Birth-Issues in Perinatal Care最新文献

{"title":"Adopting Early Essential Newborn Care (EENC) in the Delivery Room: An Implementation Study From China","authors":"Min Yang,&nbsp;Caiyun Wang,&nbsp;Linlin Cao,&nbsp;Xiu Zhu,&nbsp;Jie Lu","doi":"10.1111/birt.70009","DOIUrl":"10.1111/birt.70009","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Early Essential Newborn Care (EENC) is a highly beneficial and cost-effective set of evidence-based interventions for newborns and their mothers. However, the implementation of EENC as part of routine clinical practice in the delivery room has not yet been achieved in China. The purpose of this study was to describe the adoption of EENC in general hospitals in China and to evaluate its implementation impacts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was an implementation study. The design of the implementation process was guided by a Knowledge-to-Action Framework and the conceptual model of implementation research. Mixed methods were used to evaluate the implementation of EENC with qualitative and quantitative data collection methods, including implementation outcomes, service outcomes, and patient outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 279 patients and 25 nurse-midwives were evaluated in this study. Both the implementation and service outcomes in this study were satisfactory. Obstacles were reported in the acceptability, feasibility, adoption, and fidelity of EENC, such as the acceptance of evidence by nurse-midwives, the support of managers to implement EENC in staff under their management, and the allocation of adequate resources. For patient outcomes, the rates of exclusive breastfeeding during hospitalization (27.1% vs. 39.6%, <i>p</i> &lt; 0.05) and early initiation of breastfeeding (51.4% vs. 64.0%, <i>p</i> &lt; 0.05) improved after EENC was implemented. Furthermore, the amount of vaginal bleeding after 2 h by subjects in the EENC implementation group [(283.92 ± 71.31 mL) vs. (308.78 ± 84.42 mL), <i>t</i> = 2.694, <i>p</i> &lt; 0.05] was also significantly reduced.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>EENC can be effectively implemented in general hospitals, but some factors affecting the implementation of EENC included the acceptance of evidence by nurse-midwives, support from managers, and resource allocation. The implementation of EENC was found to be beneficial to newborns and their mothers. Our findings indicate that EENC should be incorporated as part of routine maternity care and nursing practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"53 1","pages":"155-163"},"PeriodicalIF":2.5,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979008","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 Impact of Lunar Phases During Day and Night Cycles on Perinatal Outcomes: A Nationwide Cohort Study","authors":"Karin Windsperger,&nbsp;Tim Dorittke,&nbsp;Dana A. Muin,&nbsp;Herbert Kiss,&nbsp;Wilhelm Oberaigner,&nbsp;Hermann Leitner,&nbsp;Alex Farr","doi":"10.1111/birt.70013","DOIUrl":"10.1111/birt.70013","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Light changes during the lunar cycle affect rhythms in diverse species. Human studies focusing on whether the moon influences human health have so far neglected the effects of light/dark cycles. The purpose of this study was to investigate whether lunar phases impact perinatal outcomes by considering illumination levels due to day/night rhythms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>To assess the influence of moon phases, this nationwide cohort study identified cases with a singleton pregnancy that involved daytime (06:00 a.m. to 08:59 p.m.) and nighttime (09:00 p.m. to 05:59 a.m.) delivery at ≥ 23 + 0 gestational weeks with a birthweight of ≥ 500 g. Data on women who underwent elective cesarean or labor induction were excluded from the analyses. The lunar cycle was categorized as full moon, new moon, or other lunar phases. The standardized birth ratio (SBR) was chosen as the primary outcome parameter, while the duration of labor and adverse neonatal short-term health (pH of &lt; 7.2 and/or a 5-min Apgar score of &lt; 7) were chosen as the secondary outcome variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified a total case number of 462,947 births, of which 242,518 (52.4%) occurred during the day and 220,429 (47.6%) at night. Different moon phases did not appear to influence either the SBR or adverse neonatal outcomes. However, nighttime births may show a trend toward a prolonged maximum duration of labor related to moon phases (62 vs. 65 vs. 70 h for new/full/other moon phases, <i>p</i> = 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Considering illumination levels, some moon phases may increase the risk for prolonged births during nighttime. However, assessing the effect of lunar phases on health variables is complex. Co-environmental agents should be incorporated into future analyses.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"53 1","pages":"192-200"},"PeriodicalIF":2.5,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.70013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979148","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}

{"title":"Optimal Timing of Term Births by Maternal Region of Birth: Elective Induction of Labor Compared to Expectant Management in Victoria, Australia","authors":"Sharon D. Weerasingha,&nbsp;Roshan J. Selvaratnam,&nbsp;Mary-Ann Davey,&nbsp;Sarah E. Butler,&nbsp;Kirsten R. Palmer,&nbsp;Miranda L. Davies-Tuck","doi":"10.1111/birt.70003","DOIUrl":"10.1111/birt.70003","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Induction of labor (IOL) has been suggested to mitigate the elevated risks of perinatal mortality in migrant women. The aim was to estimate the rates of perinatal mortality, cesarean, instrumental birth, and admission to the special care nursery or neonatal intensive care unit (SCN/NICU) for births following IOL compared to expectant management at 37–41 weeks' gestation by maternal region of birth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A population-based retrospective cohort of all vertex singleton, uncomplicated pregnancies, 37 to 41 weeks' gestation in Victoria, Australia, from 2012 to 2019. Perinatal mortality rates were reported by region of birth. Multivariable log binomial regression models were used to estimate the association between outcomes and IOL compared to expectant management by region of birth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was no improvement in the perinatal mortality rate with IOL at any gestation for non-Australian region of birth groups. IOL at 38 weeks was associated with an increasing risk of cesarean birth for Australian, New Zealand, Oceanic, African, and South-East Asian and East Asian-born women, with a higher risk for South Asian-born women at 39 weeks. Compared to expectant management, the risk of instrumental birth was similar at each gestational week for Australian-born women; whereas for African and South Asian-born women, the risk was highest at 37 weeks; for Oceanic-born women, this occurred at 38 weeks. An inverse relationship between the week of IOL and admission to the SCN/NICU was observed for all births.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>IOL was associated with an increased risk of cesarean birth, instrumental birth, and admission to the SCN/NICU in many situations without an improvement in perinatal mortality rates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"53 1","pages":"108-119"},"PeriodicalIF":2.5,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.70003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144857106","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}

{"title":"Developing a Co-Designed Strategy to Improve Labor Monitoring and Management in India Using the World Health Organization Labour Care Guide: A Mixed-Methods Formative Study","authors":"Elizabeth Armari,&nbsp;Sunil S. Vernekar,&nbsp;Yeshita Pujar,&nbsp;Veronica Pingray,&nbsp;Fernando Althabe,&nbsp;Luz Gibbons,&nbsp;Mabel Berrueta,&nbsp;Alvaro Ciganda,&nbsp;Rocio Rodriguez,&nbsp;Jayashree Ashok Kumar,&nbsp;Shruti Bhavi Patil,&nbsp;Aravind Karinagannanavar,&nbsp;Raveendra R. Anteen,&nbsp;Pavithra M. R.,&nbsp;Savitri Bendigeri,&nbsp;Shukla Shetty,&nbsp;B. Latha,&nbsp;Megha H. M.,&nbsp;Suman S. Gaddi,&nbsp;Shaila Chikkagowdra,&nbsp;Bellara Raghavendra,&nbsp;Caroline S. E. Homer,&nbsp;Manjunath Somannavar,&nbsp;Shivaprasad S. Goudar,&nbsp;Joshua P. Vogel","doi":"10.1111/birt.70004","DOIUrl":"10.1111/birt.70004","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Nearly half of all perinatal deaths occur during the intrapartum period due to inadequate labor monitoring and intervention. The partograph, a paper-based labor monitoring tool, can assist providers in recognizing and acting on early signs of fetal–maternal distress if used effectively. In 2020, the World Health Organization (WHO) developed a “next generation” partograph called the Labour Care Guide. There is limited evidence of how to optimize the use and impact of this new tool. This study describes the development of a co-designed LCG implementation strategy in Karnataka, India.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A targeted literature review, primary research across four public maternity hospitals (provider survey and facility assessment), and a 2-day co-design workshop with stakeholders were conducted. Findings were mapped to six target behaviors using the Theoretical Domains Framework (TDF) and the Capability, Opportunity, and Motivation-Behavior (COM-B) model to identify potential barriers and facilitators to LCG use. Consultations with local stakeholders explored these factors, and a 1-week pilot informed final refinements of the strategy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The LCG implementation strategy comprised an evidence-based provider training program centered on “low dose, high frequency” principles, and monthly audit and feedback cycles, which in turn, relies on an enabling practice environment (supportive national policy frameworks, facility-level guidelines, external partnerships, senior support, defining provider roles and expectations and adequate equipment and resources) to support its implementation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Effective use of the LCG needs a robust, context-sensitive implementation strategy. We present the first evidence-based, co-designed LCG implementation strategy which can be used to support LCG dissemination and uptake.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"53 1","pages":"120-128"},"PeriodicalIF":2.5,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.70004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838616","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}

{"title":"Childbirth Experiences in the United Kingdom Compared to the Netherlands: A Cross-Sectional Survey Study","authors":"Lauri M. M. van den Berg,&nbsp;Jens Henrichs,&nbsp;Jeroen van Dillen,&nbsp;Soo Downe,&nbsp;Corine Verhoeven,&nbsp;Ank de Jonge","doi":"10.1111/birt.70006","DOIUrl":"10.1111/birt.70006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This study was performed to compare childbirth experiences in the United Kingdom (UK) and the Netherlands (NL) and identify determinants of positive childbirth experiences in both countries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Women who gave birth in the UK (<i>n</i> = 1303) or the NL (<i>n</i> = 900) between January 2017 and December 2020 who filled in the cross-sectional Babies Born Better survey were included in this study. Fully adjusted logistic regression models were used to assess differences in the odds of a positive childbirth experience between the two countries. Hierarchical logistic regression analyses were performed to identify determinants of a positive childbirth experience, including socio-demographic factors, pregnancy and childbirth outcomes, and care-related determinants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Respondents giving birth in the UK had decreased odds of a positive childbirth experience compared to NL respondents (66% vs. 85%, AOR 0.45, CI 0.35–0.57). Significant determinants for a positive childbirth experience were multiparity, absence of pregnancy complications, a spontaneous vaginal birth, and giving birth at home. UK respondents who had a planned caesarean section had a higher likelihood of reporting a positive childbirth experience when adjusted for confounders. Having a doctor as the primary birth care provider was less likely to be associated with a positive childbirth experience in the UK.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Most women in both the NL and the UK reported positive childbirth experiences, but NL respondents were more likely to do so. Determinants of a positive birth experience were mostly factors associated with uncomplicated labor and birth, or linked with fulfilled choices and with being multiparous.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"53 1","pages":"129-138"},"PeriodicalIF":2.5,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.70006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144838615","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}

{"title":"Consensus Guidelines for Intermittent Auscultation in United States Community Birth Settings","authors":"Silke Akerson,&nbsp;Sarah Bradbury,&nbsp;Rosanna Davis,&nbsp;Wendy Gordon,&nbsp;Amy Romano,&nbsp;Holly Scholles","doi":"10.1111/birt.70002","DOIUrl":"10.1111/birt.70002","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Intermittent auscultation is the gold standard for fetal assessment in uncomplicated pregnancies and labors and is used universally in the community birth setting. Great variation exists in intermittent auscultation practices and language used by community birth midwives across the country. Current standards, as defined by midwifery schools, state midwifery licensing boards, and individual midwifery practices, differ significantly and sometimes contradict each other. Community birth midwives, nurses and birth assistants, midwifery educators and those working in community birth quality improvement have been in need of common language and guidance on best practices in intermittent auscultation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Develop and disseminate consensus standards for intermittent auscultation in the community birth setting in the United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>Creation of guidelines through a 21-month consensus process with a workgroup of educators, leaders, quality improvement experts, and practicing midwives by identifying practices supported by evidence or clinical experience, evaluating current evidence and guidelines, eliciting feedback from education, midwifery, nursing, and birth center organizations, and incorporating revisions to create the final document.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Consensus was reached on various elements of intermittent auscultation and guidelines were created. These guidelines address readiness, assessment, interpretation, and documentation of fetal heart tones, clinical decision making, and areas for future research. These guidelines provide a minimum standard for performance and documentation of intermittent auscultation in community birth midwifery practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"53 1","pages":"100-107"},"PeriodicalIF":2.5,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12894500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562075","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}

{"title":"Birth Outcomes After Sexual Violence and the Role of Disclosure to the Maternity Care Provider","authors":"Hannah de Klerk,&nbsp;Janneke Gitsels,&nbsp;Ank de Jonge,&nbsp;Elsa Montgomery,&nbsp;Janneke van't Hooft,&nbsp;Marit van der Pijl,&nbsp;Martine Hollander,&nbsp;Corine Verhoeven","doi":"10.1111/birt.70001","DOIUrl":"10.1111/birt.70001","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sexual violence (SV) history is associated with various birth outcomes. Yet, the underlying mechanisms of these associations have not been sufficiently explained. Disclosure of SV history to a maternity care provider may play an important role in maternity care providers' choice for birth interventions and in women's birth experience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional nationwide survey was conducted among women who had given birth in the 5 years prior to completing the questionnaire. Logistic regression analysis was performed to compare the associations between SV history (total, disclosed, and undisclosed) and birth outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 10,867 respondents, 1121 (10.3%) reported SV, of whom 582 (52%) disclosed to their maternity care provider. Respondents who disclosed their SV history had lower adjusted odds of episiotomy than respondents without an SV history (adjusted odds ratio [AOR] 0.71, 95% confidence intervals [95% CI] 0.56–0.90). Primiparous respondents who disclosed their SV history had increased odds of unplanned cesarean birth compared to spontaneous (OR 1.37, 95% CI 1.04–1.81) and assisted vaginal birth (OR 1.75, 95% CI 1.17–2.61). Primiparous respondents with both a disclosed and undisclosed SV history had increased adjusted odds of negative birth (AOR 1.78, 95% CI 1.50–2.12). There were no differences in referral to obstetrician-led care, home birth, preterm labor, and pharmaceutical pain relief between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>When people disclose their SV history, maternity care providers are less likely to perform an episiotomy, and more likely to choose an unplanned cesarean birth over vaginal birth. However, disclosure of SV history does not ameliorate the birth experience and we therefore recommend better implementation of trauma-informed birth support for women with an SV history.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"53 1","pages":"88-99"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.70001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546266","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}

{"title":"Interventions and Strategies for Reducing Episiotomy Rates Globally: A Systematic Review","authors":"Angela W. Chen,&nbsp;Maiah J. Hall,&nbsp;Molly R. Altman","doi":"10.1111/birt.70000","DOIUrl":"10.1111/birt.70000","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Episiotomy is still commonly practiced during childbirth worldwide, despite decades of scientific evidence that indicates no justification for its routine use. Routine episiotomy is associated with increased risk of serious maternal morbidity and no improvements in neonatal outcomes. We sought to analyze this gap between evidence-based knowledge and implementation surrounding reducing episiotomy practice. We systematically reviewed the literature to identify practices that have resulted in a change in episiotomy rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched three databases (PubMed/MEDLINE, CINAHL Complete, Embase) using key words and subject headings with no time restriction. Any studies published in English and reporting an original empirical analysis in any global, regional, or country-specific context that examined practice changes that were implemented and reported episiotomy as an outcome were included in our review. Studies were excluded if they only reported on trends or changes in episiotomy rates without examining the specific practices implemented. We sought to identify practices that resulted in a change in episiotomy rates, rather than to evaluate or compare the effectiveness of these practices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Search results returned 1265 records; 40 papers met the inclusion criteria for a full review. Twenty-five papers were included in our final analysis. All included studies documented a decrease in episiotomy rates, with 21 studies reporting a statistically significant reduction. Most studies were mixed interventions, often a combination of an educational intervention and audit and feedback.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Specific practice changes have been shown to effectively decrease the incidence of episiotomy. The findings from our review provide actionable insights for implementing evidence-based interventions to improve obstetric care. Prioritizing respectful birthing practices and reducing the routine use of episiotomy are critical steps toward addressing obstetric violence and promoting equitable, patient-centered maternity care globally.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 4","pages":"539-552"},"PeriodicalIF":2.5,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477969","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":"Characteristics and Outcomes Among Asian Birthing People in the American Association of Birth Centers Perinatal Data Registry","authors":"Amy H. Goh,&nbsp;Dia Aurora Kapoor,&nbsp;Anna Nguyen,&nbsp;Devi Soman,&nbsp;Diana R. Jolles","doi":"10.1111/birt.12923","DOIUrl":"10.1111/birt.12923","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Asian birthing people have the second highest rates of cesarean birth (CB), lowest rates of community (home and birth center), and midwife-attended births compared to other racial and ethnic groups in the United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The American Association of Birth Centers Perinatal Data Registry (PDR) was used to abstract socio-demographic and clinical data. Logistic regression analyses identified the drivers of cesarean birth among Asian birthing people in the overall and community birth eligible samples.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Between 2007 and 2021, 2983 people self-identified as Asian within the PDR. The Asian sample had a lower percentage of birth center births and a higher percentage of hospital births, CB, gestational diabetes, and postpartum hemorrhage compared to the overall sample. The cesarean rate in the Asian sample was 12.4%. Asian multiparous birthing people were at 1.5 greater odds of CB compared to White multiparous birthing people (OR = 1.54; 95% CI, 1.19–2.03; <i>p</i> &lt; 0.01). Asians in the community birth eligible group had higher odds of CB compared to their White counterparts (OR = 1.54; 95% CI, 1.23–1.93; <i>p</i> &lt; 0.01). Asian and White multiparous birthing people admitted to the hospital from the community birth eligible group had five times higher odds of CB compared to the total sample of Asian and White multiparous birthing people (OR = 5.18; 95% CI, 3.77–7.12; <i>p</i> &lt; 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>There were lower rates of CB among Asians who birthed in PDR user sites compared to the national average. Future research is needed in community birth outcomes among different Asian ethnicities and Asian birthing people's perspective on community birth.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"53 1","pages":"81-87"},"PeriodicalIF":2.5,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12923","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259432","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}

{"title":"“The Very Best That It Could Be and a Lot Better Than I Would Have Imagined”: Birthing People's Experiences of Transfer From Community to Hospital","authors":"Carrie Neerland,&nbsp;Arielle Skalisky,&nbsp;Robyn Schafer","doi":"10.1111/birt.12920","DOIUrl":"10.1111/birt.12920","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Community births (those in homes or freestanding birth centers) are increasing in the US, although they still represent a small percentage of total births. Research shows that community births can offer positive outcomes for low-risk individuals, such as fewer interventions and greater satisfaction. However, when perinatal complications arise, transfer to hospital can result in negative care outcomes and experiences. Effective integration of care and respectful communication between community and hospital providers during transfers are crucial for improving quality care measures. This study aimed to investigate the experiences and outcomes of individuals transferring from community settings to an urban US hospital with established transfer guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multi-method study, utilizing descriptive statistics and a grounded theory approach, explores the outcomes and experiences of individuals transferring from planned home or birth center births to hospital care for intrapartum management from August 2019 to August 2020. We included participants who were 18 or older, English-speaking, and had experienced a live birth following transfer from home or birth center to hospital. Quantitative outcomes were obtained through chart review. Qualitative interviews were conducted within 6 weeks post-birth, recorded, transcribed, and analyzed using constant comparative analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 82 individuals transferred during the study period, with 23 participating in qualitative interviews, we identified 5 major themes: seamless transfer, teamwork, respectful care, changing expectations, and a complex relationship with autonomy and decision-making. Participants valued smooth communication, midwife-to-midwife transfer of care, and the balance between autonomy and reliance on provider recommendations during transfers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Understanding the experiences of those who transfer from community settings to hospitals is crucial for improving perinatal care. With established guidelines for transfer in place to facilitate collaboration across care providers and birth settings, transfers can be managed effectively, resulting in respectful experiences of care with positive health outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 4","pages":"717-725"},"PeriodicalIF":2.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12920","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152904","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}