scholarly journals Consent in pregnancy - an observational study of ante-natal care in the context of Montgomery: all about risk?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jacqueline A. Nicholls ◽  
Anna L. David ◽  
Joseph Iskaros ◽  
Dimitrios Siassakos ◽  
Anne Lanceley
Keyword(s):  
Qualitative Research ◽  
Observational Study ◽  
Pregnant Women ◽  
Social Factors ◽  
Healthcare Professionals ◽  
Effective Interaction ◽  
Clinical Decision ◽  
Place Of Birth ◽  
Clinical Risk ◽  
In Pregnancy

Abstract Background How to best support pregnant women in making truly autonomous decisions which accord with current consent law is poorly understood and problematic for them and their healthcare professionals. This observational study examined a range of ante-natal consultations where consent for an intervention took place to determine key themes during the encounter. Methods Qualitative research in a large urban teaching hospital in London. Sixteen consultations between pregnant women and their healthcare professionals (nine obstetricians and three midwives) where ante-natal interventions were discussed and consent was documented were directly observed. Data were collectively analysed to identify key themes characterising the consent process. Results Four themes were identified: 1) Clinical framing - by framing the consultation in terms of the clinical decision to be made HCPs miss the opportunity to assess what really matters to a pregnant woman. For many women the opportunity to feel that their previous experiences had been ‘heard’ was an important but sometimes neglected prelude to the ensuing consultation; 2) Clinical risk dominated narrative - all consultations were dominated by information related to risk; discussion of reasonable alternatives was not always observed and women’s understanding of information was seldom verified making compliance with current law questionable; 3) Parallel narrative - woman-centred experience – for pregnant women social factors such as the place of birth and partner influences were as or more important than considerations of clinical risk yet were often missed by HCPs; 4) Cross cutting narrative - genuine dialogue - we observed variably effective interaction between the clinical (2) and patient (3) narratives influenced by trust and empathy and explicit empowering language by HCPs. Conclusion We found that ante-natal consultations that include consent for interventions are dominated by clinical framing and risk, and explore the woman-centred narrative less well. Current UK law requires consent consultations to include explicit effort to gauge a woman’s preferences and values, yet consultations seem to fail to achieve such understanding. At the very least, consultations may be improved by the addition of opening questions along the lines of ‘what matters to you most?’

scholarly journals Influenza and pertussis vaccination in pregnancy: Portrayal in online media articles and perceptions of pregnant women and healthcare professionals

Vaccine ◽  
2018 ◽  
Vol 36 (50) ◽  
pp. 7625-7631 ◽  
Author(s):  
Christopher R Wilcox ◽  
Kathryn Bottrell ◽  
Pauline Paterson ◽  
William S Schulz ◽  
Tushna Vandrevala ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Healthcare Professionals ◽  
Online Media ◽  
In Pregnancy

scholarly journals Healthcare Professionals’ Beliefs, Attitudes, Knowledge, and Behavior Around Vaping in Pregnancy and Postpartum: A Qualitative Study

2020 ◽  
Author(s):  
Abby Hunter ◽  
Judith Yargawa ◽  
Caitlin Notley ◽  
Michael Ussher ◽  
Alex Bobak ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Healthcare Professionals ◽  
Training Needs ◽  
Attitudes And Behaviors ◽  
Quit Smoking ◽  
Pregnancy And Postpartum ◽  
And Behaviors ◽  
And Behavior ◽  
And Training ◽  
In Pregnancy

Abstract Introduction Finding effective ways to help pregnant women quit smoking and maintain long-term abstinence is a public health priority. Electronic cigarettes (ie, vaping) could be a suitable cessation tool in pregnancy for those who struggle to quit; however, healthcare professionals (HCP) must be informed about these devices to offer appropriate advice. This study used the Capability, Opportunity, Motivation, and Behavior (COM-B) model and Theoretical Domains Framework (TDF) to explore HCP attitudes towards vaping in pregnancy and postpartum; beliefs about the health risks of vaping; perceived barriers and facilitators of vaping in pregnancy; knowledge of current guidelines and policies; and training needs. Methods Interviews (n = 60) were conducted with midwives (n = 17), health visitors (n = 10), general practitioners (n = 15) and stop smoking specialists (n = 18) across the United Kingdom. Interview transcriptions were analyzed thematically using the framework approach and the COM-B. Results Discussing vaping as a tool for quitting smoking in pregnancy was prevented by a lack of capability (limited knowledge of vaping, lack of training in smoking cessation); lack of opportunity (restricted by organizational policies and guidelines, lack of time and financial issues impacting on training), and negative social influences (sensationalist media and stigma associated with vaping in pregnancy); and lack of motivation (fear of future litigation and comebacks should adverse effects from vaping arise). Conclusions Factors related to capability, opportunity, and motivation were identified that influence HCPs attitudes and behaviors towards vaping in pregnancy. Gaps in knowledge and training needs were identified, which could inform the development of targeted vaping training. Implications Vaping could be suitable in pregnancy for those struggling to quit smoking. However, HCPs must be informed about these devices to offer appropriate advice. These data extend our knowledge of factors influencing HCP attitudes and behaviors towards vaping in pregnancy. Generally, vaping was perceived as safer than cigarettes, but a perceived lack of evidence, health and safety risks, dependency, and regulation issues were concerning. Considering our findings, greater efforts are needed to ensure HCPs are sufficiently informed about vaping and guidelines available. More importance should be placed on training for all HCPs who have contact with pregnant women.

scholarly journals Observational study on dietary patterns in pregnancy

2021 ◽  
Vol 16 (2) ◽  
pp. 259-264
Author(s):  
Alina Delia POPA ◽  
◽  
Lavinia CABA ◽  
Armand ENACHE ◽  
Carmen MIHALACHE ◽  
...  
Keyword(s):  
Observational Study ◽  
Pregnant Women ◽  
Dietary Patterns ◽  
Fast Food ◽  
Average Energy ◽  
Food Factor ◽  
Food Patterns ◽  
Main Component ◽  
Inadequate Nutrition ◽  
In Pregnancy

Pregnancy nutrition influences the short-term maternal and fetal prognosis, but also the state of health in the future, an inadequate diet being associated with the risk of chronic diseases in adulthood. The purpose of the study is to characterize the diet of a group of pregnant women in Iasi county in terms of macronutrient intake, but also food patterns. Material and methods. An observational study was performed on a sample of 400 pregnant women which consisted in the application of a validated food frequency questionnaire. The foods consumed were grouped into categories: meat, eggs, fish, milk and dairy products, bread and cereals, vegetables, fruits, soups, seeds and oilseeds, sweets and fast food. Factor analysis (main component analysis method) was used for the analysis of food patterns. Results. The average energy intake in the studied group was 2197 kcal/day (95% CI: 2139.57-2255.74). The intake of macronutrients during pregnancy was 86.01 g protein (95% CI: 83.64-88.39), 76.97 g lipids (95% CI: 74.59-79.35) and 297.12 g carbohydrate (95% Cl: 287.86-306.38). We identified 3 dietary patterns that explained 43.01% of the variation of consumption behaviour: healthy consumption, consisting of a diet rich in soups, fruits, eggs and vegetables; traditional consumption, which has high consumption values for bread, dairy, meat, fat and unhealthy consumption rich in the intake of sweets, fast food and seeds. Conclusions. The identified food patterns draw attention to the existence of a category at risk of developing pathology related to inadequate nutrition in pregnancy.

scholarly journals The Role of Husband in Assisting Wife Who Suffer Anemia in Pregnancy

2017 ◽  
Vol 13 (1) ◽  
pp. 28-34
Author(s):  
Angelina Da Costa Fernandes
Keyword(s):  
Qualitative Research ◽  
Iron Deficiency ◽  
Focus Groups ◽  
Pregnant Women ◽  
Descriptive Analysis ◽  
Sampling Technique ◽  
Depth Interview ◽  
Anemia In Pregnancy ◽  
In Pregnancy

Problem in anemia which is commonly suffered by pregnant women is iron deficiency due to unbalanced nutrition. A qualitative research with Ethnomethodology approach. Participants were pregnant women who are anemic with Hemoglobin levels (Hb) less than 11g/dl. 38 of participants consisting of 19 husbands as focus groups and 19 wives as triangulation group obtained through purposive sampling technique. Data obtained through the method of focus groups discussion and in-depth interview, analyzed using descriptive analysis techniques.The result showed that the husbands role in assisting the wife who suffered from anemia in pregnancy is lacking due to lack of husbnd knowledge about anemia, its causes and how to deal with anemia in pregnancy. The conclusion is the role of husband in assisting wife in pregnancy should be supported with husbands good knowledge about anemia, its causes and how to deal with anemia in pregnancy in order to prevent anemia in their wives pregnancies.

scholarly journals Determinants of influenza and pertussis vaccination uptake in pregnancy: a multi-centre questionnaire study of pregnant women and healthcare professionals

2019 ◽  
Vol 69 (suppl 1) ◽  
pp. bjgp19X703301
Author(s):  
Christopher Wilcox ◽  
Anna Calvert ◽  
Jane Metz ◽  
Eliz Kilich ◽  
Rachael Macleod ◽  
...  
Keyword(s):  
Primary Care ◽  
Pregnant Women ◽  
Odds Ratio ◽  
Healthcare Professionals ◽  
Hospital Setting ◽  
Uptake Rates ◽  
Alternative Sites ◽  
Routine Antenatal Care ◽  
Logistical Barrier ◽  
In Pregnancy

BackgroundUptake rates of influenza and pertussis vaccination in pregnancy remain suboptimal.AimTo determine the acceptability of routine vaccination among pregnant women; the confidence of maternity healthcare professionals (HCPs) discussing vaccination; and HCP opinion with regards to the optimum healthcare site for vaccine administration.MethodSeparate questionnaires for pregnant women and maternity HCPs were distributed within four NHS trusts in South England from July 2017–January 2018.ResultsResponses from 314 pregnant women and 204 HCPs (18% obstetricians, 75% midwives [both hospital and community], 7% unidentified) were analysed. Actual/intended uptake of influenza and pertussis vaccination was 78% and 92%, respectively. The commonest reason for declining vaccination was feared side effects for their child. White British women (79%) were significantly more accepting of influenza (odds ratio [OR] 3.25, 95% confidence interval [CI] = 1.67 to 6.32) and pertussis vaccination (OR 4.83, 95% CI = 1.77 to 13.19) compared with non-white British women. Among HCPs, 25% were not-at-all or slightly confident discussing vaccination. Obstetricians felt significantly more confident discussing pertussis vaccination than midwives (OR 2.05, 95% CI = 1.02 to 4.12). Among HCPs, 53%, 25%, and 16% thought vaccines should be administered in primary care (general practice), community midwifery, and the hospital setting, respectively.ConclusionMisconceptions exist regarding safety and efficacy of maternal vaccination, and framing information towards safety for the child may increase uptake. Education of HCPs is essential, and vaccine promotion should be incorporated into routine antenatal care, with an emphasis on women from ethnic minorities. Administration of vaccines in primary care may present a logistical barrier to women, however support for alternative sites appears low among HCPs.

TO REVIEW THE TIMING OF INTERVENTION WHICH WILL PROVIDE THE BEST OUTCOME IN HYPOTHYROIDISM IN PREGNANCY

2019 ◽  
Vol 3 (4) ◽  
Author(s):  
Dr. Archana Mohana ◽  
Dr. Sujata Badoniya
Keyword(s):  
Pregnant Women ◽  
Thyroid Disease ◽  
Fetal Outcome ◽  
Thyroxine Therapy ◽  
In Pregnancy

The Aim of this study is to Review the timing of intervention which will provide the Best Outcome in Hypothyroidism in Pregnancy. Hypothyroid pregnant women are appropriately managed with regular antenatal checkup and thyroxine therapy during pregnancy, a good maternal and fetal outcome can be achieved and congenital cretinism and other neuro developmental sequele in the offspring can be averted. Keywords: Intervention, Hyperthyroidism, Pregnancy & Thyroid disease.

A COMPARATIVE STUDY OF IODINE METABOLISM IN PREGNANCY, SPORADIC GOITRE AND THYROTOXICOSIS

1965 ◽  
Vol 48 (1) ◽  
pp. 14-22 ◽  
Author(s):  
S. A. Aboul-Khair ◽  
J. Crooks
Keyword(s):  
Comparative Study ◽  
Pregnant Women ◽  
Iodine Deficiency ◽  
Physiological Responses ◽  
Iodine Uptake ◽  
Thyroid Activity ◽  
Deficiency State ◽  
Iodine Metabolism ◽  
Inorganic Iodine ◽  
In Pregnancy

ABSTRACT Studies of iodine metabolism have been carried out in 15 pregnant women, 33 cases with sporadic goitre and 11 with thyrotoxicosis. A low plasma inorganic iodine was common to the three groups. In pregnancy and sporadic goitre the thyroid clearance of iodine was elevated and the absolute iodine uptake normal. A high thyroid clearance of iodine in thyrotoxicosis was associated with a high absolute iodine uptake. The results suggest that both pregnancy and sporadic goitre are physiological responses to an iodine deficiency state while the iodine deficiency state of thyrotoxicosis is secondary to increased thyroid activity.

LEUCOCYTE METABOLISM IN PREGNANCY

1960 ◽  
Vol XXXV (IV) ◽  
pp. 575-584 ◽  
Author(s):  
C. Borel ◽  
J. Frei ◽  
A. Vannotti
Keyword(s):  
Alkaline Phosphatase ◽  
Oxygen Consumption ◽  
Pregnant Women ◽  
Phosphatase Activity ◽  
Alkaline Phosphatase Activity ◽  
Lactate Production ◽  
Glucose Consumption ◽  
In Pregnancy

ABSTRACT Enzymatic studies, on leucocytes of pregnant women, show an increase of the alkaline phosphatase activity and a decrease of the glucose consumption and lactate production, as well as of proteolysis. The oxygen consumption, with succinate as substrate, does not vary.

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