Adolescent pregnancy has received little attention, despite being it is the leading cause of maternal mortality and morbidity in low-income countries, including Ethiopia. Sidama regional state is one of the regions in Ethiopia that has high rates of adolescent pregnancy. This study aimed to identify factors related to adverse outcomes of adolescent pregnancy, in the Sidama region, Ethiopia.
Methods
A hospital-based unmatched case-control study was conducted among 120 cases and 240 controls of pregnant adolescents. Structured interviews and patient record reviews were used to examine the potential correlates and adverse outcomes of adolescent pregnancy. Using binary logistic analysis, adjusted odds ratio (AOR) with 95% confidence intervals, were computed to identify factors related to adverse outcomes of adolescent pregnancies.
Results
A monthly income below the poverty level (AOR: 3.40; 95% CI, 1.21–9.58), lack of antenatal care follow-up (AOR: 4.22; 95% CI, 1.97–9.04), experiencing gender-based violence (AOR: 2.03; 95% CI, 1.16–3.57), and referral to a specialized health facility (AOR: 2.79; 95% CI,1.39, 5.62) were associated with higher odds of adverse pregnancy outcomes.
Conclusion
Several socio-economic and health care system-related determinants are associated with adverse outcomes of adolescent pregnancy. Therefore, it is crucial to improve free and accessible maternal health care services for adolescents, focusing on education, challenging social norms that condone gender-based violence as well as enhancing the referral system to lessen the burden of adverse outcomes of adolescent pregnancy.
{"title":"Correlates of adverse outcomes of adolescent pregnancy in Sidama region, Ethiopia. An unmatched case-control study","authors":"Rekiku Fikre , Sanne Gerards , Wondwosen Teklesilasie , Jessica Gubbels","doi":"10.1016/j.srhc.2024.100986","DOIUrl":"10.1016/j.srhc.2024.100986","url":null,"abstract":"<div><h3>Introduction</h3><p>Adolescent pregnancy has received little attention, despite being it is the leading cause of maternal mortality and morbidity in low-income countries, including Ethiopia. Sidama regional state is one of the regions in Ethiopia that has high rates of adolescent pregnancy. This study aimed to identify factors related to adverse outcomes of adolescent pregnancy, in the Sidama region, Ethiopia.</p></div><div><h3>Methods</h3><p>A hospital-based unmatched case-control study was conducted among 120 cases and 240 controls of pregnant adolescents. Structured interviews and patient record reviews were used to examine the potential correlates and adverse outcomes of adolescent pregnancy. Using binary logistic analysis, adjusted odds ratio (AOR) with 95% confidence intervals, were computed to identify factors related to adverse outcomes of adolescent pregnancies.</p></div><div><h3>Results</h3><p>A monthly income below the poverty level (AOR: 3.40; 95% CI, 1.21–9.58), lack of antenatal care follow-up (AOR: 4.22; 95% CI, 1.97–9.04), experiencing gender-based violence (AOR: 2.03; 95% CI, 1.16–3.57), and referral to a specialized health facility (AOR: 2.79; 95% CI,1.39, 5.62) were associated with higher odds of adverse pregnancy outcomes.</p></div><div><h3>Conclusion</h3><p>Several socio-economic and health care system-related determinants are associated with adverse outcomes of adolescent pregnancy. Therefore, it is crucial to improve free and accessible maternal health care services for adolescents, focusing on education, challenging social norms that condone gender-based violence as well as enhancing the referral system to lessen the burden of adverse outcomes of adolescent pregnancy.</p></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"41 ","pages":"Article 100986"},"PeriodicalIF":1.8,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1877575624000417/pdfft?md5=7aaaf58efcc39d5a5ba5f9fbb5086971&pid=1-s2.0-S1877575624000417-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141181461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-25DOI: 10.1016/j.srhc.2024.100985
Maria Bjelke , Marie Oscarsson , Lars Thurn , Lina Palmér
Introduction
Prolonged progress can occur in the first and second stages of labour and may contribute to a negative birth experience. However, previous studies have mainly focused on quantitative aspects or overall birth experience, and little is known about women’s experiences of a prolonged passive second stage.
Objective
To describe the lived experiences of a prolonged passive second stage of labour in nulliparous women.
Methods
A qualitative study was conducted with 15 nulliparous women with a passive second stage lasting three hours or more. Data were analysed using thematic analysis based on descriptive phenomenology.
Results
The analysis resulted in four themes: “An unknown phase” that entailed remaining in a phase that the women lacked an awareness of. “Trust and mistrust in the body’s ability” represents the mindset for vaginal birth as well as feelings of powerlessness and self-guilt. The theme “Loss of control” included experiences of frustration, fatigue, and having to deny bodily instincts. “Support through presence and involvement” signifies support through the midwife’s presence in the birthing room, although there were also descriptions of emotional or physical absence.
Conclusions
The findings contribute to the understanding of prolonged labour based on women’s lived experiences and add to the body of knowledge about the prolonged passive second stage. This study highlights that women need support through information, presence, and encouragement to remain in control. It can be beneficial during birth preparation to include knowledge about the passive second stage together with unexpected or complicated situations during birth, such as prolonged labour.
{"title":"Nulliparous women’s lived experiences of the prolonged passive stage of labour: A thematic analysis based on descriptive phenomenology","authors":"Maria Bjelke , Marie Oscarsson , Lars Thurn , Lina Palmér","doi":"10.1016/j.srhc.2024.100985","DOIUrl":"10.1016/j.srhc.2024.100985","url":null,"abstract":"<div><h3>Introduction</h3><p>Prolonged progress can occur in the first and second stages of labour and may contribute to a negative birth experience. However, previous studies have mainly focused on quantitative aspects or overall birth experience, and little is known about women’s experiences of a prolonged passive second stage.</p></div><div><h3>Objective</h3><p>To describe the lived experiences of a prolonged passive second stage of labour in nulliparous women.</p></div><div><h3>Methods</h3><p>A qualitative study was conducted with 15 nulliparous women with a passive second stage lasting three hours or more. Data were analysed using thematic analysis based on descriptive phenomenology.</p></div><div><h3>Results</h3><p>The analysis resulted in four themes: “An unknown phase” that entailed remaining in a phase that the women lacked an awareness of. “Trust and mistrust in the body’s ability” represents the mindset for vaginal birth as well as feelings of powerlessness and self-guilt. The theme “Loss of control” included experiences of frustration, fatigue, and having to deny bodily instincts. “Support through presence and involvement” signifies support through the midwife’s presence in the birthing room, although there were also descriptions of emotional or physical absence.</p></div><div><h3>Conclusions</h3><p>The findings contribute to the understanding of prolonged labour based on women’s lived experiences and add to the body of knowledge about the prolonged passive second stage. This study highlights that women need support through information, presence, and encouragement to remain in control. It can be beneficial during birth preparation to include knowledge about the passive second stage together with unexpected or complicated situations during birth, such as prolonged labour.</p></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"41 ","pages":"Article 100985"},"PeriodicalIF":1.8,"publicationDate":"2024-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141187163","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 : 2024-05-24DOI: 10.1016/j.srhc.2024.100984
Lisa Lindgren , Stavros I. Iliadis , Helena Volgsten
Objective
To explore men’s and women’s experiences regarding their history of sexual health when attending a fertility clinic.
Methods
A qualitative study with semi-structured individual interviews was conducted among heterosexual males and females seeking infertility care at a public fertility clinic in Sweden in 2022–2023. The interviews were audio-recorded, transcribed verbatim and analyzed using qualitative content analysis.
Results
Eight males and ten females were included. The analysis resulted in an overarching theme: A change from spontaneous to scheduled intercourse affects various aspects of sexual health. In the beginning of the relationship sex had been spontaneous, joyful and satisfying. However, sex was not always unproblematic, and there had been sexual changes. Sex with a reproductive purpose was scheduled according to ovulation, leading to changes in sexual behavior. Increased erectile problems in men and decreased frequency of orgasms in women, and a lack of sexual desire in both, were experienced. Men and women felt pressured to have sex when it became a requirement. Men’s sexual and women’s reproductive failures led to negative emotional reactions, including stress, frustration, disappointment, anxiety and guilt. Sexual and reproductive problems affected the relational well-being, leading to feelings of sharing the burden but also conflicts and sexual avoidance.
Conclusions
Experiencing reproductive failures, sexual problems and negative emotional reactions can affect men’s and women’s sexual health. Therefore, an implication for clinical practice among healthcare professionals during evaluation of infertility, is a need to be aware of and ask questions about sexual health after reproductive failures.
{"title":"Reproductive sex ending in failure affects sexual health – A qualitative study of men and women attending a fertility clinic","authors":"Lisa Lindgren , Stavros I. Iliadis , Helena Volgsten","doi":"10.1016/j.srhc.2024.100984","DOIUrl":"10.1016/j.srhc.2024.100984","url":null,"abstract":"<div><h3>Objective</h3><p>To explore men’s and women’s experiences regarding their history of sexual health when attending a fertility clinic.</p></div><div><h3>Methods</h3><p>A qualitative study with semi-structured individual interviews was conducted among heterosexual males and females seeking infertility care at a public fertility clinic in Sweden in 2022–2023. The interviews were audio-recorded, transcribed verbatim and analyzed using qualitative content analysis.</p></div><div><h3>Results</h3><p>Eight males and ten females were included. The analysis resulted in an overarching theme: A change from spontaneous to scheduled intercourse affects various aspects of sexual health. In the beginning of the relationship sex had been spontaneous, joyful and satisfying. However, sex was not always unproblematic, and there had been sexual changes. Sex with a reproductive purpose was scheduled according to ovulation, leading to changes in sexual behavior. Increased erectile problems in men and decreased frequency of orgasms in women, and a lack of sexual desire in both, were experienced. Men and women felt pressured to have sex when it became a requirement. Men’s sexual and women’s reproductive failures led to negative emotional reactions, including stress, frustration, disappointment, anxiety and guilt. Sexual and reproductive problems affected the relational well-being, leading to feelings of sharing the burden but also conflicts and sexual avoidance.</p></div><div><h3>Conclusions</h3><p>Experiencing reproductive failures, sexual problems and negative emotional reactions can affect men’s and women’s sexual health. Therefore, an implication for clinical practice among healthcare professionals during evaluation of infertility, is a need to be aware of and ask questions about sexual health after reproductive failures.</p></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"41 ","pages":"Article 100984"},"PeriodicalIF":1.8,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1877575624000399/pdfft?md5=0ce76a8fb000768edb852a0f2f8e5adf&pid=1-s2.0-S1877575624000399-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141131034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-23DOI: 10.1016/j.srhc.2024.100983
Cæcilie Kongsgaard Balle , Dorte Hvidtjørn , Maria Louise Birkegård Brintow , Chunsen Wu , Christina Prinds
Objective
The birth of a child is a significant life event, possibly accompanied by thoughts and feelings of existential turmoil, which some parents need to share. Maternity care professionals may be unprepared for this, as very few educational initiatives exist with a focus on existential communication. We evaluated the curriculum and delivery of a course in existential communication for midwives. The evaluation was based on participants’ experiences of self-reported self-efficacy and self-reflection before and after participation.
Methods
A parallel mixed methods design with pre- and post-course questionnaires and field observations. Quantitative data were evaluated using Mann-Whitney analyses, and open-ended questions and field observations were thematised for further analysis.
Results
Seventy-three maternity care professionals participated in the course. Of these, 69 (95%) completed a pre-course questionnaire, and 71 (97%) a post-course questionnaire. The quantitative data found a significant difference in various participant measures such as increase in self-efficacy in existential communication and understanding of existential communication. Qualitative data from the questionnaires and field observations led to six different themes including topics such as the need for reflection with peers and the presence of existential within maternity care.
Conclusions
The course evaluation suggested an increase in participants’ awareness of existential aspects of maternity care and improved self-reflection and existential awareness.
{"title":"Existential communication in maternity care – Mixed method evaluation of a postgraduate short course","authors":"Cæcilie Kongsgaard Balle , Dorte Hvidtjørn , Maria Louise Birkegård Brintow , Chunsen Wu , Christina Prinds","doi":"10.1016/j.srhc.2024.100983","DOIUrl":"10.1016/j.srhc.2024.100983","url":null,"abstract":"<div><h3>Objective</h3><p>The birth of a child is a significant life event, possibly accompanied by thoughts and feelings of existential turmoil, which some parents need to share. Maternity care professionals may be unprepared for this, as very few educational initiatives exist with a focus on existential communication. We evaluated the curriculum and delivery of a course in existential communication for midwives. The evaluation was based on participants’ experiences of self-reported self-efficacy and self-reflection before and after participation.</p></div><div><h3>Methods</h3><p>A parallel mixed methods design with pre- and post-course questionnaires and field observations. Quantitative data were evaluated using Mann-Whitney analyses, and open-ended questions and field observations were thematised for further analysis.</p></div><div><h3>Results</h3><p>Seventy-three maternity care professionals participated in the course. Of these, 69 (95%) completed a pre-course questionnaire, and 71 (97%) a post-course questionnaire. The quantitative data found a significant difference in various participant measures such as increase in self-efficacy in existential communication and understanding of existential communication. Qualitative data from the questionnaires and field observations led to six different themes including topics such as the need for reflection with peers and the presence of existential within maternity care.</p></div><div><h3>Conclusions</h3><p>The course evaluation suggested an increase in participants’ awareness of existential aspects of maternity care and improved self-reflection and existential awareness.</p></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"41 ","pages":"Article 100983"},"PeriodicalIF":1.8,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1877575624000387/pdfft?md5=834820a2655e78f08bfb46f60f0f4969&pid=1-s2.0-S1877575624000387-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141140524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-19DOI: 10.1016/j.srhc.2024.100982
Barbro Ljungberg , Panagiotis Papachristou , Sofia Zwedberg
Objective
To investigate how fathers or partners perceive their roles as new parents when confronted with early breastfeeding challenges, how they navigate these difficulties, and the specific type of support they seek from the Child Health Care Centre (CHCC).
Method
In-depth, individual interviews conducted with 12 partners of women for whom breastfeeding was difficult. Reflexive thematic analysis was applied on the interview data.
Results
Interviews resulted in three themes: 1) ‘It is a revolutionary time to be a new father’ represented a tumultuous time when fathers wanted to be involved in all decisions and part of a strong team with their partners. 2) ‘When a breastfeeding problem arose’; fathers questioned the sovereignty of breast milk and began to seek more knowledge. They experienced a strong social norm about breastfeeding that led to feelings of guilt for their partners. They felt helpless when their partners suffered and lacked support. 3) ‘Child Health Care Centre’s duty’; was instrumental, as knowledge and competence were found to be important for trust. The fathers wanted concrete solutions to breastfeeding problems and more conversations of support with the CHCC nurse.
Conclusion
Well-educated fathers desire to protect their partners as they experience suffering due to a robust social norm telling them that breastfeeding is best. This can result in them starting to question the sovereignty of breast milk. Fathers need support to help their partners successfully during breastfeeding. They want counselling to strengthen their role as parents and help them build trusting teams with their partners.
{"title":"Thoughts and experiences of well-educated fathers about their role when breastfeeding difficulties arose","authors":"Barbro Ljungberg , Panagiotis Papachristou , Sofia Zwedberg","doi":"10.1016/j.srhc.2024.100982","DOIUrl":"https://doi.org/10.1016/j.srhc.2024.100982","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate how fathers or partners perceive their roles as new parents when confronted with early breastfeeding challenges, how they navigate these difficulties, and the specific type of support they seek from the Child Health Care Centre (CHCC).</p></div><div><h3>Method</h3><p>In-depth, individual interviews conducted with 12 partners of women for whom breastfeeding was difficult. Reflexive thematic analysis was applied on the interview data.</p></div><div><h3>Results</h3><p>Interviews resulted in three themes: 1) ‘It is a revolutionary time to be a new father’ represented a tumultuous time when fathers wanted to be involved in all decisions and part of a strong team with their partners. 2) ‘When a breastfeeding problem arose’; fathers questioned the sovereignty of breast milk and began to seek more knowledge. They experienced a strong social norm about breastfeeding that led to feelings of guilt for their partners. They felt helpless when their partners suffered and lacked support. 3) ‘Child Health Care Centre’s duty’; was instrumental, as knowledge and competence were found to be important for trust. The fathers wanted concrete solutions to breastfeeding problems and more conversations of support with the CHCC nurse.</p></div><div><h3>Conclusion</h3><p>Well-educated fathers desire to protect their partners as they experience suffering due to a robust social norm telling them that breastfeeding is best. This can result in them starting to question the sovereignty of breast milk. Fathers need support to help their partners successfully during breastfeeding. They want counselling to strengthen their role as parents and help them build trusting teams with their partners.</p></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"40 ","pages":"Article 100982"},"PeriodicalIF":1.8,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1877575624000375/pdfft?md5=b476a9e58715d9118db6555ca8c5c218&pid=1-s2.0-S1877575624000375-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141090604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-07DOI: 10.1016/j.srhc.2024.100980
Julie M. Buser , Marie Laetitia Ishimwe Bazakare , Gerard Kaberuka , Ella August , Madeleine Mukeshimana , Rachel Gray , Diomede Ntasumbumuyange , Faelan E. Jacobson-Davies , Tamrat Endale , Olive Tengera , Yolanda R. Smith
Background
Addressing the gap between research and practice is crucial for enhancing reproductive healthcare outcomes. In Rwanda and other low- and middle-income countries, bolstering health researchers’ implementation science (IS) capacity is essential. We present a pre-post-intervention study assessing the influence of an intensive IS training program on Rwandan reproductive health researchers’ perceived IS knowledge and self-efficacy in applying IS in their own research.
Methods
To introduce IS principles, we held a one-day training for a diverse cohort of 25 sexual and reproductive health researchers in Rwanda. The training encompassed modules on IS concepts, methodologies, and practical applications. Pre- and post-training assessments gauged changes in participants’ perceived IS knowledge and self-efficacy in applying IS in their own work.
Results
The study revealed a significant improvement in self-efficacy related to performing IS related tasks. Researchers reported heightened confidence in designing and implementing evidence-based interventions. In terms of perceived knowledge, participants retained what they learned at 4 months. The training fostered a collaborative learning environment, encouraging participants to exchange ideas and experiences.
Conclusion
Targeted training in IS appears to enhance reproductive health researchers’ capacity to translate research into practice, potentially leading to improved healthcare outcomes in Rwanda. Moving forward, we advocate for the Ministry of Health to establish structures for IS research agenda-setting, particularly for sexual and reproductive health and rights. Ideally, universities, health systems, and research institutions will incorporate IS capacity strengthening into their routine activities. Ongoing training is crucial to reinforce and expand IS knowledge. Our findings are expected to inform future interventions and guide policy development.
背景解决研究与实践之间的差距对于提高生殖保健成果至关重要。在卢旺达和其他中低收入国家，加强健康研究人员的实施科学（IS）能力至关重要。为了介绍实施科学原则，我们为卢旺达的 25 名性健康和生殖健康研究人员举办了为期一天的培训。培训内容包括 IS 概念、方法和实际应用等模块。培训前和培训后的评估衡量了参与者对信息系统知识的感知变化以及在自己的工作中应用信息系统的自我效能。研究人员报告说，他们在设计和实施循证干预措施方面增强了信心。在感知知识方面，学员在 4 个月后仍能保持所学知识。结论有针对性的信息服务培训似乎提高了生殖健康研究人员将研究转化为实践的能力，从而有可能改善卢旺达的医疗保健成果。展望未来，我们主张卫生部建立基础设施服务研究议程制定机构，特别是在性与生殖健康和权利方面。理想的情况是，大学、卫生系统和研究机构将把加强基础设施服务能力纳入其日常活动。持续的培训对于巩固和扩展信息服务知识至关重要。我们的研究结果有望为未来的干预措施提供信息，并为政策制定提供指导。
{"title":"Strengthening healthcare delivery in Rwanda: Implementation science training for reproductive health researchers","authors":"Julie M. Buser , Marie Laetitia Ishimwe Bazakare , Gerard Kaberuka , Ella August , Madeleine Mukeshimana , Rachel Gray , Diomede Ntasumbumuyange , Faelan E. Jacobson-Davies , Tamrat Endale , Olive Tengera , Yolanda R. Smith","doi":"10.1016/j.srhc.2024.100980","DOIUrl":"https://doi.org/10.1016/j.srhc.2024.100980","url":null,"abstract":"<div><h3>Background</h3><p>Addressing the gap between research and practice is crucial for enhancing reproductive healthcare outcomes. In Rwanda and other low- and middle-income countries, bolstering health researchers’ implementation science (IS) capacity is essential. We present a pre-post-intervention study assessing the influence of an intensive IS training program on Rwandan reproductive health researchers’ perceived IS knowledge and self-efficacy in applying IS in their own research.</p></div><div><h3>Methods</h3><p>To introduce IS principles, we held a one-day training for a diverse cohort of 25 sexual and reproductive health researchers in Rwanda. The training encompassed modules on IS concepts, methodologies, and practical applications. Pre- and post-training assessments gauged changes in participants’ perceived IS knowledge and self-efficacy in applying IS in their own work.</p></div><div><h3>Results</h3><p>The study revealed a significant improvement in self-efficacy related to performing IS related tasks. Researchers reported heightened confidence in designing and implementing evidence-based interventions. In terms of perceived knowledge, participants retained what they learned at 4 months. The training fostered a collaborative learning environment, encouraging participants to exchange ideas and experiences.</p></div><div><h3>Conclusion</h3><p>Targeted training in IS appears to enhance reproductive health researchers’ capacity to translate research into practice, potentially leading to improved healthcare outcomes in Rwanda. Moving forward, we advocate for the Ministry of Health to establish structures for IS research agenda-setting, particularly for sexual and reproductive health and rights. Ideally, universities, health systems, and research institutions will incorporate IS capacity strengthening into their routine activities. Ongoing training is crucial to reinforce and expand IS knowledge. Our findings are expected to inform future interventions and guide policy development.</p></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"40 ","pages":"Article 100980"},"PeriodicalIF":1.8,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1877575624000351/pdfft?md5=303bf37adc825ffad51f5a2e746afa24&pid=1-s2.0-S1877575624000351-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140901250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-06DOI: 10.1016/j.srhc.2024.100981
Mia A. McLean , Chloé Klimos , Belinda Lequertier , Hazel Keedle , Guillaume Elgbeili , Sue Kildea , Suzanne King , Hannah G. Dahlen
Objective
The present study aimed to understand, relative to standard care, whether continuity of care models (private midwifery, continuity of care with a private doctor, continuity of care with a public midwife), and women’s experience of maternity care provision, during the perinatal period buffered the association between prenatal maternal stress (PNMS) and infant birth outcomes (gestational age [GA], birth weight [BW] and birth weight for gestational age [BW for GA]).
Methods
2207 women who were pregnant in Australia while COVID-19 restrictions were in place reported on their COVID-19 related objective hardship and subjective distress during pregnancy and provided information on their model of maternity care. Infant birth outcomes (BW, GA) were reported on at 2-months postpartum.
Results
Multiple linear regressions showed no relationship between PNMS and infant BW, GA or BW for GA, and neither experienced continuity of care, nor model of maternity care moderated this relationship. However, compared with all other models of care, women enrolled in private midwifery care reported the highest levels of experienced continuity of care and birthed infants at higher GA. BW and BW for GA were higher in private midwifery care, relative to standard care.
Conclusion
Enrollment in continuous models of perinatal care may be a better predictor of infant birth outcomes than degree of PNMS exposure. These results highlight the possibility that increased, continuous support to women during pregnancy may play an important role in ensuring positive infant birth outcomes during future pandemics.
目的本研究旨在了解，相对于标准护理，围产期的连续性护理模式（私人助产士、私人医生的连续性护理、公立助产士的连续性护理）和妇女的产科护理经验是否能缓冲产前母亲压力（PNMS）与婴儿出生结果（胎龄[GA]、出生体重[BW]和胎龄出生体重[BW for GA]）之间的关联。方法 2207 名在 COVID-19 限制措施实施期间在澳大利亚怀孕的妇女报告了她们在怀孕期间与 COVID-19 相关的客观困难和主观痛苦，并提供了有关其产妇护理模式的信息。结果多重线性回归结果显示，PNMS 与婴儿体重、性别差异或体重与性别差之间没有关系，而经历过的连续性护理或孕产妇护理模式都没有调节这种关系。然而，与所有其他护理模式相比，接受私立助产护理的产妇所报告的持续护理经验水平最高，所产婴儿的体重也较高。与标准护理相比，私立助产护理的婴儿体重和GA体重更高。这些结果表明，在未来的大流行病期间，为孕期妇女提供更多的持续支持可能会在确保婴儿顺利出生方面发挥重要作用。
{"title":"Model of perinatal care but not prenatal stress exposure is associated with birthweight and gestational age at Birth: The Australian birth in the time of COVID (BITTOC) study","authors":"Mia A. McLean , Chloé Klimos , Belinda Lequertier , Hazel Keedle , Guillaume Elgbeili , Sue Kildea , Suzanne King , Hannah G. Dahlen","doi":"10.1016/j.srhc.2024.100981","DOIUrl":"https://doi.org/10.1016/j.srhc.2024.100981","url":null,"abstract":"<div><h3>Objective</h3><p>The present study aimed to understand, relative to standard care, whether continuity of care models (private midwifery, continuity of care with a private doctor, continuity of care with a public midwife), and women’s experience of maternity care provision, during the perinatal period buffered the association between prenatal maternal stress (PNMS) and infant birth outcomes (gestational age [GA], birth weight [BW] and birth weight for gestational age [BW for GA]).</p></div><div><h3>Methods</h3><p>2207 women who were pregnant in Australia while COVID-19 restrictions were in place reported on their COVID-19 related objective hardship and subjective distress during pregnancy and provided information on their model of maternity care. Infant birth outcomes (BW, GA) were reported on at 2-months postpartum.</p></div><div><h3>Results</h3><p>Multiple linear regressions showed no relationship between PNMS and infant BW, GA or BW for GA, and neither experienced continuity of care, nor model of maternity care moderated this relationship. However, compared with all other models of care, women enrolled in private midwifery care reported the highest levels of experienced continuity of care and birthed infants at higher GA. BW and BW for GA were higher in private midwifery care, relative to standard care.</p></div><div><h3>Conclusion</h3><p>Enrollment in continuous models of perinatal care may be a better predictor of infant birth outcomes than degree of PNMS exposure. These results highlight the possibility that increased, continuous support to women during pregnancy may play an important role in ensuring positive infant birth outcomes during future pandemics.</p></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"40 ","pages":"Article 100981"},"PeriodicalIF":1.8,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913863","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}
Ensuring quality of maternal and newborn healthcare is challenging in the Democratic Republic of Congo (DRC) as the maternal and newborn mortality and morbidity rate is high. Essential for quality care is a person-centred approach. One model of person-centred care (PCC) has been developed at Gothenburg University. To support its implementation a training programme, “Mutual Meetings”, has been developed. This study aims to test the feasibility of a translated and culturally adapted version of this PCC training programme for healthcare providers in the maternal and newborn healthcare context of DRC.
Methods
The PCC programme was translated into French and tested in a workshop with 31 maternal and newborn healthcare providers in eastern DRC. The feasibility of the programme was evaluated through focus group interviews and individual interviews. The interview transcripts were analysed deductively using key components in a process evaluation framework including fidelity, dose, reach, adaptation, acceptability, and application.
Results
The French PCC programme exceeded the participants’ expectations and was found being applicable in both teaching and clinical setting with some suggested contextual modifications. Its pedagogic structure including a participatory reflective approach, was perceived innovative and inspirational, mediated a sense of comfort, and enabled the participants to use a person-centred approach towards each other.
Conclusion
The results show that the French on-site version of the PCC training programme was valid in terms of feasibility and how it was received by the participants. The study demonstrates the importance of contextual adaptation of complex interventions in new settings.
{"title":"Testing the feasibility of a translated and culturally adapted person-centred training programme in maternal and newborn healthcare in Democratic Republic of Congo: A process evaluation","authors":"Ewa Carlsson Lalloo , Frida Temple , Marie Berg , Urban Berg , Alumeti Munyali Désiré , Aline Mulunda , Malin Bogren","doi":"10.1016/j.srhc.2024.100979","DOIUrl":"https://doi.org/10.1016/j.srhc.2024.100979","url":null,"abstract":"<div><h3>Objective</h3><p>Ensuring quality of maternal and newborn healthcare is challenging in the Democratic Republic of Congo (DRC) as the maternal and newborn mortality and morbidity rate is high. Essential for quality care is a person-centred approach. One model of person-centred care (PCC) has been developed at Gothenburg University. To support its implementation a training programme, “Mutual Meetings”, has been developed. This study aims to test the feasibility of a translated and culturally adapted version of this PCC training programme for healthcare providers in the maternal and newborn healthcare context of DRC.</p></div><div><h3>Methods</h3><p>The PCC programme was translated into French and tested in a workshop with 31 maternal and newborn healthcare providers in eastern DRC. The feasibility of the programme was evaluated through focus group interviews and individual interviews. The interview transcripts were analysed deductively using key components in a process evaluation framework including fidelity, dose, reach, adaptation, acceptability, and application.</p></div><div><h3>Results</h3><p>The French PCC programme exceeded the participants’ expectations and was found being applicable in both teaching and clinical setting with some suggested contextual modifications. Its pedagogic structure including a participatory reflective approach, was perceived innovative and inspirational, mediated a sense of comfort, and enabled the participants to use a person-centred approach towards each other.</p></div><div><h3>Conclusion</h3><p>The results show that the French on-site version of the PCC training programme was valid in terms of feasibility and how it was received by the participants. The study demonstrates the importance of contextual adaptation of complex interventions in new settings.</p></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"40 ","pages":"Article 100979"},"PeriodicalIF":1.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S187757562400034X/pdfft?md5=190c5fa760dec9ccc59acc71e8047831&pid=1-s2.0-S187757562400034X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140947572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1016/j.srhc.2024.100977
Ingela Wiklund
{"title":"Episiotomy and the medicalization make childbirth worse for women","authors":"Ingela Wiklund","doi":"10.1016/j.srhc.2024.100977","DOIUrl":"https://doi.org/10.1016/j.srhc.2024.100977","url":null,"abstract":"","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"40 ","pages":"Article 100977"},"PeriodicalIF":1.8,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140906097","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 : 2024-04-30DOI: 10.1016/j.srhc.2024.100978
Sarah J Farrell , Tracey A. Mills , Tina Lavender
Aim
To understand the maternity experiences of women from minority ethnic groups who had given birth in an NHS trust in the North-West of England, and experiences of midwives caring for them.
Background
Women from minority ethnic groups have poorer maternity outcomes compared with other women. Research about maternity experiences of women from minority ethnic groups is limited but suggests that they have poorer experiences.
Method
Constructivist grounded theory was used as the framework for the study. Thirteen women and sixteen midwives were interviewed to elicit views and maternity experiences of women from minority ethnic groups. Interviews were transcribed, analysed, and focused codes developed into theoretical codes resulting in an emergent grounded theory.
Findings
Four sub-categories emerged: ‘I was feeling protected’, ‘it is just literally empowering them, ‘it will affect them more’, and ‘if people speak out it will help other people’. These sub-categories generated a substantive theory: ‘striving towards equity and women centred care’.
Discussion
Culturally sensitive, relational care made women feel safe and trust their care providers. Information provision led to reassurance and enabled women to make choices about their care. Midwives’ workload compromised care provision and disproportionally affected women from minority ethnic groups, especially those who do not speak English. Women from minority groups are less likely to complain and be represented in feedback.
Conclusion
Culturally sensitive care is meeting the individual needs of many women; however, non– English speakers are disproportionally and negatively affected by midwives’ workload, attitudes, or service challenges, reducing their reassurance and choice.
{"title":"Maternity care for women from ethnic minority backgrounds in North-West England: A grounded theory study","authors":"Sarah J Farrell , Tracey A. Mills , Tina Lavender","doi":"10.1016/j.srhc.2024.100978","DOIUrl":"https://doi.org/10.1016/j.srhc.2024.100978","url":null,"abstract":"<div><h3>Aim</h3><p>To understand the maternity experiences of women from minority ethnic groups who had given birth in an NHS trust in the North-West of England, and experiences of midwives caring for them.</p></div><div><h3>Background</h3><p>Women from minority ethnic groups have poorer maternity outcomes compared with other women. Research about maternity experiences of women from minority ethnic groups is limited but suggests that they have poorer experiences.</p></div><div><h3>Method</h3><p>Constructivist grounded theory was used as the framework for the study. Thirteen women and sixteen midwives were interviewed to elicit views and maternity experiences of women from minority ethnic groups. Interviews were transcribed, analysed, and focused codes developed into theoretical codes resulting in an emergent grounded theory.</p></div><div><h3>Findings</h3><p>Four sub-categories emerged: ‘I was feeling protected’, ‘it is just literally empowering them, ‘it will affect them more’, and ‘if people speak out it will help other people’. These sub-categories generated a substantive theory: ‘striving towards equity and women centred care’.</p></div><div><h3>Discussion</h3><p>Culturally sensitive, relational care made women feel safe and trust their care providers. Information provision led to reassurance and enabled women to make choices about their care. Midwives’ workload compromised care provision and disproportionally affected women from minority ethnic groups, especially those who do not speak English. Women from minority groups are less likely to complain and be represented in feedback.</p></div><div><h3>Conclusion</h3><p>Culturally sensitive care is meeting the individual needs of many women; however, non– English speakers are disproportionally and negatively affected by midwives’ workload, attitudes, or service challenges, reducing their reassurance and choice.</p></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"40 ","pages":"Article 100978"},"PeriodicalIF":1.8,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140822837","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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