Sexual & Reproductive Healthcare最新文献

{"title":"The importance of clinical supervision and teaching methods for midwifery students’ confidence in intrapartum care. A mixed method study","authors":"Lena Bäck ,&nbsp;Anette Björk ,&nbsp;Bharati Sharma ,&nbsp;Lisbeth Kristiansen ,&nbsp;Ingegerd Hildingsson","doi":"10.1016/j.srhc.2025.101128","DOIUrl":"10.1016/j.srhc.2025.101128","url":null,"abstract":"<div><h3>Objective</h3><div>Midwifery students’ need to be confident, and it is important to identify factors that might affect students’ confidence. Achieving registration as a midwife requires academic, clinical and professional competence. In the 1,5-year post-nursing program in Sweden 50% is allocated to clinical practice, and students must assist a minimum of 50 births. There is a lack of knowledge regarding the significance of supervision and to consider both theoretical and practical aspects of midwifery education. This study intends to identify relationships between midwifery students’ confidence in intrapartum care and associated factors. An additional aim was to provide a member check of the validity of the findings.</div></div><div><h3>Methods</h3><div>All midwifery programs in Sweden participated in this cross-sectional study, where 238 (78%) midwifery students completed a questionnaire based on the competency descriptions by the International Confederation of Midwives. Confirmatory interviews were conducted for checking the results relevance.</div></div><div><h3>Result</h3><div>The organization of midwifery education, satisfaction with supervision and theoretical teaching significantly impacted students’ confidence. Few background variables were associated with confidence.</div></div><div><h3>Conclusion</h3><div>Clinical supervision was important. Students preferred lectures and practical demonstrations instead of self-studies. The structure and quality of both practical and theoretical training are crucial for building confidence. Newly graduated midwives qualitatively confirmed the results of the analysis. They also experienced a stressful environment, only focusing on to assist at the required 50 births.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"45 ","pages":"Article 101128"},"PeriodicalIF":1.4,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144655256","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}

{"title":"The association between exclusive breastfeeding and quality of care and maternal factors in a tertiary maternity hospital in Finland: A cross-sectional study","authors":"Jaana Lojander ,&nbsp;Anna Axelin ,&nbsp;Aydin Tekay ,&nbsp;Seppo Heinonen ,&nbsp;Satu Polkko ,&nbsp;Laura Lehti ,&nbsp;Terhi Kolari ,&nbsp;Hannakaisa Niela-Vilén","doi":"10.1016/j.srhc.2025.101127","DOIUrl":"10.1016/j.srhc.2025.101127","url":null,"abstract":"<div><h3>Background</h3><div>Mothers’ perceptions of high-quality hospital care may improve breastfeeding outcomes, yet postnatal care in hospitals is often rated poorly by mothers, highlighting the need to focus on the quality and maternal perceptions of care, not just its provision. Fewer women exclusively breastfeed than intend to. The aim was to examine the association between exclusive breastfeeding, quality of care, and maternal factors based on maternal reports.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted at a Finnish maternity hospital in 2022–2023. Data were collected through an online survey of mothers within 12 weeks of childbirth. Quality of care was measured by childbirth satisfaction, early breastfeeding initiation, family-centered care, maternal satisfaction with postnatal care, and breastfeeding support. Binary logistic regression analyzed associations between exclusive breastfeeding, quality of care, and maternal factors.</div></div><div><h3>Findings</h3><div>A total of n = 160 mothers participated. Lack of early breastfeeding initiation (OR 2.20, p = 0.05), inadequate breastfeeding support (OR 2.05, p = 0.05), lower family-centered care quality (OR 2.14, p = 0.04), primiparity (OR 2.94, p &lt; 0.001), antenatal non-exclusive breastfeeding plan (OR 6.44, p &lt; 0.0001), and lower parenting self-efficacy (OR 4.98, p &lt; 0.0001) were associated with non-exclusive breastfeeding. The most significant predictor of non-exclusive breastfeeding was a lack of antenatal breastfeeding plan (OR 6.22) combined with lower parenting self-efficacy (OR 4.81).</div></div><div><h3>Conclusion</h3><div>Early breastfeeding initiation, support, and family-centered care were initially associated with breastfeeding outcomes; however, only the maternal factors—absence of antenatal breastfeeding plans and lower parenting self-efficacy—remained significantly associated with non-exclusive breastfeeding.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"45 ","pages":"Article 101127"},"PeriodicalIF":1.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144548859","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}

{"title":"Underserved groups access to reproductive services: A literature review of women aged 18–25 years","authors":"Jacqueline Wier ,&nbsp;Nikki Price ,&nbsp;Hannah Brisley ,&nbsp;Paula Brockmann","doi":"10.1016/j.srhc.2025.101126","DOIUrl":"10.1016/j.srhc.2025.101126","url":null,"abstract":"<div><div>The Covid-19 pandemic highlighted the need for several improvements for young women, in terms of accessing, funding, and strategies for the development of sexual and reproductive health care (SRH). Core recommendations were highlighted by the All-Party Parliamentary Group (APPG) Report (Johnson,2020) on sexual and reproductive Health in the UK. Key recommendations included that the choice of method and delivery of reproductive services for women is reducing. This was furthered globally by the World Health Organisation (WHO) (2023) who note a need for equity in access, supportive health monitoring and a focus on underserved groups.</div><div>This literature review was conducted using the established method of thematic analysis (Braun &amp; Clarke,2006), and in parallel with the APPG report and WHO recommendations, consolidates the findings into three key themed areas: underserved women’s reproductive healthcare, cost effective contraception, young people’s access to and understanding of fertility and contraception services. Underserved communities such as young women from marginalised groups, people of colour (Messinis et al,2021), women who have sex with women (Burkill &amp; Waterhouse2019) and women with disabilities (McCarthy,2011), experience inadequate and disparity of provision when accessing reproductive services. The review highlights limited high quality, recent, UK-based studies to further inform local governments, that considers the views and needs of young women 18–25 years when accessing reproductive services to implement change.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"45 ","pages":"Article 101126"},"PeriodicalIF":1.4,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144563840","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}

{"title":"Awareness, intentions, and attitudes towards social elective oocyte cryopreservation among female staff in assisted reproductive technology units in Athens, Greece","authors":"Eirini Manta ,&nbsp;Angeliki Bolou ,&nbsp;Nikolaos F. Vlahos ,&nbsp;Aikaterini Lykeridou ,&nbsp;Precious K. Ijoyah ,&nbsp;Antigoni Sarantaki","doi":"10.1016/j.srhc.2025.101125","DOIUrl":"10.1016/j.srhc.2025.101125","url":null,"abstract":"<div><h3>Aim</h3><div>The purpose of this study is to investigate the knowledge level and beliefs of healthcare professionals working in Assisted Reproductive Technology (ART) units in Athens, regarding Planned Oocyte Cryopreservation (POC).</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted in May 2024 among 105 female staff at two major ART units in Athens: Institute of Life IASO, IASO Maternity Hospital and the HYGEIA IVF Embryogenesis unit, Mitera Maternity Hospital. Participants completed anonymized questionnaires, adapted from Kim’s et al.(1)study on oocyte cryopreservation awareness, with written permission. The questionnaire was professionally translated into Greek and underwent a formal validation process. Informed consent was obtained from all participants.</div></div><div><h3>Results</h3><div>Among the 91 respondents (86.7 % response rate), 97.8 % were aware of POC. Younger age (p = 0.018), higher income (p = 0.024), and postgraduate education were associated with a greater likelihood of considering oocyte cryopreservation. Medical counselling was significantly associated with consideration of POC (p = 0.001), while those informed through educational lectures were more likely to view it positively. Despite professional exposure, only half had received fertility counselling. Participants were divided into two groups: those who had considered egg freezing (N = 46) and those who had not (N = 45). There were significant differences in age, income, education level, and information sources between groups.</div></div><div><h3>Conclusion</h3><div>This study highlights that ART professionals in Greece support a woman’s right to freeze her eggs for social reasons and strongly endorse the need for fertility counselling during OB/GYN visits. Structured education and clinical guidance appear critical in shaping attitudes toward POC.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"45 ","pages":"Article 101125"},"PeriodicalIF":1.4,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144502596","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}

{"title":"Traumatic birth experience and posttraumatic stress disorder: The psychometric properties of the Icelandic version of the City Birth Trauma Scale (City BiTS)","authors":"Valgerður Lísa Sigurðardóttir ,&nbsp;Linda Bára Lýðsdóttir ,&nbsp;Emma Marie Swift","doi":"10.1016/j.srhc.2025.101124","DOIUrl":"10.1016/j.srhc.2025.101124","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study was to investigate the psychometric properties of the Icelandic City Birth Trauma Scale (City BiTS) and assess the prevalence of childbirth related post-traumatic stress symptoms and post-traumatic stress disorder in the Icelandic population.</div></div><div><h3>Methods</h3><div>The City BiTS was translated to Icelandic and tested for face-validity (n = 6). Data was collected in 2022 in an online cross-sectional survey among mothers 6–12 weeks postpartum (<em>n</em> = 616). Exploratory Factor Analysis (EFA) was used to test the underlying factor structure. Internal consistency was assessed using Cronbach’s alpha and McDonald’s Omega. Convergent validity was evaluated with Spearmańs rank correlation with Birth Satisfaction Scale Revised (BSS-R) and Edinburgh Postnatal Depression Scale. Discriminant validity was explored through correlations with BSS-R. Mann-Whitney <em>U</em> test and Kruskal-Wallis test was used for assessment of group differences. Dunn’s paired tests were conducted for variables with more than two groups.</div></div><div><h3>Results</h3><div>Of 616 women, 15.6 % had traumatic birth experiences and 2.4 % fulfilled the criteria of childbirth-related post-traumatic stress. EFA showed that a two-factor model presented the best fit, comprising birth-related symptoms and general symptoms. Internal consistency of the Icelandic version of City BiTS was good; for birth-related symptoms subscale (α = 0.88, McDonald’s omega = 0.91); for general symptoms subscale (α = 0.87, McDonald’s omega = 0.89).</div></div><div><h3>Conclusions</h3><div>This version of the City BiTS is the first measurement in Icelandic, assessing childbirth-related PTSD according to DSM-5 criteria and provides a two-factor model for clinical and research purpose. Subsequent research should further validate the two-factor structure across diverse populations and settings.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"45 ","pages":"Article 101124"},"PeriodicalIF":1.4,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510951","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}

{"title":"Maternal and neonatal outcomes of membrane stripping in rural canadian group B Streptococcus-colonized pregnancies","authors":"Franciska Otaner ,&nbsp;Roksana Behruzi","doi":"10.1016/j.srhc.2025.101123","DOIUrl":"10.1016/j.srhc.2025.101123","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate the safety of membrane sweeping in Group B Streptococcus-positive pregnancies by assessing maternal and neonatal surrogate outcomes in a rural, midwifery-led birth center.</div></div><div><h3>Methods</h3><div>A retrospective chart review was conducted for 67 Group B Streptococcus-positive pregnant women under midwife care—31 who received membrane stripping and 36 who did not—were analyzed using data from the birth center’s database and Medesync hospital records.</div></div><div><h3>Results</h3><div>No early-onset neonatal Group B Streptococcus cases were reported. Membrane stripping showed no association with intrapartum transfers (p &gt; 0.99) or reasons for transfer (p = 0.13). Apgar scores at 1, 5, and 10 min were unaffected (p = 0.37, 0.81, 0.80). Mean gestational age was higher with membrane stripping (40.2 vs. 39.4 weeks, p = 0.02, d = 0.62), though not clinically significant. Higher birth weight in the membrane stripping group (3663.0 g vs. 3394.8 g, p = 0.01, Cohen’s d = 0.63) was similarly not clinically significant. No effects were observed on birth type (p &gt; 0.99), feeding type at 72 h or 6 weeks (p = 0.82, p &gt; 0.99), transfer after 32 weeks (p = 0.36), or maternal and neonatal clinical notes (p = 0.29, p &gt; 0.99). Potential confounders like gravida, para, abortus status (p = 0.79, p = 0.20, p = 0.26), prior cesarean section (p = 0.99), and maternal age (p = 0.69) did not affect outcomes.</div></div><div><h3>Conclusions</h3><div>Membrane stripping was not associated with adverse maternal or neonatal surrogate outcomes in Group B Streptococcus-positive pregnancies. These findings support its potential safety, though larger multi-center studies are needed to inform clinical guidelines.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"45 ","pages":"Article 101123"},"PeriodicalIF":1.4,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144280341","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}

{"title":"The Vietnamese version of the childbirth fear prior to pregnancy scale: A validation study","authors":"Thi Thuy Hang Ho ,&nbsp;Thi Hoan Nguyen ,&nbsp;Tiet-Hanh Dao-Tran","doi":"10.1016/j.srhc.2025.101120","DOIUrl":"10.1016/j.srhc.2025.101120","url":null,"abstract":"<div><h3>Background</h3><div>Fear of childbirth affects women’s attitudes toward childbirth, birth choices, health outcomes, and relationships with their baby, partner, and family. Although more Vietnamese women postpone or avoid pregnancy, understanding this fear is limited due to a lack of a valid and reliable measurement scale.</div></div><div><h3>Aim</h3><div>This study translated, adapted, and validated the Childbirth Fear Prior to Pregnancy Scale (CFPP) for Vietnamese users.</div></div><div><h3>Methods</h3><div>Multistep methodological research was conducted between August and October 2021. The research had two phases: (1) translation and cultural adaptation, and (2) validation. Validation was conducted on 510 Vietnamese women who participated in a cross-sectional design study and were selected by convenience sampling methods. Face validity, structural validity, convergent validity and internal consistency reliability were tested.</div></div><div><h3>Results</h3><div>The V-CFPP was comprehensible and culturally appropriate to Vietnamese women prior to pregnancy. The V-CFPP is unidimensional. Childbirth Fear Prior to Pregnancy, measured using the V-CFPP, was significantly associated with depression (r = 0.28, p &lt; 0.05), anxiety (r = 0.30, p &lt; 0.05), and stress (r = 0.29, p &lt; 0.05). The V-CFPP has a Cronbach’s α coefficient of 0.94.</div></div><div><h3>Conclusion</h3><div>The V-CFPP has satisfactory face, structural, and convergent validity. Its internal consistency reliability is excellent. The V-CFPP is a valid and reliable measurement scale for assessing the fear of childbirth prior to pregnancy among Vietnamese women, both nationally and internationally.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"45 ","pages":"Article 101120"},"PeriodicalIF":1.4,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144262129","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}

{"title":"Factors affecting provision of high-quality maternal and newborn healthcare in Zanzibar – A qualitative study","authors":"Hibaq Warsame ,&nbsp;Malin Bogren ,&nbsp;Margaret Sylvester Tayari ,&nbsp;Sanura Salim ,&nbsp;Helen Elden ,&nbsp;Herborg Holter","doi":"10.1016/j.srhc.2025.101122","DOIUrl":"10.1016/j.srhc.2025.101122","url":null,"abstract":"<div><h3>Objectives</h3><div>In Tanzania and Zanzibar, the maternal mortality ratio remains high, hence, this study explored factors affecting the provision of high-quality maternal and newborn healthcare in Zanzibar.</div></div><div><h3>Methods</h3><div>A qualitative research design was used, with data collected through five focus group discussions (FGDs) with healthcare providers. The discussions, held in Swahili, included midwives, nurses, and medical doctors (n = 27) working at five childbirth clinics in Zanzibar. A semi-structured FGD guide was used. All discussions were audio-recorded, transcribed, and translated into English. Content analysis was performed.</div></div><div><h3>Results</h3><div>Three generic categories describe the factors affecting the provision of high-quality maternal and newborn healthcare: i) a shortage of essential resources, including medical equipment, medication, and an emergency transport system; ii) an inadequate working environment, characterized by understaffing, low salaries, limited involvement of and protection for healthcare providers, and a lack of clinical guidelines; and iii) healthcare perception and cultural dynamics encompassing mistrust of healthcare providers, as well as cultural beliefs and practices.</div></div><div><h3>Conclusions</h3><div>The study highlights critical barriers to the provision of high-quality maternal and newborn care in Zanzibar, including resource shortages, inadequate working environments, and cultural perceptions of healthcare. These findings suggest that addressing systemic challenges, such as improving resource allocation and enhancing healthcare infrastructure, is essential for advancing maternal and newborn health outcomes. Additionally, efforts to align healthcare practices with local cultural dynamics are crucial to improving service utilization. These findings underscore the need for targeted interventions to strengthen healthcare delivery and reduce maternal and newborn mortality in Zanzibar and similar settings.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"45 ","pages":"Article 101122"},"PeriodicalIF":1.4,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144253410","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}

{"title":"Expectant and new mothers’ experiences from digital midwifery care and information during pregnancy and postpartum","authors":"Bäckström Caroline,&nbsp;Nilvér Helena,&nbsp;Byhmer Linda,&nbsp;Stridh Tiina,&nbsp;Palmér Lina","doi":"10.1016/j.srhc.2025.101121","DOIUrl":"10.1016/j.srhc.2025.101121","url":null,"abstract":"<div><h3>Objective</h3><div>Globally, the use of digital solutions in midwifery care, parental information, and antenatal classes is increasing. However, research on how these digital solutions function for mothers has not kept pace. Therefore, the aim of this study was to describe expectant and new mothers’ experiences from digital midwifery care and information during pregnancy and postpartum.</div></div><div><h3>Methods</h3><div>This is a Swedish study with a qualitative method and an inductive approach. Twelve expectant and new mothers were individually interviewed, and data was analysed using thematic analysis.</div></div><div><h3>Results</h3><div>The results are presented in one overall theme: <em>An ongoing Negotiation between digital and physical midwifery care is required to promote engagement and address needs,</em> and three themes: <em>A complement that creates flexibility but request balance; Enable participation and inclusion of partners</em>, and <em>The needs of being seen and heard are met to various extends.</em></div></div><div><h3>Conclusion</h3><div>While the flexibility offered through digital midwifery care and parental information is beneficial and facilitates convenience for mothers, digital midwifery care is not entirely interchangeable with physical midwifery care, including antenatal classes. An ongoing negotiation between digital and physical midwifery care is essential to achieve balanced midwifery care that addresses the unique, individual needs of mothers throughout different stages during pregnancy and postpartum.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"45 ","pages":"Article 101121"},"PeriodicalIF":1.4,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144262144","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}

{"title":"Women’s experiences of the transition phase of physiological labour during freebirth: A qualitative study","authors":"Eleanor Young ,&nbsp;Karen-Ann Clarke ,&nbsp;Rachel Reed ,&nbsp;Carolyn Hastie","doi":"10.1016/j.srhc.2025.101115","DOIUrl":"10.1016/j.srhc.2025.101115","url":null,"abstract":"<div><h3>Purpose</h3><div>There is a poverty of knowledge relating to the transition phase of labour and undisturbed childbirth physiology. This study explored women’s experiences of the transition phase of physiological labour during freebirth.</div></div><div><h3>Background</h3><div>Transition within physiological labour is described as a phase occurring as a woman ends the first stage of labour. The woman may display a range of signs and symptoms, including shaking, thirst, nausea, difficulty in communication, irritation, loss of control and inability to cope.</div></div><div><h3>Aim</h3><div>The study aimed to explore women’s experiences of the transition phase of physiological labour during an intended, unassisted labour and birth, known as freebirth.</div></div><div><h3>Methods</h3><div>A qualitative study design, using narrative inquiry was undertaken. Individual in-depth interviews were conducted with women who had experienced physiological births in Australia without the presence of registered health practitioners, doulas or childbirth attendants (n = 10). Reflexive thematic analysis was undertaken to identify themes and patterns.</div></div><div><h3>Findings</h3><div>Women experienced a physiological ‘peak intensity’ of labour that was individualised and nuanced. Three over-arching themes, <em>inner world</em>, <em>outer world</em> and <em>other world,</em> were conceptualised from data analysis. The <em>inner world</em> focussed on the somatic experience of labour. The <em>outer world</em> centred on the women’s perceptions of others and feelings of safety. The <em>other world</em> explored experiences of liminal space and oneness.</div></div><div><h3>Conclusions</h3><div>Findings support earlier studies regarding how women experience physiological processes and affirm that women experience the peak intensity of labour in individualised ways which are not reflected or supported in the common midwifery discourse. This study provides evidence about women’s experiences of physiological labour and insight into their dynamic <em>inner, outer</em> and <em>other</em> worlds. Further research is recommended into the freebirth experience in Australia from the perspective of childbirth physiology, and how the context of the birth setting, and midwifery practice may influence physiology and experience. It is also recommended that emergent knowledge on the altered states of consciousness and the sexual nature of birth be explored.</div></div>","PeriodicalId":54199,"journal":{"name":"Sexual & Reproductive Healthcare","volume":"45 ","pages":"Article 101115"},"PeriodicalIF":1.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144242098","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}