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}
Sharon Weerasingha, Kirstin Tindal, Kirsten Palmer, Stacey J. Ellery, Miranda Davies-Tuck
Background
Given the rise in migrant women giving birth in high-income countries (HICs) there is a need to identify and evaluate the efficacy of existing interventions that address disparities in adverse pregnancy outcomes experienced by migrant women.
Objective
This review aims to identify any antenatal interventions offered to migrant women living in HICs, evaluate their efficacy at improving perinatal and maternal adverse outcomes, and to identify and evaluate pregnancy management guidelines relating to migrant status or ethnicity-specific practices or recommendations.
Search Strategy
Medline, Embase, CINAHL, Scopus, TRIP, ProQuest, and the International Guidelines Library were searched from January 2010 to March 2023.
Selection Criteria
English-language randomized controlled trials, mixed-methods, and observational studies reporting perinatal and maternal outcomes in women living in HICs receiving a migrant-specific antenatal intervention. An additional search of any pregnancy management guidelines relating to migrant status or ethnicity-specific practices or recommendations was completed.
Data Collection and Analysis
Two authors independently conducted data extraction. Outcomes of interest included perinatal (stillbirth, neonatal death, 5-min post-delivery Apgar score < 7, NICU admission, small for gestational age, large for gestational age, low birth weight, and preterm birth) and maternal outcomes (mortality, gestational diabetes, gestational hypertension, pre-eclampsia, caesarean birth, instrumental birth, and induction of labour). Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated and pooled for meta-analysis using a random-effects model. All studies and guidelines were assessed using relevant risk assessment tools.
Main Results
Six studies met the inclusion criteria for this review. Meta-analysis showed that infants born to women offered a migrant-specific antenatal intervention had lower odds of stillbirth (OR 0.60 95% CI 0.37–0.97, p = 0.04, I2 = 0%) when compared to those in the standard care group. However, the use of migrant-specific interventions increased the odds of la
背景：鉴于高收入国家（HICs）移民妇女生育人数的增加，有必要确定和评估现有干预措施的有效性，以解决移民妇女所经历的不良妊娠结局的差异。目的：本综述旨在确定为生活在高收入国家的移民妇女提供的任何产前干预措施，评估其改善围产期和孕产妇不良结局的功效，并确定和评估与移民身份或种族特定做法或建议相关的妊娠管理指南。检索策略：2010年1月至2023年3月检索了Medline、Embase、CINAHL、Scopus、TRIP、ProQuest和国际指南库。选择标准：英语随机对照试验、混合方法和观察性研究，报告高收入国家妇女接受移民特异性产前干预的围产期和孕产妇结局。完成了对与移徙身份或特定种族做法或建议有关的任何妊娠管理准则的进一步搜索。数据收集和分析：两位作者独立进行数据提取。关注的结局包括围产期（死产、新生儿死亡、产后5分钟Apgar评分）。主要结果：6项研究符合本综述的纳入标准。荟萃分析显示，与标准护理组相比，接受移民特异性产前干预的妇女所生婴儿的死产几率较低（OR 0.60 95% CI 0.37-0.97, p = 0.04, I2 = 0%）。然而，使用移民特异性干预措施增加了引产的几率（OR 1.38 95% CI 1.27-1.49, p = 2 = 0%）。此外，我们确定了18条指导方针；然而，没有针对移民或种族的建议得到高水平证据的支持。结论：对于生活在高收入国家的移民妇女，存在几种针对移民的产前干预措施。这些措施包括胎儿监测、集体产前保健计划和助产士文化培训计划。尽管干预之间存在异质性，但它们共同降低了死产的几率。在已确定的妊娠管理指南中，大多数建议主要基于对观察性和队列研究的系统评价，强调缺乏目前可用的临床试验的高质量证据。
{"title":"Do Antenatal Interventions Improve Maternal and Perinatal Outcomes for Migrant Women Living in High-Income Countries and What Guidelines Exist for Migrant Women? A Systematic Review and Meta-Analysis","authors":"Sharon Weerasingha, Kirstin Tindal, Kirsten Palmer, Stacey J. Ellery, Miranda Davies-Tuck","doi":"10.1111/birt.12903","DOIUrl":"10.1111/birt.12903","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Given the rise in migrant women giving birth in high-income countries (HICs) there is a need to identify and evaluate the efficacy of existing interventions that address disparities in adverse pregnancy outcomes experienced by migrant women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This review aims to identify any antenatal interventions offered to migrant women living in HICs, evaluate their efficacy at improving perinatal and maternal adverse outcomes, and to identify and evaluate pregnancy management guidelines relating to migrant status or ethnicity-specific practices or recommendations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Search Strategy</h3>\u0000 \u0000 <p>Medline, Embase, CINAHL, Scopus, TRIP, ProQuest, and the International Guidelines Library were searched from January 2010 to March 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Selection Criteria</h3>\u0000 \u0000 <p>English-language randomized controlled trials, mixed-methods, and observational studies reporting perinatal and maternal outcomes in women living in HICs receiving a migrant-specific antenatal intervention. An additional search of any pregnancy management guidelines relating to migrant status or ethnicity-specific practices or recommendations was completed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Collection and Analysis</h3>\u0000 \u0000 <p>Two authors independently conducted data extraction. Outcomes of interest included perinatal (stillbirth, neonatal death, 5-min post-delivery Apgar score < 7, NICU admission, small for gestational age, large for gestational age, low birth weight, and preterm birth) and maternal outcomes (mortality, gestational diabetes, gestational hypertension, pre-eclampsia, caesarean birth, instrumental birth, and induction of labour). Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated and pooled for meta-analysis using a random-effects model. All studies and guidelines were assessed using relevant risk assessment tools.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Results</h3>\u0000 \u0000 <p>Six studies met the inclusion criteria for this review. Meta-analysis showed that infants born to women offered a migrant-specific antenatal intervention had lower odds of stillbirth (OR 0.60 95% CI 0.37–0.97, <i>p</i> = 0.04, <i>I</i><sup>2</sup> = 0%) when compared to those in the standard care group. However, the use of migrant-specific interventions increased the odds of la","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 4","pages":"529-538"},"PeriodicalIF":2.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12903","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544586","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}
Jessica L. Liddell, Alison Monroe, Tess A. Carlson, Katrina Mullan
Background
Although extremely common, and with a broad range of associated negative outcomes for both parents and infants, the full impact and cost of perinatal mood and anxiety disorders (PMADs) is under-researched. Rural states, such as Montana, in particular experience gaps in access to mental healthcare and high rates of PMADs, emphasizing a need for an economic analysis of untreated PMADs. To address this gap, a cost analysis of the impact of untreated PMADs in Montana was conducted using 2021 birth data.
Methods
A cost-of-illness analysis was conducted to estimate the incremental costs of untreated PMADs in Montana. Secondary data sources and peer-reviewed literature were utilized to provide baseline estimates of the prevalence of maternal and birth outcomes in Montana and to estimate the impact of PMADs on these outcomes from the perinatal period through the first year postpartum.
Results
Using 15% as the PMAD prevalence rate in Montana, the total estimated incremental cost of untreated perinatal mood and anxiety disorders for births in 2021 is about $21.7 million. This is about $12,897 per impacted mother–child pair.
Discussion
This study provides needed insight into the economic impact of untreated PMADs and highlights the broad range of negative impacts PMADs have on the well-being of parents and infants. This study highlights the importance of providing effective treatment to people experiencing PMADs to improve the health of both parents and their infants and has important policy implications for increased funding and workforce development for the detection and treatment of PMADs.
{"title":"The Cost of Untreated Perinatal Mood and Anxiety Disorders (PMADs) in Montana: An Economic Analysis of Perinatal Mental Health in a Rural State","authors":"Jessica L. Liddell, Alison Monroe, Tess A. Carlson, Katrina Mullan","doi":"10.1111/birt.12901","DOIUrl":"10.1111/birt.12901","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although extremely common, and with a broad range of associated negative outcomes for both parents and infants, the full impact and cost of perinatal mood and anxiety disorders (PMADs) is under-researched. Rural states, such as Montana, in particular experience gaps in access to mental healthcare and high rates of PMADs, emphasizing a need for an economic analysis of untreated PMADs. To address this gap, a cost analysis of the impact of untreated PMADs in Montana was conducted using 2021 birth data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cost-of-illness analysis was conducted to estimate the incremental costs of untreated PMADs in Montana. Secondary data sources and peer-reviewed literature were utilized to provide baseline estimates of the prevalence of maternal and birth outcomes in Montana and to estimate the impact of PMADs on these outcomes from the perinatal period through the first year postpartum.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Using 15% as the PMAD prevalence rate in Montana, the total estimated incremental cost of untreated perinatal mood and anxiety disorders for births in 2021 is about $21.7 million. This is about $12,897 per impacted mother–child pair.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This study provides needed insight into the economic impact of untreated PMADs and highlights the broad range of negative impacts PMADs have on the well-being of parents and infants. This study highlights the importance of providing effective treatment to people experiencing PMADs to improve the health of both parents and their infants and has important policy implications for increased funding and workforce development for the detection and treatment of PMADs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 4","pages":"583-593"},"PeriodicalIF":2.5,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392067","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}
Edythe L. Mangindin, Helga Gottfreðsdóttir, Kathrin Stoll, Franka Cadée, Elín Inga Lárusdóttir, Emma M. Swift
Introduction
Childbirth experience can affect women's long-term health and well-being. However, there is limited knowledge on whether migrant status affects woman's experience during childbirth. We aimed to answer the following research questions: (1) Is there a difference in childbirth experience between migrant and native-born women in Iceland; and (2) Are migrant women more likely to experience mistreatment in childbirth compared to native-born women in Iceland?
Methods
An online survey was developed including the Childbirth Experience Questionnaire 2 to assess overall childbirth experience, and descriptive analysis and linear regression were conducted to determine differences between migrant and native-born women in Iceland. The mistreatment by care providers in childbirth indicators were used to evaluate mistreatment in childbirth, and frequencies and logistic regression were conducted. Both regression models were adjusted for sociodemographic and obstetric factors.
Results
A total of 1365 women participated. Migrant women reported statistically significantly lower scores for birth experience compared to native-born women (F [12, 1352] = 23.97, p < 0.001). There was no statistical difference between groups regarding mistreatment in childbirth. One in four of all women reported at least one form of mistreatment.
Conclusion
This study suggests that there are areas in maternity care that can be improved upon, particularly in providing care for migrant women and addressing mistreatment in childbirth for all. Our results suggest further research in this area as well as evaluation of maternity systems, training in cultural competency and effective communication.
{"title":"Childbirth Experience, Mistreatment, and Migrant Status: A Retrospective Cross-Sectional Study","authors":"Edythe L. Mangindin, Helga Gottfreðsdóttir, Kathrin Stoll, Franka Cadée, Elín Inga Lárusdóttir, Emma M. Swift","doi":"10.1111/birt.12900","DOIUrl":"10.1111/birt.12900","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Childbirth experience can affect women's long-term health and well-being. However, there is limited knowledge on whether migrant status affects woman's experience during childbirth. We aimed to answer the following research questions: (1) Is there a difference in childbirth experience between migrant and native-born women in Iceland; and (2) Are migrant women more likely to experience mistreatment in childbirth compared to native-born women in Iceland?</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An online survey was developed including the Childbirth Experience Questionnaire 2 to assess overall childbirth experience, and descriptive analysis and linear regression were conducted to determine differences between migrant and native-born women in Iceland. The mistreatment by care providers in childbirth indicators were used to evaluate mistreatment in childbirth, and frequencies and logistic regression were conducted. Both regression models were adjusted for sociodemographic and obstetric factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1365 women participated. Migrant women reported statistically significantly lower scores for birth experience compared to native-born women (<i>F</i> [12, 1352] = 23.97, <i>p</i> < 0.001). There was no statistical difference between groups regarding mistreatment in childbirth. One in four of all women reported at least one form of mistreatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study suggests that there are areas in maternity care that can be improved upon, particularly in providing care for migrant women and addressing mistreatment in childbirth for all. Our results suggest further research in this area as well as evaluation of maternity systems, training in cultural competency and effective communication.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 4","pages":"572-582"},"PeriodicalIF":2.5,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12900","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Raquel Z. Rivera, Micaela Lara Cadena, Jess F. Gutfreund, Esperanza Dodge
Background
Black, Indigenous, and people of color (BIPOC) families comprise a disproportionately low percentage of home and freestanding birth center births in New Mexico (NM), despite NM Medicaid coverage of care by Licensed Midwives (LMs) in these settings. The purpose of this study was to examine why low income BIPOC seek out LM care, how they benefit from this model of care, and which factors facilitate and obstruct access.
Methods
We conducted 7 focus groups with 55 low income BIPOC individuals who had birthed in New Mexico in the past 5 years. Participants in four of the groups intended to birth with an LM in the community setting; participants in three of the groups intended to birth in a hospital.
Results
Prior negative birthing experiences at hospitals were the most-often discussed reason for choosing LM care. The aspects of LM care most commonly described as beneficial were: (1) the high quality of one-to-one individualized and holistic care offered by LMs, as well as (2) the respectfulness of care received. Medicaid coverage of LM care and special payment allowances made by LMs were cited as two important facilitators of access to LM care. Barriers to care included the lack of general awareness of LM care, the persisting stigma against community birth, the small number of LMs, and payment and insurance coverage challenges.
Conclusion
LM care is beneficial for many families seeking respectful and accessible care, especially in underserved areas. BIPOC birthing individuals' reflections on their experiences with LM care provide valuable information that should be considered when designing and revising perinatal care systems and policies with the intent of increasing access to high-quality maternal and newborn care in New Mexico and, more generally, the United States.
{"title":"The Benefits of Licensed Midwifery and Community Birth Among BIPOC Birthing People in New Mexico","authors":"Raquel Z. Rivera, Micaela Lara Cadena, Jess F. Gutfreund, Esperanza Dodge","doi":"10.1111/birt.12884","DOIUrl":"10.1111/birt.12884","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Black, Indigenous, and people of color (BIPOC) families comprise a disproportionately low percentage of home and freestanding birth center births in New Mexico (NM), despite NM Medicaid coverage of care by Licensed Midwives (LMs) in these settings. The purpose of this study was to examine why low income BIPOC seek out LM care, how they benefit from this model of care, and which factors facilitate and obstruct access.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted 7 focus groups with 55 low income BIPOC individuals who had birthed in New Mexico in the past 5 years. Participants in four of the groups intended to birth with an LM in the community setting; participants in three of the groups intended to birth in a hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Prior negative birthing experiences at hospitals were the most-often discussed reason for choosing LM care. The aspects of LM care most commonly described as beneficial were: (1) the high quality of one-to-one individualized and holistic care offered by LMs, as well as (2) the respectfulness of care received. Medicaid coverage of LM care and special payment allowances made by LMs were cited as two important facilitators of access to LM care. Barriers to care included the lack of general awareness of LM care, the persisting stigma against community birth, the small number of LMs, and payment and insurance coverage challenges.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>LM care is beneficial for many families seeking respectful and accessible care, especially in underserved areas. BIPOC birthing individuals' reflections on their experiences with LM care provide valuable information that should be considered when designing and revising perinatal care systems and policies with the intent of increasing access to high-quality maternal and newborn care in New Mexico and, more generally, the United States.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 2","pages":"285-290"},"PeriodicalIF":2.8,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12884","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anna Melamed, Lucia Rocca-Ihenacho, Anna Horn, Christine McCourt, Frances Rivers, Marina Alice Sylvia Daniele
Background
In UK maternity care, racialized women have worse experiences and clinical outcomes than White women. Midwife-led birth settings (MLBS), including home births and midwife-led units, both freestanding and alongside hospitals, are all available as choices for low-risk women in the UK. MLBS deliver optimal outcomes for low-risk women with uncomplicated pregnancies, including for racialized women, and can offer culturally specific care, possibly mitigating existing social inequalities. Evidence suggests that racialized women access MLBS less than White women.
Aim
To map existing literature on facilitators and barriers to accessing MLBS for racialized women and to identify emerging themes.
Method
A scoping review of UK literature over the last 10 years using OVID, Ebsco Host, and gray literature. Search, selection, and data extraction were performed using PRISMA and JBI guidelines. Data were analyzed using inductive thematic analysis.
Results
Fourteen articles met the inclusion criteria, only one addressing the research question directly and others containing some relevant material. Six themes were identified: admission criteria, information giving, the role of antenatal groups, bias and assumptions, beliefs about birth, and MLBS as empowering.
Conclusions
There is a lack of research on racialized women's access to MLBS. Community outreach, having midwifery services embedded in the community, defaulting to MLBS for women categorized as low risk, continuity of carer, and interventions achieving a reduction in care-giver bias may improve access and outcomes.
{"title":"Facilitators and Barriers to Access to Midwife-Led Birth Settings for Racialized Women in the UK: A Scoping Review","authors":"Anna Melamed, Lucia Rocca-Ihenacho, Anna Horn, Christine McCourt, Frances Rivers, Marina Alice Sylvia Daniele","doi":"10.1111/birt.12897","DOIUrl":"10.1111/birt.12897","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In UK maternity care, racialized women have worse experiences and clinical outcomes than White women. Midwife-led birth settings (MLBS), including home births and midwife-led units, both freestanding and alongside hospitals, are all available as choices for low-risk women in the UK. MLBS deliver optimal outcomes for low-risk women with uncomplicated pregnancies, including for racialized women, and can offer culturally specific care, possibly mitigating existing social inequalities. Evidence suggests that racialized women access MLBS less than White women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To map existing literature on facilitators and barriers to accessing MLBS for racialized women and to identify emerging themes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A scoping review of UK literature over the last 10 years using OVID, Ebsco Host, and gray literature. Search, selection, and data extraction were performed using PRISMA and JBI guidelines. Data were analyzed using inductive thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fourteen articles met the inclusion criteria, only one addressing the research question directly and others containing some relevant material. Six themes were identified: admission criteria, information giving, the role of antenatal groups, bias and assumptions, beliefs about birth, and MLBS as empowering.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There is a lack of research on racialized women's access to MLBS. Community outreach, having midwifery services embedded in the community, defaulting to MLBS for women categorized as low risk, continuity of carer, and interventions achieving a reduction in care-giver bias may improve access and outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 3","pages":"491-502"},"PeriodicalIF":2.5,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12897","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ramatu Abdul Hamid Alhassan, Sara Baumann, Abimbola Fapohunda, Janet Awopole Yepakeh Tiah, Timothy Tienbia Laari, Lauren Narbey, Nancy A. Niemczyk, Victoria Bam, Martina Anto-Ocrah
<div> <section> <h3> Background/Introduction</h3> <p>Midwives provide skilled, primary, reproductive, and sexual health care to women, adolescent girls, and infants throughout the perinatal period, promoting health and safeguarding against obstetric emergencies and maternal and infant mortality. In many cultures, midwifery has been a predominantly female profession. However, in emerging research, the proportion of male midwives is growing to augment shortages of female midwives, prompting a need for further research that explores the contributions of male midwives in maternal and child health. The objective of this scoping review was to synthesize key findings from the literature regarding the growing, global workforce of male midwives. Specifically, we aimed to evaluate (1) the temporal nature of the publications, (2) the geographic distributions of the emerging literature, and (3) the key findings regarding male midwives' training and work experiences.</p> </section> <section> <h3> Methods</h3> <p>We used Semantic Scholar and Google Scholar to identify relevant, peer-reviewed articles using the keywords “gender,” “male,” “men,” “midwifery,” and “nurse midwives,” that met the inclusion criteria: (1) primary research papers, (2) published in the English language (for ease of understanding by the multinational, interdisciplinary authorship team), (3) explored male midwives' experiences during training/education and working, and (4) published between 2000 and 2023. Papers were excluded if they exclusively focused on females or nurses or other health professionals.</p> </section> <section> <h3> Results</h3> <p>Our initial search yielded 57 articles, with an additional nine obtained by reviewing the references. After excluding duplicates and reviewing based on inclusion criteria, 26 papers were included in the scoping review. All 26 articles were published between 2011 and 2023, with the majority (65%, <i>n</i> = 17) of articles focused on populations in the African region (Aims 1 and 2). Key findings (Aim 3) were as follows: 1. Training experiences of male midwives: Compared to other regions, male midwifery students in African, Middle Eastern, and Asian settings reported challenging training conditions, possibly influenced by sociocultural factors and gendered expectations of men in these settings. 2. Pregnant/birthing persons' delivery experiences and gendered preferences for their attending midwife: A significant number of birthing persons would choose female midwives over male midwives for their care, despite acknowledging similar skill sets. However, younger clients, urban residents, and non-traditional men expressed a need for gender equity and g
{"title":"Men as Midwifery Professionals: A Scoping Review","authors":"Ramatu Abdul Hamid Alhassan, Sara Baumann, Abimbola Fapohunda, Janet Awopole Yepakeh Tiah, Timothy Tienbia Laari, Lauren Narbey, Nancy A. Niemczyk, Victoria Bam, Martina Anto-Ocrah","doi":"10.1111/birt.12894","DOIUrl":"10.1111/birt.12894","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Introduction</h3>\u0000 \u0000 <p>Midwives provide skilled, primary, reproductive, and sexual health care to women, adolescent girls, and infants throughout the perinatal period, promoting health and safeguarding against obstetric emergencies and maternal and infant mortality. In many cultures, midwifery has been a predominantly female profession. However, in emerging research, the proportion of male midwives is growing to augment shortages of female midwives, prompting a need for further research that explores the contributions of male midwives in maternal and child health. The objective of this scoping review was to synthesize key findings from the literature regarding the growing, global workforce of male midwives. Specifically, we aimed to evaluate (1) the temporal nature of the publications, (2) the geographic distributions of the emerging literature, and (3) the key findings regarding male midwives' training and work experiences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used Semantic Scholar and Google Scholar to identify relevant, peer-reviewed articles using the keywords “gender,” “male,” “men,” “midwifery,” and “nurse midwives,” that met the inclusion criteria: (1) primary research papers, (2) published in the English language (for ease of understanding by the multinational, interdisciplinary authorship team), (3) explored male midwives' experiences during training/education and working, and (4) published between 2000 and 2023. Papers were excluded if they exclusively focused on females or nurses or other health professionals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our initial search yielded 57 articles, with an additional nine obtained by reviewing the references. After excluding duplicates and reviewing based on inclusion criteria, 26 papers were included in the scoping review. All 26 articles were published between 2011 and 2023, with the majority (65%, <i>n</i> = 17) of articles focused on populations in the African region (Aims 1 and 2). Key findings (Aim 3) were as follows: 1. Training experiences of male midwives: Compared to other regions, male midwifery students in African, Middle Eastern, and Asian settings reported challenging training conditions, possibly influenced by sociocultural factors and gendered expectations of men in these settings. 2. Pregnant/birthing persons' delivery experiences and gendered preferences for their attending midwife: A significant number of birthing persons would choose female midwives over male midwives for their care, despite acknowledging similar skill sets. However, younger clients, urban residents, and non-traditional men expressed a need for gender equity and g","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 3","pages":"376-392"},"PeriodicalIF":2.5,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12146427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cesarean delivery is a contributing factor to many delivery care and postpartum maternal morbidities, especially when a cesarean delivery is unnecessary. Mexico has one of the highest cesarean birth rates in Latin America, and as such, our objective was to identify the sociodemographic, reproductive, maternal care, and health-related characteristics associated with the prevalence of planned and emergency cesarean births in Mexico.
Methods
Using nationally representative data from a Mexican probabilistic survey (ENSANUT 2021), we examined and developed a cross-sectional analysis of women aged 12 to 19 with a live-birth and women 20 to 49 years who had their last live-birth within five years before the survey (n = 1330). We used multinomial logistic regression analysis to examine predictors associated with planned and emergency cesarean births.
Results
The live-births within our sample included 50.7% vaginal, 27.5% emergency cesarean births, and 21.8% planned cesarean births. Younger age groups at delivery, speaking an indigenous language, and receiving delivery care at open public services are negatively associated with having any cesarean birth. Receiving delivery care at private institutions and having hypertension during pregnancy increases the odds of having both planned and emergency cesarean births. Emergency cesarean births are positively associated with tertiary education and negatively correlated with the parity of three or more children, while planned cesarean births are more likely for women with a parity of two.
Discussion
Efforts to reduce unnecessary cesarean births should include evidence-based medicine recommendations, actions to avoid the first cesarean birth, and providing pregnant women with counseling to support informed decisions.
{"title":"Sociodemographic and Health-Related Risk Factors Associated With Planned and Emergency Cesarean Births in Mexico","authors":"Jessica Irene Contreras, Leticia Suárez-López, Celia Hubert","doi":"10.1111/birt.12896","DOIUrl":"10.1111/birt.12896","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cesarean delivery is a contributing factor to many delivery care and postpartum maternal morbidities, especially when a cesarean delivery is unnecessary. Mexico has one of the highest cesarean birth rates in Latin America, and as such, our objective was to identify the sociodemographic, reproductive, maternal care, and health-related characteristics associated with the prevalence of planned and emergency cesarean births in Mexico.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using nationally representative data from a Mexican probabilistic survey (<i>ENSANUT</i> 2021), we examined and developed a cross-sectional analysis of women aged 12 to 19 with a live-birth and women 20 to 49 years who had their last live-birth within five years before the survey (<i>n</i> = 1330). We used multinomial logistic regression analysis to examine predictors associated with planned and emergency cesarean births.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The live-births within our sample included 50.7% vaginal, 27.5% emergency cesarean births, and 21.8% planned cesarean births. Younger age groups at delivery, speaking an indigenous language, and receiving delivery care at open public services are negatively associated with having any cesarean birth. Receiving delivery care at private institutions and having hypertension during pregnancy increases the odds of having both planned and emergency cesarean births. Emergency cesarean births are positively associated with tertiary education and negatively correlated with the parity of three or more children, while planned cesarean births are more likely for women with a parity of two.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Efforts to reduce unnecessary cesarean births should include evidence-based medicine recommendations, actions to avoid the first cesarean birth, and providing pregnant women with counseling to support informed decisions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 2","pages":"353-361"},"PeriodicalIF":2.8,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrew Symon, Berit Mortensen, Are Hugo Pripp, Manju Chhugani, Samuel Adjorlolo, Caroline Badzi, Renu Kharb, Elysse Prussing, Alison McFadden, Nicola M. Gray, Allison Cummins
Background
Quality maternity care is known to improve a range of maternal and neonatal outcomes. The Lancet Series on Midwifery's Quality Maternal and Newborn Care (QMNC) Framework is a high-level synthesis of the global evidence on quality maternity care. Initial qualitative work demonstrated the Framework's adaptability in evaluating service user and provider perceptions of the quality of maternity care. However, evaluating services at scale requires a survey instrument. This paper reports the validation of the QMNC Framework index (QMNCFi), a five-part survey for the evaluation of maternity care across diverse settings.
Methods
International online English language survey of women who had given birth in the previous year in Australia, Ghana, India and the United Kingdom (UK). It was distributed through service user networks (UK and Australia) and at postnatal clinics (Ghana and India). All forms were completed online. Test–retest was conducted to assess reliability.
Results
Five hundred and forty mothers completed the survey (Australia 136; Ghana 131; India 153; UK 120). Construct validity: Cronbach's α in 12 of the survey's 13 sections ranged from 0.795 to 0.986; for the remaining section the alpha was 0.594. Reliability: 55 participants completed the QMNCFi a second time. Intraclass correlation coefficient results ranged from 0.657 to 0.939 across the 13 sections. Field researchers in Ghana and India reported that the survey was easily understood and completed.
Conclusion
This survey has shown that, across diverse contexts, the QMNCFi is a valid, reliable, and comprehensive tool for measuring service user perceptions of the quality of care over time.
{"title":"Validating the Quality Maternal and Newborn Care Framework Index: A Global Tool for Quality-of-Care Evaluations","authors":"Andrew Symon, Berit Mortensen, Are Hugo Pripp, Manju Chhugani, Samuel Adjorlolo, Caroline Badzi, Renu Kharb, Elysse Prussing, Alison McFadden, Nicola M. Gray, Allison Cummins","doi":"10.1111/birt.12895","DOIUrl":"10.1111/birt.12895","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Quality maternity care is known to improve a range of maternal and neonatal outcomes. The Lancet Series on Midwifery's Quality Maternal and Newborn Care (QMNC) Framework is a high-level synthesis of the global evidence on quality maternity care. Initial qualitative work demonstrated the Framework's adaptability in evaluating service user and provider perceptions of the quality of maternity care. However, evaluating services at scale requires a survey instrument. This paper reports the validation of the QMNC Framework index (QMNCFi), a five-part survey for the evaluation of maternity care across diverse settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>International online English language survey of women who had given birth in the previous year in Australia, Ghana, India and the United Kingdom (UK). It was distributed through service user networks (UK and Australia) and at postnatal clinics (Ghana and India). All forms were completed online. Test–retest was conducted to assess reliability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five hundred and forty mothers completed the survey (Australia 136; Ghana 131; India 153; UK 120). Construct validity: Cronbach's <i>α</i> in 12 of the survey's 13 sections ranged from 0.795 to 0.986; for the remaining section the alpha was 0.594. Reliability: 55 participants completed the QMNCFi a second time. Intraclass correlation coefficient results ranged from 0.657 to 0.939 across the 13 sections. Field researchers in Ghana and India reported that the survey was easily understood and completed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This survey has shown that, across diverse contexts, the QMNCFi is a valid, reliable, and comprehensive tool for measuring service user perceptions of the quality of care over time.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55350,"journal":{"name":"Birth-Issues in Perinatal Care","volume":"52 2","pages":"347-352"},"PeriodicalIF":2.8,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/birt.12895","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142632527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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