http://localhost:8080/xmlui/handle/123456789/11213 2026-04-11T21:07:42Z http://localhost:8080/xmlui/handle/123456789/11377 Title: Women’s expectations, preferences and needs in midwifery care – results from the qualitative Midwifery Care (MiCa) study: Childbirth and early parenthood Authors: Makarova, Nataliya; Janke, Toni Maria; Schmittinger, Janne; Agricola, Caroline Johanna; Ebinghaus, Merle; Blome, Christine; Zyria, Birgit-Christiane Abstract: Objective: The main goals of our study were (I) the investigation of expectations and preferences as well as (II) the determination of needs of women in regard to midwifery care. Design: Descriptive phenomenology was used to investigate the ways in which women experienced childbirth and early parenthood. A descriptive qualitative research design was chosen, using focus groups. Setting: ix online focus groups were carried out with 19 women for this part of the Midwifery Care (MiCa) study, mainly from the north of Germany. Participants: Women shortly after birth, in puerperium and the first year after childbirth were recruited in Germany. A purposeful strategy according to maximum variation sampling was applied to reach diversity in the sample regarding age and previous children. Data were analysed using qualitative content analysis, according to Mayring, with support of the qualitative data analysis software MAXQDA 2022. Findings: Six main categories were derived for both childbirth and early parenthood: (a) involvement of family, (b) need for information, (c) physical and psychological aspects and (d) orientation in the healthcare system. In each group, one main category about provision of healthcare was developed: (e) care around childbirth and (f) midwifery care in early parenthood. Women attached great importance to the communication with midwives and favoured the involvement of their partners in the childbirth process and during parenting. Based on different experiences and inconsistency of information, women would prefer consistency in staff and communication as well as standardised information. Conclusions: From the user’s perspective, midwifery care is crucial during childbirth and the child’s first year of life. Current health care during and after childbirth and early parenthood lacks individualised care models, emotional support, adequate and professional communication between different health care providers, and consistency in midwifery care. Our findings should be translated into health care delivery with effective interprofessional teamwork within the continuity of midwifery care. Further quantitative research should analyse the individual healthcare situations of women in the reproductive phase of their life as well as of the applied healthcare models in order to personalise care and to improve healthcare quality. 2024-04-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/11376 Title: Women’s caesarean section preferences: A multicountry cross-sectional survey in low- and middle-income countries Authors: Etcheverry, Camille; Betran, Ana Pilar; Loenzien, Myriam de; Kabor´e, Charles; Lumbiganon, Pisake; Carroli, Guillermo; Mac, Quoc Nhu Hung; Gialdini, Celina Abstract: Objective: To measure the proportion of women’s preferences for CS in hospitals with high caesarean section rates and to identify related factors. Design: A cross-sectional hospital-based postpartum survey was conducted. We used multilevel multivariate logistic regression and probit models to analyse the association between women’s caesarean section preferences and maternal characteristics. Probit models take into account selection bias while excluding women who had no preference. Setting: Thirty-two hospitals in Argentina, Thailand, Vietnam and Burkina Faso were selected. Participants: A total of 1,979 post-partum women with no potential medical need for caesarean section were included among a representative sample of women who delivered at each of the participating facilities during the data collection period. Findings: The overall caesarean section rate was 23.3 %. Among women who declared a preference in late pregnancy, 9 % preferred caesarean section, ranging from 1.8 % in Burkina Faso to 17.8 % in Thailand. Primiparous women were more likely to prefer a caesarean section than multiparous women (β=+0.16 [+0.01; +0.31]; p = 0.04). Among women who preferred caesarean section, doctors were frequently cited as the main influencers, and “avoid pain in labour” was the most common perceived benefit of caesarean section. Key conclusions: Our results suggest that a high proportion of women prefer vaginal birth and highlight that the preference for caesarean section is linked to women’s fear of pain and the influence of doctors. These results can inform the development of interventions aimed at supporting women and their preferences, providing them with evidence-based information and changing doctors’ behaviour in order to reduce the number of unnecessary caesarean sections. 2024-03-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/11375 Title: What is ‘physiological birth’? A scoping review of the perspectives of women and care providers Authors: Henshall, Brooke I.; Grimes, Heather A.; Davis, Jennifer; East, Christine E. Abstract: Problem: Physiological birth was defined by the World Health Organization in 1997, however, clinical practices in childbirth have changed considerably since this time. Background: Ambiguous terms in healthcare such as ‘physiological birth’ may cause confusion amongst care providers and consumers. Aim: To identify what is known about physiological birth, and how perceptions of physiological birth manifest in current literature. Methods: This review followed the Joanna Briggs Institute methodology for scoping reviews and the PRISMA-ScR checklist. Four databases were searched using keywords relating to physiological birth. Relevant studies were identified using agreed criteria, and data were extracted and synthesised. Results: A total of 24 studies met the inclusion criteria for this review. Three connected factors were identified: (1) Physiological birth in a risk-averse system, (2) Dominant voices in birth, and (3) Lack of exposure to physiological birth. No unified universal definition of physiological birth was identified in the literature. Discussion: ‘Physiological birth’ as a term lacks consistency. A risk-averse healthcare system could be a barrier to physiological birth. Dominant voices in the birthing space can dictate the way birth occurs. Lack of exposure to physiological birth may diminish the acquisition and maintenance of important skills and knowledge among care providers. Recognising the factors important to women could lead to a positive birth experience. Conclusion: Excluding a woman’s subjective experience from health professionals’ understanding of physiological birth increases the likelihood of risk management being the paramount objective in clinical decision-making. We propose it is timely to align clinical understanding of physiological birth with midwifery’s woman-centred professional philosophy. 2024-02-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/11374 Title: UK student midwives’ theoretical knowledge, confidence, and experience of intermittent auscultation of the fetal heart rate during labour: An online cross-sectional survey Authors: Phillips, K.; Sanders, J.; Warren, L.E. Abstract: Aim: This study aimed to explore student midwives’ theoretical knowledge of intrapartum intermittent auscultation, their confidence in, and their experience of this mode of fetal monitoring. Design and Setting: An online cross-section survey with closed and open questions. Descriptive statistics were used to analyse participants’ intermittent auscultation knowledge, confidence, and experience. Reflexive thematic analysis was used to identify patterns within the free text about participants’ experiences. Participants: Undergraduate midwifery students (n = 303) from Nursing and Midwifery Council-approved educational institutions within the United Kingdom. Findings: Most participants demonstrated good theoretical knowledge. They had witnessed the technique being used in clinical practice, and when performed, the practice was reported to be in line with national guidance. In closed questions, participants reported feeling confident in their intermittent auscultation skills; however, these data contrasted with free-text responses. Conclusion: This cross-sectional survey found that student midwives possess adequate knowledge of intermittent auscultation. However, reflecting individual clinical experiences, their confidence in their ability to perform intermittent auscultation varied. A lack of opportunity to practice intermittent auscultation, organisational culture, and midwives’ preferences have caused student midwives to question their capabilities with this essential clinical skill, leaving some with doubt about their competency close to registration. 2024-02-01T00:00:00Z