scholarly journals Authoritative knowledge of childbirth and obstetrics: analysis of discursive practices of Russian perinatal specialists

2020 ◽  
Vol 4 (4) ◽  
pp. 84-99 ◽  
Author(s):  
Anna A. Ozhiganova

The article discusses discursive practices of official and alternative perinatal specialists: obstetricians and gynecologists, midwives of maternity hospitals, domestic midwives and doulas. To analyze these practices, the author uses the notion of authoritative knowledge proposed by Brigitte Jordan and dating back to the power-knowledge concept by Michel Foucault. The author focuses on controversial but widely used concepts such as obstetric violence and natural childbirth. Additionally, the author regards such relatively new for the Russian community concepts as humanization of childbirth, obstetric model, demedicalization of childbirth, etc. The study is based on the materials of the founding conference of the professional non-profit association Obstetric Union, which was held at Moscow Perinatal Medical Center Mother and Child on November 30 – December 1, 2019.

Author(s):  
Mahnaz Zarshenas ◽  
Yun Zhao ◽  
Colin W. Binns ◽  
Jane A. Scott

The rate of Caesarean section (CS) without medical indication has increased markedly worldwide in the past decades. This study reports the incidence of CS and identifies the determinants of elective and emergency CS as separate pregnancy outcomes in a cohort of Iranian women. Mothers (n = 700) of healthy, full-term infants were recruited from five maternity hospitals in Shiraz. The association between maternal socio-demographic and biomedical factors with mode of delivery was explored using multivariable, multinomial logistic regression. Most mothers underwent either an elective (35.4%) or emergency (34.7%) CS. After adjustment, women were more likely to deliver by elective CS than vaginally if they were older (≥30 year) compared to younger mothers (<25 year) (Relative Risk Ratio (RRR) 2.22; 95% Confidence Interval (CI) 1.28, 3.84), and had given birth at a private hospital (RRR 3.64; 95% CI 1.79, 7.38). Compared to those educated to primary or lower secondary level, university educated women were more likely to have undergone an elective (RRR 2.65; 95% CI 1.54, 4.58) or an emergency CS (RRR 3.92; 95% CI 2.27, 6.78) than a vaginal delivery. Similarly, overweight or obese women were more likely than healthy weight women to have undergone an elective (RRR 1.91; 95% CI 1.27, 2.87) or an emergency CS (RRR 2.02; 95% CI 1.35, 3.02) than a vaginal delivery. Specialist education of obstetricians and midwives along with financial incentives paid to private hospitals to encourage natural delivery may help in the reduction of unnecessary CS in Iran. In addition, to increase their childbirth knowledge and self-efficacy, pregnant women need to have the opportunity to attend purposefully designed antenatal childbirth preparation classes where they receive evidence-based information on natural childbirth and alternative methods of pain control, as well as the risks and indications for CS.


2019 ◽  
Vol 13 (4) ◽  
pp. 200-208 ◽  
Author(s):  
Yusuf Moolla ◽  
Ahmed Adam ◽  
Marlon Perera ◽  
Nathan Lawrentschuk

Background/Aims: In today's information era, patients often seek information regarding health using the internet. We assessed reliability and validity of internet information regarding ‘prostate cancer'. Methods: Search term ‘prostate cancer' used on Google website (June 2017). Critical analysis was performed on first 100 hits using JAMA benchmarks, DISCERN score, Health on the Net. Results: 33 500 000 hits returned. Top 100 hits were critically analyzed. Ten links [duplicate links (n = 7), book reviews (n = 1), dead sites (n = 2)] were excluded, therefore 90 were analyzed. Subcategories assessed included: commercial (53.33%), university/medical center (24.44%), government (13.33%); non-governmental/ non-profit organizations (8.89%). Sub-type of information content assessed included: factual (74.44%), clinical trials (18.89%); stories (5.56%); question and answer (1.11%). Website rated as HONcode seal positive (14,44%) or seal negative (85,56%). Website content based on JAMA benchmarks: 0 benchmarks (4.44%), 1 benchmark (16.67%), 2 benchmarks (34.44%), 3 benchmarks (27.78%), 4 benchmarks (16.67%). DISCERN score rated: ‘low' score (16-32) = 12 websites (13.33%), ‘moderate' score (33-64 points) = 68 websites (75.56%), ‘high' score (≥ 65 points) = 10 websites (11.11%). Conclusion: Critical assessment of ‘Prostate Cancer' information on the internet, showed that overall quality was observed to be accurate, however majority of individual websites are unreliable as a source of information by itself for patients. Doctors and patients need to be aware of this ‘quality vs quantity' discrepancy when sourcing PCa information on the internet.


2016 ◽  
Vol 23 (04) ◽  
pp. 467-471
Author(s):  
Laleh Dehghanpisheh ◽  
Golnar Sabetian ◽  
Zeinabosadat Fatahi

One of the most severe pain that a woman experiences in her lifetime is laborpain which leads to increase their desire to perform caesarean section. In the present study weassessed the attitudes and awareness of obstetricians and midwives by raising their knowledgeand skills, to increase the rate of vaginal delivery and reduce the cesarean. Methods: StudyDesign: Qualitative study. Setting: Obstetricians and Midwives from throughout the ShirazCity, South of Iran, were participated by completing the questionnaire. Period: 6 months in2015. Statistical analysis was performed using the SPSS software, version 20.0. The resultswere presented as frequency (percentage). Results: 118 individuals including 25 (21%)Obstetricians and 93 (79%) Midwives were participated in the current study. Both obstetriciansand midwives preferred normal vaginal delivery (NVD) (83.9%). 91% of subjects believed thatthe reason of preference of NVD is the safety of mother and child. 34.7% of individuals wasfully aware of painless labor. 21.2% had average information. Most of the subjects was agreedwith the painless labor method (92.4%) and 4.2% was disagreed. Lack of pain and calmnessduring labor (62.2%) and reduction of fear of natural childbirth (50.5%) were the main reasonsof agreements. 85.2% of obstetrics and midwives believed that the number of painless labor inIran in comparison to international standards is less than desired. Conclusions: Although themajority of obstetricians and midwives were agreed with the painless labor in hospitals, almosthalf of them were aware of the painless delivery. Raising the knowledge of health care providersabout painless delivery can influence on awareness and attitude of them and parturient towardnormal vaginal delivery.


2020 ◽  
Vol 29 ◽  
Author(s):  
Enimar de Paula ◽  
Valdecyr Herdy Alves ◽  
Diego Pereira Rodrigues ◽  
Felipe de Castro Felicio ◽  
Renata Corrêa Bezerra de Araújo ◽  
...  

ABSTRACT Objectives: to understand the perception of managers of public maternity hospitals in the Metropolitan Region II of the state of Rio de Janeiro regarding obstetric violence and the measures to face it aiming at guaranteeing the quality of care. Method: a descriptive, exploratory study with a qualitative approach, conducted with 16 health managers from five maternity hospitals in Metropolitan Region II in the state of Rio de Janeiro. Data were collected through interviews, applied from May 2017 to May 2018, and submitted to content analysis in the thematic modality. Results: the research pointed out thenon-reception, technocratic principles of childbirth, refusal of the companion, disrespect to humanized practices centered on physiology and the choice of women, the need for health training as a guide for the humanization policy and the management of health units, professional unpreparedness for performance and lack of involvement of professionals with longer service time to modify practices in obstetric care. Thus, the need to break away from obstetric violence at the structural/institutional level was evident in order to guarantee quality care for women. Conclusion: it is the responsibility of the managers to provide training to health professionals regarding performance that respects the scientific evidence, the centrality and the axes of policies and recommendations in the area of sexual and reproductive health, especially to women regarding their autonomy.


2021 ◽  
Vol 8 ◽  
pp. 237437352110606
Author(s):  
Tsetsegmaa Parchaa ◽  
Ganchimeg Togoobaatar ◽  
Rieko Kishi Fukuzawa ◽  
Badamkhand Chunagsuren ◽  
Batbold Tseleejav ◽  
...  

Women’s experiences of childbirth have a significant impact on mother and child health and well-being as well as quality of care. A valid and reliable tool is needed to assess women's experience. This study aim was to adapt the Childbirth Experience Questionnaire to the Mongolian context and assess its psychometric properties. The study conducted between October and January 2019 at the public maternity hospital in Ulaanbaatar by recruiting a total of 828 low-risk postpartum women. The response rate was 92% (n = 761). Confirmatory factor analysis indicated a good fit for the 4-factor model. Reliability was good for the overall instrument (Cronbach's alpha = 0.83) and for individual domains (Cronbach's alphas ranging from 0.45 to 0.80). The overall and domain scores were significantly higher among women who had previous birth experience, who did not receive oxytocin augmentation, and who experienced a shorter labor duration (<12 h).The Mongolian version of the Childbirth Experience Questionnaire is a valid and reliable tool for exploring the childbirth experience. It can be used to promote women-centered, respectful care in maternity hospitals.


2018 ◽  
Vol 12 (9) ◽  
pp. 2407
Author(s):  
Meyrenice Cruz Da Silva ◽  
Bianca De Moura Feijó ◽  
Francisca Aslana Nargila Sousa Pereira ◽  
Francisca Joseane Farias Guerra ◽  
Idalina Santiago dos Santos ◽  
...  

RESUMOObjetivo: investigar as formas de violência obstétrica na assistência prestada ao parto e ao nascimento. Método: estudo quantitativo, exploratório, descritivo e transversal realizado com 169 puérperas em maternidades públicas. Os dados foram coletados por meio de questionário e a análise pelo Software Microsoft Office Excel®-2013. Posteriormente, as informações foram organizadas em um banco de dados e apresentadas em tabelas. Resultados: ao avaliar as formas de violência obstétrica, identificaram-se cuidado indigno e abuso verbal, discriminação baseada em certos atributos (por exemplo, raça), abandono, negligência ou recusa da assistência e detenção nos serviços prestados. Conclusão: a região rural brasileira investigada apresentou variados tipos de violência obstétrica, semelhantes aos dados nacionais, requerendo ações com vistas à sua eliminação. Descritores: Enfermagem Obstétrica; Enfermagem; Parto; Abuso Físico; Exposição à Violência; Serviços de Saúde Rural.ABSTRACT Objective: to investigate the forms of obstetric violence in childbirth and birth care. Method: a quantitative, exploratory, descriptive and cross - sectional study with 169 mothers in public maternity hospitals. Data were collected through a questionnaire and analysis by Microsoft Office Excel®-2013 Software. Subsequently, the information was organized into a database and presented in tables. Results: when evaluating forms of obstetric violence, unfair care and verbal abuse, discrimination based on certain attributes (eg race), abandonment, neglect or refusal of care and detention in the services provided were identified. Conclusion: the Brazilian rural region investigated presented several types of obstetric violence, similar to the national data, requiring actions with a view to its elimination.  Descriptors: Obstetric Nursing; Nursing; Parturition; Physical Abuse; Exposure to Violence; Rural Health Services.RESUMEN Objetivo: investigar las formas de violencia obstétrica en la asistencia prestada al parto y al nacimiento. Método: estudio cuantitativo, exploratorio, descriptivo y transversal realizado con 169 puérperas en maternidades públicas. Los datos fueron recolectados por medio de un cuestionario y el análisis por el software Microsoft Office Excel®-2013. Posteriormente, las informaciones fueron organizadas en una base de datos y se presentaron en tablas. Resultados: al evaluar las formas de violencia obstétrica, se identificaron el cuidado indigno y el abuso verbal, la discriminación basada en ciertos atributos (por ejemplo, raza), abandono, negligencia o rechazo de la asistencia y detención en los servicios prestados. Conclusión: la región rural brasileña investigada presentó variados tipos de violencia obstétrica, semejantes a los datos nacionales, requiriendo acciones con miras a su eliminación. Descriptores: Enfermería Obstétrica; Enfermería; Parto; Abuso Físico; Exposición a la Violencia; Servicios de Salud Rural.


2021 ◽  
Vol 76 (5) ◽  
pp. 429-435
Author(s):  
Alexander N. Strizhakov ◽  
Irina V. Ignatko ◽  
Anastsia A. Churganova ◽  
Alexandr G. Aslanov

Background. Today we have not really highly informative methods for assessing the state of the uterine scar. This fact does not allow us to formulate clear selection criteria for spontaneous delivery for patients who had cesarean section (CS). The result of the formulated problem is not only an increase in the frequency of repeated abdominal delivery, but also a fivefold increase in the risks of intraoperative and postoperative complications for women of reproductive age. Aims explore the property, structure and morphological features of the myometrial scar tissue by developing a physical model based on morphological predictors. Materials and methods. The study included 49 women who ahead a second caesarean section in the maternity hospital at the S.S. Yudin state medical center. The patients had scar tissue excised in the lower uterine segment and the resulting biopsies were divided into 2 fragments. The first fragment of biopsies was necessary for performing a morphological study, based on the results of which randomization was carried out into groups. The main group included 24 fragments, where the scar tissue was well-established, and the comparison group included 25 fragments, where according to morphological research, signs of its insolvency were revealed. Further assessment of the scar state was performed using the second fragment of biopsies by creating a physical model of the study, on the basis of which the dependence of elongation on the applied force was estimated. The study was conducted in the laboratory of scientific research on the development of bioprostheses of the CSSC A.N. Bakuleva. Results. Based on a morphological study, it was confirmed that the failure of the scar is based on the disorganization of connective tissue, indicating the possible presence of undifferentiated connective tissue dysplasia for the patient. The physical model of the study demonstrated that the presence of such a difficult-to-diagnose pathology leads to a decrease in the elasticity, and therefore-the strength and elasticity of the scar on the uterus. Conclusions. For this period of time, we need to improve methods for assessing the condition of the uterine scar in order to resolve the issue of the possibility of conducting natural childbirth for patients after undergoing CS surgery. It is possible that the created physical model will be able to evaluate the predictive ability of ultrasonic elastography within the framework of this problem. It is important to remember that scar formation is the final stage of regeneration, therefore, the maximum number of answers to a detailed study of morphological and immunohistochemical features of the myometrium, as it is the primary matrix on which will be the formation of scar tissue.


2018 ◽  
Vol 12 (7) ◽  
pp. 2050 ◽  
Author(s):  
Cristine Da Silva Kopereck ◽  
Greice Carvalho de Matos ◽  
Marilu Correa Soares ◽  
Ana Paula De Lima Escobal ◽  
Pricilla Porto Quadro ◽  
...  

RESUMOObjetivo: conhecer a produção científica acerca da violência obstétrica. Método: revisão integrativa, no período de 2007 a 2016, nas bases de dados MEDLINE, Lilacs e na biblioteca eletrônica Scielo. Os artigos foram selecionados por meio da busca com os descritores: Parto, Parto normal, Parto humanizado, Cesárea, Gravidez, Tocologia, Trabalho de parto e Violência, sendo utilizado os operadores booleanos AND e OR como ferramenta para o cruzamento destes. Resultados: foram considerados relevantes à temática deste estudo 29 artigos, categorizados em três tipos de violência considerando a similaridade de conteúdos, a saber: violência institucional, violência moral/ psicológica/ verbal e violência física. Conclusão: esta revisão permitiu perceber que a violência obstétrica se faz presente em diferentes âmbitos de cuidado, confirmando que as ações ainda são insuficientes para sua erradicação. Descritores: Saúde da Mulher; Parto; Parto Normal; Cesárea; Tocologia; Violência. ABSTRACT Objective: to know the scientific production about obstetric violence. Method: integrative review of articles published from 2007 to 2016, sought in MEDLINE, Lilacs and the Scielo electronic library. The articles were selected through search with the descriptors: Childbirth, Normal childbirth, Humanized childbirth, Cesarean section, Pregnancy, Tocology, Labor and Violence, using the Boolean operators AND and OR as a tool to cross them. Results: twenty-nine articles were considered relevant and categorized in three types of violence, considering the similarity of content: institutional violence, moral/psychological/verbal violence, and physical violence. Conclusion: this review allowed us to understand that obstetric violence is present in different areas of care, confirming that the actions are still insufficient for its eradication. Descriptors: Women's Health; Childbirth; Natural Childbirth; Cesarean section; Tocology; Violence. RESUMEN Objetivo: conocer la producción científica acerca de la violencia obstétrica. Método: revisión integradora, en el período de 2007 a 2016, en las bases de datos MEDLINE, Lilacs y en la biblioteca eletrónica Scielo. Los artículos fueron seleccionados por medio de la búsqueda con los descriptores: Parto, Parto normal, Parto humanizado, Cesárea, Embarazo, Tocología, Trabajo de parto y Violencia, siendo utilizado los operadores booleanos AND y OR como herramienta para el cruzamiento de estos. Resultados: fueron considerados relevantes a la temática de este estudio 29 artículos, categorizados en tres tipos de violencia considerando la similitud de contenidos, a saber: violencia institucional, violencia moral/psicológica/verbal y violencia física. Conclusión: esta revisión permitió percibir que la violencia obstétrica se hace presente en diferentes ámbitos de cuidado, confirmando que las acciones aún son insuficientes para su erradicación. Descriptores: Salud de la Mujer; Parto; Parto Normal; Cesárea; Tocología; Violencia.                                                                                                    


2018 ◽  
Vol 12 (1) ◽  
pp. 236 ◽  
Author(s):  
Diego Pereira Rodrigues ◽  
Valdecyr Herdy Alves ◽  
Raquel Santana Vieira ◽  
Diva Cristina Morett Romano Leão ◽  
Enimar de Paula ◽  
...  

RESUMOObjetivo: analisar as práticas consideradas violentas na atenção obstétrica. Método: revisão integrativa, com coleta de dados nas bases de dados Web of Science, CINAHL, Scopus, MEDLINE, LILACS e a biblioteca virtual SciELO, com artigos dos últimos cinco anos, em idioma inglês, espanhol e português, obtendo 13 artigos selecionados que foram submetidos à técnica de Análise de Conteúdo, na modalidade Análise Temática. Resultados: foram identificadas as seguintes categorias <<Violência obstétrica: tipologia, definições, legislação>>; <<A violência obstétrica na percepção da equipe obstétrica>>; <<A violência obstétrica na percepção das usuárias>>. Conclusão: a violência obstétrica está inserida com as práticas dos profissionais de saúde, como a episiotomia, a manobra de kristeller, a medicalização do parto, e o cuidado no contexto do processo de nascimento deve ocorrer de forma respeitosa e, assim, enfrentar atos de violência. Desse modo, o estudo contribui para o conhecimento acerca das práticas desrespeitosas com a mulher no contexto da parturição. Descritores: Obstetrícia; Trabalho de Parto; Parto Normal; Violência contra a Mulher; Parto Humanizado; Direitos Sexuais e Reprodutivos.ABSTRACT Objective: to analyze practices considered violent in obstetric care. Method: integrative review, with data collection in the Web of Science, CINAHL, Scopus, MEDLINE, LILACS databases and the SciELO virtual library with articles of the last five years in English, Spanish and Portuguese, obtaining 13 selected articles that were submitted to the Content Analysis technique, in the Thematic Analysis modality. Results: the following categories have been identified: 'Obstetric violence: typology, definitions, legislation'; << Obstetric violence in the perception of the obstetric team >>; << Obstetric violence in the perception of users >>. Conclusion: obstetric violence is inserted with the practices of health professionals, such as episiotomy, kristeller maneuver, medicalization of childbirth, and care in the context of the birth process should occur in a respectful way and, thus, face acts of violence. Thus, the study contributes to the knowledge about disrespectful practices with women in the context of parturition. Descritores: Obstetrics; Labor, Obstetric; Natural Childbirth; Violence Against Women; Humanizing Delivery; Reproductive Rights.RESUMEN Objetivo: analizar las prácticas consideradas violentas en la atención obstétrica. Método: revisión integrativa, con recolección de datos en las bases de datos Web of Science, CINAHL, Scopus, MEDLINE, LILACS y la biblioteca virtual SciELO, con artículos de los últimos cinco años, en Inglés, español y portugués lenguaje, obteniendo 13 artículos seleccionados, que fueron sometidos a la técnica de Análisis de Contenido, en el modo de análisis temático. Resultados: se identificaron las siguientes categorías << Violencia obstétrica: tipología, definiciones, legislación >>; << La violencia obstétrica en la percepción del equipo obstétrico >>; << La violencia obstétrica en la percepción de las usuarias >>. Conclusión: la violencia obstétrica está inserida con las prácticas de los profesionales de salud, como la episiotomía, la maniobra de kristeller, la medicalización del parto, y el cuidado en el contexto del proceso de nacimiento debe ocurrir de forma respetuosa y, así, enfrentar actos de violencia. De ese modo, el estudio contribuye al conocimiento acerca  de las prácticas irrespetuosas con la mujer en el contexto de la parturición. Descritores: Obstétrica; Trabajo de Parto; Parto Normal; Parto Humanizado; Violencia contra la Mujer; Parto Humanizado; Derechos Sexuales y Reproductivos.


2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Jie Chen ◽  
Yaer Chen ◽  
Fang Wang ◽  
Chunbo Qiu

The objective of this paper is to study the curative effect of music combined with hypnosis on labor pains during childbirth. Based on the algorithm of data mining, we randomly selected 100 women who delivered babies in obstetric units from October 2020 to June 2021, set the control group and the observation group, obtained the relevant clinical data through comparison, and analyzed the value of music combined with hypnotic analgesia midwifery in obstetrics. The results showed that the number of spontaneous delivery cases in the observation group was higher than that in the control group ( P < 0.05 ) and the delivery time in the observation group was better than that in the control group ( P < 0.05 ). It is proved that music combined with hypnosis can effectively improve the rate of natural childbirth and shorten the overall labor time, so as to guarantee the health of mother and child.


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