Birth (Berkeley, Calif.)[JOURNAL]

Sun 200 papers

Midwives' Physiological Approach at the Third Stage of Labour: A Scoping Review.

Tarlazzi E, Berini V, Brevi L … +7 more , Ferrandino R, Tormen M, Parma D, Cappadona R, Fumagalli S, Nespoli A, Simonazzi G

Birth · 2026 Jun · PMID 41492697 · Full text

INTRODUCTION: The third stage of labour occurs between the birth of the foetus and the expulsion of the placenta. A major complication during this stage is postpartum hemorrhage, which poses a significant concern for mat... INTRODUCTION: The third stage of labour occurs between the birth of the foetus and the expulsion of the placenta. A major complication during this stage is postpartum hemorrhage, which poses a significant concern for maternal health. To mitigate this risk, active management strategies have emerged, raising concerns about the safety of physiological management following a physiological birth. Midwives play a vital role in ensuring a safe third stage of labour by minimizing medical intervention and preventing postpartum hemorrhage. This scoping review aims to map the evidence on midwifery practices that support a physiological third stage of labour. METHODS: We conducted a scoping review using the Joanna Briggs Institute methodology. We retrieved articles from PUBMED, PsycINFO (via EBSCO), CINAHL (via EBSCO), LILACS, SCOPUS, ClinicalTrials.gov, Open Science Framework, ProQuest Dissertations and Theses, Cochrane Library, and JBI. RESULTS: The search yielded 2190 articles, with 1779 remaining after duplicates were removed. Screening identified 80 articles for review; 63 were excluded, resulting in 17 articles defining key findings. Two articles contributed to a theoretical framework for a physiological approach. Ten articles further discussed how midwives provide care during this stage to maintain normalcy. Three articles debated the safety of expectant management for low-risk women, while three studies also suggested new risk factors for postpartum hemorrhage. CONCLUSION: Midwifery care during the physiological third stage of labour must balance safety and trust in the woman's body. More research is needed to assess expectant management in home births and midwifery-led units, with a focus on individual needs and the long-term impacts of a physiological approach.

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"Shifting the Culture and the Way That We Practice": Perinatal Clinicians' Cognitive, Behavioral, and Team-Level Changes Following Equity-Focused Interventions.

Garrett SB, Walia A, Miller F … +5 more , Jones L, Powell B, Chambers Butcher BD, Dohan D, Simon MA

Birth · 2026 Jan · PMID 41489216 · Publisher ↗

INTRODUCTION: In recent years, US hospitals have implemented novel interventions to reduce racism, bias, and their effects in perinatal healthcare (e.g., implicit bias training, anti-racism seminars). Healthcare workers... INTRODUCTION: In recent years, US hospitals have implemented novel interventions to reduce racism, bias, and their effects in perinatal healthcare (e.g., implicit bias training, anti-racism seminars). Healthcare workers may also encounter informal interventions in support of these goals (e.g., peer feedback on microaggressions). There is little scholarship on how equity-focused interventions affect clinicians and clinical teams. METHODS: Using qualitative in-depth interview data from 20 California hospital-based perinatal clinicians, we investigated changes in how perinatal clinicians approached their work following equity-focused interventions. RESULTS: Sixteen respondents discussed changes they observed in themselves or their colleagues. We categorized these as: (1) cognitive changes (e.g., recognizing one's own biased thinking and behavior; better understanding the role of racism in disparities); (2) individual behavior changes (e.g., speaking up about inequities; assessing and mitigating bias in one's own behavior; acting more intentionally when caring for patients at risk for worse outcomes); and (3) team behavior changes (e.g., greater intra-colleague discussion of equity topics; collective accountability; efforts to reduce the harms of bias in clinical care). Many described interventions that overlapped or even synergized with one another, including combinations of formal and informal efforts. CONCLUSIONS: Our findings suggest that equity-focused interventions can produce observable changes in perinatal patient-care processes. However, it may be challenging for evaluators and healthcare leaders alike to understand what interventions, in what combinations and perinatal settings, produce desired results. Researchers will need innovative methods and a deep understanding of the intervention context to rigorously study these novel interventions-overlapping, multi-level, synergistic-and their effects.

Birth (Berkeley, Calif.)[JOURNAL]

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