http://localhost:8080/xmlui/handle/123456789/10808 2026-04-11T21:07:42Z http://localhost:8080/xmlui/handle/123456789/10816 Title: Midwives’ experiences with a safe childbirth checklist: A grounded theory study Authors: Skirnisdottir, Vik Eline; Østenfor, Myre Marte; Vika, Nilsen Anne Britt; Katrine, Aasekjær Abstract: Objective: The aim of this study was to explore midwives’ experiences with a safe childbirth checklist used in handover situations from birth to hospital discharge. Quality of care and patient safety is highly recognised and a priority within health services globally. In handover situations, checklists have proven to reduce unwanted variation by standardising processes, which in turn contribute to increased quality of care. To improve the quality of care, a safe childbirth checklist was implemented at a large maternity hospital in Norway. Design: We conducted a Glaserian grounded theory (GT) study. Setting and participants: A total of 16 midwives were included. We included three midwives in one focus group and conducted 13 individual interviews. Years of experience as midwives ranged from one to 30 years. All included midwives worked in a large maternity hospital in Norway. Findings: The main concern faced by the midwives who used the checklist included no common understanding of the purpose of the checklist nor consensus on how to use the checklist. The generated grounded theory, individualistic interpretation of the checklist, involved the following three strategies that all seemed to explain how the midwives solved their main concern: 1) not questioning the checklist, 2) constantly evaluating the checklist, and 3) distancing oneself from the checklist. Experiencing an unfortunate event concerning the healthcare of both mother or newborn was a condition that could alter the midwives understanding and use of the checklist. Key conclusions: The findings in this study showed that a general lack of common understanding and consensus on the rationale for implementing a safe childbirth checklist led to variations between midwives in how and whether the checklist was used. The safe childbirth checklist was described as long and detailed. It was not necessarily the midwife who was expected to sign the checklist who had carried out the tasks signed for. To ensure patient safety, recommendations for future practice include securing that separate sections of a safe childbirth checklist are limited to a specific time-point and midwife. Implications for practice: Findings emphasise the importance of implementation strategies supervised by the leaders of the healthcare services. Further research should explore the understanding of organisational and cultural context when implementing a safe childbirth checklist to clinical practice. 2023-04-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/10814 Title: ‘It’s about developing a trustful relationship’: A Realist Evaluation of midwives’ relational competencies and confidence in a Danish antenatal psychosocial assessment programme Authors: Andersen, Clara Graugaard; Thomsen, Louise Lund Holm; Gram, Pernille; Overgaard, Charlotte Abstract: Objective: to explore how contextual conditions influence midwives’ relational competencies, ability and confidence to undertake psychosocial assessment of pregnant women and their partners during the first antenatal consultation that identifies expectant parents in vulnerable positions. Design: a realist evaluation carried out through three phases: 1) development 2) testing and 3) refinement of programme theories. Data was generated through realist interviews and observations. Setting: nine community-based and hospital-based midwife clinics in the North Region of Denmark. Intervention: a dialogue-based psychosocial assessment programme in the the North Region of Denmark was evaluated. Participants and data: 15 midwives were interviewed and 16 observations of midwives undertaking psychosocial assessment during the first antenatal consultation were conducted. Findings: contextual conditions at multiple levels which supported midwives’ relational competencies, autonomy and the power of peer reflection—and thus facilitation of a woman-centred approach and trust—were identified, i.e., being experienced, having interest, organisational prioritisation of peer reflection and flexibility. Where midwives lacked experience, competency development regarding psychosocial assessment, opportunities for peer reflection and autonomy to individualise care for expectant parents in vulnerable positions, the approach to assessment tended to become institution-centred which caused a distant dialogue and instrumental assessment which potentially harmed the midwife-woman/couple relationship. Conclusion: midwives’ ability and confidence to undertake psychosocial assessment were affected by whether individual and organisational contextual conditions empowered them to assess and care for expectant parents within a philosophy of woman-centred care. Accordingly, development of trustful midwife-woman/couple relationships — which is essential for disclosure — was achievable. These conditions become fundamental for securing quality of antenatal care for expectant parents in vulnerable positions. 2023-03-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/10812 Title: Fear and anxiety is what I recall the best.": A phenomenological examination of mothers’ pregnancy experiences during COVID-19 in the United States Authors: Huynh, Tuyen; Boise, Courtney; Kihntopf, Michaela Elizabeth; Schaefer, Abbie Ann; Schafer, Morgan Abstract: Objective: The purpose of this phenomenological study is to understand mothers’ lived pregnancy experiences during the COVID-19 pandemic. Design: A qualitative, phenomenological study Setting: Participants completed the demographic survey online and semi-structured interviews, via video conferencing between November and December 2021 Participants: A sample of 28 mothers who were pregnant during the COVID-19 pandemic participated in the study. Methods and Results: An inductive, thematic approach was used to analyze the data. Two central themes and eight subthemes emerged from the six-phase thematic analysis. The first central theme, Depth of Knowledge About COVID-19, included the following subthemes: 1) Vaccines and 2) Uncertainty for Exposure. The second central theme, Impacts of COVID-19, had six subthemes: 1) Types of Support Received, 2) COVID19 Restrictions, 3) Childcare, 4) Mental Health, 5) Spending More Time at Home, and 6) Isolation. Conclusions: Findings of this study revealed mothers experienced a significant amount of stress and anxiety related to the coronavirus pandemic during their pregnancy. Implications for practice: Our findings highlight the need to provide pregnant mothers comprehensive care, including mental health services, adequate access to social support, and providing clear information regarding COVID-19 vaccination and its impacts on pregnancy. 2023-04-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/10811 Title: Exploring disability prevalence among childbearing women attending a tertiary maternity service in Melbourne, Australia using an audit and cross-sectional survey Authors: Benzie, Charlie; McLachlan, Helen; Forster, Della; Newton, Michelle Abstract: Background: Although there is an estimated rate of 10% of women of childbearing age in Australia who have a disability, there is a lack of accurate prevalence data, with the true rate unknown. The timing and questions used to collect women’s disability status in pregnancy vary, and there is limited knowledge on how women accessing maternity services in Australia would like to be asked about their disability status. Objective: To explore the prevalence of women with a disability receiving maternity care using a direct and indirect disability identification question. Secondary aims were to explore how women would like to be asked about their disability status and to examine the difference between self-reported and cliniciandocumented disability status within medical records. Research design/Setting: The study was conducted at a tertiary maternity hospital in Melbourne, Australia, and included two components. Component one used a cross-sectional survey with two different cohorts of women administered face-to-face on the postnatal ward (Cohort 1 – February 2019, Cohort 2 – December 2019). In Cohort 1, a specific disability identification question asked: ‘Can you please tell me if you identify as someone who has a disability?’. In Cohort 2, an indirect disability identification question asked: ‘Do you require additional assistance or support?’. Other questions explored women’s views on disability identification. Component two consisted of an audit of the medical records to compare disability documentation in the medical records of the women who participated with women’s disability self-identification status. Results: 371/467 (79%) of eligible women that were approached participated in Cohort 1 and in Cohort 2, 295/346 (85%) of eligible women that were approached participated in the study. In Cohort 1, 5% (17/371) of women self-identified with having a disability. In Cohort 2 16% (46/295) of women reported needing additional assistance/support, however of these, only nine women viewed this as a disability. In Cohort 1, of the women who self-identified as having a disability, 82% had this recorded in their medical record. An additional 12% (43/354) of women in Cohort 1 who may have had a disability according to the Australian Bureau of Statistics classification, did not self-identify as having a disability. In Cohort 2, 37% (17/43) of women who self-identified as needing additional support did not have these needs documented in the medical record. Less than a quarter of women in both cohorts were asked about their disability status during their maternity care. Women with a disability or additional support needs suggested both direct and indirect ways of being asked about their disability status, and their responses were similar to women who did not self-identify with having a disability or additional support needs. Conclusions: Disability prevalence data is highly dependant on the wording of the disability identification question. It may be appropriate to ask about disability both indirectly, in terms of additional support needs, and directly, to enable disclosure for those who do identify with a disability. Disability questioning should be routine and standardised guidelines around disability identification should be developed to allow for tailored adjustments to care on an individual level. 2023-04-01T00:00:00Z