Journal Of Midwifery & Women's Health[JOURNAL]
Sun
103 papers
Determinants of obstructed labor among women attending intrapartum care in Amhara Region, Northwest Ethiopia: A hospital-based unmatched case-control study.
Dile M, Demelash H, Meseret L … +5 more , Abebe F, Adefris M, Goshu YA, Ayele AS, Liyeh TM
Womens Health (Lond) · 2020 · PMID 32842920 · Full text
OBJECTIVES: maternal and neonatal mortality in Ethiopia is a major reproductive health problem. Obstructed labor is one of the leading causes of maternal, fetal, and neonatal morbidity in developing countries. The eviden...
OBJECTIVES: maternal and neonatal mortality in Ethiopia is a major reproductive health problem. Obstructed labor is one of the leading causes of maternal, fetal, and neonatal morbidity in developing countries. The evidence regarding its determinants at the tertiary level of care is sparse. Therefore, this study aimed to study the determinants of obstructed labor among women attending intrapartum care in Amhara region referral hospitals. METHODS: A Hospital-based unmatched case-control study was conducted from March 1stto August 30, 2017. Cases were women whose labor was obstructed (n = 270), and controls were women whose labor was not obstructed (n = 540). Both cases and controls were selected randomly, and a proportional to size allocation was made to the referral hospitals selected for the study. A binary and a multivariable logistic regression model was computed to identify the determinant factors at 95% CI. RESULTS: The mean age of the study participants was 27.66 years (27.4 ± 5.44 for cases and 28.15 ± 6.16 for controls), ranging between 16 and 45 years. Relatively, higher proportions of cases than controls were unable to read and write (58.5%) and were urban residents (53.7%). Distance from hospital, distance from health center, mothers inability to read and write, mothers primary level of education, more than 28 weeks of gestation at the first visit of antenatal care, 37 to 42 weeks at admission, above 42 weeks at admission, women of a merchant spouse, and history of pregnancy-related complications were the positive determinants of obstructed labor. However, mothers whose gestational age was 16 to 28 weeks at the first antenatal care visit were 62% less likely to be exposed to obstructed labor. CONCLUSIONS: Obstetric, service-related, and system factors were predictors of obstructed labor. Improving women's literacy status, health service access, and utilization will help reduce obstructed labor.
Measuring the cost-effectiveness of midwife-led versus physician-led intrapartum teams in developing countries.
Friedman HS, Liang M, Banks JL
Womens Health (Lond) · 2015 Jul · PMID 26258663 · Publisher ↗
International agencies have advocated scaling-up of midwifery resources as an important method for improving maternal health and reducing maternal mortality rates (MMR). The cost-effectiveness of midwife-led versus physi...
International agencies have advocated scaling-up of midwifery resources as an important method for improving maternal health and reducing maternal mortality rates (MMR). The cost-effectiveness of midwife-led versus physician-led intrapartum care is an important consideration in the human resource planning required to reduce MMR. Studies suggest that midwife-led teams can achieve comparable effectiveness and outcomes using less medically intensive care compared with physician-led teams. In the absence of adequate medical cost data, decision makers should consider the substantially lower average costs for three main drivers: salaries, benefits and incentives (≥two-times lower); preservice training (three-times lower) and attrition (two-times lower) necessary to deliver intrapartum care at the level of midwife competencies. This suggests that scale-up of midwifery resources is a less expensive and more cost-effective way to reduce MMRs and could potentially increase access to skilled intrapartum care.
Increased BMI during pregnancy: how do midwife lead maternity carers respond?
Pan SY, Dixon L, Paterson H … +1 more , Campbell N
Womens Health (Lond) · 2015 Jul · PMID 26238556 · Publisher ↗
AIM: To determine the knowledge base of midwife lead maternity carers (LMCs) and explore their adjustments in practice for obese women. MATERIALS & METHODS: A nationwide cohort study of LMC midwives in New Zealand concer...
AIM: To determine the knowledge base of midwife lead maternity carers (LMCs) and explore their adjustments in practice for obese women. MATERIALS & METHODS: A nationwide cohort study of LMC midwives in New Zealand concerning obesity in pregnancy using an electronic survey. RESULTS: A total of 428 LMCs responded. Most respondents were aware of the risks of obesity during pregnancy. Midwives felt it was important to provide customized care. Various barriers to accessing support for obese women within the health system were identified. Discussing weight and obesity was acknowledged as a sensitive issue for both the woman and the midwife. CONCLUSION: This study highlights the need to improve access to and availability of supportive maternity services and resources for pregnant women with increased BMI.
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