The Creation of a Birthing Centre: Considering the Prevention of Post-Natal Depression.

<p>This thesis explores the notion of interior architecture as a tool in the prevention on of post natal depression. This research is part of a larger and current theoretical argument that places interior architecture in a catalyst role for the prevention of mental illness. Initial research shows that the act of giving birth and its physical and mental recovery are tightly linked to the potential development of depressive disorder. Accordingly this research will explore the spatial requirements for birthing with the prevention of mental disorder in mind. The design will be developed at the intersection of a series of criteria of spatial qualities in the prevention of depressive orders and evidence based hospital design parameters for birthing. This research aims to establish a comprehensive base guideline specific for the design of birthing centres, focusing on the prevention of post natal depression. The design here presented is a series of tests and assessment of this guideline.</p>

The Creation of a Birthing Centre: Considering the Prevention of Post-Natal Depression.

<p>This thesis explores the notion of interior architecture as a tool in the prevention on of post natal depression. This research is part of a larger and current theoretical argument that places interior architecture in a catalyst role for the prevention of mental illness. Initial research shows that the act of giving birth and its physical and mental recovery are tightly linked to the potential development of depressive disorder. Accordingly this research will explore the spatial requirements for birthing with the prevention of mental disorder in mind. The design will be developed at the intersection of a series of criteria of spatial qualities in the prevention of depressive orders and evidence based hospital design parameters for birthing. This research aims to establish a comprehensive base guideline specific for the design of birthing centres, focusing on the prevention of post natal depression. The design here presented is a series of tests and assessment of this guideline.</p>

Overconsumption of fluids during labour leading to water intoxication and a tonic–clonic seizure in a healthy labourer

A 33-year-old woman in her first pregnancy with no significant medical history had a tonic–clonic seizure one hour after delivery due to acute hyponatraemia caused by excess intake of fluids. She was admitted to a birthing centre as a low-risk labourer where she spent 19 hours including 4 hours in the second stage of labour. Throughout the labour, she was encouraged to drink as per her own initiative and thirst. However, there was no monitoring of fluid intake. In spite of initial confusion about the cause of the seizure, a multidisciplinary approach helped with diagnosis of an underlying pathology and allowed timely treatment to avoid adverse outcomes in this patient. We would like to increase awareness of a possibility, however rare, of water intoxication due to fluid overconsumption by patients in labour and encourage production of information guidance for monitoring of fluid intake of women in labour.

A retrospective observational study of critically unwell patients retrieved from Thames Hospital between April 2018 and December 2020

ABSTRACT INTRODUCTIONIn New Zealand, critically ill patients who present to rural hospitals are typically treated, stabilised and transferred to facilities where more appropriate resources are available. AIMThe aim of this study was to describe patients who presented critically unwell and required retrieval from Thames Hospital in the Waikato region. METHODSNotes were reviewed retrospectively for patients who were retrieved from Thames Hospital between 1 April 2018 and 31 December 2020. Patients were excluded if they were retrieved from the offsite birthing centre or their notes were not available to the authors. RESULTSDuring the study period, 56 patients were retrieved by intensive care teams based at Waikato, Starship or Auckland Hospitals. Patients had a median age of 57 years and most were female (60.7%). Māori patients were over-represented in the retrieval cohort compared with the population presenting to the emergency department (30.4% vs. 20.1%, P &lt; 0.001). We found that 41% of patients presented after-hours when there was only one senior medical officer available on site and 70 procedures were performed, including rapid sequence induction, which was required by 19.6% of patients. DISCUSSIONThis study describes a population of critically unwell patients who were retrieved from a rural hospital. The key finding is that nearly half of these patients presented after-hours when there was only one senior medical officer available on site. This doctor also has sole responsibility for all other patients in the hospital. We recommend that referral centres streamline the retrieval processes for rural hospitals.

Parents of babies who participated in an invasive clinical study report a positive experience: the Glucose in Well Babies (GLOW) study

ObjectiveThere is a paucity of data about normal blood metabolite concentrations in healthy babies, in part because of a reluctance to undertake non-therapeutic invasive testing in newborns. The Glucose in Well Babies study (GLOW) sought to describe blood glucose, lactate and beta-hydroxybutyrate concentrations in healthy term babies over the first 5 postnatal days. We also sought to understand both parents’ experience of participation in this invasive non-therapeutic study.Design, setting, patients and interventionsEligible babies were healthy, term, appropriately grown singletons born in a birthing centre, hospital or home within the greater Hamilton area and then discharged home. Babies had subcutaneous continuous glucose monitoring placed soon after birth, up to 14 heel-prick blood samples, twice-daily home visits and parents were asked to record all feeds. At study completion, both parents were asked to independently complete a questionnaire about their experience.ResultsAll eligible babies completed the study and every parent completed the questionnaire (65 fathers, 66 mothers). Parents reported they liked contributing to improving healthcare (126/131, 96%) and support from the GLOW team (119/131, 91%). Nearly all (127/131, 97%) would participate in GLOW again if they had another eligible baby, and all would recommend GLOW to family and friends. Two-thirds of parents (87/131, 66%) reported that participation had made them more likely to contribute to clinical research in the future.ConclusionsNon-therapeutic studies involving invasive procedures in healthy term babies are feasible, and parents were positive about their experience.

Birthing centre infrastructure in Nepal post 2015 earthquake

We suggest that a focus on improving facility delivery services starting from the most severely affected districts could be the necessary step towards achieving universal health care. Technical and financial support offered by international development partners can play a crucial role in enhancing the capabilities of health care facilities including birthing centres.