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Midwifery, maternity, pregnancy.

Ellie Wernham, Jason Gurney, James Stanley, Lis Ellison-Loschmann, Diana Sarfati
BACKGROUND: Internationally, a typical model of maternity care is a medically led system with varying levels of midwifery input. New Zealand has a midwife-led model of care, and there are movements in other countries to adopt such a system. There is a paucity of systemic evaluation that formally investigates safety-related outcomes in relationship to midwife-led care within an entire maternity service. The main objective of this study was to compare major adverse perinatal outcomes between midwife-led and medical-led maternity care in New Zealand...
September 2016: PLoS Medicine
Dorothy Shaw, Jeanne-Marie Guise, Neel Shah, Kristina Gemzell-Danielsson, K S Joseph, Barbara Levy, Fontayne Wong, Susannah Woodd, Elliott K Main
In high-income countries, medical interventions to address the known risks associated with pregnancy and birth have been largely successful and have resulted in very low levels of maternal and neonatal mortality. In this Series paper, we present the main care delivery models, with case studies of the USA and Sweden, and examine the main drivers of these models. Although nearly all births are attended by a skilled birth attendant and are in an institution, practice, cadre, facility size, and place of birth vary widely; for example, births occur in homes, birth centres, midwifery-led birthing units in hospitals, and in high intervention hospital birthing facilities...
September 14, 2016: Lancet
Sarah R Chwah, Amanda Reilly, Beverley Hall, Anthony J O'Sullivan, Amanda Henry
AIMS: To compare pregnancy care, maternal and neonatal outcomes of women with Body Mass Index (BMI) >30 enrolled in a Weight Intervention Group versus other models of antenatal care. METHODS: Retrospective, case-control study of mothers with BMI >30 managed with a specialised programme versus age-matched women enrolled in standard models of care. RESULTS: One thousand, one hundred and fifteen of 9954 pregnant women with singleton pregnancies, had a BMI >30, of whom 9...
September 2016: Obstetric Medicine
Marije Lamain-de Ruiter, Anneke Kwee, Christiana A Naaktgeboren, Inge de Groot, Inge M Evers, Floris Groenendaal, Yolanda R Hering, Anjoke J M Huisjes, Cornel Kirpestein, Wilma M Monincx, Jacqueline E Siljee, Annewil Van 't Zelfde, Charlotte M van Oirschot, Simone A Vankan-Buitelaar, Mariska A A W Vonk, Therese A Wiegers, Joost J Zwart, Arie Franx, Karel G M Moons, Maria P H Koster
OBJECTIVE:  To perform an external validation and direct comparison of published prognostic models for early prediction of the risk of gestational diabetes mellitus, including predictors applicable in the first trimester of pregnancy. DESIGN:  External validation of all published prognostic models in large scale, prospective, multicentre cohort study. SETTING:  31 independent midwifery practices and six hospitals in the Netherlands. PARTICIPANTS:  Women recruited in their first trimester (<14 weeks) of pregnancy between December 2012 and January 2014, at their initial prenatal visit...
2016: BMJ: British Medical Journal
Brigitte B M Tebbe, Berend Terluin, Mireille N M van Poppel
OBJECTIVE: the Four-Dimensional Symptom Questionnaire (4DSQ) measures four dimensions of common psychopathology: distress, depression, anxiety and somatization. The instrument is developed and validated for general practice. A previous validation study of the 4DSQ for midwifery practice indicated that pregnant women respond differently to the items of the 4DSQ. This phenomenon is called item bias. The present study is a followup validation study in which pregnant women were followed up until one year post partum, to assess pregnancy-related item bias...
September 2016: Midwifery
Joeri Vermeulen, Eva Swinnen, Florence D'haenens, Ronald Buyl, Katrien Beeckman
OBJECTIVE: to explore women's preferences with regard to their preferred health professional during labour and childbirth in case of an uncomplicated pregnancy, and to gain insight into women's knowledge of the legal competences of midwives. DESIGN: a descriptive observational study. SETTING: Brussels metropolitan region, Belgium. PARTICIPANTS: women in their reproductive age, living in the Brussels metropolitan region, with Dutch or French as their first language (n=830)...
September 2016: Midwifery
Sue Kruske, Sue Kildea, Bec Jenkinson, Jennifer Pilcher, Sarah Robin, Margaret Rolfe, Jude Kornelsen, Lesley Barclay
BACKGROUND: Primary Maternity Units (PMUs) offer less expensive and potentially more sustainable maternity care, with comparable or better perinatal outcomes for normal pregnancy and birth than higherlevel units. However, little is known about how these maternity services operate in rural and remote Australia, in regards to location, models of care, service structure, support mechanisms or sustainability. This study aimed to confirm and describe how they operate. DESIGN: a descriptive, cross-sectional study was undertaken, utilising a 35-item survey to explore current provision of maternity care in rural and remote PMUs across Australia...
September 2016: Midwifery
Q Wang, L H Wang, A L Wang, F Wang, X Y Wang, Y P Qiao, M Su, L X Dou, L W Fang
OBJECTIVE: To describe the changing demographic profile over time of pregnant women diagnosed with HIV infection, and trends in mode of delivery and pregnancy outcome. METHODS: An observational investigation was conducted based on a population of 1 128 HIV-positive pregnant women at eight sites in China in provinces with high prevalence of HIV among pregnant women and children between 2007 and 2013. The study area included Shangcai and Weishi counties in Henan province; Ruili and Longchuan counties and Linxiang prefecture in Yunnan province; Yining County in Xinjiang; and Lingshan county and Babu district in Guangxi province...
July 6, 2016: Zhonghua Yu Fang Yi Xue za Zhi [Chinese Journal of Preventive Medicine]
Wendy E Brodribb, Benjamin L Mitchell, Mieke L van Driel
BACKGROUND: While there is a significant focus on the health and well-being of women during pregnancy, labour and birth, much less emphasis is placed on the care of postpartum women and their infants in primary care following the birth. Some studies have investigated the role of GPs in postpartum care, and others examined facilitators and barriers to mothers accessing care. However there is little information available to investigate the effect of practice related factors on access to care of mothers and infants at this time...
2016: BMC Health Services Research
Sara E Borrelli, Helen Spiby, Denis Walsh
BACKGROUND: The literature review reveals general information about a good midwife from a range of perspectives and what childbearing women generally value in a midwife, but there is a lack of information around mothers' perspectives of what makes a good midwife specifically during labour and birth, and even less in the context of different places of birth. AIM: To conceptualise first-time mothers' expectations and experiences of a good midwife during childbirth in the context of different birthplaces...
August 2016: Midwifery
A N Rosman, F Vlemmix, S Ensing, B C Opmeer, S Te Hoven, J Velzel, M de Hundt, S van den Berg, H Rota, J A M van der Post, B W J Mol, M Kok
OBJECTIVE: to assess the mode of childbirth and adverse neonatal outcomes in women with a breech presentation with or without an external cephalic version attempt, and to compare the mode of childbirth among women with successful ECV to women with a spontaneous cephalic presentation. DESIGN: prospective matched cohort study. SETTING: 25 clusters (hospitals and its referring midwifery practices) in the Netherlands. Data of the Netherlands perinatal registry for the matched cohort...
August 2016: Midwifery
Ethelwynn L Stellenberg, Nompumelelo L Ngwekazi
BACKGROUND: Many factors or medical conditions may influence the outcome of pregnancy,which in turn, may increase infant and maternal morbidity and mortality. One such condition is an increase in blood pressure (BP). SETTING: The study was conducted in maternity obstetrical units (MOUs) in primary healthcare clinics (PHCs) in the Eastern Cape, South Africa. OBJECTIVES: To determine the knowledge about hypertensive disorders during pregnancy (HDPs) of registered midwives working in MOUs in PHCs...
2016: African Journal of Primary Health Care & Family Medicine
Giulia Dante, Isabella Neri, Raffaele Bruno, Chiara Salvioli, Fabio Facchinetti
BACKGROUND: In many countries midwives are the primary providers of care for childbearing women. The aim of the present study was to compare the outcomes of childbirth occurring in the birth benter (midwifery-lead) vs. the traditional delivery room organization (doctor-lead) of the Policlinico of Modena Hospital. METHODS: A prospective observational study was conducted over four years. At 35-36th week, women with a single, uneventful pregnancy, being classified at low-risk according to The National Institute for Health and Care Excellence (NICE) guidelines on intrapartum care, were offered to deliver with standard care assistance (SC) in a doctors-led unit or in the Birth Centre (BC)...
June 2016: Minerva Ginecologica
Marianne Mitchell
Midwives in the UK should have appropriate education in order to provide optimum care for women with female genital mutilation (FGM) and know how to safeguard any children who could be at risk. In addition to this, women with FGM have a right to progress though their pregnancy and beyond, safely and confidently, in a supportive environment, and must be empowered to do so. Efforts are being strengthened by the government to tackle the issue of FGM and prevent further cases; therefore all those working in maternity care need to ensure they are equipped to deal with this issue...
April 2016: Practising Midwife
Tomas Pantoja, Edgardo Abalos, Evelina Chapman, Claudio Vera, Valentina P Serrano
BACKGROUND: Postpartum haemorrhage (PPH) is the single leading cause of maternal mortality worldwide. Most of the deaths associated with PPH occur in resource-poor settings where effective methods of prevention and treatment - such as oxytocin - are not accessible because many births still occur at home, or in community settings, far from a health facility. Likewise, most of the evidence supporting oxytocin effectiveness comes from hospital settings in high-income countries, mainly because of the need of well-organised care for its administration and monitoring...
April 14, 2016: Cochrane Database of Systematic Reviews
Jamila Arrish, Heather Yeatman, Moira Williamson
BACKGROUND: Maternal nutrition during pregnancy affects the health of the mother and the baby. Midwives are ideally placed to provide nutrition education to pregnant women. There is limited published research evidence of Australian midwives' nutrition knowledge, attitudes and confidence. AIM: To investigate Australian midwives' nutrition knowledge, attitudes and confidence in providing nutrition education during pregnancy. METHODS: Members of the Australian College of Midwives (n=4770) were sent an invitation email to participate in a web-based survey, followed by two reminders...
March 25, 2016: Women and Birth: Journal of the Australian College of Midwives
Sue Kildea, Yu Gao, Margaret Rolfe, Cathryn M Josif, Sarah J Bar-Zeev, Malinda Steenkamp, Sue Kruske, Desley Williams, Terry Dunbar, Lesley M Barclay
OBJECTIVE: to compare the quality of care before and after the introduction of the new Midwifery Group Practice. DESIGN: a cohort study. SETTING: the health centers (HCs) in two of the largest remote Aboriginal communities (population 2200-2600) in the Top End of the Northern Territory (NT), each located approximately 500km from Darwin. The third study site was the Royal Darwin Hospital (RDH) which provides tertiary care. METHODS: a 2004-06 retrospective cohort (n=412 maternity cases) provided baseline data...
March 2016: Midwifery
Yvonne J Fontein-Kuipers, Marlein Ausems, Raymond de Vries, Marianne J Nieuwenhuijze
We evaluated the effect of the intervention WazzUp Mama?! on antenatal maternal distress in a non-randomized pre-post study including healthy women in 17 Dutch midwifery practices. The control group (n = 215) received antenatal care-as-usual. The experimental group (n = 218) received the intervention. Data were collected at the first and third trimester of pregnancy. Maternal distress (MD) was measured with the Edinburgh Depression Scale (EDS), State-Trait Anxiety Inventory (STAI), and Pregnancy-Related Anxiety Questionnaire (PRAQ)...
October 2016: Archives of Women's Mental Health
Y Tony Yang, Laura B Attanasio, Katy B Kozhimannil
BACKGROUND: Despite research indicating that health, cost, and quality of care outcomes in midwife-led maternity care are comparable with and in some case preferable to those for patients with physician-led care, midwifery plays a more important role in some U.S. states than in others. However, this variability is not well-understood. OBJECTIVES: This study estimates the association between state scope of practice laws related to the autonomy of midwifery practice with the certified nurse-midwifery (CNM) workforce, access to midwife-attended births, and childbirth-related procedures and outcomes...
May 2016: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
Catherine McParlin, Debbie Carrick-Sen, Ian N Steen, Stephen C Robson
OBJECTIVE: To assess the feasibility of implementing a complex intervention involving rapid intravenous rehydration and ongoing midwifery support as compared to routine in-patient care for women suffering from severe nausea and vomiting in pregnancy, (NVP)/hyperemesis gravidarum (HG). STUDY DESIGN: 53 pregnant women attending the Maternity Assessment Unit (MAU), Newcastle upon Tyne NHS Foundation Trust, Newcastle, UK with moderate-severe NVP, (as determined by a Pregnancy Unique Quantification of Emesis and Vomiting [PUQE] score ≥nine), consented to participate in this pilot randomised controlled trial (RCT)...
May 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
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