Holst , Frida Lygnegård , Jenny Hallgren , Caroline Bäckström

Objective

The couple’s relationship is affected by the transition to parenthood, but research findings are mixed, with some studies showing positive effects on the relationship and others indicating negative impacts. This study aims to explore first-time mothers’ and their partners’ perceived quality of dyadic relationship (QDR36) during pregnancy and the following eight years after childbirth as well as what factors that are associated with a higher QDR36.

Methods

A prospective longitudinal cohort study on 917 Swedish parents, with repeated questionnaires at: gestational week 25 (T1); first week after childbirth (T2); six months (T3); one year (T4); two years (T5); four years (T6), and eight years (T7) after childbirth. Non-parametric tests and Cohen’s effect size calculation were conducted to analyze change over time in QDR36. Multiple linear regressions were carried out with index for QDR36 as dependent variable, at all time points (T1-T7).

Results

QDR36 varied over time among both first-time mothers and partners, showing an increase between T1 and T2, followed by a decrease between each point in time. QDR36 was statistically lower at T7 compared to all other points in time (T1-T6). Variations were observed in the variables that were associated with a higher QDR36 at different time points, however higher sense of coherence (SOC-13) and social support (MSPSS) were consistently associated.

Conclusion

First-time mothers and partners’ perceived quality of couple relationship declines the first eight years after birth. To support them in their couple relationship, healthcare professionals should acknowledge parents’ sense of coherence and social support.

这对夫妇的关系受到父母身份转变的影响，但研究结果好坏参半，一些研究表明对关系有积极影响，另一些研究表明有消极影响。本研究旨在探讨第一次母亲及其伴侣在怀孕期间和分娩后8年的双元关系感知质量（QDR36），以及与较高QDR36相关的因素。方法对917名瑞典父母进行前瞻性纵向队列研究，在妊娠第25周（T1）进行重复问卷调查；分娩后第一周（T2）；六个月（T3）；一年（T4）；两年（T5）；产后4年（T6）和8年（T7）。采用非参数检验和Cohen效应量计算来分析QDR36随时间的变化。在所有时间点（T1-T7），以QDR36指数为因变量进行多元线性回归。结果qdr36在首次生育的母亲和伴侣之间随时间变化，在T1和T2之间增加，然后在每个时间点之间减少。与其他时间点（T1-T6）相比，T7时QDR36较低。在不同的时间点，与较高的QDR36相关的变量存在差异，但较高的连贯性（SOC-13）和社会支持（MSPSS）始终相关。结论初生母亲和伴侣对夫妻关系的感知质量在产后8年内呈下降趋势。为了支持他们的夫妻关系，医疗保健专业人员应该承认父母的一致性和社会支持感。

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引用次数: 0

Enhancement of midwives’ and child healthcare nurses’ attitudes towards the WHO’s recommendations following breastfeeding training: A quasi-experimental study 加强助产士和儿童保健护士对世界卫生组织母乳喂养培训建议的态度：一项准实验研究

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

Sexual & Reproductive Healthcare

Pub Date : 2025-12-01 Epub Date: 2025-10-05 DOI: 10.1016/j.srhc.2025.101152

Ingrid Blixt , Philip Fowler , Ove Axelsson , Eva-Lotta Funkquist

Objective

This study aimed to assess healthcare professionals’ attitudes towards breastfeeding, in line with the WHO guidelines, before and after a breastfeeding intervention in Sweden.

Methods

A quasi-experimental, prospective, longitudinal before-and-after design with a control group was used. Data were collected between 2020 and 2021. The sample included 26 midwives and child healthcare nurses in the intervention group, and 18 in the control group, all working in antenatal and child healthcare centres. The intervention group received breastfeeding training based on the WHO recommendations. The 15-item Healthcare Professionals’ Attitudes instrument was used to measure attitudes.

Results

The intervention improved attitudes on nine of the 15 questions immediately post-training, with effects maintained at one-year. The largest change was for the item: ‘It is appropriate for infants to wait until they are six months old before tasting samples’ (p = 0.000). At follow-up, five items differed significantly between groups: ‘Infants can have commercial milk formula in the evening if they breastfeed frequently at night’ (p = 0.002), ‘It is inappropriate for a mother to breastfeed a one-year-old in a restaurant’ (p = 0.017), ‘It is appropriate for infants to breastfeed every three hours’ (p = 0.020), ‘When a mother has bleeding nipples, it is appropriate to inform her that formula is acceptable’ (p = 0.023), and ‘It is important for infants to have uninterrupted sleep at night’ (p = 0.047).

Conclusion

The breastfeeding training programme improved healthcare professionals’ attitudes towards breastfeeding, with positive effects sustained one year following the intervention.

目的本研究旨在评估卫生保健专业人员对母乳喂养的态度，符合世卫组织的指导方针，母乳喂养干预前后在瑞典。方法采用准实验、前瞻性、纵向前后对照设计，并设对照组。数据收集于2020年至2021年之间。样本包括干预组的26名助产士和儿童保健护士，对照组的18名助产士和儿童保健护士，均在产前和儿童保健中心工作。干预组接受了基于世卫组织建议的母乳喂养培训。采用15项医疗专业人员态度量表测量态度。结果干预后立即改善了15个问题中的9个问题的态度，效果维持了一年。最大的变化是在项目上：“婴儿应该等到6个月大的时候再品尝样品”（p = 0.000）。在随访中，五项在两组之间有显著差异：婴儿可以有商业配方奶粉在晚上如果他们晚上经常母乳喂养(p = 0.002),它不适合母乳喂养的母亲在餐馆一个一岁大的(p = 0.017),这是适合婴儿母乳喂养每三小时(p = 0.020),当一个母亲乳头出血,它是适当的通知她,公式是可以接受的(p = 0.023),和它对婴儿晚上有不间断的睡眠很重要的(p = 0.047)。结论母乳喂养培训项目改善了医护人员对母乳喂养的态度，干预后一年仍有积极效果。

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引用次数: 0

Digital midwifery care – Blurring boundaries and finding new paths for midwifery care during pregnancy and postpartum: A qualitative study on Swedish midwives’ experiences 数字助产护理——模糊界限，为怀孕和产后助产护理寻找新的途径：瑞典助产士经验的定性研究。

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

Sexual & Reproductive Healthcare

Pub Date : 2025-12-01 Epub Date: 2025-09-15 DOI: 10.1016/j.srhc.2025.101147

Bäckström Caroline, Nilvér Helena, Lindgren Carina, Ludvigsson Elinor, Grönstervall Sabina, Moberg-Monsén Beatrice, Palmér Lina

Objective

In recent years, digital health interventions have increased in society. Swedish midwifery care is no exception, as digital solutions are increasingly being used during pregnancy and postpartum care for expectant and new parents. Therefore, the aim of this study was to explore midwives’ experiences of digital midwifery care and information during pregnancy and postpartum.

Methods

Focus groups and individual interviews were held with fourteen Swedish midwives working within antenatal care. Data analysis was conducted using thematic analysis.

Results

The results are presented in one overall theme: Digital Midwifery Care – Blurring boundaries and finding new paths for midwifery care, and three themes: Digital midwifery care is shaped by organizational prerequisites constraining and supporting; Digital midwifery care poses challenges establishing trustful relationships, and Digital midwifery care enhances accessibility, enabling participation.

Conclusion

Digital midwifery care is experienced by midwives as blurring the boundaries and finding new paths for midwifery care. Midwives negotiate with themselves, not losing the caring relationship as a core dimension of midwifery. Digital transformation within midwifery care has altered midwives’ way of working, and thus probably also their approach to caring.

目的：近年来，数字健康干预措施在社会上有所增加。瑞典的助产护理也不例外，数字解决方案越来越多地用于孕妇和新父母的孕期和产后护理。因此，本研究的目的是探讨助产士在怀孕和产后的数字助产护理和信息的体验。方法：对14名从事产前保健工作的瑞典助产士进行焦点小组和个人访谈。数据分析采用专题分析法。结果：结果呈现在一个总体主题中：数字助产护理-模糊界限并寻找助产护理的新路径，以及三个主题：数字助产护理受到组织先决条件的限制和支持；数字助产护理对建立信任关系提出了挑战，数字助产护理提高了可及性，促进了参与。结论：数字化助产服务模糊了助产服务的界限，为助产服务开辟了新的途径。助产士与自己协商，并没有失去作为助产服务核心维度的关怀关系。助产护理的数字化转型改变了助产士的工作方式，因此可能也改变了她们的护理方法。

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引用次数: 0

Proactive versus standard support of labor in the latent phase – A randomized, controlled clinical trial 潜伏期分娩的主动支持与标准支持-一项随机对照临床试验

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

Sexual & Reproductive Healthcare

Pub Date : 2025-12-01 Epub Date: 2025-09-05 DOI: 10.1016/j.srhc.2025.101144

Marit Larsen , Maria Underdal , Øyvind Salvesen , Negin Sadati , Ingebjørg Laache , Møyfrid Brenne Fehn , Raija Dahlø , Stine Bernitz , Eszter Vanky

Objective

Long latent phase of labor with subsequent prolonged total labor duration increases the risk of obstetric interventions and complications. We explored whether Proactive Support of Labor (PSL) compared to Standard Support of Labor (SSL) in the latent phase, reduces the rate of complicated deliveries in nulliparous women.

Design

Randomized, controlled trial (RCT).

Methods

A single-center RCT, at St. Olav’s University Hospital of Trondheim, Norway, including 356 nulliparous women in the latent phase of labor with a singleton pregnancy, cephalic presentation and spontaneous term onset of labor.

Main outcome measures

The composite rate of complicated deliveries, defined as instrumental delivery, caesarean section (CS), estimated blood loss >500 ml, intrapartum temperature >38.0⁰ °C, shoulder dystocia, perineal laceration grade III or IV, or Apgar score <7 at 5 min.

Results

We found no difference in the composite rate of complicated deliveries, 40 % vs 34 % respectively, (OR = 1.3 (95 % CI = 0.8–2.0), p-value = 0.302), or the individual components of complicated deliveries, between PSL and SSL groups. In the PSL group, both the duration of labor and the individual maximum dosage of oxytocin were reduced. The number of vaginal examinations and transfer to neonatal intensive care unit in the PSL and SSL groups were similar. More women in the PSL group received epidural analgesia.

Conclusion

Proactive support of labor in the latent phase did not reduce the rate of complicated deliveries, but shortened labor duration, with lower maximum oxytocin dosage. Proactive support of labor may be considered as an alternative option for some nulliparous women to prevent a long latent phase of labor, without compromising maternal or newborn safety.

目的产程潜伏期过长和总产程延长增加了产科干预和并发症的风险。我们探讨了主动分娩支持（PSL）与标准分娩支持（SSL）在潜伏期是否可以降低无产妇女的复杂分娩率。随机对照试验（RCT）。方法在挪威特隆赫姆圣奥拉夫大学医院进行一项单中心随机对照试验，纳入356例处于产程潜伏期、单胎妊娠、头位分娩和自然足月分娩的产妇。主要结局指标复杂分娩的复合率，定义为器械分娩、剖宫产（CS）、估计出血量（500 ml）、产时温度（38.00℃）、肩难产、会阴撕裂III级或IV级，或5分钟Apgar评分（7分）。结果我们发现复杂分娩的复合率无差异，分别为40% vs 34% (or = 1.3 (95% CI = 0.8-2.0)， p值= 0.302)，或复杂分娩的各个组成部分。在PSL和SSL组之间。PSL组产程持续时间和个体最大催产素用量均有所减少。PSL组和SSL组的阴道检查次数和转到新生儿重症监护病房的次数相似。PSL组更多的妇女接受硬膜外镇痛。结论潜伏期积极助产并不能降低复杂分娩的发生率，但能缩短产程，降低最大催产素用量。对于一些无产妇女来说，在不影响产妇或新生儿安全的情况下，积极支持分娩可能被视为一种替代选择，以防止长时间的分娩潜伏期。

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引用次数: 0

Work motivation among midwives in medium-sized labour wards in Denmark – An interview study 丹麦中型产房助产士的工作动机——一项访谈研究

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

Sexual & Reproductive Healthcare

Pub Date : 2025-12-01 Epub Date: 2025-09-26 DOI: 10.1016/j.srhc.2025.101151

Aleksandra Storm , Maiken Fabricius Damm , Caroline Moos , Christina Prinds

Introduction

Midwives are essential in securing high-quality maternity care. Despite several calls to action to curb the attrition rates of midwives, it is a continuing worldwide problem. Little is known about midwiveś work motivation, and understanding this can be key to improving well-being among midwives and thus lowering attrition rates. This study specifically explored midwiveś work-life from a salutogenic perspective focusing on aspects contributing to work motivation rather reasons behind resignation rates.

Objective

To explore midwives’ experiences and perceptions of work motivation from a salutogenic perspective.

Methods

A qualitative study was conducted with 15 female midwives working in two medium-sized labor wards (approximately 1600 childbirths annually). Participants were interviewed between December 2023 and April 2024. Data was synthesized using Reflexive Thematic Analysis.

Results

The analyses resulted in three themes: labor ward size, work-life balance and recognition. Participants elaborated on how workplace size, supportive relationships, self-awareness in work practice, and recognition from patients, peers, and management were key to work motivation. Notably, one of the labor wards had a significantly high proportion of midwives with over 15 years of experience.

Conclusion

By exploring midwives’ experiences through a salutogenic lens, this study highlights key aspects that foster work motivation and professional well-being. Key motivators included manageable ward size, supportive relationships, work-life balance, and recognition from patients, colleagues, and leadership. Notably, a labor ward with a high proportion of experienced midwives exemplified how these factors can foster long-term engagement. Future research could implement different strategies to test how they improve midwives’ motivation.

助产士对于确保高质量的产妇护理至关重要。尽管有人呼吁采取行动遏制助产士的流失率，但这是一个持续存在的全球性问题。人们对助产士的工作动机知之甚少，了解这一点可能是改善助产士幸福感的关键，从而降低流失率。本研究特别从健康的角度探讨了midwiveva的工作-生活，重点关注有助于工作动机的方面，而不是辞职率背后的原因。目的从健康学的角度探讨助产士对工作动机的感受和体会。方法对两个中型产房（年分娩约1600例）的15名女助产士进行定性研究。参与者在2023年12月至2024年4月期间接受了采访。数据采用自反性主题分析进行综合。结果分析得出三个主题：劳动病房规模、工作生活平衡和认可。参与者详细阐述了工作场所的规模、相互支持的关系、工作实践中的自我意识、患者、同事和管理层的认可是工作动机的关键。值得注意的是，其中一个产房拥有超过15年经验的助产士的比例非常高。结论：本研究从健康角度探讨助产士的经验，强调了促进工作动机和职业幸福感的关键方面。主要的激励因素包括可管理的病房规模、支持性关系、工作与生活的平衡以及患者、同事和领导的认可。值得注意的是，一个有高比例经验丰富的助产士的分娩病房证明了这些因素如何能够促进长期参与。未来的研究可以实施不同的策略来测试它们如何提高助产士的积极性。

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引用次数: 0