scholarly journals Community-based bilingual doulas for migrant women in labour and birth – findings from a Swedish register-based cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Ulrika Byrskog ◽  
Rhonda Small ◽  
Erica Schytt
Keyword(s):  
Nitrous Oxide ◽  
Pain Relief ◽  
Hospital Stay ◽  
Birth Outcomes ◽  
Well Being ◽  
Adverse Outcomes ◽  
Obstetric Outcomes ◽  
Migrant Women ◽  
Community Based ◽  
Nulliparous Women

Abstract Background Community-based bilingual doula (CBD) services have been established to respond to migrant women’s needs and reduce barriers to high quality maternity care. The aim of this study was to compare birth outcomes for migrant women who received CBD support in labour with birth outcomes for (1) migrant women who experienced usual care without CBD support, and (2) Swedish-born women giving birth during the same time period and at the same hospitals. Methods Register study based on data retrieved from a local CBD register in Gothenburg, the Swedish Medical Birth Register and Statistics Sweden. Birth outcomes for migrant women with CBD support were compared with those of migrant women without CBD support and with Swedish-born women. Associations were investigated using multivariable logistic regression, reported as odds ratios (aORs) with 95% confidence intervals (CI), adjusted for birth year, maternal age, marital status, hypertension, diabetes, BMI, disposable income and education. Results Migrant women with CBD support (n = 880) were more likely to have risk factors for adverse pregnancy outcomes than migrant women not receiving CBD support (n = 16,789) and the Swedish-born women (n = 129,706). In migrant women, CBD support was associated with less use of pain relief in nulliparous women (epidural aOR 0.64, CI 0.50–0.81; bath aOR 0.64, CI 0.42–0.98), and in parous women with increased odds of induction of labour (aOR 1.38, CI 1.08–1.76) and longer hospital stay after birth (aOR 1.19, CI 1.03–1.37). CBD support was not associated with non-instrumental births, perineal injury or low Apgar score. Compared with Swedish-born women, migrant women with CBD used less pain relief (nulliparous women: epidural aOR 0.50, CI 0.39–0.64; nitrous oxide aOR 0.71, CI 0.54–0.92; bath aOR 0.55, CI 0.36–0.85; parous women: nitrous oxide aOR 0.68, CI 0.54–0.84) and nulliparous women with CBD support had increased odds of emergency caesarean section (aOR 1.43, CI 1.05–1.94) and longer hospital stay after birth (aOR 1.31, CI 1.04–1.64). Conclusions CBD support appears to have potential to reduce analgesia use in migrant women with vulnerability to adverse outcomes. Further studies of effects of CBD support on mode of birth and other obstetric outcomes and women’s experiences and well-being are needed.

scholarly journals Community-based doula support for migrant women during labour and birth: study protocol for a randomised controlled trial in Stockholm, Sweden (NCT03461640)

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e031290
Author(s):  
Erica Schytt ◽  
Anna Wahlberg ◽  
Amani Eltayb ◽  
Rhonda Small ◽  
Nataliia Tsekhmestruk ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Study Protocol ◽  
Controlled Trial ◽  
Well Being ◽  
Ethical Review ◽  
Control Group ◽  
Migrant Women ◽  
Intrapartum Care ◽  
Community Based ◽  
Randomised Controlled

IntroductionMigrant women consistently rate their care during labour and birth more negatively than non-migrant women, due to communication difficulties, lack of familiarity with how care is provided, and discrimination and prejudicial staff attitudes. They also report being left alone, feeling fearful, unsafe and unsupported, and have poorer birth outcomes than non-migrant women. Community-based doulas (CBDs) are bilingual women from migrant communities who are trained in childbirth and labour support, and who facilitate communication between woman-partner-staff during childbirth. This study protocol describes the design, rationale and methods of a randomised controlled trial that aims to evaluate the effectiveness of CBD support for improving the intrapartum care experiences and postnatal well-being of migrant women giving birth in Sweden.Methods and analysisA randomised controlled trial. From six antenatal care clinics in Stockholm, Sweden, we aim to recruit 200 pregnant Somali, Arabic, Polish, Russian and Tigrinya-speaking women who cannot communicate fluently in Swedish, are 18 years or older and with no contraindications for vaginal birth. In addition to standard labour support, women are randomised to CBD support (n=100) or no such support during labour (n=100). Trained CBDs meet with women once or twice before the birth, provide emotional, physical and communication support to women throughout labour and birth in hospital, and then meet with women once or twice after the birth. Women’s ratings of the intrapartum care experiences and postnatal well-being are assessed at 6–8 weeks after the birth using selected questions from the Migrant Friendly Maternity Care Questionnaire and by the Edinburgh Postnatal Depression Scale. The intervention group will be compared with the control group using intention-to-treat analyses. ORs and 95% CIs will be estimated and adjustments made if key participant characteristics differ between trial arms.Ethics and disseminationThe study was approved by the Regional Ethical Review Board in Stockholm (approval number: 2018/12 - 31/2).Trial registration numberNCT03461640; Pre-results.

scholarly journals Adverse Birth Outcomes among Nulliparous vs. Multiparous Women

2011 ◽  
Vol 126 (6) ◽  
pp. 797-805 ◽  
Author(s):  
Marie Lynn Miranda ◽  
Sharon E. Edwards ◽  
Evan R. Myers
Keyword(s):  
Birth Outcomes ◽  
Live Birth ◽  
Birth Outcome ◽  
Adverse Outcomes ◽  
Adverse Birth Outcomes ◽  
The North ◽  
Nulliparous Women ◽  
Multiparous Women ◽  
The Difference ◽  
Age Adjusted Rates

Objectives. Previous studies indicate that nulliparous women (i.e., women having no previous births) are at higher risk for adverse birth outcomes than multiparous women (i.e., women having had at least one previous birth). We examined whether part of the difference in adverse outcome rates is attributable to nulliparous women with poor pregnancy outcomes being less likely (through choice or fecundity differences) to have a subsequent live birth within the same time period as nulliparous women without adverse outcomes. Methods. Using deterministic matching, we linked nulliparous women from the North Carolina Detailed Birth Record to subsequent births. We employed statistical and simulation-based analyses to estimate first birth outcome rate differences between nulliparous women who did have a subsequent live birth vs. those who did not. Our Markov simulations focused on preterm birth (PTB). Results. Among nulliparous women who were not linked to a second birth, maternal age-adjusted rates of multiple adverse outcomes were all statistically higher compared with rates for linked women. These results also held in race/ethnicity-specific analyses. Simulations found that the relative risk of PTB associated with a history of PTB was underestimated if some women who would have been at risk for PTB did not experience a second birth. Conclusions. The observed differences in rates of adverse outcomes between nulliparous and multiparous women are partly attributable to higher-risk women not having a subsequent live birth, either by choice or due to fecundity differences.

Organizational Justice enhances Subjective Well-being

2016 ◽  
Vol 3 (3) ◽  
Author(s):  
Ms. Anjali Sahai ◽  
Prof. (Dr). Abha Singh
Keyword(s):  
Organizational Justice ◽  
Satisfaction With Life ◽  
Interactional Justice ◽  
Well Being ◽  
Adverse Outcomes ◽  
Satisfaction With Life Scale ◽  
Subjective Well Being ◽  
Negative Experience ◽  
Life Scale ◽  
The Relationship

Organizational Justice has the potential to create major impact on organizations and employees alike. These include greater commitment, trust, enhanced job performance, more citizenship behaviors and less number of conflicts. It has been reported that employees seem to have a universal concern for Justice that transcends the self and that many are subject to biases at various point of time in their work life. Sometimes these biases lead to adverse outcomes including decreased level of subjective well-being. Subjective well-being is a broad category that includes life satisfaction, positive affect, and low negative affect, such as anger, sadness and fear. Thus to study the relationship between Organizational justice and subjective well-being, a sample of 88 employees working in Private Universities of NCR region were examined. For this purpose, the Organizational Justice scales consisting of Measure of Procedural & Interactional Justice and Distributive Justice Index scale by Moorman, Blakely & Niehoff (1998) and Subjective Wellbeing Scales inclusive of the Satisfaction with Life Scale(SWLS),Scale of Positive and Negative Experience(SPANE) and Flourishing Scale (FS) by Ed Diener (2004)were used. Results indicate significant relationship between the three types of Organizational justice and subjective well-being of employees.

Social Capital and Sustainable Health Care: An Analysis of Community Based Palliative Care Model of Kerala

2015 ◽  
Vol 1 (1) ◽  
Author(s):  
Abdul Azeez. E.P
Keyword(s):  
Social Capital ◽  
Palliative Care ◽  
Social Services ◽  
Social Inclusion ◽  
Well Being ◽  
Vital Role ◽  
Voluntary Organizations ◽  
Community Based ◽  
The Social ◽  
Palliative Care Units

Social Capital is the most crucial asset which significantly influence the efficacy and resilience of any community. Social capital is a dependent variable that depends upon the competence and coherence of the individuals in the community and mode of social relationships, trust and networks they maintain. It is one of the most sustainable social resources that originate from human relations and results on the mutual support of people. Utilization of Social capital has a wide applicability in the process of social inclusion, especially in dealing with the vulnerable and disadvantaged sections in the community itself. Voluntary organizations are very keen to utilize the social capital for community/social services and community development in a sustainable manner. Community based de-institutionalized Palliative Care is one of the foremost among such organizations that made social capital in a strategic way for social inclusion and community well being. This paper analyses the extent to which different elements of social capital helps in initiating the sustainable community based palliative care movement by assessing the unique intervention strategies carried out by the palliative care. This paper explores conceptual questions of how social capital and voluntary community based services are correlated. A case study method was adopted for the study in which ten palliative care units were analyzed. The results show that a number of social capital elements are playing a vital role in the sustainability of community palliative care movement in Kerala.

scholarly journals The Cumulative Risk of Chemical and Nonchemical Exposures on Birth Outcomes in Healthy Women: The Fetal Growth Study

2019 ◽  
Vol 16 (19) ◽  
pp. 3700 ◽  
Author(s):  
Leah Zilversmit Pao ◽  
Emily W. Harville ◽  
Jeffrey K. Wickliffe ◽  
Arti Shankar ◽  
Pierre Buekens
Keyword(s):  
Birth Outcomes ◽  
Fetal Growth ◽  
Cumulative Risk ◽  
Logistic Models ◽  
Growth Curves ◽  
Adverse Outcomes ◽  
Risk Scores ◽  
Growth Study ◽  
Race Ethnicity ◽  
Pregnancy Weight

Metals, stress, and sociodemographics are commonly studied separately for their effects on birth outcomes, yet often jointly contribute to adverse outcomes. This study analyzes two methods for measuring cumulative risk to understand how maternal chemical and nonchemical stressors may contribute to small for gestational age (SGA). SGA was calculated using sex-specific fetal growth curves for infants of pregnant mothers (n = 2562) enrolled in the National Institute of Child Health and Human Development (NICHD) Fetal Growth Study. The exposures (maternal lead, mercury, cadmium, Cohen’s perceived stress, Edinburgh depression scores, race/ethnicity, income, and education) were grouped into three domains: metals, psychosocial stress, and sociodemographics. In Method 1 we created cumulative risk scores using tertiles. Method 2 employed weighted quantile sum (WQS) regression. For each method, logistic models were built with three exposure domains individually and race/ethnicity, adjusting for age, parity, pregnancy weight gain, and marital status. The adjusted effect of overall cumulative risk with three domains, was also modeled using each method. Sociodemographics was the only exposure associated with SGA in unadjusted models ((odds ratio) OR: 1.35, 95% (confidence interval) CI: 1.08, 1.68). The three cumulative variables in adjusted models were not significant individually, but the overall index was associated with SGA (OR: 1.17, 95% CI: 1.02, 1.35). In the WQS model, only the sociodemographics domain was significantly associated with SGA. Sociodemographics tended to be the strongest risk factor for SGA in both risk score and WQS models.

scholarly journals POS0719 ADVERSE OUTCOMES AND REHOSPITALIZATION AFTER DELIVERY AMONG WOMEN WITH SYSTEMIC LUPUS ERYTHEMATOSUS OR RHEUMATOID ARTHRITIS AND THEIR INFANTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 609.1-609
Author(s):  
J. Sabo ◽  
N. Singh ◽  
D. A. Crane ◽  
D. R. Doody ◽  
M. A. Schiff ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Hospital Discharge ◽  
Birth Outcomes ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Lupus Erythematosus ◽  
Adverse Outcomes ◽  
Systemic Lupus ◽  
Cesarean Deliveries

Background:Women with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) have greater risk of adverse obstetric and birth outcomes than women without these conditions. Infant outcomes are less well-studied. It is unknown whether re-hospitalization after delivery occurs more often for affected mothers and their infants.Objectives:We compared obstetric outcomes among women with and without RA or SLE, and birth outcomes among their infants. Maternal and infant rehospitalizations <2 years of delivery were also compared.Methods:This population-based cohort study used linked birth-hospital discharge data from Washington State for 1987-2014. International Classification of Disease 9th revision (ICD9) codes identified all women with RA (ICD9 714.X, 725.X) and SLE (ICD9 710, 710.0, 710.1) in the hospital discharge record at delivery, and a 10:1 comparison group of women without these codes. Analyses were restricted to singleton live births (1,223 RA; 1,354 SLE). Poisson regression with robust standard errors estimated relative risks (RR) and 95% confidence intervals (CI) for selected outcomes, accounting for delivery year, maternal age, and parity.Results:Many adverse outcomes were more common among RA and SLE cases than among comparison women. Preeclampsia occurred more often during pregnancies of women with RA (RR 1.42, 95% CI 1.17-1.71) or SLE (RR 2.33, 95% CI 2.01-2.70), as did preterm rupture of membranes (PROM, RR 2.85, 95% CI 2.20-3.72 for RA; RR 3.28, 95% CI 2.54-4.23 for SLE). Cesarean deliveries were more common among nulliparous women in both groups (RR 1.32, 95% CI 1.18-1.48 for both conditions). Infants of women with RA or SLE were more likely to weigh <2500 g (RR 2.08, 95% CI 1.72-2.52 for RA; RR 4.88, 95% CI 4.27-5.58 for SLE), be small for gestational age (RR 1.25, 95% CI 1.07-2.50; RR 2.30; 2.04-2.59, respectively), delivered at <32 weeks gestation (RR 1.83, 95% CI 1.13-2.97; RR 5.13, 95% CI 3.75-7.01, respectively), and require neonatal intensive care unit admission (NICU, RR 1.89, 95% CI 1.56-2.30; RR 2.71, 95% CI 2.25-3.28, respectively). Infants of women with SLE were more likely to have a malformation (RR 1.46, 95% CI 1.21-1.75) or die within 2 years (RR 2.11, 95% CI 1.21-3.67). Rehospitalization levels among both women with RA (RR 2.22; 1.62-3.04) and SLE (RR 2.78, 95% CI 2.15-3.59) were greatest <6 months of delivery and declined over time. Infants of women with SLE had increased rehospitalization <6 months (RR 1.64, 95% CI 1.36-1.98).Conclusion:Consistent with prior literature, we found women with RA or SLE experienced many adverse outcomes. In our data, these included preeclampsia, PROM, and cesarean deliveries, with increased risks more notable among women with SLE. Infants of women with either condition were more likely to weigh <2500g, be <32 weeks gestation, small for gestational age, and require NICU admission than infants of comparison women. Only infants of women with SLE had increased malformations. Maternal rehospitalization after delivery was more common in both groups; most marked at <6 months. Infant rehospitalizations were increased in both cohorts to a lesser extent. Close follow-up during this time period is crucial to minimize adverse outcomes.Disclosure of Interests:Julianna Sabo: None declared, Namrata Singh: None declared, Deborah A. Crane: None declared, David R. Doody: None declared, Melissa A. Schiff: None declared, Beth A. Mueller Shareholder of: Household owns shares in AstraZeneca

Formalization as a tool for environmental peacebuilding? Artisanal and small-scale mining in Liberia and Sierra Leone

2021 ◽  
Vol 97 (1) ◽  
pp. 35-55
Author(s):  
Christina Ankenbrand ◽  
Abrina Welter ◽  
Nina Engwicht
Keyword(s):  
Sierra Leone ◽  
Well Being ◽  
Small Scale ◽  
Transformative Change ◽  
Community Based ◽  
Community Benefits ◽  
Sustainable Peace ◽  
Underlying Causes ◽  
Ethical Sourcing ◽  
The Ideal

Abstract Artisanal and small-scale mining (ASM) has long been a vital source of livelihoods for rural populations in the global South. Yet, it has also been linked to a host of social, political and environmental adversities, including violent conflict. As environmental peacebuilding increasingly stresses the importance of livelihood improvement as a means of fostering peace in conflict-affected extractive societies, ASM formalization has been identified as a solution to mitigate the sector's challenges, thereby addressing underlying causes of conflict. This article critically investigates the contribution of ASM formalization to sustainable peace by focusing on its impact on the livelihood dimension of peacebuilding. It analyses the livelihood impact of three formalization interventions in the diamond sectors of two countries: cooperatives in Liberia, and, in Sierra Leone, ethical sourcing schemes and a community-based natural resource management initiative. In line with calls for a paradigm shift from a narrow legalization-centred understanding of formalization to a broader approach that accounts for livelihood quality, the analysis presented here focuses on interventions that were informed by the ideal of improving the well-being of ASM workers and communities. We propose three pathways through which ASM formalization could potentially contribute to livelihood enhancement: income security, working conditions and community benefits. Based on fieldwork, this article highlights the challenges of generating livelihood improvements through formalization. Even when specifically designed to address the needs of ASM communities, during implementation, they risk prioritizing a narrow conceptualization of formalization and thus failing to become a conductor of transformative change.

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