Stephanie Batram-Zantvoort, Céline Miani, Ilaria Mariani, Emanuelle Pessa Valente, Mehreen Zaigham, Ingvild Hersoug Nedberg, Magdalena Kurbanović, Elizabete Pumpure, Anja Bohinec, Antigone Sarantaki, Barbara Baranowska, Alessia Abderhalden-Zellweger, Elise de La Rochebrochard, Raquel Costa, Marina Ruxandra Otelea, Alina Liepinaitienė, Jelena Radetic, Amira Ćerimagić, Maryse Arendt, Martina König-Bachmann, Stefano Delle Vedove, Karolina Linden, Sigrun Kongslien, Daniela Drandić, Darta Kreslina, Zalka Drglin, Dimitra Metallinou, Urszula Tataj-Puzyna, Michael Gemperle, Virginie Rozée, Heloísa Dias, Marija Mizgaitienė, Jovana Ruzicic, Imola Simon, Simona Fumagalli, Helen Elden, Eline Skirnisdottir Vik, Barbara Mihevc Ponikvar, Aikaterini Lykeridou, Beata Szlendak, Claire de Labrusse, Tiago Miguel Pinto, Simona Jazdauskienė, Christoph Zenzmaier, Ilana Chertok, Emma Sacks, Marzia Lazzerini, IMAgiNE EURO Study group
Background
Mitigation measures implemented in response to the COVID-19 pandemic led to significant changes in maternity care across Europe, including restrictions on companions during labor and birth. This cross-sectional study explores the association between the presence of a companion of choice and a positive perception of the birth experience. Additionally, it explores the association between health professionals' attention, assistance, and availability during labor and birth and a positive perception of birth.
Methods
We utilized a structured, validated online questionnaire, available in 25 languages, to assess the quality of maternal care during the COVID-19 pandemic from women's perspectives. We conducted logistic regression to explore associations between variables related to the presence of a companion of choice, health professionals' attention, assistance, and availability, and positive perceptions of birth, when controlled for confounders, including birth mode and medical interventions.
Results
Responses from 48,039 women across 20 countries in the WHO European Region were included. Always having a companion of choice during birth (aOR: 2.11) and always receiving adequate care from health professionals (assistance aOR: 2.12, attention aOR: 36.64, availability aOR: 2.12) were associated with positive birth perception. Instrumental births (aOR: 0.76), episiotomies (aOR: 0.74), fundal pressure (aOR: 0.52), and cesarean births (planned aOR: 0.80, unplanned prelabor aOR: 0.60, unplanned in-labor aOR: 0.52) were associated with less positive birth perceptions.
Discussion
This study highlights the critical role of having a chosen companion and receiving adequate attention, assistance, and availability from health professionals in promoting positive birth perceptions, even in times of crisis such as the COVID-19 pandemic. Ensuring the presence of a companion of choice and comprehensive professional support is crucial for delivering high-quality, respectful maternity care.
{"title":"The Association Between Women's Perception of Birth During the Pandemic, Companion of Choice and Support From Health Professionals: A Cross-Sectional Study in 20 Countries in the WHO European Region","authors":"Stephanie Batram-Zantvoort, Céline Miani, Ilaria Mariani, Emanuelle Pessa Valente, Mehreen Zaigham, Ingvild Hersoug Nedberg, Magdalena Kurbanović, Elizabete Pumpure, Anja Bohinec, Antigone Sarantaki, Barbara Baranowska, Alessia Abderhalden-Zellweger, Elise de La Rochebrochard, Raquel Costa, Marina Ruxandra Otelea, Alina Liepinaitienė, Jelena Radetic, Amira Ćerimagić, Maryse Arendt, Martina König-Bachmann, Stefano Delle Vedove, Karolina Linden, Sigrun Kongslien, Daniela Drandić, Darta Kreslina, Zalka Drglin, Dimitra Metallinou, Urszula Tataj-Puzyna, Michael Gemperle, Virginie Rozée, Heloísa Dias, Marija Mizgaitienė, Jovana Ruzicic, Imola Simon, Simona Fumagalli, Helen Elden, Eline Skirnisdottir Vik, Barbara Mihevc Ponikvar, Aikaterini Lykeridou, Beata Szlendak, Claire de Labrusse, Tiago Miguel Pinto, Simona Jazdauskienė, Christoph Zenzmaier, Ilana Chertok, Emma Sacks, Marzia Lazzerini, IMAgiNE EURO Study group","doi":"10.1111/birt.12915","DOIUrl":"10.1111/birt.12915","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Mitigation measures implemented in response to the COVID-19 pandemic led to significant changes in maternity care across Europe, including restrictions on companions during labor and birth. This cross-sectional study explores the association between the presence of a companion of choice and a positive perception of the birth experience. Additionally, it explores the association between health professionals' attention, assistance, and availability during labor and birth and a positive perception of birth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We utilized a structured, validated online questionnaire, available in 25 languages, to assess the quality of maternal care during the COVID-19 pandemic from women's perspectives. We conducted logistic regression to explore associations between variables related to the presence of a companion of choice, health professionals' attention, assistance, and availability, and positive perceptions of birth, when controlled for confounders, including birth mode and medical interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Responses from 48,039 women across 20 countries in the WHO European Region were included. Always having a companion of choice during birth (aOR: 2.11) and always receiving adequate care from health professionals (assistance aOR: 2.12, attention aOR: 36.64, availability aOR: 2.12) were associated with positive birth perception. Instrumental births (aOR: 0.76), episiotomies (aOR: 0.74), fundal pressure (aOR: 0.52), and cesarean births (planned aOR: 0.80, unplanned prelabor aOR: 0.60, unplanned in-labor aOR: 0.52) were associated with less positive birth perceptions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This study highlights the critical role of having a chosen companion and receiving adequate attention, assistance, and availability from health professionals in promoting positive birth perceptions, even in times of crisis such as the COVID-19 pandemic. Ensuring the presence of a companion of choice and comprehensive professional support is crucial for delivering high-quality, respectful maternity care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 4","pages":"677-689"},"PeriodicalIF":2.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12915","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782033","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}
In the UK, families in temporary accommodation reached record numbers in 2023. Pregnant mothers experiencing homelessness are at risk of poor health outcomes, yet little is known about their experiences. Most biomedical research emphasizes obstetric outcomes rather than maternal experiences. Our study aimed to explore maternal experiences of pregnancy while living in temporary accommodation in the UK.
Methods
Using an interpretivist paradigm and critical feminist theory, we collected and analyzed semi-structured interview narratives from pregnant and postnatal mothers experiencing homelessness. Interviews with key workers from relevant Third Sector Organisations provided complementary insights. Study planning included Patient and Public Involvement. Data were analyzed using reflexive thematic analysis.
Results
Fourteen mothers and six keyworkers were interviewed. Reflexive thematic analysis generated three themes. Theme one, Pregnant/postnatal bodies in unsafe spaces, described participants' experiences with unsafe accommodations, exposure to environmental hazards, and frequent moves which affected physical and mental health. In Undermining mothers, participants explained how the constant struggle to meet basic needs eroded opportunities to engage with caring roles and destabilized their sense of being “good” mothers. Together these contributed to pregnancy disengagement and feeling unprepared for birth. The third key theme, Feeling unseen in midwifery blind spots, describes barriers to accessing maternity services, as well as interactions with midwives that often reinforced feelings of being invisible.
Discussion
Living in temporary accommodations whilst pregnant negatively impacts physical, mental, and emotional well-being. Improving care for pregnant mothers experiencing homelessness requires systemic change within housing and maternity services to acknowledge housing security as an essential need for pregnant and parenting mothers.
{"title":"Pregnant and Homeless in the UK: A Qualitative Analysis of Maternal Experiences in Temporary Accommodation","authors":"Sara Cumming, Andrew Symon","doi":"10.1111/birt.12919","DOIUrl":"10.1111/birt.12919","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In the UK, families in temporary accommodation reached record numbers in 2023. Pregnant mothers experiencing homelessness are at risk of poor health outcomes, yet little is known about their experiences. Most biomedical research emphasizes obstetric outcomes rather than maternal experiences. Our study aimed to explore maternal experiences of pregnancy while living in temporary accommodation in the UK.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using an interpretivist paradigm and critical feminist theory, we collected and analyzed semi-structured interview narratives from pregnant and postnatal mothers experiencing homelessness. Interviews with key workers from relevant Third Sector Organisations provided complementary insights. Study planning included Patient and Public Involvement. Data were analyzed using reflexive thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fourteen mothers and six keyworkers were interviewed. Reflexive thematic analysis generated three themes. Theme one, <i>Pregnant/postnatal bodies in unsafe spaces</i>, described participants' experiences with unsafe accommodations, exposure to environmental hazards, and frequent moves which affected physical and mental health. In <i>Undermining mothers</i>, participants explained how the constant struggle to meet basic needs eroded opportunities to engage with caring roles and destabilized their sense of being “good” mothers. Together these contributed to pregnancy disengagement and feeling unprepared for birth. The third key theme, <i>Feeling unseen in midwifery blind spots</i>, describes barriers to accessing maternity services, as well as interactions with midwives that often reinforced feelings of being invisible.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Living in temporary accommodations whilst pregnant negatively impacts physical, mental, and emotional well-being. Improving care for pregnant mothers experiencing homelessness requires systemic change within housing and maternity services to acknowledge housing security as an essential need for pregnant and parenting mothers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 3","pages":"503-510"},"PeriodicalIF":2.5,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12919","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782078","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}
Charlotte Leroy, Elizaveta Fomenko, Régine Goemaes, Virginie Van Leeuw, Judith Racapé, Sophie Alexander
Objective
To assess the effect of maternity unit characteristics on the cesarean section (CS) rate, using Robson's Ten-Group Classification System (TGCS) and considering the sociodemographic and medical characteristics of the mother.
Methods
The study, conducted in Belgium from 2011 to 2019, employed an analytical design utilizing a nationwide register of routine data and focused on hospital births. The CS rate was analyzed by neonatal intensive care unit (NICU) availability and by maternal unit size for TGCS groups 1, 2, and 5, which were the highest contributors to the total CS rate. Multivariable logistic regression models and generalized linear mixed-effects models were utilized to analyze the association between the maternity itself and CS.
Results
The overall CS rate was 20.8%, displaying a twofold variation across maternity units. This variation persisted irrespective of the presence or absence of a NICU and the maternity unit's size. Our findings highlighted a significant association between maternity unit characteristics (size and NICU availability) and the likelihood of performing CS in TGCS groups 1, 2, and 5. This association did not change after adjustment for sociodemographic and medical characteristics. However, the majority of odds ratios for maternity-related variables lost their significance in the multilevel analysis compared to simple logistic regressions.
Conclusions
The CS rate seems to be more influenced by the “philosophy” of the maternity unit than its specific size and NICU characteristics. Future research is needed to explore the underlying mechanisms of this association and to identify potential interventions that could reduce CSs performed without clinical indication in different settings.
{"title":"Effect of Maternity Characteristics on Cesarean Birth Rates in Belgium: A Robson Classification Approach","authors":"Charlotte Leroy, Elizaveta Fomenko, Régine Goemaes, Virginie Van Leeuw, Judith Racapé, Sophie Alexander","doi":"10.1111/birt.12916","DOIUrl":"10.1111/birt.12916","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the effect of maternity unit characteristics on the cesarean section (CS) rate, using Robson's Ten-Group Classification System (TGCS) and considering the sociodemographic and medical characteristics of the mother.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study, conducted in Belgium from 2011 to 2019, employed an analytical design utilizing a nationwide register of routine data and focused on hospital births. The CS rate was analyzed by neonatal intensive care unit (NICU) availability and by maternal unit size for TGCS groups 1, 2, and 5, which were the highest contributors to the total CS rate. Multivariable logistic regression models and generalized linear mixed-effects models were utilized to analyze the association between the maternity itself and CS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The overall CS rate was 20.8%, displaying a twofold variation across maternity units. This variation persisted irrespective of the presence or absence of a NICU and the maternity unit's size. Our findings highlighted a significant association between maternity unit characteristics (size and NICU availability) and the likelihood of performing CS in TGCS groups 1, 2, and 5. This association did not change after adjustment for sociodemographic and medical characteristics. However, the majority of odds ratios for maternity-related variables lost their significance in the multilevel analysis compared to simple logistic regressions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The CS rate seems to be more influenced by the “philosophy” of the maternity unit than its specific size and NICU characteristics. Future research is needed to explore the underlying mechanisms of this association and to identify potential interventions that could reduce CSs performed without clinical indication in different settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 4","pages":"690-698"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755696","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}
Carla Meurk, Susan Roberts, Michael Lam, Lisa Wittenhagen, Leonie Callaway, Katherine Moss, Jayne Lucke, Ruth Barker, Elissa Waterson, Natasha Malmstrom, Edward Weaver, Elisabeth Hoehn, Ed Heffernan
Introduction
This article presents an assessment of the mental health profile of women who were the subject of a suicide-related call to police or paramedics around the time of (i) pregnancy or (ii) surgical termination of pregnancy compared to (iii) other women of a similar age.
Methods
Findings are drawn from a population-wide linked dataset of approximately 70,000 individuals who were the subject of a suicide-related call to police or paramedics in Queensland, Australia. Mental health diagnoses were assessed based on the Diagnostic and Statistical Manual (fifth edition). Behavior, impairment, symptoms, and social functioning were assessed using Health of the Nation Outcome Scores (HoNOS).
Results
32.7% of individuals had a record of one or more confirmed mental health diagnoses. The presence of a mental health diagnosis differed significantly across subgroups. Rates of clinically significant problems, as measured by HoNOS, differed significantly across groups for most items.
Conclusion
Findings present a complex picture of the relationship between mental health diagnosis, pregnancy or termination of pregnancy, and other stressors experienced around the time of a suicide-related contact with police or paramedics.
{"title":"Mental Health Profile Relating to Suicide Crises Among Women in and Around Pregnancy and Surgical Termination of Pregnancy: A Data Linkage Study","authors":"Carla Meurk, Susan Roberts, Michael Lam, Lisa Wittenhagen, Leonie Callaway, Katherine Moss, Jayne Lucke, Ruth Barker, Elissa Waterson, Natasha Malmstrom, Edward Weaver, Elisabeth Hoehn, Ed Heffernan","doi":"10.1111/birt.12917","DOIUrl":"10.1111/birt.12917","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This article presents an assessment of the mental health profile of women who were the subject of a suicide-related call to police or paramedics around the time of (i) pregnancy or (ii) surgical termination of pregnancy compared to (iii) other women of a similar age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Findings are drawn from a population-wide linked dataset of approximately 70,000 individuals who were the subject of a suicide-related call to police or paramedics in Queensland, Australia. Mental health diagnoses were assessed based on the Diagnostic and Statistical Manual (fifth edition). Behavior, impairment, symptoms, and social functioning were assessed using Health of the Nation Outcome Scores (HoNOS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>32.7% of individuals had a record of one or more confirmed mental health diagnoses. The presence of a mental health diagnosis differed significantly across subgroups. Rates of clinically significant problems, as measured by HoNOS, differed significantly across groups for most items.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Findings present a complex picture of the relationship between mental health diagnosis, pregnancy or termination of pregnancy, and other stressors experienced around the time of a suicide-related contact with police or paramedics.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 4","pages":"699-707"},"PeriodicalIF":2.5,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12917","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733378","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}
Fiona Weeks, Rebecca Myerson, Ronald Gangnon, Jennifer Dykema, Candi Cornelius, Tiffany Green
Introduction
The postpartum visit is an important opportunity to prevent pregnancy-related morbidity and mortality; however, about 1 in 10 birthing people do not attend this visit. Intrapartum care experiences are an understudied factor that may contribute to postpartum healthcare engagement.
Materials and Methods
We analyze data from a novel survey supplement on intrapartum care experiences administered to a probability-based population sample of people who have recently given birth through the Wisconsin Pregnancy Risk Assessment Monitoring System.
Results
In regression models adjusting for a robust set of individual characteristics and birth hospital clustering, we find that lower provider responsiveness during intrapartum care is associated with increased odds of forgoing the postpartum visit (aOR 1.4, 95% CI 1.0–2.0).
Discussion
The quality of care received during the birth hospitalization may shape how birthing people feel about health care providers and their willingness to attend future visits. Experiences of care during the intrapartum period may contribute to future health care utilization. Improving these experiences is an opportunity to promote long-term health.
产后随访是预防妊娠相关发病和死亡的重要机会；然而，大约十分之一的产妇没有参加这次访问。产时护理经验是一个未充分研究的因素，可能有助于产后保健参与。材料和方法：我们分析了一项关于分娩时护理经验的新调查补充数据，该调查是通过威斯康星州妊娠风险评估监测系统对最近分娩的基于概率的人群样本进行的。结果：在校正了一组稳健的个体特征和出生医院聚类的回归模型中，我们发现产中护理时较低的提供者反应性与放弃产后就诊的几率增加有关（aOR 1.4, 95% CI 1.0-2.0）。讨论：分娩住院期间接受的护理质量可能会影响分娩患者对卫生保健提供者的感觉以及他们未来就诊的意愿。分娩期间的护理经验可能有助于未来的卫生保健利用。改善这些经历是促进长期健康的一个机会。
{"title":"Intrapartum Care Experiences Associated With Postpartum Visit Attendance","authors":"Fiona Weeks, Rebecca Myerson, Ronald Gangnon, Jennifer Dykema, Candi Cornelius, Tiffany Green","doi":"10.1111/birt.12910","DOIUrl":"10.1111/birt.12910","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The postpartum visit is an important opportunity to prevent pregnancy-related morbidity and mortality; however, about 1 in 10 birthing people do not attend this visit. Intrapartum care experiences are an understudied factor that may contribute to postpartum healthcare engagement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We analyze data from a novel survey supplement on intrapartum care experiences administered to a probability-based population sample of people who have recently given birth through the Wisconsin Pregnancy Risk Assessment Monitoring System.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In regression models adjusting for a robust set of individual characteristics and birth hospital clustering, we find that lower provider responsiveness during intrapartum care is associated with increased odds of forgoing the postpartum visit (aOR 1.4, 95% CI 1.0–2.0).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The quality of care received during the birth hospitalization may shape how birthing people feel about health care providers and their willingness to attend future visits. Experiences of care during the intrapartum period may contribute to future health care utilization. Improving these experiences is an opportunity to promote long-term health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 4","pages":"652-658"},"PeriodicalIF":2.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12910","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607291","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}
Molly R. Altman, Teresa van Winkle, Brittany Ferrell, A. J. Lowik, Kodiak R. S. Soled, Lesley A. Tarasoff, Jeanette McCulloch, Kathrin Stoll, Juno Obedin-Maliver, Saraswathi Vedam, Birth Includes US Community Steering Council
Introduction
Despite increased recognition of and support for family building among lesbian, gay, bisexual, transgender, queer, Two-Spirit, and other sexual and gender minoritized (LGBTQ2S+) populations, there is still little evidence describing the experiences of pregnancy care within these populations in quantifiable ways. This paper describes our pilot study process and the feasibility of implementing a community-developed survey measuring respectful pregnancy care within LGBTQ2S+ communities.
Methods
Using a participatory action research approach, a Community Steering Council developed and piloted the Birth Includes Us survey. To assess the feasibility of the survey, recruitment was assessed through how participants heard about the study, and enrollment and survey completion were tracked in the REDCap survey platform. We used descriptive statistics to report the demographics of the pilot sample.
Results
Recruitment through social media, predominantly Facebook, was an effective route to reach the target population, accounting for over 60% of the sample. Of the 404 eligible participants who opened the survey, 91% completed the survey. The pilot study sample represented 41/50 states in the USA and 5/13 provinces and territories across Canada. While only 17% of the sample were members of racially minoritized communities, there was wide representation across genders and sexualities.
Conclusion
The findings of this feasibility pilot study will inform the implementation of the Birth Includes Us survey to ensure the recruitment, enrollment, and retention of diverse participants. Lessons learned from this process will also support researchers in developing mitigating strategies to minimize the harm incurred during the process of LGBTQ2S+ family building.
{"title":"Feasibility of a Community-Developed Survey Measuring Experiences of Pregnancy Care for LGBTQ2S+ Families","authors":"Molly R. Altman, Teresa van Winkle, Brittany Ferrell, A. J. Lowik, Kodiak R. S. Soled, Lesley A. Tarasoff, Jeanette McCulloch, Kathrin Stoll, Juno Obedin-Maliver, Saraswathi Vedam, Birth Includes US Community Steering Council","doi":"10.1111/birt.12911","DOIUrl":"10.1111/birt.12911","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Despite increased recognition of and support for family building among lesbian, gay, bisexual, transgender, queer, Two-Spirit, and other sexual and gender minoritized (LGBTQ2S+) populations, there is still little evidence describing the experiences of pregnancy care within these populations in quantifiable ways. This paper describes our pilot study process and the feasibility of implementing a community-developed survey measuring respectful pregnancy care within LGBTQ2S+ communities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using a participatory action research approach, a Community Steering Council developed and piloted the Birth Includes Us survey. To assess the feasibility of the survey, recruitment was assessed through how participants heard about the study, and enrollment and survey completion were tracked in the REDCap survey platform. We used descriptive statistics to report the demographics of the pilot sample.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Recruitment through social media, predominantly Facebook, was an effective route to reach the target population, accounting for over 60% of the sample. Of the 404 eligible participants who opened the survey, 91% completed the survey. The pilot study sample represented 41/50 states in the USA and 5/13 provinces and territories across Canada. While only 17% of the sample were members of racially minoritized communities, there was wide representation across genders and sexualities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings of this feasibility pilot study will inform the implementation of the Birth Includes Us survey to ensure the recruitment, enrollment, and retention of diverse participants. Lessons learned from this process will also support researchers in developing mitigating strategies to minimize the harm incurred during the process of LGBTQ2S+ family building.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 3","pages":"517-526"},"PeriodicalIF":2.5,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607288","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}
Poor sleep in pregnancy is associated with several adverse maternal and infant outcomes. Psychoeducational interventions may offer a safe and acceptable first-line intervention to help with sleep disturbances.
Aim
To identify and review studies that examined the effect of psycho-educational interventions on sleep in pregnancy and to identify moderators in the treatment effects of the interventions.
Methods
An integrative review methodology was used. A comprehensive search in five electronic databases retrieved 1250 articles. Eligible studies (n = 12) were assessed for methodological quality according to the “QualSyst” rapid appraisal tool. Data were extracted and recorded using a modified Covidence form. Quantitative data were summarized in a meta-analysis or narrative synthesis. Qualitative data were narratively reported.
Findings
Twelve studies with three different sleep interventions: Cognitive Behavioral Therapy for Insomnia (CBT-I), Sleep Healthy Education (SHE) and relaxation training were included. Given the variation in study methodologies and interventions, only quantitative results from RCT trials using CBT-I were summarized in the meta-analysis. CBT-I was found to be statistically significant in improving sleep quality in pregnancy (Standard Mean Difference = −0.78; 95% CI = −1.01, −0.54, p < 0.001). Few studies reported the efficacy of SHE and relaxation training. Potential moderators had no effect on the measured sleep quality outcome. Overall, psychoeducational interventions were acceptable to participants during pregnancy.
Conclusion
There is insufficient evidence on which to base the recommendations about the effectiveness of all psychoeducational interventions to improve sleep. Based on the available literature, CBT-I is an evidence-based intervention to improve sleep quality in pregnancy.
背景：妊娠期睡眠不足与几种不良母婴结局相关。心理教育干预可以提供一个安全和可接受的一线干预，以帮助睡眠障碍。目的：识别和回顾有关心理教育干预对妊娠期睡眠影响的研究，并确定干预治疗效果的调节因子。方法：采用综合评价方法。在五个电子数据库中进行全面检索，检索到1250篇文章。根据“QualSyst”快速评估工具对符合条件的研究（n = 12）进行方法学质量评估。使用修改后的covid表格提取和记录数据。定量数据在荟萃分析或叙事综合中进行总结。对定性数据进行叙述性报道。研究结果：12项研究纳入了三种不同的睡眠干预措施：失眠认知行为疗法（CBT-I）、睡眠健康教育（SHE）和放松训练。考虑到研究方法和干预措施的差异，荟萃分析中仅总结了使用CBT-I的RCT试验的定量结果。CBT-I在改善妊娠期睡眠质量方面具有统计学意义(标准差= -0.78；95% CI = -1.01, -0.54， p结论：关于所有心理教育干预措施改善睡眠的有效性的建议证据不足。根据现有文献，CBT-I是一种基于证据的改善妊娠期睡眠质量的干预措施。
{"title":"The Efficacy of Psycho-Educational Interventions to Optimize Women's Sleep in Pregnancy: An Integrative Review","authors":"Vishnuvarthini Visvanathan, Wendy Pollock, Yasmin Zisin, Suzanne Willey","doi":"10.1111/birt.12902","DOIUrl":"10.1111/birt.12902","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Poor sleep in pregnancy is associated with several adverse maternal and infant outcomes. Psychoeducational interventions may offer a safe and acceptable first-line intervention to help with sleep disturbances.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To identify and review studies that examined the effect of psycho-educational interventions on sleep in pregnancy and to identify moderators in the treatment effects of the interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An integrative review methodology was used. A comprehensive search in five electronic databases retrieved 1250 articles. Eligible studies (<i>n</i> = 12) were assessed for methodological quality according to the “QualSyst” rapid appraisal tool. Data were extracted and recorded using a modified Covidence form. Quantitative data were summarized in a meta-analysis or narrative synthesis. Qualitative data were narratively reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Twelve studies with three different sleep interventions: Cognitive Behavioral Therapy for Insomnia (CBT-I), Sleep Healthy Education (SHE) and relaxation training were included. Given the variation in study methodologies and interventions, only quantitative results from RCT trials using CBT-I were summarized in the meta-analysis. CBT-I was found to be statistically significant in improving sleep quality in pregnancy (Standard Mean Difference = −0.78; 95% CI = −1.01, −0.54, <i>p <</i> 0.001). Few studies reported the efficacy of SHE and relaxation training. Potential moderators had no effect on the measured sleep quality outcome. Overall, psychoeducational interventions were acceptable to participants during pregnancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There is insufficient evidence on which to base the recommendations about the effectiveness of all psychoeducational interventions to improve sleep. Based on the available literature, CBT-I is an evidence-based intervention to improve sleep quality in pregnancy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 2","pages":"228-242"},"PeriodicalIF":2.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12902","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588228","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}
Childbirth is a pivotal event marked by diverse vocalizations, yet scant research examines healthcare providers' perspectives on vocalization during birth. This study seeks to address this gap by exploring the attitudes and practices of various healthcare professionals regarding vocalization during labor and birth.
Methods
This study used a qualitative comparison approach, grounded in Organizational Cultural Phenomenon of Humanized Childbirth. Five discipline specific focus groups were conducted with doulas, nurses, community midwives, hospital midwives, and obstetricians to explore provider perceptions and experiences with vocalization during childbirth.
Results
Analysis of the focus groups indicated five overarching themes: (1) Shame and apologies, (2) Providers inhibiting or facilitating vocalization of gendered norms, (3) Affirmations or “Mantras,” (4) Right and wrong sounds, and (5) Developing comfort with vocalization.
Discussion
The findings underscore the need for education on supporting vocalization during childbirth. The tension between provider expectations and birthing individuals' autonomy highlights broader issues of paternalism in Western childbirth practices. Addressing these dynamics can foster a more respectful and empowering birth environment, promoting positive birth experiences.
{"title":"Impolite Birth: Provider Perspectives on Vocalization During Childbirth","authors":"Lee Roosevelt, Kris Danford, Ruth Zielinski","doi":"10.1111/birt.12907","DOIUrl":"10.1111/birt.12907","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Childbirth is a pivotal event marked by diverse vocalizations, yet scant research examines healthcare providers' perspectives on vocalization during birth. This study seeks to address this gap by exploring the attitudes and practices of various healthcare professionals regarding vocalization during labor and birth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study used a qualitative comparison approach, grounded in Organizational Cultural Phenomenon of Humanized Childbirth. Five discipline specific focus groups were conducted with doulas, nurses, community midwives, hospital midwives, and obstetricians to explore provider perceptions and experiences with vocalization during childbirth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Analysis of the focus groups indicated five overarching themes: (1) Shame and apologies, (2) Providers inhibiting or facilitating vocalization of gendered norms, (3) Affirmations or “Mantras,” (4) Right and wrong sounds, and (5) Developing comfort with vocalization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The findings underscore the need for education on supporting vocalization during childbirth. The tension between provider expectations and birthing individuals' autonomy highlights broader issues of paternalism in Western childbirth practices. Addressing these dynamics can foster a more respectful and empowering birth environment, promoting positive birth experiences.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 4","pages":"627-633"},"PeriodicalIF":2.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12907","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588225","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}
The professional title “midwife” is predicated on the understanding that people who access their services have a normative relationship between their gender and assigned sex. As trans and non-binary people increasingly require access to midwifery services, this paper proposes an alternative professional title that is inclusive and liberates midwives from continuously reinscribing the sex/gender binary in their nomenclature. We work with Levitas's Utopia as Method framework to propose the title of Lead Perinatal Practitioner. Working through the archaeological, ontological and architectural modes, we explain the rationale for each component part of the title. “Lead” foregrounds the profession's relationship with autonomy, which is considered foundational but threatened by encroaching medicalization. “Perinatal” encompasses not just the birthing person but also the neonate and the physiological process and timeframe encapsulating pregnancy and birth currently absent. “Practitioner” captures the reflexivity, skill, and active engagement already inscribed in allied healthcare professions that use this title. We argue that when combined, they signal a trailblazing contribution towards the eradication of gender inequalities in the reproductive arena by uncoupling the profession from patriarchal oppression inscribed in the sex/gender binary, which has hitherto been positioned as the sine qua non of midwifery.
{"title":"From Midwife to Lead Perinatal Practitioner: A Utopian Vision","authors":"John Pendleton, Sally Pezaro","doi":"10.1111/birt.12913","DOIUrl":"10.1111/birt.12913","url":null,"abstract":"<p>The professional title “midwife” is predicated on the understanding that people who access their services have a normative relationship between their gender and assigned sex. As trans and non-binary people increasingly require access to midwifery services, this paper proposes an alternative professional title that is inclusive and liberates midwives from continuously reinscribing the sex/gender binary in their nomenclature. We work with Levitas's <i>Utopia as Method</i> framework to propose the title of Lead Perinatal Practitioner. Working through the archaeological, ontological and architectural modes, we explain the rationale for each component part of the title. “Lead” foregrounds the profession's relationship with autonomy, which is considered foundational but threatened by encroaching medicalization. “Perinatal” encompasses not just the birthing person but also the neonate and the physiological process and timeframe encapsulating pregnancy and birth currently absent. “Practitioner” captures the reflexivity, skill, and active engagement already inscribed in allied healthcare professions that use this title. We argue that when combined, they signal a trailblazing contribution towards the eradication of gender inequalities in the reproductive arena by uncoupling the profession from patriarchal oppression inscribed in the sex/gender binary, which has hitherto been positioned as the sine qua non of midwifery.</p>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 3","pages":"511-516"},"PeriodicalIF":2.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12913","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588220","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}
Caroline Trillingsgaard Mejdahl, Lone Hvidman, Rikke Bek Helmig, Sidsel Boie, Anna Højkjær Larsen, Maria Lundbo, Jeanette Ziska, Stina Lou
Background
The increasing frequency of induction of labor (IOL) prompts explorations into women's experiences. To inform individualized obstetric care, this study aimed to investigate the experiences of Danish pregnant women who underwent out-patient medical IOL and were not in active labor 48 h after IOL initiation.
Methods
A qualitative interview study with 28 women who had experienced prolonged IOL (all indications). The women were recruited at two obstetric departments approximately 48 h after IOL initiation and telephone interviewed 2–6 weeks after birth (average of 37 min duration). Interviews were recorded, transcribed, and analyzed using thematic analysis.
Results
The first theme describes the underlying rationale in the women's description of IOL and birth: ‘Motivated by the birth of a healthy baby.’ The results show how the women accepted medical indications for IOL, found comfort in the out-patient regimen, and felt secure about the health of their baby, even if the prolonged IOL was frustrating. The results show how ‘progress’ became a primary motivator for suggesting and accepting interventions. The second theme describes four ‘Situations of discouragement’ that are clusters of events during IOL and birth that could challenge the women's expectations and boundaries, for example, experiencing excessive pain or not feeling heard. Despite challenges, most women viewed their experiences positively, remaining open to future IOL.
Discussion
The findings underscore the complexity of women's experiences during IOL and birth, emphasizing the need for healthcare professionals to navigate diverse, individual preferences while prioritizing maternal and fetal well-being.
{"title":"Women's Experiences of Induction of Labor and Birth After Prolonged Medical Induction: A Qualitative Study From Denmark","authors":"Caroline Trillingsgaard Mejdahl, Lone Hvidman, Rikke Bek Helmig, Sidsel Boie, Anna Højkjær Larsen, Maria Lundbo, Jeanette Ziska, Stina Lou","doi":"10.1111/birt.12912","DOIUrl":"10.1111/birt.12912","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The increasing frequency of induction of labor (IOL) prompts explorations into women's experiences. To inform individualized obstetric care, this study aimed to investigate the experiences of Danish pregnant women who underwent out-patient medical IOL and were not in active labor 48 h after IOL initiation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A qualitative interview study with 28 women who had experienced prolonged IOL (all indications). The women were recruited at two obstetric departments approximately 48 h after IOL initiation and telephone interviewed 2–6 weeks after birth (average of 37 min duration). Interviews were recorded, transcribed, and analyzed using thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The first theme describes the underlying rationale in the women's description of IOL and birth: ‘<i>Motivated by the birth of a healthy baby</i>.’ The results show how the women accepted medical indications for IOL, found comfort in the out-patient regimen, and felt secure about the health of their baby, even if the prolonged IOL was frustrating. The results show how ‘progress’ became a primary motivator for suggesting and accepting interventions. The second theme describes four <i>‘Situations of discouragement’</i> that are clusters of events during IOL and birth that could challenge the women's expectations and boundaries, for example, experiencing excessive pain or not feeling heard. Despite challenges, most women viewed their experiences positively, remaining open to future IOL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The findings underscore the complexity of women's experiences during IOL and birth, emphasizing the need for healthcare professionals to navigate diverse, individual preferences while prioritizing maternal and fetal well-being.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 4","pages":"659-668"},"PeriodicalIF":2.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12912","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574696","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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