Birth (Berkeley, Calif.)[JOURNAL]
Sun
200 papers
Initiated Breastfeeding and Physiological Patterns in Newborn Infants When Reunited With Mother After Separation Due to Elective Cesarean Birth.
Ayala A, Erlandsson K, Christensson K … +3 more , Christensson E, Cavada G, Velandia M
Birth · 2025 Mar · PMID 39369425 · Full text
BACKGROUND: The purpose of this study was to compare the effects of two caregiving models on full-term healthy infants' wakefulness, rooting and sucking reflexes, initiation of breastfeeding, and physiological parameters...
BACKGROUND: The purpose of this study was to compare the effects of two caregiving models on full-term healthy infants' wakefulness, rooting and sucking reflexes, initiation of breastfeeding, and physiological parameters when reunited with their mothers after a mother-infant separation of 130 min after elective cesarean birth. METHODS: Ninety-five mother-infant pairs participated in a randomized controlled trial, in which full-term healthy infants were allocated to be either dressed in their mothers' arms (n = 56) or skin-to-skin with their mother (n = 39) when reunited with the mother within 130 min after cesarean birth. Data were collected by the Neonatal Behavioral Assessment Scale (NBAS) to assess the infants' wakefulness and prebreastfeeding behaviors. Physiological parameters were assessed at 15 min intervals, from 130 to 205 min after birth. Time to first breastfeed was measured in minutes from the reunion with the mother. RESULTS: The primary finding was that physiologic parameters did not differ but time for initiation of breastfeeding after the reunion with the mother was significantly faster in the skin-to-skin group compared to the infants in the mothers' arms group (p = 0.005). Over the full study period, a more relaxed state and drowsy were found in the skin-to-skin group compared to the infants in the mothers' arms group. CONCLUSION: Healthy full-term infants born by elective cesarean, who were cared for by their mothers when reunited within 130 min of separation and cared for by their fathers during the mother-infant separation, initiated breastfeeding successfully and showed stable physiological patterns.
Maternal and Neonatal Consequences of Early Augmentation of Labor Among Women With Spontaneous Onset of Labor: A National Population-Based Study.
Girault A, Blondel B, Fraser W … +2 more , Goffinet F, Le Ray C
Birth · 2025 Jun · PMID 39350465 · Full text
BACKGROUND: While some labor interventions are essential in preventing maternal and neonatal morbidity, there is little evidence to support systematic early augmentation of labor (EAL). Our objective was to assess the as...
BACKGROUND: While some labor interventions are essential in preventing maternal and neonatal morbidity, there is little evidence to support systematic early augmentation of labor (EAL). Our objective was to assess the association between EAL and cesarean delivery rate, postpartum hemorrhage and adverse neonatal outcomes. METHODS: Population-based study using data from the 2016 French Perinatal Survey. Women with a singleton cephalic fetus, delivering at term after a spontaneous labor were included. "EAL" was defined by artificial rupture of the membranes (AROM) and/or oxytocin within 1 h of admission and/or duration between interventions of less than 1 h. Women without EAL were women without labor augmentation or without EAL. The primary endpoint, cesarean delivery and the secondary endpoints were compared between women with and without EAL using univariate analysis. A multivariable logistic regression was adjusted on the suspected confounders and a propensity score approach was then performed. RESULTS: Among the 7196 women included, 1524 (21.2%) had EAL. Cesarean delivery rates were significantly higher in the EAL group compared with the no EAL group, 8.40% versus 6.15% (p < 0.01). EAL was associated with cesarean delivery in the multivariable analysis aOR 1.45 95% CI [1.15-1.82] and in the cohort matched on the propensity score, OR 1.56 [1.17-2.07]. EAL was not associated with severe postpartum hemorrhage, low 5-min Apgar score, low neonatal cord pH or transfer to NICU. CONCLUSION: EAL is frequent, involving one in five spontaneous laboring women in France. This practice is associated with an increased cesarean delivery risk.
Reasons for Neonatal Presentations to Pediatric Emergency Departments in Catania: Multicentric Cross-Sectional Analysis and Exhaustive Review of the Literature.
Falsaperla R, Meli M, Sortino V … +6 more , Marino S, Tardino L, Trobia GL, Barbagallo M, Scalia B, Sicilian Group of the Italian Society of Neonatology (SIN)
Birth · 2025 Jun · PMID 39315701 · Full text
INTRODUCTION: This study aimed to characterize neonatal admissions to pediatric emergency departments (PEDs) in Catania, to analyze the primary pediatric conditions leading to these admissions, and to explore the associa...
INTRODUCTION: This study aimed to characterize neonatal admissions to pediatric emergency departments (PEDs) in Catania, to analyze the primary pediatric conditions leading to these admissions, and to explore the association between the demographic characteristics of the population and the severity of their presentations. MATERIALS AND METHODS: A retrospective analysis was conducted on neonates (aged <28 days) admitted to three PEDs in Catania between January 2015 and December 2019. Additionally, a comprehensive review of the literature on this topic was performed. RESULTS: A total of 5183 neonates presented during the study period, with a median age of 14 days at admission. The top three diagnoses were neonatal jaundice (15%), abdominal discomfort (12%), and upper airway inflammation (11%). The majority of cases were classified as non-urgent (green) at triage (59%). Overall, 1296 patients (25%) required hospitalization; 95% of those assigned a yellow triage color at admission required hospitalization. Only 33% of hospitalized patients were referred by parents, while the majority were referred by primary care pediatricians. The highest number of admissions occurred in August, while the peak in hospitalizations was in February. CONCLUSIONS: The majority of neonatal PED admissions are for non-acute conditions that do not require immediate medical attention. This concerning trend leads to increased workloads for PED staff, higher healthcare costs, and potential risks to neonates. Possible causes include insufficient caregiver knowledge, inadequate parental education, and suboptimal transition from hospital to primary care pediatric services.
The midwifery capabilities theory: How midwives enact woman-centered care to address systemic inequity.
Naughton S, Baldwin A, Harvey C … +1 more , Capper T
Birth · 2025 Sep · PMID 39297756 · Full text
BACKGROUND: Healthcare for childbearing women with complex needs demands a multi-disciplinary approach requiring transitions between care providers, paradigms, and models of care. These transitions may create disconnects...
BACKGROUND: Healthcare for childbearing women with complex needs demands a multi-disciplinary approach requiring transitions between care providers, paradigms, and models of care. These transitions may create disconnects between women and the maternity care "system." Poorly managed care transitions can lead to women becoming hostage to the power struggles between healthcare organizations and the professionals working within them, further increasing the risk of poor outcomes. This paper presents the findings of a study that aimed to better understand how midwives provide woman-centered care for women with complex needs in the real world of maternity services. METHODS: A constructivist grounded theory approach, using Clarke's situational analysis to extend critical and feminist perspectives in data analysis. Qualitative data were obtained from two sources: publicly available data, and individual interviews with providers of care (midwives) and recipients of care (women with complex pregnancies). RESULTS: Woman-centered care is defined as care in which the woman is seen, heard, and known. "The midwifery capabilities theory" describes the process whereby midwives create opportunities to develop women's capabilities. Capabilities are enabled through the midwifery relationship creating space, moments in time, and equalizing power and positionality. CONCLUSIONS: Aligning with contemporary theories surrounding the provision of midwifery care, the midwifery capabilities theory recognizes the individual health and social status of women and the rights to self-determination. This centers care around each individual's needs, which, in addition to improving health and well-being outcomes, contributes to improved self-confidence, enhancing engagement through authentic professional relationships.
The Association Between Doula Care and Childbirth-Related Post-Traumatic Stress Disorder Symptoms: The Mediating Role of Childbirth Experience.
Lai X, Chen J, Lu D … +6 more , Wang L, Lu X, Chen I, Krewski D, Wen SW, Xie RH
Birth · 2025 Jun · PMID 39297755 · Publisher ↗
INTRODUCTION: Although the benefits of doula care during childbirth are well-known, its impact on childbirth-related post-traumatic stress disorder (CB-PTSD) symptoms are less thoroughly characterized. This study aimed t...
INTRODUCTION: Although the benefits of doula care during childbirth are well-known, its impact on childbirth-related post-traumatic stress disorder (CB-PTSD) symptoms are less thoroughly characterized. This study aimed to explore the association between doula care and CB-PTSD symptoms and the potential mediating role of childbirth experience on this association. METHODS: A prospective cohort study was conducted in a hospital in China, enrolling women with singleton live vaginal births. The exposure and primary outcome factors of interest were doula care and CB-PTSD symptoms, with childbirth experience as a mediating factor. Questionnaires were administered to collect baseline data and childbirth experience at 3 days postpartum, and CB-PTSD symptoms from participants at 42 days postpartum. Linear regression analysis was used to analyze the relationship between doula care, childbirth experience, and CB-PTSD symptoms, while the mediating role of childbirth experience was analyzed using the SPSS (PROCESS) modeling tool. RESULTS: A total of 445 eligible women were included in the final analysis, including 120 who received doula care and 325 who did not. Linear regression analyses found that doula care was independently associated with CB-PTSD symptoms (β = -0.11, p < 0.05) and childbirth experience (β = 0.50, p < 0.001). Childbirth experience was significantly associated with CB-PTSD symptoms (β = -0.17, p < 0.001). Childbirth experience mediated the association between doula care and CB-PTSD symptoms (indirect effect = -1.08, 95% CI -1.91 to -0.10), even after adjusting for potential confounders. CONCLUSIONS: Childbirth experience serves as a mediator of the association between doula care and CB-PTSD symptoms. By providing supportive care for women during childbirth, their childbirth experience could be improved, thereby reducing the risk of CB-PTSD symptoms.
Weight Bias in the Perinatal Period: An Integrative Review.
Bradford HM, Puhl RM, Phillippi JC … +2 more , Dietrich MS, Neal JL
Birth · 2025 Jun · PMID 39297743 · Full text
BACKGROUND: Weight bias toward individuals with higher body weights in healthcare settings is associated with adverse health behaviors, reduced healthcare utilization, and poor health outcomes. The purpose of this integr...
BACKGROUND: Weight bias toward individuals with higher body weights in healthcare settings is associated with adverse health behaviors, reduced healthcare utilization, and poor health outcomes. The purpose of this integrative review was to explore: (1) What has been measured and described regarding perinatal care providers' and students' weight bias toward pregnant, birthing, and postpartum individuals with higher body weights? (2) What has been measured and described regarding pregnant, birthing, and postpartum individuals' experiences of weight bias? (3) What is the association of experiences of weight bias with perinatal and mental health outcomes among pregnant, birthing, and postpartum individuals? METHODS: We conducted a systematic search in CINAHL, PubMed, and PsycINFO databases to identify relevant research publications related to the Medical Subject Headings (MeSH) terms weight prejudice (and related terms) and pregnancy (and related terms). The review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), Johns Hopkins Nursing Evidence-Based Practice model for study quality determination, and the Whittemore and Knafl integrative review framework for data extraction and analyses. RESULTS: Twenty-two publications met inclusion criteria, representing six countries and varying study designs. This review found pervasive sources of explicit weight bias in the perinatal period, including care providers and close relationships. Experiences of weight bias among pregnant and postpartum individuals are associated with adverse perinatal and mental health outcomes. DISCUSSION: The findings address a knowledge gap regarding a summary of literature on weight bias in the perinatal period and elucidate its prevalence as well as its negative influence on perinatal and mental health outcomes. Future research efforts on this topic must examine the nature and extent of perinatal care providers' weight bias by demographic factors and explore its association with clinical decision-making and perinatal and mental health outcomes.
Just go with your body? A conversation analytic study of the transition from first to second stage of labor in UK midwife-led care.
Jackson C, Beynon-Jones S
Birth · 2024 Dec · PMID 39305166 · Publisher ↗
BACKGROUND: The transition from first to second stage of labor is poorly understood. While the onset of second stage is defined by cervical measurement, dilation cannot be directly sensed or externally observed. Thus, un...
BACKGROUND: The transition from first to second stage of labor is poorly understood. While the onset of second stage is defined by cervical measurement, dilation cannot be directly sensed or externally observed. Thus, uncertainty exists when women report pushing urges before dilation is confirmed. This study aimed to explore how sensations of pushing and uncertainty over progress are interactionally managed. METHODS: We audio/video recorded the labors of 37 women in two midwife-led units in England. Our analysis focused on a subset of 28 recordings that featured discussion of transition from first to second stage of labor. The interactions between midwives, laboring women and their birth partners were transcribed and analyzed using conversation analysis. RESULTS: We identified a 'pushing until proven otherwise' rule granting temporary, contingent authority to bodily urges to push while tracking progress over time. Specifically, midwives supported reported pushing sensations without insisting on examinations. Caution was occasionally expressed in distinguishing between irresistible and forced pushing. Across multiple contractions, midwives watched and waited for alignment of sensations with signs of descent. Where signs of progress were absent over time, examinations were treated as clinically indicated. DISCUSSION: Thus, a complex interplay of women's sensations and midwifery expertise produced care. Compared to past research, our analysis demonstrates increased validation of embodied experience in contemporary midwife-led practice. However, uncertainty still requires navigation through collaborative work. We evidence how this navigation is accomplished in real-time interactions.
Traumatic experiences, quality of life, and organizational commitment among midwives: A cross-sectional study.
Segal K, Kagan I
Birth · 2025 Mar · PMID 39225410 · Publisher ↗
BACKGROUND: The work of midwives is emotionally challenging. Midwives share moments of joy, when a baby is born, and attend complex events of loss and trauma. Exposure to childbirth complications, emergencies, and loss c...
BACKGROUND: The work of midwives is emotionally challenging. Midwives share moments of joy, when a baby is born, and attend complex events of loss and trauma. Exposure to childbirth complications, emergencies, and loss can affect their professional quality of life and functioning. This aspect of midwives' practice has not been sufficiently researched. AIM: To examine the associations between exposures to traumatic events, post-traumatic symptoms, and personal resilience with professional quality of life and organizational commitment among hospital midwives. METHODS: Participants in this cross-sectional study conducted in 2020 included 131 midwives from three large hospitals in central Israel. Data were collected using a structured self-administered questionnaire that examined socio-demographic characteristics, exposure to traumatic events during childbirth, personal resilience, post-traumatic symptoms, professional quality of life, and organizational commitment. RESULTS: The three most traumatic events for midwives were: neonatal death or feared death, maternal death or feared death, and stillbirth. The more frequent the exposure to traumatic events, the more numerous and intense the post-traumatic symptoms. The more numerous and intense the post-traumatic symptoms, the higher the level of professional burnout and compassion fatigue and the lower the compassion satisfaction. Higher compassion satisfaction and lower professional burnout were associated with higher organizational commitment. Personal resilience, country of birth, post-traumatic symptoms, and organizational commitment predicted compassion satisfaction. CONCLUSIONS: Midwives' exposure to traumatic events is associated with the onset of post-traumatic symptoms, impaired professional quality of life, and reduced organizational commitment, and is accompanied by burnout and compassion fatigue. There is a need to address this issue in training programs and to develop organizational support and policies to improve midwives' well-being and quality of care.
Fear of Childbirth After Major Orthopedic Traumas: A Nationwide Multi-Register Analysis.
Vaajala M, Liukkonen R, Kuitunen I … +3 more , Ponkilainen V, Mattila VM, Kekki M
Birth · 2025 Mar · PMID 39215429 · Full text
BACKGROUND: The aim of this study was to evaluate the association between previous major traumas and the prevalence of fear of childbirth (FOC) and the subsequent effects of FOC on the intended mode of delivery. METHODS:...
BACKGROUND: The aim of this study was to evaluate the association between previous major traumas and the prevalence of fear of childbirth (FOC) and the subsequent effects of FOC on the intended mode of delivery. METHODS: In this nationwide retrospective register-based cohort study, data from the Care Register for Health Care were linked with the National Medical Birth Register (MBR) to evaluate the prevalence of FOC after major traumas. A total of 18,573 pregnancies met the inclusion criteria. A multivariable logistic regression model was used to assess the effects of FOC on the intended mode of delivery. Women with major traumas before pregnancy were compared to individuals with wrist fractures. Adjusted odds ratios (aORs) with 95% CIs between the groups were compared. RESULTS: Of those pregnancies that occurred after major traumas, 785 (6.2%) women were diagnosed with FOC after traumatic brain injury (TBI), 111 (6.1%) women after spine fracture, 38 (5.0%) women after pelvic fracture, 22 (3.2%) women after hip or thigh fracture, and 399 (5.2%) women in the control group. Among those women diagnosed with FOC, the adjusted odds for elective CB as an intended mode of delivery were highest among women with previous spine fractures (aOR 2.28, CI 1.45-3.60) when compared to the control group. CONCLUSIONS: We found no evidence of differences in maternal FOC in patients with preceding major traumas when compared to the control group. Therefore, it seems highly likely that the major trauma itself is the explanatory factor for the increased rate of elective CB.
Birthing parent postpartum acute care use: Multilevel opportunities for strengthening healthcare.
Busse CE, Stuebe AM, Tumlinson K … +4 more , Tucker C, Vladutiu CJ, Pence B, Tully KP
Birth · 2024 Dec · PMID 39212149 · Publisher ↗
BACKGROUND: Two-thirds of pregnancy-related deaths occur from 1 day to 1 year after birth, and medical complications frequently occur after birth. Postpartum health concerns are often urgent, requiring timely medical car...
BACKGROUND: Two-thirds of pregnancy-related deaths occur from 1 day to 1 year after birth, and medical complications frequently occur after birth. Postpartum health concerns are often urgent, requiring timely medical care, which may contribute to a reliance on acute care. One approach to improving postpartum health is to investigate birthing parents' accounts of acute care use in the months after birth, which is what we did in this study. METHODS: This mixed-methods study included questionnaire responses, semi-structured interviews, and chart review of 18 English-speaking individuals who used acute care in the 90 days after birth in the southeastern United States. Interviews were conducted remotely, recorded, and professionally transcribed. Qualitative data were inductively coded to iteratively develop categories and themes with respect to contributors and barriers to postpartum acute care use. RESULTS: Birthing parents engaged in complex decision-making processes to decide where and when to seek postpartum acute care in response to their urgent health concerns. Many described fear and uncertainty about their postpartum health. Most participants contacted a healthcare practitioner before using acute care, followed their guidance, and were treated or otherwise reassured at the acute care visit. DISCUSSION: These findings suggest multilevel opportunities for strengthening healthcare systems, including better-preparing individuals for the postpartum period and structuring care to accommodate birthing parents and include their support systems. The insights from this study can inform multilevel strategies for strengthening healthcare so that birthing parents are safe and well postpartum.
Experiences of attending prenatal ultrasounds during the COVID-19 pandemic in Australia: A cross-sectional survey.
Nightingale HJ, Watts C, Pham K
Birth · 2025 Mar · PMID 39177421 · Full text
BACKGROUND: Prenatal ultrasounds form an important part of routine maternity care in Australia and indeed internationally. The COVID-19 pandemic necessitated rapid changes in society and healthcare to curb transmission,...
BACKGROUND: Prenatal ultrasounds form an important part of routine maternity care in Australia and indeed internationally. The COVID-19 pandemic necessitated rapid changes in society and healthcare to curb transmission, with evidence demonstrating detrimental impacts on childbearing women associated with these restrictions. However, experiences with pandemic restrictions for prenatal ultrasounds in relation to distress, patient expectations, and satisfaction are largely unknown. This study aimed to explore the experiences of pregnant women attending prenatal ultrasound during the pandemic in Australia. METHODS: A cross-sectional online survey of people in Australia who had undergone at least one prenatal ultrasound during the period of maternity care restrictions was performed. The survey included validated tools for assessing post-traumatic stress, satisfaction, and expectations with maternity care. RESULTS: A total of 1280 responses were obtained. Almost 37% of respondents returned a PCL-C score consistent with probable post-traumatic stress disorder. Unexpected ultrasound findings or a high PCL-C score were more likely to have higher expectations and lower levels of satisfaction with their maternity care experience. Having an ultrasound for pregnancy loss, fetal abnormality, and/or a prior post-traumatic stress disorder diagnosis were the strongest factors correlating with a high PCL-C score. DISCUSSION: The prevalence of post-traumatic stress symptoms in the study population is concerning and elucidates the distress experienced in association with prenatal ultrasounds during pandemic restrictions in Australia. Maternity services should acknowledge the high levels of service consumers with post-trauma symptoms and consider trauma-responsive maternity care adaptations in response to adverse perinatal outcomes for those afflicted with post-trauma and distress-related symptoms.
The First Baby Study: What women would like to have known about first childbirth. A mixed-methods study.
Levett KM, Sutcliffe KL, Vanderlaan J … +1 more , Kjerulff KH
Birth · 2024 Dec · PMID 39166782 · Publisher ↗
BACKGROUND: Although prenatal care providers aim to prepare women for first childbirth, little research has explored retrospectively what birthing people would like to have known before first childbirth. AIM: To describe...
BACKGROUND: Although prenatal care providers aim to prepare women for first childbirth, little research has explored retrospectively what birthing people would like to have known before first childbirth. AIM: To describe women's reports of what they would like to have known before first childbirth but feel they were not told. METHODS: This is a secondary analysis of the First Baby Study, a large prospective cohort study conducted in Pennsylvania, USA. Telephone interviews were conducted with 3006 women 1 month after their first childbirth. Women were first asked: "Was there anything that you would have liked to have known before your delivery that you were not told?". If "yes" they were asked a second question: "Please tell me what you would have liked to have known before your delivery". ANALYSIS: A convergent mixed-methods analysis including descriptive analytics to compare characteristics of women by answers to the first question, and qualitative content analysis of women's open-ended answers to the second question. FINDINGS: A total of 441 women (14.7%) reported there was something they would like to have known before their first childbirth. Women described that communication with care providers was their main concern. They would have liked a better understanding of their options before birth, more agency in decision-making, and more information about the topics of their body, their birth, their baby, and what to expect beyond birth. CONCLUSIONS: Results highlight important topics for childbirth education, and the impact of gaps in shared decision-making, patient-provider communication, and supportive care practices for first childbirth, especially where women have identified vulnerabilities.
How well can the fetal heart rate baseline be assessed by intrapartum intermittent auscultation? An interrater reliability and agreement study.
Engelhart CH, Vanbelle S, Øian P … +3 more , Pay ASD, Kaasen A, Blix E
Birth · 2024 Dec · PMID 39164990 · Publisher ↗
BACKGROUND: We aimed to examine the inter-reliability and agreement among midwives when assessing the fetal heart rate (FHR) using the handheld Doppler. The primary aim was to measure the reliability and agreement of FHR...
BACKGROUND: We aimed to examine the inter-reliability and agreement among midwives when assessing the fetal heart rate (FHR) using the handheld Doppler. The primary aim was to measure the reliability and agreement of FHR baseline (baseline) as beats per minute (bpm). The secondary aims were to measure fluctuations from the baseline, defined as increases and decreases, and classifications (normal or abnormal) of FHR soundtracks. This is the first interrater reliability and agreement study on intermittent auscultation (IA) to our knowledge. METHODS: The participant population consisted of 154 women in labor, from a mixed-risk population and admitted to hospital for intrapartum care. The rater population were 16 midwives from various maternity care settings in Norway. A total of 154 soundtracks were recorded with a handheld Doppler device, and the 16 raters assessed 1-min soundtracks once, through an online survey (Nettskjema). They assessed the baseline, FHR increase or decrease, and the FHR classification. The primary outcome, baseline, was measured with intraclass correlation coefficient (ICC). The secondary outcomes were measured with kappa and proportion of agreement. RESULTS: The interrater reliability for the baseline (bpm) was ICC(A,1) 0.74 (95% CI 0.69-0.78). On average, an absolute difference of 7.9 bpm (95% CI 7.3-8.5 bpm) was observed between pairs of raters. CONCLUSION: Our results demonstrate an acceptable level of reliability and agreement in assessing the baseline using a handheld Doppler.
Domestic and family violence and associated maternal and perinatal outcomes: A population-based retrospective cohort study.
Baird KM, Phipps H, Javid N … +1 more , Stephen de Vries B
Birth · 2025 Mar · PMID 39162071 · Full text
BACKGROUND: Domestic family violence (DFV) is a global health concern affecting one in three women worldwide. Women are vulnerable to DFV throughout their life; however, pregnancy introduces an increased risk of experien...
BACKGROUND: Domestic family violence (DFV) is a global health concern affecting one in three women worldwide. Women are vulnerable to DFV throughout their life; however, pregnancy introduces an increased risk of experiencing DFV for millions of women and birthing people. METHODS: Routinely collected data from two hospitals in one local health district in New South Wales, Australia, were examined to determine the prevalence of DFV from 2010 to 2019. Demographics and outcome factors were compared by a reported history of DFV. Multivariable logistic regression was used to assess for predictors of DFV and to assess DFV as a predictor of adverse maternal and perinatal outcomes. RESULTS: One percent of women (538/52,469) experienced DFV in the past year. Women experiencing domestic violence were more likely to be younger and have previous children, and had higher Edinburgh Depression Scores. These women were more likely to experience stillbirth (1.5% vs. 0.6%, p = 0.005). Maternal age < 25 years, cigarette smoking, alcohol use in pregnancy, mental health issues, and place of birth were associated with a recent history of DFV after adjusting for confounders. Recent DFV was associated with preterm birth and mental health issues but was not associated with admission to the neonatal nursery, small-for-gestational-age birthweight, or caesarean section after adjusting for confounders. CONCLUSION: There was a relationship between DFV and poorer health outcomes for both women and their babies. This study highlighted that stillbirth is high among the population of women who experience DFV when compared to women who do not experience DFV.
Posttraumatic growth and its associations with perceived stress and core beliefs in women after traumatic childbirth during the COVID-19 pandemic.
Silva R, Prata AP, Abreu W … +10 more , Brandão T, Brandão S, Riklikiene O, Jarasiunaite-Fedosejeva G, González Mesa ES, Gökçe İsbir G, Inci F, Kömürcü Akik B, Uriko K, Thompson G
Birth · 2025 Sep · PMID 39155526 · Publisher ↗
BACKGROUND: The COVID-19 pandemic added new challenges and stressors to the childbirth period, potentially increasing the risk of traumatic childbirth experiences. There is little known about posttraumatic growth (PTG) i...
BACKGROUND: The COVID-19 pandemic added new challenges and stressors to the childbirth period, potentially increasing the risk of traumatic childbirth experiences. There is little known about posttraumatic growth (PTG) in a childbearing population. This study describes PTG in women after traumatic childbirth during the COVID-19 pandemic and its association with sociodemographic, birth-related characteristics, traumatic childbirth events, perceived stress, and core beliefs, as well as explores what factors predict PTG. METHODS: A cross-sectional study was conducted with 202 women who self-identified as having experienced traumatic childbirth. Measures included sociodemographic and birth-related characteristics, traumatic childbirth events, self-reported stress during childbirth, the PTG Inventory, and the Core Beliefs Inventory (CBI). RESULTS: Perceived stress at the time of birth was very high in 70% of the respondents. CBI showed moderate disruption of core beliefs. 41.6% of mothers indicated substantial PTG. Education and type of birth were related to perceived stress levels; higher disruption of core beliefs was observed in individuals who experienced perineal trauma and lack of partners' presence during childbirth, and higher disruption of core beliefs was positively associated with PTG. Predictive models showed that perceived stress had a minimal effect, while the disruption of core beliefs showed a significant positive association with PTG. CONCLUSION: Traumatic childbirth experiences during the COVID-19 pandemic were positively related to PTG. Health professionals should create an environment where women can explore their feelings and emotions. Changes in current practices are also necessary as cesareans have been shown to be highly associated with high levels of perceived stress.
Unveiling injustice: Disrupting child removal policies and upholding breastfeeding: An emancipatory framework.
Peek A, Hamilton S, Atchan M … +2 more , Jojo N, Northam H
Birth · 2025 Sep · PMID 39149793 · Full text
Before colonization, Aboriginal and Torres Strait Islander communities had nurturing, holistic, and communitarian approaches that promoted extended and healthy lives for their children. Colonization, marked by policies o...
Before colonization, Aboriginal and Torres Strait Islander communities had nurturing, holistic, and communitarian approaches that promoted extended and healthy lives for their children. Colonization, marked by policies of genocide and assimilation, has resulted in an alarming overrepresentation of Aboriginal and Torres Strait Islander children under the care of child protection agencies, resulting in compromised health outcomes and reduced life expectancies. We are conducting a study designed to enhance positive developmental outcomes for Aboriginal and Torres Strait Islander children by articulating and enabling the rights of mothers and children to breastfeed in the context of a child protection intervention and child removal. To understand and address this problem, it is critical to implement culturally safe, de-colonized, emancipatory research that is guided by and benefits Aboriginal and Torres Strait Islander communities. This article presents an emancipatory framework that we are applying to our study using an Aboriginal participatory action research approach, that serves as a guide for non-Indigenous researchers seeking to conduct research with Indigenous communities. We emphasize the importance of incorporating an Aboriginal participatory action research framework, using community consultation and codesign; culturally secure data collection methods, and paying attention to Indigenous data sovereignty. Developing trusting respectful relationships is conducive to knowledge acquisition, exchange, and use, when research approaches deeply rooted in community involvement are applied. A call to action by the critical midwifery studies collective, urges non-Indigenous researchers to become accountable allies that demonstrates respect for community leadership while actively striving to ensure research does not perpetuate further harm, and produces effective change. This article provides an overview of ways to conduct ethical emancipatory research with Indigenous participants, that is, of benefit to midwifery practitioners and is applicable to many areas of research, policy, and practice.
Labor outcomes in caseload midwifery compared with standard midwifery care: A cohort study.
Hjorth S, Brülle AL, Kristensen H … +2 more , Frederiksen A, Nohr EA
Birth · 2024 Dec · PMID 39140615 · Publisher ↗
BACKGROUND: Research has shown caseload midwifery to increase the chance of vaginal birth, but this may not be the case in settings with high vaginal birth rates in standard care. This study investigated the association...
BACKGROUND: Research has shown caseload midwifery to increase the chance of vaginal birth, but this may not be the case in settings with high vaginal birth rates in standard care. This study investigated the association between caseload midwifery and birth mode, labor interventions, and maternal and neonatal outcomes at a large obstetric unit in Denmark. METHODS: Cohort study including medical records on live, singleton births fr om June 2018 until February 2022. Exposure was caseload midwifery care compared with standard midwifery care. The primary outcome was birth mode, and secondary outcomes were other outcomes of labor. Adjusted risk ratios (aRR) with 95% confidence intervals (CI) were estimated by log-binomial regression. RESULTS: Among 16,110 pregnancies, 3162 pregnancies (19.6%) received caseload midwifery care. Caseload midwifery was associated with fewer planned cesareans (aRR 0.63 [95% CI 0.54-0.74]) and emergency cesareans (aRR 0.86 [95% CI 0.75-0.95]). No differences in labor induction, use of epidural analgesia, oxytocin augmentation, or anal sphincter tears were observed. Caseload midwifery performed more amniotomies (aRR 1.14 [95% CI 1.02-1.27]) and tended to perform more episiotomies (aRR 1.19 [95% CI 0.96-1.48]). Postpartum hemorrhage (aRR 0.90 [95% CI 0.82-0.99]) and low Apgar score were less likely (aRR 0.54 [95% CI 0.37-0.77]), and early discharge more likely (aRR 1.22 [95% CI 1.17-1.28]) in caseload midwifery. CONCLUSION: In caseload midwifery care, a higher vaginal birth rate was observed with no increase in adverse outcomes, mainly due to a lower likelihood of planned cesarean. Also, fewer children were born with low Apgar scores.
Parents' and healthcare providers' perceptions, experiences, knowledge of, and attitudes toward kangaroo care of preterm babies in hospital settings: Mixed-methods systematic review.
Almutairi A, Gavine A, McFadden A
Birth · 2024 Dec · PMID 39140585 · Publisher ↗
BACKGROUND: Kangaroo care is an effective intervention to increase survival and improve the health and development of preterm infants. Despite this, implementation of kangaroo care globally remains low. The objectives of...
BACKGROUND: Kangaroo care is an effective intervention to increase survival and improve the health and development of preterm infants. Despite this, implementation of kangaroo care globally remains low. The objectives of this review were to: (a) synthesize evidence on parents' and healthcare practitioners' perceptions, experiences, knowledge of, and attitudes toward kangaroo care of preterm babies in hospital settings; and (b) establish parents' satisfaction with kangaroo care. METHODS: Studies of any design were included if they focused on parents' or healthcare practitioners' perceptions, experiences, knowledge of, and attitudes to kangaroo care of preterm babies, or reported parents' satisfaction, and were conducted in hospital settings. The search of seven electronic databases, African Journals Online, World Health Organization regional databases, and a gray literature search was conducted in April/May 2020, and updated in January 2024. Study selection was undertaken by two independent reviewers. Quality assessment using the Mixed Method Appraisal Tool and data extraction were completed by one reviewer with a 10% check by a second reviewer. Data were synthesized narratively using a parallel results convergent integrated design. RESULTS: Thirty-seven studies, 19 quantitative, 16 qualitative, and 2 mixed methods, were included. The findings suggested that while healthcare practitioners generally demonstrated knowledge about kangaroo care, there was a notable minority with insufficient understanding among those who received training. Parents' knowledge, particularly among fathers, was limited. Both healthcare practitioners and parents appeared to have positive attitudes to kangaroo care. Little is known about parental satisfaction with kangaroo care. CONCLUSIONS: Most healthcare practitioners were knowledgeable about kangaroo care, but parents had limited knowledge. This review findings suggest a need to enhance parental knowledge of kangaroo care before neonatal unit admission, and training is needed for HCPs to implement kangaroo care consistently.
Assessing patient autonomy in the context of TeamBirth, a quality improvement intervention to improve shared decision-making during labor and birth.
Neergheen VL, Chaer LE, Plough A … +18 more , Curtis E, Paterson VJ, Short T, Bright A, Lipsitz S, Murphy A, Miller K, Subramanian L, Radichel E, Ervin J, Castleman L, Brown E, Yeboah T, Simas TM, Terk D, Vedam S, Shah N, Weiseth A
Birth · 2024 Dec · PMID 39140579 · Publisher ↗
BACKGROUND: Respectful maternity care includes shared decision-making (SDM). However, research on SDM is lacking from the intrapartum period and instruments to measure it have only recently been developed. TeamBirth is a...
BACKGROUND: Respectful maternity care includes shared decision-making (SDM). However, research on SDM is lacking from the intrapartum period and instruments to measure it have only recently been developed. TeamBirth is a quality improvement initiative that uses team huddles to improve SDM during labor and birth. Team huddles are structured meetings including the patient and full care team when the patient's preferences, care plans, and expectations for when the next huddle will occur are reviewed. METHODS: We used patient survey data (n = 1253) from a prospective observational study at four U.S. hospitals to examine the relationship between TeamBirth huddles and SDM. We measured SDM using the Mother's Autonomy in Decision-Making (MADM) scale. Linear regression models were used to assess the association between any exposure to huddles and the MADM score and between the number of huddles and the MADM score. RESULTS: In our multivariable model, experiencing a huddle was significantly associated with a 3.13-point higher MADM score. When compared with receiving one huddle, experiencing 6+ huddles yielded a 3.64-point higher MADM score. DISCUSSION: Patients reporting at least one TeamBirth huddle experienced significantly higher SDM, as measured by the MADM scale. Our findings align with prior research that found actively involving the patient in their care by creating structured opportunities to discuss preferences and choices enables SDM. We also demonstrated that MADM is sensitive to hospital-based quality improvement, suggesting that future labor and birth interventions might adopt MADM as a patient-reported experience measure.
Toward a semiotics of midwifery: Multimodal communication's effects on accessibility, equity, and power dynamics.
Celeste J
Birth · 2025 Sep · PMID 39133552 · Publisher ↗
According to semiotics, we live in a world of signs, where almost anything can act as a signifier and convey meaning. But what of the semiotic landscape of midwifery? What signs are present within a client's multi-sensor...
According to semiotics, we live in a world of signs, where almost anything can act as a signifier and convey meaning. But what of the semiotic landscape of midwifery? What signs are present within a client's multi-sensory experience of their midwifery care? How are these signs functioning to increase equity and accessibility? Or worse, how might certain aspects of the client's experience communicate unjust power dynamics? Semiotics allows us to examine a wide communicative and educational environment. By paying particular attention to the multivalent meanings of different signs-be they written, visual, oral, or even physical-we can start to see how multimodal communication plays a vital role in a client's perception of equity and power. One way to improve client experience is by approaching education and semiotic experience from the same place as trauma-informed care. A more health-literate sensitive approach viewed through the lens of semiotics assumes all clients have little previous knowledge or comfort within a care setting. This hyperawareness and criticality of the semiotic environment would allow midwives to acknowledge various sensory and communicative biases and intentionally redesign the entire client experience. The semiotic landscape is then curated to meet the needs of the most important audience-those marginalized and discriminated against whether that is because of education, finances, race, gender, or any other intersectional identity. We must acknowledge the fact that all sign systems can either reinforce abusive power relations or work to improve them. For what is at stake here is not just a client's overall comfort, but their full understanding of the care they are receiving, the options they have, and their autonomy within their entire perinatal experience.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe