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}
Michalina Ilska, Anna Kołodziej-Zaleska, Anna Brandt-Salmeri, Heidi Preis, Marci Lobel
Background
The COVID-19 pandemic posed new and unpredictable challenges worldwide, having a particular effect on vulnerable groups, including pregnant women. The occurrence of these stressful circumstances likely increased women's fear of childbirth, a critical issue in pregnancy with consequences for various outcomes.
Methods
This cross-sectional study investigated fear of childbirth in pregnant women during three waves of the COVID-19 pandemic in Poland and identified factors predicting severe fear. Participants were recruited through social media platforms. In total, 2462 pregnant women completed the study questionnaire during the first (n = 1079), second (n = 1119), or third (n = 264) waves of the pandemic. Fear of childbirth was measured with the Fear of Birth visual analog scale (FOBS) using a cut-off score of ≥ 54 to indicate clinically relevant fear of childbirth. COVID-19-related stress was assessed using the Pandemic-Related Pregnancy Stress Scale (PREPS).
Results
Fear of childbirth was present in 51.5%, 61.9%, and 56.8% of participants at the three waves, respectively. Women who were pregnant during the first and third waves had lower fear of childbirth scores than those who were pregnant during the second wave. This could be explained by changes in infection rates and the severity of the disease, restrictions in maternity care, and the availability of vaccinations. In successive pandemic waves, predictors of severe fear of childbirth (FoC), especially related to COVID-19, differed. Across waves, the most powerful predictor was stress originating from feeling unprepared for birth.
Discussion
Fear of childbirth differed across pandemic time points. Pandemic waves should be considered in future review studies and meta-analyses.
{"title":"Changes in Fear of Childbirth and Its Predictors Over Three COVID-19 Pandemic Waves in Poland","authors":"Michalina Ilska, Anna Kołodziej-Zaleska, Anna Brandt-Salmeri, Heidi Preis, Marci Lobel","doi":"10.1111/birt.12904","DOIUrl":"10.1111/birt.12904","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The COVID-19 pandemic posed new and unpredictable challenges worldwide, having a particular effect on vulnerable groups, including pregnant women. The occurrence of these stressful circumstances likely increased women's fear of childbirth, a critical issue in pregnancy with consequences for various outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study investigated fear of childbirth in pregnant women during three waves of the COVID-19 pandemic in Poland and identified factors predicting severe fear. Participants were recruited through social media platforms. In total, 2462 pregnant women completed the study questionnaire during the first (<i>n</i> = 1079), second (<i>n</i> = 1119), or third (<i>n</i> = 264) waves of the pandemic. Fear of childbirth was measured with the Fear of Birth visual analog scale (FOBS) using a cut-off score of ≥ 54 to indicate clinically relevant fear of childbirth. COVID-19-related stress was assessed using the Pandemic-Related Pregnancy Stress Scale (PREPS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fear of childbirth was present in 51.5%, 61.9%, and 56.8% of participants at the three waves, respectively. Women who were pregnant during the first and third waves had lower fear of childbirth scores than those who were pregnant during the second wave. This could be explained by changes in infection rates and the severity of the disease, restrictions in maternity care, and the availability of vaccinations. In successive pandemic waves, predictors of severe fear of childbirth (FoC), especially related to COVID-19, differed. Across waves, the most powerful predictor was stress originating from feeling unprepared for birth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Fear of childbirth differed across pandemic time points. Pandemic waves should be considered in future review studies and meta-analyses.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 4","pages":"594-605"},"PeriodicalIF":2.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574695","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}
One-on-one professional support during labor is recognized for its role in promoting physiological birth, reducing interventions, and enhancing women's birthing experiences. Throughout physiological birth, many women encounter an altered state of consciousness. This state not only facilitates the normal birth process but also empowers women during and after childbirth. Recently, the flow—a mental state of complete absorption and energized focus in an activity, with a sense of control and high motivation—has been identified as a measure of this experience during physiological birth. This study aimed to discover whether one-on-one continuous professional support would improve the childbirth experience by increasing the likelihood of physiological birth and a heightened state of flow during childbirth.
Methods
Women with childbirth experience were recruited through social media. Participants (n = 788) completed an online survey: the Flow State Scale (FSS) and a demographic questionnaire, including details about the professional support received during childbirth.
Results
One-on-one professional support was significantly associated with natural childbirth (midwife: 80.9%, doula: 65.7%) and lower medical interventions (midwife: 19.1%, doula: 34.3%) compared to conventional professional assistance (natural birth: 44.4%, interventions: 55.6%). A MANCOVA analysis revealed significant differences in flow state levels, with women receiving one-on-one support experiencing the highest flow state.
Conclusions
This research validates the significant correlation between one-on-one support—provided by midwives or doulas—and physiological birth. It also establishes for the first time a correlation between women in childbirth receiving continuous one-on-one professional support and heightened flow state levels, signifying a positive and empowering birthing experience.
{"title":"Birthing With Others: Exploring the Efficacy of One-On-One Professional Support on Physiological Birth and Flow State","authors":"Orli Dahan, Alon Goldberg","doi":"10.1111/birt.12908","DOIUrl":"10.1111/birt.12908","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>One-on-one professional support during labor is recognized for its role in promoting physiological birth, reducing interventions, and enhancing women's birthing experiences. Throughout physiological birth, many women encounter an altered state of consciousness. This state not only facilitates the normal birth process but also empowers women during and after childbirth. Recently, the flow—a mental state of complete absorption and energized focus in an activity, with a sense of control and high motivation—has been identified as a measure of this experience during physiological birth. This study aimed to discover whether one-on-one continuous professional support would improve the childbirth experience by increasing the likelihood of physiological birth and a heightened state of flow during childbirth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Women with childbirth experience were recruited through social media. Participants (<i>n</i> = 788) completed an online survey: the Flow State Scale (FSS) and a demographic questionnaire, including details about the professional support received during childbirth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One-on-one professional support was significantly associated with natural childbirth (midwife: 80.9%, doula: 65.7%) and lower medical interventions (midwife: 19.1%, doula: 34.3%) compared to conventional professional assistance (natural birth: 44.4%, interventions: 55.6%). A MANCOVA analysis revealed significant differences in flow state levels, with women receiving one-on-one support experiencing the highest flow state.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This research validates the significant correlation between one-on-one support—provided by midwives or doulas—and physiological birth. It also establishes for the first time a correlation between women in childbirth receiving continuous one-on-one professional support and heightened flow state levels, signifying a positive and empowering birthing experience.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 4","pages":"634-640"},"PeriodicalIF":2.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12908","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558888","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}
Simona Fumagalli, Antonella Nespoli, Maria Panzeri, Laura Antolini, Elisabetta Colciago, Anna Adami, Matilde Maria Canepa, Elsa Del Bo, Raffaella Ferrara, Paola Agnese Mauri, Angelo Cagnacci, Marcello Ceccaroni, Carmen Dattolo, Giovanna Esposito, Massimo Piergiuseppe Franchi, Franco Gorlero, Gianpaolo Grisolia, Francesca Grosso, Agnese Lecis, Marta Mazzeo Melchionda, Virginia Michelerio, Luana Mogavino, Chiara Ogliari, Michela Ramunno, Arsenio Spinillo, Sabrina Valletta, Patrizia Vergani, Anna Locatelli
Introduction
Maternal birth satisfaction is correlated to long-term outcomes and is influenced by the place of birth. In Italy, most births occur in hospitals. Our study aimed to assess whether the organizational level (I vs. II) of the Maternity Unit (MU) had any impact on birth satisfaction.
Methods
A multicentric cohort study was conducted in 11 Italian MUs, classified as Level I (for low-risk pregnancies or with minor complications) or Level II (for low and high-risk women) according to organizational, structural, and technical standards. Birth satisfaction was measured using the Italian version of the BSS-R, composed of three sub-scales. Data analysis was performed using Stata/MP18.0.
Results
Among 1642 participants, maternal satisfaction was similar in I and II level MUs (27.7 vs. 27.2; p-value 0.096). Women who gave birth in an I level MU were found to have a greater Quality of care sub-scale score compared to participants who gave birth in a II level MU (14.28 vs. 13.87; p-value < 0.001). The three sub-scales contributed differently to the total score, with a minor contribution given by the Stress Experienced (8.65/16) and the Women's Attributes sub-scales (4.72/8).
Conclusion
This study contributes to understanding how the level of the MU might impact women's birth satisfaction. Factors affecting the Women's Attributes and the Stress Experienced sub-scales' scores should be considered to increase maternal satisfaction with birth, improving the quality of maternity services.
前言：产妇分娩满意度与长期预后相关，并受出生地影响。在意大利，大多数分娩是在医院进行的。我们的研究旨在评估产科（MU）的组织水平（I vs II）是否对分娩满意度有任何影响。方法：根据组织、结构和技术标准，对11名意大利妇女进行多中心队列研究，分为I级（低危妊娠或伴有轻微并发症）和II级（低危和高危妇女）。出生满意度采用意大利版的BSS-R量表进行测量，该量表由三个子量表组成。数据分析采用Stata/MP18.0软件。结果：在1642名参与者中，母亲满意度在I和II级MUs中相似(27.7 vs 27.2；假定值0.096)。与在II级MU分娩的参与者相比，在I级MU分娩的妇女被发现具有更高的护理质量亚量表得分(14.28比13.87；结论：本研究有助于理解MU水平如何影响妇女的生育满意度。应综合考虑影响产妇属性和压力经历分量表得分的因素，提高产妇分娩满意度，提高产妇服务质量。
{"title":"Effect of Maternity Units' Organizational Levels on Maternal Birth Satisfaction: A Multicentric Cohort Study","authors":"Simona Fumagalli, Antonella Nespoli, Maria Panzeri, Laura Antolini, Elisabetta Colciago, Anna Adami, Matilde Maria Canepa, Elsa Del Bo, Raffaella Ferrara, Paola Agnese Mauri, Angelo Cagnacci, Marcello Ceccaroni, Carmen Dattolo, Giovanna Esposito, Massimo Piergiuseppe Franchi, Franco Gorlero, Gianpaolo Grisolia, Francesca Grosso, Agnese Lecis, Marta Mazzeo Melchionda, Virginia Michelerio, Luana Mogavino, Chiara Ogliari, Michela Ramunno, Arsenio Spinillo, Sabrina Valletta, Patrizia Vergani, Anna Locatelli","doi":"10.1111/birt.12909","DOIUrl":"10.1111/birt.12909","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Maternal birth satisfaction is correlated to long-term outcomes and is influenced by the place of birth. In Italy, most births occur in hospitals. Our study aimed to assess whether the organizational level (I vs. II) of the Maternity Unit (MU) had any impact on birth satisfaction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A multicentric cohort study was conducted in 11 Italian MUs, classified as Level I (for low-risk pregnancies or with minor complications) or Level II (for low and high-risk women) according to organizational, structural, and technical standards. Birth satisfaction was measured using the Italian version of the BSS-R, composed of three sub-scales. Data analysis was performed using Stata/MP18.0.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 1642 participants, maternal satisfaction was similar in I and II level MUs (27.7 vs. 27.2; <i>p</i>-value 0.096). Women who gave birth in an I level MU were found to have a greater Quality of care sub-scale score compared to participants who gave birth in a II level MU (14.28 vs. 13.87; <i>p</i>-value < 0.001). The three sub-scales contributed differently to the total score, with a minor contribution given by the Stress Experienced (8.65/16) and the Women's Attributes sub-scales (4.72/8).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study contributes to understanding how the level of the MU might impact women's birth satisfaction. Factors affecting the Women's Attributes and the Stress Experienced sub-scales' scores should be considered to increase maternal satisfaction with birth, improving the quality of maternity services.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 4","pages":"641-651"},"PeriodicalIF":2.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12909","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544588","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 qualitative descriptive study of the experiences of US labor and delivery nurses follows the World Health Organization's call to address abuse and disrespect of women in maternity care. The majority of research about abuse and disrespect for childbearing women has been conducted in Africa, Asia, and Europe, but the US is unique as a high-income country with largely capitalist or privatized health care. The objective of this study was to gain knowledge about abuse and disrespect in hospital-based maternity care in the US from the perspective of labor and delivery nurses.
Methods
Using a qualitative descriptive methodology, online data collection followed by optional interviews, we solicited the experiences of labor and delivery nurses regarding their experiences with patients being treated unethically in obstetric care. Content analysis was used to interpret the data into themes.
Results
One hundred sixty-eight (N = 168) participants provided written examples of unethical treatment they had witnessed in their professional experience, and 7 interviews were conducted. Four major themes were identified: Violation of the Trust that We are Going to Keep You and Your Baby Safe; Assault; Stripping a Patient of Autonomy; and Failure of the Hospital to Provide Safe Conditions for Birth.
Discussion
People within the healthcare system are aware of abuse and disrespect, but it is often hidden by stakeholders who have conflicting interests. Perpetrators of abuse and disrespect are people and systems. More research is necessary to quantify and address the problems from within the healthcare system.
{"title":"Abuse and Disrespect in Obstetric Care in the United States: A Qualitative Descriptive Study of Nurse Experiences","authors":"Umber Darilek, Sara L. Gill","doi":"10.1111/birt.12905","DOIUrl":"10.1111/birt.12905","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This qualitative descriptive study of the experiences of US labor and delivery nurses follows the World Health Organization's call to address abuse and disrespect of women in maternity care. The majority of research about abuse and disrespect for childbearing women has been conducted in Africa, Asia, and Europe, but the US is unique as a high-income country with largely capitalist or privatized health care. The objective of this study was to gain knowledge about abuse and disrespect in hospital-based maternity care in the US from the perspective of labor and delivery nurses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using a qualitative descriptive methodology, online data collection followed by optional interviews, we solicited the experiences of labor and delivery nurses regarding their experiences with patients being treated unethically in obstetric care. Content analysis was used to interpret the data into themes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One hundred sixty-eight (<i>N</i> = 168) participants provided written examples of unethical treatment they had witnessed in their professional experience, and 7 interviews were conducted. Four major themes were identified: <i>Violation of the Trust that We are Going to Keep You and Your Baby Safe; Assault; Stripping a Patient of Autonomy; and Failure of the Hospital to Provide Safe Conditions for Birth.</i></p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>People within the healthcare system are aware of abuse and disrespect, but it is often hidden by stakeholders who have conflicting interests. Perpetrators of abuse and disrespect are people and systems. More research is necessary to quantify and address the problems from within the healthcare system.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 4","pages":"606-617"},"PeriodicalIF":2.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12905","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544583","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}
Kiran McCloskey, Amber Woodard, Chere Gregory, Lewis Lipscomb, Noellee Clarke, Jennifer Neilsen
Background
Non-Hispanic Black individuals have the highest odds of having a nulliparous term singleton vertex (NTSV) cesarean birth out of all racial and ethnic groups, but this disparity is not well understood. This study assesses the factors associated with overall rates of NTSV cesarean delivery, differences in reasons for cesarean births, and door-to-delivery time among individuals who had an NTSV cesarean delivery.
Methods
Retrospective analyses assessed n = 31,826 NTSV births from January 1, 2016 to December 31, 2021 at 11 medical centers in North Carolina. For each outcome variable, multivariate regression estimated Black-White disparities while controlling for clinical and social covariates. Models included random intercepts for facility and delivery provider.
Results
After accounting for covariates, non-Hispanic Black patients were more likely to have an NTSV cesarean delivery compared to non-Hispanic White patients (AOR = 1.48, 95% CI 1.47, 1.69). Among those who had an NTSV cesarean delivery, non-Hispanic Black patients were more likely than non-Hispanic White patients to have a cesarean delivery due to fetal intolerance of labor (AOR = 2.10, 95% CI 1.87, 2.42). Non-Hispanic Black patients had a shorter door-to-delivery time for unscheduled NTSV cesarean deliveries than non-Hispanic White patients (b = −1.80, 95% CI −2.50, −1.11).
Conclusions
We confirmed the persistence of a racial disparity in cesarean delivery rates after controlling for multiple social and clinical factors. As fetal intolerance of labor has been described as a subjective indicator, and faster door-to-delivery time for cesarean deliveries may indicate faster decision making, our findings indicate a need to better understand decision making around cesarean deliveries.
背景：非西班牙裔黑人在所有种族和民族群体中有最高的无产期单胎顶点（NTSV）剖宫产的几率，但这种差异尚未得到很好的理解。本研究评估了NTSV剖宫产的总体发生率、剖宫产原因的差异以及剖宫产的上门分娩时间。方法：回顾性分析北卡罗来纳州11个医疗中心2016年1月1日至2021年12月31日n = 31826例NTSV新生儿。对于每个结果变量，在控制临床和社会协变量的同时，多变量回归估计了黑白差异。模型包括对设施和交付提供者的随机拦截。结果：在考虑协变量后，非西班牙裔黑人患者比非西班牙裔白人患者更有可能发生NTSV剖宫产（AOR = 1.48, 95% CI 1.47, 1.69）。在NTSV剖宫产患者中，非西班牙裔黑人患者比非西班牙裔白人患者更有可能因胎儿分娩不耐受而剖宫产（AOR = 2.10, 95% CI 1.87, 2.42）。非西班牙裔黑人患者在非计划的NTSV剖宫产中从门口到分娩的时间比非西班牙裔白人患者短（b = -1.80, 95% CI -2.50, -1.11）。结论：在控制了多种社会和临床因素后，我们证实了种族差异在剖宫产率上的持续存在。由于胎儿分娩不耐受被描述为一种主观指标，而剖宫产从门口到分娩的时间越快，可能意味着剖宫产的决策速度越快，我们的研究结果表明，需要更好地了解剖宫产的决策过程。
{"title":"Racial Disparities in Nulliparous Singleton Term Vertex Cesarean Deliveries: Rates, Reasons, and Time to Delivery","authors":"Kiran McCloskey, Amber Woodard, Chere Gregory, Lewis Lipscomb, Noellee Clarke, Jennifer Neilsen","doi":"10.1111/birt.12906","DOIUrl":"10.1111/birt.12906","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Non-Hispanic Black individuals have the highest odds of having a nulliparous term singleton vertex (NTSV) cesarean birth out of all racial and ethnic groups, but this disparity is not well understood. This study assesses the factors associated with overall rates of NTSV cesarean delivery, differences in reasons for cesarean births, and door-to-delivery time among individuals who had an NTSV cesarean delivery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective analyses assessed <i>n</i> = 31,826 NTSV births from January 1, 2016 to December 31, 2021 at 11 medical centers in North Carolina. For each outcome variable, multivariate regression estimated Black-White disparities while controlling for clinical and social covariates. Models included random intercepts for facility and delivery provider.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After accounting for covariates, non-Hispanic Black patients were more likely to have an NTSV cesarean delivery compared to non-Hispanic White patients (AOR = 1.48, 95% CI 1.47, 1.69). Among those who had an NTSV cesarean delivery, non-Hispanic Black patients were more likely than non-Hispanic White patients to have a cesarean delivery due to fetal intolerance of labor (AOR = 2.10, 95% CI 1.87, 2.42). Non-Hispanic Black patients had a shorter door-to-delivery time for unscheduled NTSV cesarean deliveries than non-Hispanic White patients (<i>b</i> = −1.80, 95% CI −2.50, −1.11).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We confirmed the persistence of a racial disparity in cesarean delivery rates after controlling for multiple social and clinical factors. As fetal intolerance of labor has been described as a subjective indicator, and faster door-to-delivery time for cesarean deliveries may indicate faster decision making, our findings indicate a need to better understand decision making around cesarean deliveries.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 4","pages":"618-626"},"PeriodicalIF":2.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12906","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544590","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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