scholarly journals A daunting journey: A qualitative comparative study of women’s experiences of accessing midwifery care

2021 ◽  
Vol 57 ◽  
Author(s):  
Adrienne Priday ◽  
Deborah Payne ◽  
Marion Hunter
Keyword(s):  
Neonatal Mortality ◽  
Maternity Care ◽  
Smooth Transition ◽  
Structured Interviews ◽  
Midwifery Care ◽  
Health Region ◽  
Early Access ◽  
Before And After ◽  
Multiparous Women ◽  
Economically Deprived

Background: Early engagement with a maternity carer is recommended as a means of reducing stillbirth and neonatal mortality. This is especially important for women who live in high deprivation areas, as these areas have been associated with late access to maternity/midwifery care and significantly higher rates of stillbirth and neonatal mortality. Co-locating midwives at general practitioner (GP) clinics in such an area was established with the aim of facilitating women’s early access to midwifery care. Aim: To explore the experience of multiparous women who live in socio-economically deprived communities within the Counties Manukau Health region and who accessed the services of midwives at co-located clinics. Method: Interpretive descriptive methodology was used to explore the experiences of each woman before and after using a co-located midwifery clinic. One-to-one, semi-structured interviews were undertaken and data examined using thematic analysis. Findings: The eight women interviewed found accessing Lead Maternity Care (LMC) midwives during early pregnancy a daunting journey before being able to use a co-located clinic in the Counties Manukau Health region. Barriers identified were: a lack of knowledge about how to find a LMC midwife, limited finance and limited time. These impacted on women’s ability and confidence to find a suitable LMC midwife. The women expressed the need for help to circumvent the maternity care maze through receiving a recommendation for a LMC midwife and having access to a midwife co-located at their GP clinic. Conclusions: The participants encountered numerous barriers accessing early LMC midwifery care. Enablers to accessing early LMC midwifery care include receiving recommendations from GP clinic personnel, and midwives being co-located at GP clinics to make maternity care convenient and with a smooth transition from GP to LMC midwife care.

scholarly journals Women’s characteristics and care outcomes of caseload midwifery care in the Netherlands: a retrospective cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Pien Offerhaus ◽  
Suze Jans ◽  
Chantal Hukkelhoven ◽  
Raymond de Vries ◽  
Marianne Nieuwenhuijze
Keyword(s):  
The Netherlands ◽  
Maternity Care ◽  
Perinatal Outcomes ◽  
Vaginal Birth ◽  
Current Effort ◽  
Midwifery Care ◽  
Caseload Midwifery ◽  
Multiparous Women ◽  
Mode Of Birth ◽  
Care Outcomes

Abstract Background The maternity care system in the Netherlands is well known for its support of community-based midwifery. However, regular midwifery practices typically do not offer caseload midwifery care – one-to-one continuity of care throughout pregnancy and birth. Because we know very little about the outcomes for women receiving caseload care in the Netherlands, we compared caseload care with regular midwife-led care, looking at maternal and perinatal outcomes, including antenatal and intrapartum referrals to secondary (i.e., obstetrician-led) care. Methods We selected 657 women in caseload care and 1954 matched controls (women in regular midwife-led care) from all women registered in the Dutch Perinatal Registry (Perined) who gave birth in 2015. To be eligible for selection the women had to be in midwife-led antenatal care beyond 28 gestational weeks. Each woman in caseload care was matched with three women in regular midwife-led care, using parity, maternal age, background (Dutch or non-Dutch) and region. These two cohorts were compared for referral rates, mode of birth, and other maternal and perinatal outcomes. Results In caseload midwifery care, 46.9% of women were referred to obstetrician-led care (24.2% antenatally and 22.8% in the intrapartum period). In the matched cohort, 65.7% were referred (37.4% antenatally and 28.3% in the intrapartum period). In caseload care, 84.0% experienced a spontaneous vaginal birth versus 77.0% in regular midwife-led care. These patterns were observed for both nulliparous and multiparous women. Women in caseload care had fewer inductions of labour (13.2% vs 21.0%), more homebirths (39.4% vs 16.1%) and less perineal damage (intact perineum: 41.3% vs 28.2%). The incidence of perinatal mortality and a low Apgar score was low in both groups. Conclusions We found that when compared to regular midwife-led care, caseload midwifery care in the Netherlands is associated with a lower referral rate to obstetrician-led care – both antenatally and in the intrapartum period – and a higher spontaneous vaginal birth rate, with similar perinatal safety. The challenge is to include this model as part of the current effort to improve the quality of Dutch maternity care, making caseload care available and affordable for more women.

scholarly journals Health care workers’ perceptions of episiotomy in the era of respectful maternity care: a qualitative study of an obstetric training program in Mexico

2020 ◽  
Author(s):  
Rodrigo de Jesús Garcia-Cerde ◽  
Maria del Pilar Torres-Pereda ◽  
Marisela Olvera-Garcia ◽  
Jennifer Meghan Hulme
Keyword(s):  
Qualitative Study ◽  
Maternity Care ◽  
Medical Personnel ◽  
Respectful Maternity Care ◽  
Structured Interviews ◽  
Post Intervention ◽  
Care Workers ◽  
Before And After ◽  
Effective Prophylaxis ◽  
The Moment

Abstract Background Episiotomy in Mexico is highly prevalent and often routine - performed in up to 95% of births to primiparous women. The WHO suggests that episiotomy be used in selective cases, with an expected prevalence of 15%. Training programs to date have been unsuccessful in changing this practice. This research aims to understand how health personal, at four community hospitals in Mexico, perceive episiotomy, both before and after training in respectful maternity care, obstetric and neonatal emergencies. Methods This is a descriptive and interpretative qualitative study. We conducted Fifty-three pre and post-intervention (PRONTO© Program) semi-structured interviews with generalists, specialists and nurses (N = 32, 56% women). Thematic analysis was carried out using Atlas-ti© software to iteratively organize codes. Through interpretive triangulation, the team found theoretical saturation and explanatory depth on key analytical categories. Results Themes fell into six major themes surrounding their perceptions of episiotomy: as a predictable practice, as a prophylactic intervention, as a procedure that resolves problems in the moment, as a practice that gives the clinician control, as a risky practice, and the role of social norms in practicing it. Results show contradictory discourses among professionals. Despite the growing support for the selective use of episiotomy, it remains positively perceived as an effective prophylaxis for the complications of childbirth while maintaining control in the hands of medical personnel. Conclusions Perceptions of episiotomy shed light on how and why routine episiotomy persists, and provides insight into the multi-faceted approaches that will be required to affect this and other harmful obstetrical practices.

Transition from Childcare Institutions to Adulthood for Youth: Through the Lens of Identity and Gender

2020 ◽  
pp. 234930032098055
Author(s):  
Garima Sharma
Keyword(s):  
Young Adults ◽  
Qualitative Study ◽  
Social Factor ◽  
Smooth Transition ◽  
Structured Interviews ◽  
Male And Female ◽  
Female Youth ◽  
Youth Identity ◽  
The Social ◽  
And Gender

This article explores the transition of youth from childcare institutions as young adults through the lens of youth identity and gender. The research revolves around rethinking the delicate boundaries of adolescence and adulthood for the ‘institutionalised’ youth that is already on the edge of the society. This research tries to understand and decode the experiences of youth, who have lived in the childcare institutions. The childcare institutions reinforce the gender roles through its practices and structure, enabling gaps and challenges for both male and female youth outside the childcare institutions. There is an absence of a strong mechanism, enabling the smooth transition of youth from childcare institutions to adulthood. This results in unprepared young adults for an unplanned transition, fostering several challenges on them as they exit the childcare system. This is a qualitative study. The research includes both male and female youth who have lived in childcare institutions situated in Delhi. The data was collected using semi-structured interviews with the youth. This study finds that youth leaving the childcare institutions are at higher risks of having negative adult outcomes in life. While there is an absolute absence of any body or mechanism to help the youth transit smoothly, childcare institutions reinforce the inferiority and exclusion on a child during the stay period, creating a foundation for youth to perceive the social factor outside the institutions.

scholarly journals Impact of COVID-19 Pandemic on Retail Structure in Barcelona: From Tourism-Phobia to the Desertification of City Center

2021 ◽  
Vol 13 (15) ◽  
pp. 8215
Author(s):  
Lluís Frago Clols
Keyword(s):  
Multiple Scales ◽  
Real Estate Market ◽  
Structured Interviews ◽  
City Center ◽  
Urban Theory ◽  
The Real Estate ◽  
Tourist Flows ◽  
Before And After ◽  
The Impact ◽  
The City

COVID-19 has meant major transformations for commercial fabric. These transformations have been motivated by the collapse of consumer mobility at multiple scales. We analyzed the impact of the collapse of global tourist flows on the commercial fabric of Barcelona city center, a city that has been a global reference in over-tourism and tourism-phobia. Fieldwork in the main commercial areas before and after the pandemic and complementary semi-structured interviews with the main agents involved highlight the relationship between global tourist flows and commercial fabric. The paper shows how the end of global tourism has meant an important commercial desertification. The end of the integration of the city center into global consumer flows has implications for urban theory. It means a downscaling of the city center and the questioning of traditional center-periphery dynamics. It has been shown that the tourist specialization of commerce has important effects on the real estate market and makes it particularly vulnerable. However, the touristic specialization of commercial activities as a strategy of resilience has also been presented. This adaptation faces the generalized commercial desertification that drives the growing concentration of consumption around the online channel.

scholarly journals Impact of the Paralympic Games on the Beliefs of Children with Physical Disabilities Engaging in Sports and Physical Activities: A Chinese Perspective

2021 ◽  
Vol 18 (14) ◽  
pp. 7296
Author(s):  
Jing Qi ◽  
Jin-He Cai ◽  
Xun Meng
Keyword(s):  
Attitude Change ◽  
Physical Disabilities ◽  
Chinese Children ◽  
Physical Education Teachers ◽  
Structured Interviews ◽  
Negative Attitudes ◽  
Before And After ◽  
Sports And Physical Activity ◽  
The Impact ◽  
Paralympic Games

The purpose of this qualitative study was to explore the beliefs of Chinese children with physical disabilities engaging in sports and physical activity (PA), and the impact of the Paralympic Games on these beliefs. Five Chinese children with physical disabilities (female = 2, male = 3) were recruited for participating in the workshops of the Paralympic Games and PA, and received individual semi-structured interviews before and after the workshop implementations. Interview transcripts were analysed and presented as descriptive summaries. Three themes emerged based on the analysis of the participants’ interview data: (1) shocked, knowledgeable, and useful; (2) willingness to try, and (3) hope to obtain support. Results indicated that children with physical disabilities in this study acknowledged the positive outcomes of participating in the workshops of the Paralympic Games on the sports and PA engagement attitude change. However, children with disabilities also expressed that they need more related knowledge and information. The results of the study revealed that impairment and contextual factors (i.e., lack of support from family and physical education teachers, unsafe environments, and negative attitudes of peers without disabilities) were barriers to sports and PA engagement among children with physical disabilities in this study.

scholarly journals Exploring the potential for introducing home monitoring of blood pressure during pregnancy into maternity care: current views and experiences of staff—a qualitative study

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e037874
Author(s):  
Lisa Hinton ◽  
James Hodgkinson ◽  
Katherine L Tucker ◽  
Linda Rozmovits ◽  
Lucy Chappell ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Maternity Care ◽  
Healthcare Providers ◽  
Home Monitoring ◽  
Structured Interviews ◽  
Group Discussions ◽  
Self Monitoring ◽  
Team Members ◽  
Registration Number ◽  
In Pregnancy

ObjectiveOne in 20 women are affected by pre-eclampsia, a major cause of maternal and perinatal morbidity, death and premature birth worldwide. Diagnosis is made from monitoring blood pressure (BP) and urine and symptoms at antenatal visits after 20 weeks of pregnancy. There are no randomised data from contemporary trials to guide the efficacy of self-monitoring of BP (SMBP) in pregnancy. We explored the perspectives of maternity staff to understand the context and health system challenges to introducing and implementing SMBP in maternity care, ahead of undertaking a trial.DesignExploratory study using a qualitative approach.SettingEight hospitals, English National Health Service.ParticipantsObstetricians, community and hospital midwives, pharmacists, trainee doctors (n=147).MethodsSemi-structured interviews with site research team members and clinicians, interviews and focus group discussions. Rapid content and thematic analysis undertaken.ResultsThe main themes to emerge around SMBP include (1) different BP changes in pregnancy, (2) reliability and accuracy of BP monitoring, (3) anticipated impact of SMBP on women, (4) anticipated impact of SMBP on the antenatal care system, (5) caution, uncertainty and evidence, (6) concerns over action/inaction and patient safety.ConclusionsThe potential impact of SMBP on maternity services is profound although nuanced. While introducing SMBP does not reduce the responsibility clinicians have for women’s health, it may enhance the responsibilities and agency of pregnant women, and introduces a new set of relationships into maternity care. This is a new space for reconfiguration of roles, mutual expectations and the relationships between and responsibilities of healthcare providers and women.Trial registration numberNCT03334149.

scholarly journals 3416 Building Resilience & Wisdom in Clinical and Translational Researchers: A Mixed-Method Study of a Pilot Curricular Intervention

2019 ◽  
Vol 3 (s1) ◽  
pp. 63-63
Author(s):  
Sandra Burks ◽  
Karen Johnston ◽  
Nicole Chiotta-McCollum ◽  
Natalie May ◽  
John Schorling ◽  
...  
Keyword(s):  
Development Program ◽  
Junior Faculty ◽  
Early Career ◽  
Structured Interviews ◽  
Curricular Intervention ◽  
Resilience Scale ◽  
Before And After ◽  
Study Population ◽  
Career Development Program ◽  
Research Workforce

OBJECTIVES/SPECIFIC AIMS: The clinical and translational research workforce is in jeopardy due to investigator attrition and competing demands upon researchers. Resilience and wisdom are measurable traits that can be acquired. The aim of this study was to examine a pilot curricular intervention promoting resilience and wisdom formation in early-career translational researchers. METHODS/STUDY POPULATION: We conducted a prospective, mixed-methods evaluation of a curricular intervention promoting the development of wisdom and resilience among junior faculty in a career development program. Six 90 minute sessions were delivered between September 2017 and January 2018. Pre- and post- resilience and wisdom were measured using the Connor Davidson Resilience Scale and 3D-Wisdom Scale. Individual semi-structured interviews were conducted before and after the intervention RESULTS/ANTICIPATED RESULTS: Five scholars participated. Median resilience and wisdom scores revealed moderate levels of each trait; pre- and post-scores were not significantly different. Four themes emerged from the analysis of interview transcripts: 1. “Success” broadly defined; 2. Adversity threatens success; 3. Community breeds resilience; and 4. Wisdom formation parallels growth towards independence. DISCUSSION/SIGNIFICANCE OF IMPACT: An intervention aimed at developing capacities of resilience and wisdom is feasibly delivered to early career researchers. The relationship between these capacities and the sustainability of a research career warrants additional study.

Who do the women trust for maternity care: A knowledge network–based study in rural India

2018 ◽  
Vol 48 (2) ◽  
pp. 87-100
Author(s):  
Amrita ◽  
Ram Babu Roy
Keyword(s):  
Knowledge Sharing ◽  
Rural Women ◽  
Maternity Care ◽  
Knowledge Network ◽  
Primary Data ◽  
Rural India ◽  
Structured Interviews ◽  
Danger Signs ◽  
Policies And Programs ◽  
Women In India

Background: Knowledge about the causes of critical ailments and risks during a maternity episode is crucial for women’s health. Although maternity-care knowledge is present both in explicit and tacit forms, there is a lack of requisite knowledge among women. Rural women rely on their community for such knowledge. Objective: This article sought to analyse knowledge-sharing practices of rural women in India in relation to critical decisions during a maternity episode. Method: Primary data were gathered through interview of 306 married women, who had had at least one childbirth during the previous 5 years, and were collected using structured interviews conducted in 10 villages of two districts in West Bengal, India. Their knowledge level of risks and networks of communication was examined for four critical decisions: (i) general health, (ii) choice of delivery method, (iii) antenatal check-up visits and (iv) nutrition. Results: This empirical study using degree-centrality method demonstrated that the pattern of knowledge flow is not uniform for different types of decisions. Many women were not aware of critical danger signs during pregnancy episodes. Only 28% of participants could mention at least three danger signs during pregnancy episodes. For the purposes of this study, these women were considered “knowledgeable.” Discussion: Maternal health in the community could be improved by redesigning the knowledge network for sharing the maternity-care knowledge of risks and danger signs. This research highlights the influence of culture on maternity-related knowledge-sharing in rural India and uncovers structural holes in the knowledge network. Implications: Results of this research could be used to design policies and programs to create community-based knowledge networks for maternity care.

Effects of Teacher Portfolio Construction on English Language Teachers' Perceived Teaching Competencies

2017 ◽  
pp. 185-207
Author(s):  
Ece Zehir Topkaya ◽  
Handan Çelik
Keyword(s):  
English Language ◽  
Language Teachers ◽  
Portfolio Construction ◽  
Structured Interviews ◽  
Teaching Competencies ◽  
Teachers Perceptions ◽  
Before And After ◽  
Native Teachers ◽  
English Language Teachers ◽  
Teacher Portfolio

This study investigates the effects of teacher portfolio construction upon in-service English language teachers' perceived teaching competencies. With the participation of six non-native teachers, data were collected through questionnaires and semi-structured interviews conducted before and after a sixteen-week teacher portfolio construction program. Analyses of the data through descriptive statistics and inductive content analysis revealed that the teachers' perceptions related to their teaching competencies were quite high prior to the portfolio construction process. After the process, however, decrease was observed in the teachers' perceived competencies. Findings also showed that the portfolio construction program was effective for the teachers' in that the process led them to become more self-evaluative, thus reflective and realistic about their competencies.

scholarly journals Unpacking the Political Effects of Social Movements With a Strong Digital Component: The Case of #IdleNoMore in Canada

2020 ◽  
Vol 6 (2) ◽  
pp. 205630512091558 ◽  
Author(s):  
Emmanuelle Richez ◽  
Vincent Raynauld ◽  
Abunya Agi ◽  
Arief B. Kartolo
Keyword(s):  
Social Media ◽  
Policy Outcomes ◽  
The Political ◽  
Structured Interviews ◽  
Protest Movements ◽  
Indigenous Policy ◽  
Political Narrative ◽  
Political Impact ◽  
Before And After ◽  
Media Component

While many scholars have studied collective action with a strong social media component led by marginalized groups, few have unpacked how this form of political engagement captures the attention of established political elites and, in some cases, influences the mainstream political narrative and policy outcomes. Fewer have focused on the political impact of social media-intensive Indigenous protest movements. This article addresses these gaps in the academic literature. It does so by examining the online and offline impact of the Indigenous-led Idle No More movement at the federal level in Canada. To evaluate the movement’s effects on the public political narrative on Indigenous-related issues, this article reviews the content of the House of Commons Question Period before and after the emergence of the movement in December 2012. To measure Idle No More’s impact on policy outcomes, this article compares federal budgets and the volume of policy proposals pertaining to Indigenous Affairs introduced in the years preceding the beginning of the movement to those that came in the years following it. Semi-structured interviews with key stakeholders are also conducted to better comprehend the political impact of the movement. The study posits that protests coincided with momentary changes to the salience of Indigenous policy issues, but not with significant policy outcomes in that area.

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