Edythe L. Mangindin, Helga Gottfreðsdóttir, Kathrin Stoll, Franka Cadée, Elín Inga Lárusdóttir, Emma M. Swift
Introduction
Childbirth experience can affect women's long-term health and well-being. However, there is limited knowledge on whether migrant status affects woman's experience during childbirth. We aimed to answer the following research questions: (1) Is there a difference in childbirth experience between migrant and native-born women in Iceland; and (2) Are migrant women more likely to experience mistreatment in childbirth compared to native-born women in Iceland?
Methods
An online survey was developed including the Childbirth Experience Questionnaire 2 to assess overall childbirth experience, and descriptive analysis and linear regression were conducted to determine differences between migrant and native-born women in Iceland. The mistreatment by care providers in childbirth indicators were used to evaluate mistreatment in childbirth, and frequencies and logistic regression were conducted. Both regression models were adjusted for sociodemographic and obstetric factors.
Results
A total of 1365 women participated. Migrant women reported statistically significantly lower scores for birth experience compared to native-born women (F [12, 1352] = 23.97, p < 0.001). There was no statistical difference between groups regarding mistreatment in childbirth. One in four of all women reported at least one form of mistreatment.
Conclusion
This study suggests that there are areas in maternity care that can be improved upon, particularly in providing care for migrant women and addressing mistreatment in childbirth for all. Our results suggest further research in this area as well as evaluation of maternity systems, training in cultural competency and effective communication.
{"title":"Childbirth Experience, Mistreatment, and Migrant Status: A Retrospective Cross-Sectional Study","authors":"Edythe L. Mangindin, Helga Gottfreðsdóttir, Kathrin Stoll, Franka Cadée, Elín Inga Lárusdóttir, Emma M. Swift","doi":"10.1111/birt.12900","DOIUrl":"10.1111/birt.12900","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Childbirth experience can affect women's long-term health and well-being. However, there is limited knowledge on whether migrant status affects woman's experience during childbirth. We aimed to answer the following research questions: (1) Is there a difference in childbirth experience between migrant and native-born women in Iceland; and (2) Are migrant women more likely to experience mistreatment in childbirth compared to native-born women in Iceland?</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An online survey was developed including the Childbirth Experience Questionnaire 2 to assess overall childbirth experience, and descriptive analysis and linear regression were conducted to determine differences between migrant and native-born women in Iceland. The mistreatment by care providers in childbirth indicators were used to evaluate mistreatment in childbirth, and frequencies and logistic regression were conducted. Both regression models were adjusted for sociodemographic and obstetric factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1365 women participated. Migrant women reported statistically significantly lower scores for birth experience compared to native-born women (<i>F</i> [12, 1352] = 23.97, <i>p</i> < 0.001). There was no statistical difference between groups regarding mistreatment in childbirth. One in four of all women reported at least one form of mistreatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study suggests that there are areas in maternity care that can be improved upon, particularly in providing care for migrant women and addressing mistreatment in childbirth for all. Our results suggest further research in this area as well as evaluation of maternity systems, training in cultural competency and effective communication.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 4","pages":"572-582"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12900","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076639","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}
Raquel Z. Rivera, Micaela Lara Cadena, Jess F. Gutfreund, Esperanza Dodge
Background
Black, Indigenous, and people of color (BIPOC) families comprise a disproportionately low percentage of home and freestanding birth center births in New Mexico (NM), despite NM Medicaid coverage of care by Licensed Midwives (LMs) in these settings. The purpose of this study was to examine why low income BIPOC seek out LM care, how they benefit from this model of care, and which factors facilitate and obstruct access.
Methods
We conducted 7 focus groups with 55 low income BIPOC individuals who had birthed in New Mexico in the past 5 years. Participants in four of the groups intended to birth with an LM in the community setting; participants in three of the groups intended to birth in a hospital.
Results
Prior negative birthing experiences at hospitals were the most-often discussed reason for choosing LM care. The aspects of LM care most commonly described as beneficial were: (1) the high quality of one-to-one individualized and holistic care offered by LMs, as well as (2) the respectfulness of care received. Medicaid coverage of LM care and special payment allowances made by LMs were cited as two important facilitators of access to LM care. Barriers to care included the lack of general awareness of LM care, the persisting stigma against community birth, the small number of LMs, and payment and insurance coverage challenges.
Conclusion
LM care is beneficial for many families seeking respectful and accessible care, especially in underserved areas. BIPOC birthing individuals' reflections on their experiences with LM care provide valuable information that should be considered when designing and revising perinatal care systems and policies with the intent of increasing access to high-quality maternal and newborn care in New Mexico and, more generally, the United States.
{"title":"The Benefits of Licensed Midwifery and Community Birth Among BIPOC Birthing People in New Mexico","authors":"Raquel Z. Rivera, Micaela Lara Cadena, Jess F. Gutfreund, Esperanza Dodge","doi":"10.1111/birt.12884","DOIUrl":"10.1111/birt.12884","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Black, Indigenous, and people of color (BIPOC) families comprise a disproportionately low percentage of home and freestanding birth center births in New Mexico (NM), despite NM Medicaid coverage of care by Licensed Midwives (LMs) in these settings. The purpose of this study was to examine why low income BIPOC seek out LM care, how they benefit from this model of care, and which factors facilitate and obstruct access.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted 7 focus groups with 55 low income BIPOC individuals who had birthed in New Mexico in the past 5 years. Participants in four of the groups intended to birth with an LM in the community setting; participants in three of the groups intended to birth in a hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Prior negative birthing experiences at hospitals were the most-often discussed reason for choosing LM care. The aspects of LM care most commonly described as beneficial were: (1) the high quality of one-to-one individualized and holistic care offered by LMs, as well as (2) the respectfulness of care received. Medicaid coverage of LM care and special payment allowances made by LMs were cited as two important facilitators of access to LM care. Barriers to care included the lack of general awareness of LM care, the persisting stigma against community birth, the small number of LMs, and payment and insurance coverage challenges.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>LM care is beneficial for many families seeking respectful and accessible care, especially in underserved areas. BIPOC birthing individuals' reflections on their experiences with LM care provide valuable information that should be considered when designing and revising perinatal care systems and policies with the intent of increasing access to high-quality maternal and newborn care in New Mexico and, more generally, the United States.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 2","pages":"285-290"},"PeriodicalIF":2.8,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12884","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820125","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}
Anna Melamed, Lucia Rocca-Ihenacho, Anna Horn, Christine McCourt, Frances Rivers, Marina Alice Sylvia Daniele
Background
In UK maternity care, racialized women have worse experiences and clinical outcomes than White women. Midwife-led birth settings (MLBS), including home births and midwife-led units, both freestanding and alongside hospitals, are all available as choices for low-risk women in the UK. MLBS deliver optimal outcomes for low-risk women with uncomplicated pregnancies, including for racialized women, and can offer culturally specific care, possibly mitigating existing social inequalities. Evidence suggests that racialized women access MLBS less than White women.
Aim
To map existing literature on facilitators and barriers to accessing MLBS for racialized women and to identify emerging themes.
Method
A scoping review of UK literature over the last 10 years using OVID, Ebsco Host, and gray literature. Search, selection, and data extraction were performed using PRISMA and JBI guidelines. Data were analyzed using inductive thematic analysis.
Results
Fourteen articles met the inclusion criteria, only one addressing the research question directly and others containing some relevant material. Six themes were identified: admission criteria, information giving, the role of antenatal groups, bias and assumptions, beliefs about birth, and MLBS as empowering.
Conclusions
There is a lack of research on racialized women's access to MLBS. Community outreach, having midwifery services embedded in the community, defaulting to MLBS for women categorized as low risk, continuity of carer, and interventions achieving a reduction in care-giver bias may improve access and outcomes.
{"title":"Facilitators and Barriers to Access to Midwife-Led Birth Settings for Racialized Women in the UK: A Scoping Review","authors":"Anna Melamed, Lucia Rocca-Ihenacho, Anna Horn, Christine McCourt, Frances Rivers, Marina Alice Sylvia Daniele","doi":"10.1111/birt.12897","DOIUrl":"10.1111/birt.12897","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In UK maternity care, racialized women have worse experiences and clinical outcomes than White women. Midwife-led birth settings (MLBS), including home births and midwife-led units, both freestanding and alongside hospitals, are all available as choices for low-risk women in the UK. MLBS deliver optimal outcomes for low-risk women with uncomplicated pregnancies, including for racialized women, and can offer culturally specific care, possibly mitigating existing social inequalities. Evidence suggests that racialized women access MLBS less than White women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To map existing literature on facilitators and barriers to accessing MLBS for racialized women and to identify emerging themes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A scoping review of UK literature over the last 10 years using OVID, Ebsco Host, and gray literature. Search, selection, and data extraction were performed using PRISMA and JBI guidelines. Data were analyzed using inductive thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fourteen articles met the inclusion criteria, only one addressing the research question directly and others containing some relevant material. Six themes were identified: admission criteria, information giving, the role of antenatal groups, bias and assumptions, beliefs about birth, and MLBS as empowering.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There is a lack of research on racialized women's access to MLBS. Community outreach, having midwifery services embedded in the community, defaulting to MLBS for women categorized as low risk, continuity of carer, and interventions achieving a reduction in care-giver bias may improve access and outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 3","pages":"491-502"},"PeriodicalIF":2.5,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12897","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803431","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}
Ramatu Abdul Hamid Alhassan, Sara Baumann, Abimbola Fapohunda, Janet Awopole Yepakeh Tiah, Timothy Tienbia Laari, Lauren Narbey, Nancy A. Niemczyk, Victoria Bam, Martina Anto-Ocrah
<div> <section> <h3> Background/Introduction</h3> <p>Midwives provide skilled, primary, reproductive, and sexual health care to women, adolescent girls, and infants throughout the perinatal period, promoting health and safeguarding against obstetric emergencies and maternal and infant mortality. In many cultures, midwifery has been a predominantly female profession. However, in emerging research, the proportion of male midwives is growing to augment shortages of female midwives, prompting a need for further research that explores the contributions of male midwives in maternal and child health. The objective of this scoping review was to synthesize key findings from the literature regarding the growing, global workforce of male midwives. Specifically, we aimed to evaluate (1) the temporal nature of the publications, (2) the geographic distributions of the emerging literature, and (3) the key findings regarding male midwives' training and work experiences.</p> </section> <section> <h3> Methods</h3> <p>We used Semantic Scholar and Google Scholar to identify relevant, peer-reviewed articles using the keywords “gender,” “male,” “men,” “midwifery,” and “nurse midwives,” that met the inclusion criteria: (1) primary research papers, (2) published in the English language (for ease of understanding by the multinational, interdisciplinary authorship team), (3) explored male midwives' experiences during training/education and working, and (4) published between 2000 and 2023. Papers were excluded if they exclusively focused on females or nurses or other health professionals.</p> </section> <section> <h3> Results</h3> <p>Our initial search yielded 57 articles, with an additional nine obtained by reviewing the references. After excluding duplicates and reviewing based on inclusion criteria, 26 papers were included in the scoping review. All 26 articles were published between 2011 and 2023, with the majority (65%, <i>n</i> = 17) of articles focused on populations in the African region (Aims 1 and 2). Key findings (Aim 3) were as follows: 1. Training experiences of male midwives: Compared to other regions, male midwifery students in African, Middle Eastern, and Asian settings reported challenging training conditions, possibly influenced by sociocultural factors and gendered expectations of men in these settings. 2. Pregnant/birthing persons' delivery experiences and gendered preferences for their attending midwife: A significant number of birthing persons would choose female midwives over male midwives for their care, despite acknowledging similar skill sets. However, younger clients, urban residents, and non-traditional men expressed a need for gender equity and g
{"title":"Men as Midwifery Professionals: A Scoping Review","authors":"Ramatu Abdul Hamid Alhassan, Sara Baumann, Abimbola Fapohunda, Janet Awopole Yepakeh Tiah, Timothy Tienbia Laari, Lauren Narbey, Nancy A. Niemczyk, Victoria Bam, Martina Anto-Ocrah","doi":"10.1111/birt.12894","DOIUrl":"10.1111/birt.12894","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Introduction</h3>\u0000 \u0000 <p>Midwives provide skilled, primary, reproductive, and sexual health care to women, adolescent girls, and infants throughout the perinatal period, promoting health and safeguarding against obstetric emergencies and maternal and infant mortality. In many cultures, midwifery has been a predominantly female profession. However, in emerging research, the proportion of male midwives is growing to augment shortages of female midwives, prompting a need for further research that explores the contributions of male midwives in maternal and child health. The objective of this scoping review was to synthesize key findings from the literature regarding the growing, global workforce of male midwives. Specifically, we aimed to evaluate (1) the temporal nature of the publications, (2) the geographic distributions of the emerging literature, and (3) the key findings regarding male midwives' training and work experiences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used Semantic Scholar and Google Scholar to identify relevant, peer-reviewed articles using the keywords “gender,” “male,” “men,” “midwifery,” and “nurse midwives,” that met the inclusion criteria: (1) primary research papers, (2) published in the English language (for ease of understanding by the multinational, interdisciplinary authorship team), (3) explored male midwives' experiences during training/education and working, and (4) published between 2000 and 2023. Papers were excluded if they exclusively focused on females or nurses or other health professionals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our initial search yielded 57 articles, with an additional nine obtained by reviewing the references. After excluding duplicates and reviewing based on inclusion criteria, 26 papers were included in the scoping review. All 26 articles were published between 2011 and 2023, with the majority (65%, <i>n</i> = 17) of articles focused on populations in the African region (Aims 1 and 2). Key findings (Aim 3) were as follows: 1. Training experiences of male midwives: Compared to other regions, male midwifery students in African, Middle Eastern, and Asian settings reported challenging training conditions, possibly influenced by sociocultural factors and gendered expectations of men in these settings. 2. Pregnant/birthing persons' delivery experiences and gendered preferences for their attending midwife: A significant number of birthing persons would choose female midwives over male midwives for their care, despite acknowledging similar skill sets. However, younger clients, urban residents, and non-traditional men expressed a need for gender equity and g","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 3","pages":"376-392"},"PeriodicalIF":2.5,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12146427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803446","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}
Cesarean delivery is a contributing factor to many delivery care and postpartum maternal morbidities, especially when a cesarean delivery is unnecessary. Mexico has one of the highest cesarean birth rates in Latin America, and as such, our objective was to identify the sociodemographic, reproductive, maternal care, and health-related characteristics associated with the prevalence of planned and emergency cesarean births in Mexico.
Methods
Using nationally representative data from a Mexican probabilistic survey (ENSANUT 2021), we examined and developed a cross-sectional analysis of women aged 12 to 19 with a live-birth and women 20 to 49 years who had their last live-birth within five years before the survey (n = 1330). We used multinomial logistic regression analysis to examine predictors associated with planned and emergency cesarean births.
Results
The live-births within our sample included 50.7% vaginal, 27.5% emergency cesarean births, and 21.8% planned cesarean births. Younger age groups at delivery, speaking an indigenous language, and receiving delivery care at open public services are negatively associated with having any cesarean birth. Receiving delivery care at private institutions and having hypertension during pregnancy increases the odds of having both planned and emergency cesarean births. Emergency cesarean births are positively associated with tertiary education and negatively correlated with the parity of three or more children, while planned cesarean births are more likely for women with a parity of two.
Discussion
Efforts to reduce unnecessary cesarean births should include evidence-based medicine recommendations, actions to avoid the first cesarean birth, and providing pregnant women with counseling to support informed decisions.
{"title":"Sociodemographic and Health-Related Risk Factors Associated With Planned and Emergency Cesarean Births in Mexico","authors":"Jessica Irene Contreras, Leticia Suárez-López, Celia Hubert","doi":"10.1111/birt.12896","DOIUrl":"10.1111/birt.12896","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cesarean delivery is a contributing factor to many delivery care and postpartum maternal morbidities, especially when a cesarean delivery is unnecessary. Mexico has one of the highest cesarean birth rates in Latin America, and as such, our objective was to identify the sociodemographic, reproductive, maternal care, and health-related characteristics associated with the prevalence of planned and emergency cesarean births in Mexico.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using nationally representative data from a Mexican probabilistic survey (<i>ENSANUT</i> 2021), we examined and developed a cross-sectional analysis of women aged 12 to 19 with a live-birth and women 20 to 49 years who had their last live-birth within five years before the survey (<i>n</i> = 1330). We used multinomial logistic regression analysis to examine predictors associated with planned and emergency cesarean births.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The live-births within our sample included 50.7% vaginal, 27.5% emergency cesarean births, and 21.8% planned cesarean births. Younger age groups at delivery, speaking an indigenous language, and receiving delivery care at open public services are negatively associated with having any cesarean birth. Receiving delivery care at private institutions and having hypertension during pregnancy increases the odds of having both planned and emergency cesarean births. Emergency cesarean births are positively associated with tertiary education and negatively correlated with the parity of three or more children, while planned cesarean births are more likely for women with a parity of two.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Efforts to reduce unnecessary cesarean births should include evidence-based medicine recommendations, actions to avoid the first cesarean birth, and providing pregnant women with counseling to support informed decisions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 2","pages":"353-361"},"PeriodicalIF":2.8,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632505","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}
Andrew Symon, Berit Mortensen, Are Hugo Pripp, Manju Chhugani, Samuel Adjorlolo, Caroline Badzi, Renu Kharb, Elysse Prussing, Alison McFadden, Nicola M. Gray, Allison Cummins
Background
Quality maternity care is known to improve a range of maternal and neonatal outcomes. The Lancet Series on Midwifery's Quality Maternal and Newborn Care (QMNC) Framework is a high-level synthesis of the global evidence on quality maternity care. Initial qualitative work demonstrated the Framework's adaptability in evaluating service user and provider perceptions of the quality of maternity care. However, evaluating services at scale requires a survey instrument. This paper reports the validation of the QMNC Framework index (QMNCFi), a five-part survey for the evaluation of maternity care across diverse settings.
Methods
International online English language survey of women who had given birth in the previous year in Australia, Ghana, India and the United Kingdom (UK). It was distributed through service user networks (UK and Australia) and at postnatal clinics (Ghana and India). All forms were completed online. Test–retest was conducted to assess reliability.
Results
Five hundred and forty mothers completed the survey (Australia 136; Ghana 131; India 153; UK 120). Construct validity: Cronbach's α in 12 of the survey's 13 sections ranged from 0.795 to 0.986; for the remaining section the alpha was 0.594. Reliability: 55 participants completed the QMNCFi a second time. Intraclass correlation coefficient results ranged from 0.657 to 0.939 across the 13 sections. Field researchers in Ghana and India reported that the survey was easily understood and completed.
Conclusion
This survey has shown that, across diverse contexts, the QMNCFi is a valid, reliable, and comprehensive tool for measuring service user perceptions of the quality of care over time.
{"title":"Validating the Quality Maternal and Newborn Care Framework Index: A Global Tool for Quality-of-Care Evaluations","authors":"Andrew Symon, Berit Mortensen, Are Hugo Pripp, Manju Chhugani, Samuel Adjorlolo, Caroline Badzi, Renu Kharb, Elysse Prussing, Alison McFadden, Nicola M. Gray, Allison Cummins","doi":"10.1111/birt.12895","DOIUrl":"10.1111/birt.12895","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Quality maternity care is known to improve a range of maternal and neonatal outcomes. The Lancet Series on Midwifery's Quality Maternal and Newborn Care (QMNC) Framework is a high-level synthesis of the global evidence on quality maternity care. Initial qualitative work demonstrated the Framework's adaptability in evaluating service user and provider perceptions of the quality of maternity care. However, evaluating services at scale requires a survey instrument. This paper reports the validation of the QMNC Framework index (QMNCFi), a five-part survey for the evaluation of maternity care across diverse settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>International online English language survey of women who had given birth in the previous year in Australia, Ghana, India and the United Kingdom (UK). It was distributed through service user networks (UK and Australia) and at postnatal clinics (Ghana and India). All forms were completed online. Test–retest was conducted to assess reliability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five hundred and forty mothers completed the survey (Australia 136; Ghana 131; India 153; UK 120). Construct validity: Cronbach's <i>α</i> in 12 of the survey's 13 sections ranged from 0.795 to 0.986; for the remaining section the alpha was 0.594. Reliability: 55 participants completed the QMNCFi a second time. Intraclass correlation coefficient results ranged from 0.657 to 0.939 across the 13 sections. Field researchers in Ghana and India reported that the survey was easily understood and completed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This survey has shown that, across diverse contexts, the QMNCFi is a valid, reliable, and comprehensive tool for measuring service user perceptions of the quality of care over time.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 2","pages":"347-352"},"PeriodicalIF":2.8,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12895","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632527","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}
J. Boujenah, M. Belabbas, A. Tigaizin, A. Benbara, I. Hensienne, M. Fermaut, L. Carbillon
Background
It is unclear if a history of cesarean birth (CB) is a risk factor for postpartum hemorrhage (PPH) even after a successful planned vaginal birth.
Methods
A historical retrospective cohort study from all deliveries (42,456) between 2004 and 2019. Inclusion criteria were as follows: (i) women with only one previous CB; (ii) liveborn cephalic singleton pregnancy and term spontaneous labor; (iii) successful planned vaginal birth; (iv) no operative vaginal delivery; and (v) no history of PPH. Women who experienced intrapartum uterine rupture leading to CB were excluded. Those who experienced uterine rupture diagnosed after vaginal birth were not excluded. The labor after cesarean (LAC) group (109 women with previous CB and current vaginal birth) were compared with 2 control groups to consider the parity: control group 1 (1633 nulliparous women) and control group 2 (4197 parous women). The main outcome was the rate of PPH (> 500 mL). Multivariate analysis was performed to investigate whether previous CB was an independent risk factor for PPH. Bivariate analysis and causal framework was used to determine the relation between variables of clinical interest.
Results
The PPH rates in the LAC group, control group 1, and control group 2 were 12.8%, 5.3%, and 6.4%, respectively. Irrespective of the group control (1 or 2), a history of CB was associated with an increased risk of PPH: adjusted odds ratio (aOR) 2.38 [95% confidence interval (CI) 1.28–4.44] (adjusted with maternal age, overweight, hyperthermia, and use of oxytocin) and aOR 2.16 [95% CI 1.20–3.87] (adjusted with maternal age and overweight) for Groups 1 (parous) and 2 (nulliparous), respectively.
Conclusion
A history of cesarean birth could be a risk factor for PPH even after successful planned vaginal delivery.
{"title":"A History of Cesarean Birth as a Risk Factor for Postpartum Hemorrhage Even After Successful Planned Vaginal Birth","authors":"J. Boujenah, M. Belabbas, A. Tigaizin, A. Benbara, I. Hensienne, M. Fermaut, L. Carbillon","doi":"10.1111/birt.12892","DOIUrl":"10.1111/birt.12892","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>It is unclear if a history of cesarean birth (CB) is a risk factor for postpartum hemorrhage (PPH) even after a successful planned vaginal birth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A historical retrospective cohort study from all deliveries (42,456) between 2004 and 2019. Inclusion criteria were as follows: (i) women with only one previous CB; (ii) liveborn cephalic singleton pregnancy and term spontaneous labor; (iii) successful planned vaginal birth; (iv) no operative vaginal delivery; and (v) no history of PPH. Women who experienced intrapartum uterine rupture leading to CB were excluded. Those who experienced uterine rupture diagnosed after vaginal birth were not excluded. The labor after cesarean (LAC) group (109 women with previous CB and current vaginal birth) were compared with 2 control groups to consider the parity: control group 1 (1633 nulliparous women) and control group 2 (4197 parous women). The main outcome was the rate of PPH (> 500 mL). Multivariate analysis was performed to investigate whether previous CB was an independent risk factor for PPH. Bivariate analysis and causal framework was used to determine the relation between variables of clinical interest.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The PPH rates in the LAC group, control group 1, and control group 2 were 12.8%, 5.3%, and 6.4%, respectively. Irrespective of the group control (1 or 2), a history of CB was associated with an increased risk of PPH: adjusted odds ratio (aOR) 2.38 [95% confidence interval (CI) 1.28–4.44] (adjusted with maternal age, overweight, hyperthermia, and use of oxytocin) and aOR 2.16 [95% CI 1.20–3.87] (adjusted with maternal age and overweight) for Groups 1 (parous) and 2 (nulliparous), respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A history of cesarean birth could be a risk factor for PPH even after successful planned vaginal delivery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 2","pages":"337-346"},"PeriodicalIF":2.8,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632289","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}
Pregnant women face the challenge of managing early labor on their own until they feel the need to seek professional support. However, professional support during such a vulnerable stage of labor may sometimes be insufficient. This study aims to understand pregnant women's care needs during early labor in order to improve the quality of care provided at the onset of labor.
Methods
A scoping review was conducted following a systematic search strategy in May 2021 and in August 2022 concentrating on pregnant women in early labor with spontaneous onset of labor. A sensitive search strategy was used with five different databases. The articles were screened by two independent researchers. Data were extracted and mapped to answer the research question.
Results
52 articles were included. Major reasons for seeking professional help are to receive reassurance and get advice and information on how to cope with early labor. Furthermore, many women express the need for professional guidance. Several articles demonstrated women's preferences for hospital admission or a continuous care model. While some women want empowerment and empathy from a midwife, others require clear instructions on helpful measures or even clinical interventions within the process.
Conclusions
Managing early labor without professional support creates a major challenge for pregnant women and nurtures insecurities and anxiety. Protecting women from unnecessary interventions is a well-intentioned plan, yet a lack of support in early labor may sometimes jeopardize a positive birth experience. New ways need to be elaborated to support women-centred and individualized approaches to providing early labor care.
{"title":"Pregnant Women's Care Needs During Early Labor–A Scoping Review","authors":"Antonia N. Mueller, Susanne Grylka-Baeschlin","doi":"10.1111/birt.12891","DOIUrl":"10.1111/birt.12891","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Pregnant women face the challenge of managing early labor on their own until they feel the need to seek professional support. However, professional support during such a vulnerable stage of labor may sometimes be insufficient. This study aims to understand pregnant women's care needs during early labor in order to improve the quality of care provided at the onset of labor.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A scoping review was conducted following a systematic search strategy in May 2021 and in August 2022 concentrating on pregnant women in early labor with spontaneous onset of labor. A sensitive search strategy was used with five different databases. The articles were screened by two independent researchers. Data were extracted and mapped to answer the research question.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>52 articles were included. Major reasons for seeking professional help are to receive reassurance and get advice and information on how to cope with early labor. Furthermore, many women express the need for professional guidance. Several articles demonstrated women's preferences for hospital admission or a continuous care model. While some women want empowerment and empathy from a midwife, others require clear instructions on helpful measures or even clinical interventions within the process.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Managing early labor without professional support creates a major challenge for pregnant women and nurtures insecurities and anxiety. Protecting women from unnecessary interventions is a well-intentioned plan, yet a lack of support in early labor may sometimes jeopardize a positive birth experience. New ways need to be elaborated to support women-centred and individualized approaches to providing early labor care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 2","pages":"207-227"},"PeriodicalIF":2.8,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12891","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632503","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}
This letter responds to Cernat et al.'s study on counseling about cannabis use during pregnancy and lactation, drawing parallels with addiction treatment practices in Taiwan. We highlight the importance of open, non-judgmental approaches and harm reduction strategies in counseling pregnant women with substance use disorders. Our experience at a psychiatric center in Taiwan emphasizes the need for continuous counseling throughout pregnancy and postpartum, particularly given the observed increase in cannabis use among new mothers. We support the study's emphasis on exploring patients' perceived benefits from cannabis use and addressing underlying reasons for use. By integrating insights from qualitative studies on patient perspectives, we have improved patient engagement and outcomes in our practice. This commentary underscores the global relevance of the study's findings and calls for continued research to bridge the gap between clinician and patient experiences in perinatal cannabis use counseling.
{"title":"Enhancing Perinatal Cannabis Use Counseling: Insights From Taiwan's Addiction Treatment Practice","authors":"Ya-Yun Tsai, Lien-Chung Wei","doi":"10.1111/birt.12898","DOIUrl":"10.1111/birt.12898","url":null,"abstract":"<div>\u0000 \u0000 <p>This letter responds to Cernat et al.'s study on counseling about cannabis use during pregnancy and lactation, drawing parallels with addiction treatment practices in Taiwan. We highlight the importance of open, non-judgmental approaches and harm reduction strategies in counseling pregnant women with substance use disorders. Our experience at a psychiatric center in Taiwan emphasizes the need for continuous counseling throughout pregnancy and postpartum, particularly given the observed increase in cannabis use among new mothers. We support the study's emphasis on exploring patients' perceived benefits from cannabis use and addressing underlying reasons for use. By integrating insights from qualitative studies on patient perspectives, we have improved patient engagement and outcomes in our practice. This commentary underscores the global relevance of the study's findings and calls for continued research to bridge the gap between clinician and patient experiences in perinatal cannabis use counseling.</p>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"51 4","pages":"878-879"},"PeriodicalIF":2.8,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632528","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}
Immigrants and newcomers are identified by many provincial midwifery associations as “priority populations.” Recently, newcomer populations have shifted considerably, with more people coming to Canada with precarious immigration status who are increasingly ineligible for public healthcare insurance and facing barriers to accessing care. Our aims were to: (1) gain an understanding of the policies related to equitable access to midwifery care and how they may apply to migrant groups without public healthcare insurance and (2) identify existing policy themes, gaps, and regulatory barriers that limit access for this vulnerable population in Canada.
Methods
We conducted a high-level document content analysis using a health equity framework. We aimed to identify language related to equitable access in midwifery services, with particular emphasis on uninsured populations. A total of 64 documents were analyzed, including legislation and publicly available statements from midwifery regulatory bodies and associations.
Results
Midwifery regulatory authorities and associations across Canada are consistent in establishing an expectation that midwives will provide accessible care to diverse clientele. However, how these commitments are put into practice varies considerably between jurisdictions. We compared the cases of Manitoba and Ontario to illustrate the disconnect between commitments to priority populations and implementation.
Discussion
While there is a clearly demonstrated intention to provide equitable access to midwifery care to all people, including “priority populations” like migrants and newcomers, in practice, these commitments have not been fully realized. Equity is encumbered by broader structural issues, such as the growth in the number of newcomers without access to public health insurance. Moves toward equity within midwifery and healthcare more broadly need to meaningfully engage with other policy sectors, such as immigration, to be able to adapt to emerging issues affecting reproductive care, such as the growing precarity of newcomer populations in Canada.
{"title":"Translating Priorities Into Practice: Midwifery Care for Uninsured Migrant Populations Across Canada","authors":"Heidi Elias, Lindsay Larios","doi":"10.1111/birt.12893","DOIUrl":"10.1111/birt.12893","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Immigrants and newcomers are identified by many provincial midwifery associations as “priority populations.” Recently, newcomer populations have shifted considerably, with more people coming to Canada with precarious immigration status who are increasingly ineligible for public healthcare insurance and facing barriers to accessing care. Our aims were to: (1) gain an understanding of the policies related to equitable access to midwifery care and how they may apply to migrant groups without public healthcare insurance and (2) identify existing policy themes, gaps, and regulatory barriers that limit access for this vulnerable population in Canada.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a high-level document content analysis using a health equity framework. We aimed to identify language related to equitable access in midwifery services, with particular emphasis on uninsured populations. A total of 64 documents were analyzed, including legislation and publicly available statements from midwifery regulatory bodies and associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Midwifery regulatory authorities and associations across Canada are consistent in establishing an expectation that midwives will provide accessible care to diverse clientele. However, how these commitments are put into practice varies considerably between jurisdictions. We compared the cases of Manitoba and Ontario to illustrate the disconnect between commitments to priority populations and implementation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>While there is a clearly demonstrated intention to provide equitable access to midwifery care to all people, including “priority populations” like migrants and newcomers, in practice, these commitments have not been fully realized. Equity is encumbered by broader structural issues, such as the growth in the number of newcomers without access to public health insurance. Moves toward equity within midwifery and healthcare more broadly need to meaningfully engage with other policy sectors, such as immigration, to be able to adapt to emerging issues affecting reproductive care, such as the growing precarity of newcomer populations in Canada.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 3","pages":"482-490"},"PeriodicalIF":2.5,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12893","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607532","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}
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