Nursing Midwifery Commons^™

Woman-Centred Ethics: A Feminist Participatory Action Research, Kate Buchanan, Sadie Geraghty, Lisa Whitehead, Elizabeth Newnham

Research outputs 2022 to 2026

Introduction: Contemporary ethical issues in the maternity system are nuanced, complex and layered. Medicalisation and the reported rise in incidence of mistreatment and birth trauma, has been described as unethical. Some authors suggest bioethical principles are limited in terms of guiding everyday care of pregnancy and birth. There is currently no known published research which explores what birthing people say is ethical. Aims: This study sought to explore women's experience of maternity care from an ethical perspective. Method: A Feminist Participatory Action Research (FPAR) was conducted over three years, in two phases. A Community Action Research Group (CARG) was formed …

Home Visitation To Prevent And Reduce Postpartum Depression, Anna Bauer, Madison Polley, Laura Boesken Dnp, Msn, Rn

Posters-at-the-Capitol

Postpartum depression (PPD) occurs in 13-19% of women worldwide, and is a stigmatized medical condition affecting maternal and infantile long term outcomes. The purpose of this evidence-based practice project was to determine if women at high risk for PPD are affected by home visitation programs from discharge up to three years postpartum. CINHAL Ultimate, Google Scholar, and Medline databases were used. Current evidence supports the use of home-visitation programs for postpartum women to decrease the prevalence and the symptoms of PPD by allowing nurses access into homes to provide early intervention for PPD. In addition to providing care for prevention …

Does The Anastatica Hierochuntica Plant Shorten The Duration Of Labour? A Prospective Observational Study, Filiz Okumuş, Halime Öncü-Çelik, Nevin Şahin

Journal of Asian Midwives (JAM)

Objective: This study aims to investigate the effect of Anastatica Hierochuntica L. on the duration of labour in primiparous women.
Methods: A prospective, case-controlled study with an intervention (n=28) and control (n=29) group. Participants were not randomized; their preferences related to the use of the A. Hierochuntica L. determined the group in which they would be included. In the intervention group, Anastatica Hierochuntica L. was used by all women. Standard care continued for both the intervention and control group. The duration of the first and second stage of labour were evaluated and compared between groups.
Results: Participants’ mean of age …

Why Skin-To-Skin Contact Is Not Made A Traditional Practice Right After Childbirth? Hindrances Behind Its Non-Implementation, Ateefa Al-Noor

Journal of Asian Midwives (JAM)

Skin-to-skin contact (SSC) is the practice in which a newborn is dried and placed immediately on mother’s chest. Both the mother and the baby gains benefits from this as it aids in breastfeeding and helps baby adjust to temperature outside the mother’s womb. However, not many midwives in hospitals carry out this crucial practice. Staff shortage, lack of awareness and time constraints were identified as the main determinants because SSC was not implemented. Realistic measures should be taken to enhance SSC as discussed in the paper. Thus, promotion of SSC soon after childbirth will be advantageous for neonatal quality of …

Jam – Winter 2022, Rafat Jan, Edwin Van Teijlingen, Kiran Mubeen, Abeer Musaddique

Journal of Asian Midwives (JAM)

No abstract provided.

Implementation Of Staff Education To Standardize The Use Of Positions During The First Stage Of Labor, Minh Chau T. Phan

Master's Projects and Capstones

This project aims to educate labor and delivery (L&D) nurses on effective laboring positions that can aid fetal descent during the first stage of labor. In an L&D unit of a south Bay Area County hospital, there is a lack of standardization of knowledge and practices on laboring positions among the nursing staff. Evidence shows that upright positions and frequent mobility are effective in shortening the duration of labor and minimizing unnecessary cesarean deliveries. Based on the evidence, a project was implemented using verbal education of evidence-based laboring positions. An educational handout was also provided along with a recorded video …

Postpartum Depression For Mothers With Early Fetal Death Or Stillbirths, Callie Goldman

Symposium of Student Scholars

Background: Many times, prevention of early fetus death and stillbirths is possible; however, some mortality events are spontaneous or unavoidable. While existing research reveals the likelihood of postpartum depression for mothers following birth, few studies address the potential for postpartum depression of mothers of stillbirth or demised fetuses. The purpose of this study is to determine how mothers can be better prepared for the hardship of losing a baby during childbirth, while going through common difficulties, such as postpartum depression, following birth. Methods: A mixed method approach will be conducted to gather qualitative (interview) and quantitative (Edinburgh Postnatal Depression Scale …

Effects And Outcomes Of Different Laboring Positions And The Influence From Societal Norms, Amberlyn Heskett

Nursing | Senior Theses

Background

Within labor and delivery, every birth is different. Alarmingly, the U.S. has the highest maternal mortality rate, including death during labor, among developed countries (World Health Organization, 2022). Many maternal deaths may be preventable.

In the U.S., the use of forceps, vacuum-assisted birth, episiotomies, and emergency C-sections are common for women during childbirth. Even though some laboring positions may assist birthing more than others, there often is resistance to allowing various positions due to outside influences, including societal norms, hospital management, and healthcare professional training. Women in labor are vulnerable and look to their nurses for support during the …

Experiences Of Mothers And Significant Others In Accessing Comprehensive Healthcare In The First 1000 Days Of Life Post-Conception During Covid-19 In Rural Uganda, Grace Nakate, Sean Mackay, Eunice Ndirangu, Valerie Fleming

School of Nursing & Midwifery, East Africa

Background: COVID-19 presented an unprecedented global public health challenge because of its rapid and relentless spread, and many countries instituted lockdowns to prevent the spread of infection. Although this strategy mayhave been appropriate to reduce infection, it presented unintended difficulties in rural Uganda, especially in maternal and born newborn care. For example, some services were suspended, meaning the nearest health facility was at a considerable distance. This study explored the experiences of mothers and their significant others of comprehensive care in the first 1000 days of life post-conception during the COVID-19 pandemic in Bunghokho-Mutoto sub-county, Mbale District, Uganda.

Methods …

Critical Thinking Development In Undergraduate Midwifery Students: An Australian Validation Study Using Rasch Analysis, Amanda G. Carter, Amanda Müller, Michelle Gray, Dianne Bloxsome, Kristen Graham, Dolores Dooley, Linda Sweet

Research outputs 2022 to 2026

Background: Well-developed critical thinking skills are required to provide midwifery care that is safe, evidence-based, and woman-centred. A valid, reliable tool to measure is required the application of critical thinking in midwifery practice. The Carter Assessment of Critical Thinking in Midwifery (CACTiM) has previously been psychometrically assessed using classical methods at a single site. This study aims to further evaluate the properties of CACTiM tools using Rasch analysis in a diverse group of midwifery students and preceptors. Methods: The CACTiM tools were completed by undergraduate midwifery students studying at three Australian universities and their preceptors. Midwifery students’ critical thinking was …

Impact Of The Maternity Care Changes Of The Covid-19 Pandemic On Pregnant Women And Their Birth Partners: An Integrative Literature Review, Rebekah Kemp

MSN in Leadership in Nursing Final Projects

Introduction: In March 2020, the novel coronavirus originating out of Wuhan in China and spreading rapidly worldwide, became known as the COVID-19 pandemic. Patients with pre-existing conditions, such as the elderly and pregnant women, are among those most vulnerable to severe infection due to COVID-19. Increased pulmonary expansion in the respiratory tract make pregnant women more susceptible to viral respiratory infections and exacerbation of illnesses like COVID-19. Another major concern correlated with the pandemic and pregnancy is its effect on pregnant women’s mental health. Unique physiological and psychological changes place pregnant women at an increased risk for experiencing mental health …

Harnessing The Nursing And Midwifery Workforce To Boost Australia's Clinical Research Impact, Marion Eckert, Claire M. Rickard, Deborah Forsythe, Kathleen Baird, Judith Finn, Andrea Gilkison, Richard Gray, Caroline S.E. Homer, Sandy Middleton, Stephen Neville, Lisa Whitehead, Greg R. Sharplin, Samantha Keogh

Research outputs 2022 to 2026

For the Medical Research Future Fund (MRFF) to achieve its full impact, it is necessary for health practitioners to be trained and reliably funded to deliver research and translation alongside their clinical work. We offer insight into current systems, concerns and suggestions as this applies to clinical research in nursing and midwifery. Nurses and midwives globally have a long record of delivering high quality clinical research that improves care and outcomes. An analysis of four landmark nursing-led studies in the United States illustrates the value-adding potential of such research: for every grant dollar, the return on investment ranged from $202 …

Resilience And Prenatal Mental Health In Pakistan: A Qualitative Inquiry, Shireen Shehzad, David Arthur, An-Sofie Van Parys, Nicole Letourneau, Gail Wagnild, Shahirose Sadrudin Premji, Nargis Asad, Olivier Degomme

School of Nursing & Midwifery

Background: Women in Pakistan suffer from a high rate of depression. The stress of low-income, illiteracy, exposure to violence and living in a patriarchal society are predisposing vulnerabilities for depression, particularly during and following pregnancy. The resilience of an individual plays a significant role in promoting prenatal mental health, but this has yet to be thoroughly researched. In this article, our objective is to identify the core characteristics of resilience among pregnant women, which will then help us in developing an intervention.
Methods: The exploratory-descriptive study was conducted over 6 months in five different antenatal hospitals in Sindh, Pakistan. A …

A Qualitative Document Analysis Of Policies Influencing Preeclampsia Management By Midwives In Ghana, Isabella Garti, Michelle Gray, Angela Bromley, Jing-Yu (Benjamin) Tan

Research outputs 2022 to 2026

Background: Preeclampsia is a global issue that causes significant morbidity and mortality in low- and middle-income countries (LMICs). The care women with preeclampsia receive in LMICs is below the standard experienced by women in westernised countries due to multiple interacting factors. A review of policy factors influencing the management of preeclampsia in Ghana is needed. Aim: This study focuses on the midwife's role and scope of practice concerning preeclampsia management. The study aimed to explore the congruence between Ghanaian preeclampsia guidelines and international best practice recommendations for midwifery practice. The study also aimed to describe how recommendations are incorporated into …

Capacity Building Among Nursing And Midwifery Professional Associations In East Africa, Stephen Ruhmel, Eunice Ndirangu, Joseph Mwizerwa, Ahmed Sarki, Eunice Pallangyo

School of Nursing & Midwifery, East Africa

Background: Despite improvements in educational opportunities, policy changes, and pay raises in the nursing and midwifery professions in East Africa, poor working conditions, few professional development opportunities, and a general lack of respect for these professions predominate. These issues contribute to a low quality of care among a population with a high burden of communicable diseases. Health professional associations may help to address these challenges by providing a voice for nurses and midwives.

Objective: This study evaluated the impact of a 5-year programme focused on strengthening nurses’ and midwives’ professional associations in East Africa. Methods: This study used …

Adherence To Screening And Management Guidelines Of Maternal Group B Streptococcus Colonization In Pregnancy, Sabine Pangerl, Deborah Sundin, Sadie Geraghty

Research outputs 2022 to 2026

Aims: To investigate Group B Streptococcus (GBS) colonization in pregnancy; adherence to antenatal GBS screening and adherence to the intrapartum antibiotics protocol within two models of care (midwifery and non-midwifery led). Design: This retrospective quantitative study has employed a descriptive design using administrative health data. Methods: Data from five maternity hospitals in metropolitan and regional Western Australia that included 22,417 pregnant women who gave birth between 2015 and 2019 were examined, applying descriptive statistics using secondary data analysis. Results: The study revealed an overall GBS colonization rate of 21.7% with similar rates in the different cohorts. A lower adherence to …

Sub-Saharan African Women’S Views And Experiences Of Risk Factors For Obstetric Fistula: A Qualitative Systematic Review, Lydia Babatunde Bulndi, Deborah Ireson, Esther Adama, Sara Bayes

Research outputs 2022 to 2026

Background: Obstetric fistula used as synonymous with VVF in this study, is an abnormal communication/hole between the urinary tract and the genital tract or the gastrointestinal tract and the genital tract, resulting from prolonged obstructed labour. VVF may cause sufferers to experience chronic urinary/faecal incontinence, and the stigma of continuing foul odour. VVF is primarily caused by prolonged obstructed labour, which is brought about by a range of causes. Recently, it has been proposed that women’s groups and fistula survivors should suggest interventions to reduce or prevent the incidence of obstetric fistula. Objective: The objective of this review was to …

Challenges Experienced By Newly Qualified Nurse-Midwives Transitioning To Practice In Selected Midwifery Settings In Northern Malawi, Mathews Brave Mtegha, Elizabeth Chodzaza, Ellen Chirwa, Fatch Welcome Kalembo, Maggie Zgambo

Research outputs 2022 to 2026

Background: Literature shows that newly qualified nurse-midwives face challenges integrating into the workforce during their transition period from education to practice. However, little is known about the needs and challenges of Malawian nurse-midwives during their transition from education to practice. The aim of the study was to explore the transition experiences of newly qualified nurse-midwives working in selected midwifery units in Northern Malawi. Methodology: A qualitative descriptive approach was used. Data were collected through in-depth interviews using semi-structured interview guides from a purposive sample of 19 participants (13 newly qualified nurse-midwives and 6 key informants). The researchers developed two interview …

No One Should Have To Give Birth Alone: An Analysis Of The Efficacy Of Community-Based Doula Programs Serving Ethnic Minorities In San Francisco, Maria Margaret Nelson

Master's Projects and Capstones

Adverse birth outcomes for both the parent and the child disproportionately affect people of color. Evidence demonstrates that one of the ways to mitigate these negative consequences is through the utilization of a doula, a trained birth companion that is not a medical provider but whose role it is to physically and emotionally support the patient through pregnancy, birth, and postpartum. Community-based doula programs, where the doula is of the same cultural background as the client, are particularly effective in improving birth outcomes in communities of color by providing culturally competent care and helping to navigate a healthcare system that …

Quantification Of Obstetric Hemorrhage, Alma Garcia

Student Scholarly Projects

Practice Problem: The practice problem identified involved the inconsistent measurement of blood loss during the postpartum period due to the standard practice of estimating blood loss. Estimates are subjective measures that can have variable results based on interpretation and thus provide minimal meaningful data.

PICOT: The question that guided this project was structured in the following PICOT format. In postpartum women (P), how does the implementation of quantitative blood loss measurements (I), compared to estimated blood loss measurement (C), affect the early identification of severe hemorrhage (O), during the recovery period (T)?

Evidence: Obstetric hemorrhage is a preventable event that …

Care Ethics Framework For Midwifery Practice: A Scoping Review, Kate Buchanan, Elizabeth Newnham, Deborah Ireson, Clare Davison, Sadie Geraghty

Research outputs 2022 to 2026

Background:

As a normative theory, care ethics has become widely theorized and accepted. However, there remains a lack of clarity in relation to its use in practice, and a care ethics framework for practice. Maternity care is fraught with ethical issues and care ethics may provide an avenue to enhance ethical sensitivity.

Aim:

The purpose of this scoping review is to determine how care ethics is used amongst health professions, and to collate the information in data charts to create a care ethics framework and definition for midwifery practice.

Method:

The scoping review was conducted according to the Preferred Reporting …

Saliva Cortisol Diurnal Variation And Stress Responses In Term And Preterm Infants, David Q. Stoye, James P. Boardman, Clive Osmond, Gemma Sullivan, Gillian Lamb, Gill S. Black, Natalie Z. M. Homer, Nina Nelson, Elvar Theodorsson, Evalotte Mörelius, Rebecca M. Reynolds

Research outputs 2022 to 2026

Objective:

To determine if preterm birth is associated with adaptation of the hypothalamic–pituitary–adrenal (HPA) axis and whether HPA axis programming relates to the degree of prematurity (defined as extremely preterm birth at < 28 weeks or very preterm birth at 28–32 weeks gestation).

Design:

This study reports findings from a prospective birth cohort. Saliva cortisol concentrations were measured prevaccination and postvaccination, and in the morning and evening, at 4 months chronological age.

Setting:

Infants born at a single Scottish hospital.

Participants:

45 term-born, 42 very preterm and 16 extremely preterm infants.

Outcomes:

Cortisol stress response to vaccination (postvaccination minus prevaccination cortisol concentrations), diurnal slope (log-transformed morning minus log-transformed evening cortisol values) …

Factors Influencing Utilisation Of Services Provided By Community Midwives And Their Non-Retention In District Thatta, Pakistan: A Qualitative Study Protocol, Bakhtawar M Hanif Khowaja, Anam Shahil Feroz, Sarah Saleem

Department of Obstetrics & Gynaecology

Introduction: Drawing on the well-acknowledged evidence of community midwives services to address the issue of high maternal mortality, the Government of Pakistan initiated the Community Midwifery (CMW) programme in 2006 to provide skilled birth attendance to pregnant women living in rural areas. Despite a large investment in CMW programme, the availability of community midwives in rural areas following their training is a constant struggle. The concerns related to the training, support and acceptability of community midwives need to be studied in order to identify gaps in the provision of skilled maternal and newborn healthcare. Therefore, this study aims to explore …

Implicit Bias Training For Perinatal Nursing, Racheal Lakine-Harden

Dissertations

Problem: Maternal and fetal morbidity and mortality is a rising health care crisis in the United States. Black women are disproportionately affected. Clinician implicit bias and medical racism have been named as factors in this crisis. Recommendations to address this public health peril include; educating and raising awareness among front-line perinatal nursing staff on implicit bias and its consequences for Black women. The purpose of this project is to evaluate the impact of implicit bias training on nurses’ awareness of implicit bias, attitudes, and beliefs about disparities, and the likelihood to engage in behaviors to reduce or address racial bias …

Implementation Of Quantitative Blood Loss Tool To Detect Postpartum Hemorrhage After Vaginal Delivery, Rachael Williams

Dissertations

Problem Maternal deaths and comorbidities related to postpartum hemorrhage (PPH) continue to be high despite being quite preventable. The delay in recognition and treatment of PPH due to the use of imprecise estimated blood loss (EBL) instead of precise measurement using quantitative blood loss (QBL) attributes to this issue.

Methods For this quality improvement (QI) project, a descriptive, observational design was used to gather quantitative data regarding QBL implementation instead of EBL as well as the number of PPH’s identified. A pilot cohort of staff nurses participated by documenting QBL two hours after each delivery. The nurses were given an …

Prenatal Education For Black Mothers And Their Support Persons As An Intervention For Improving Initiation Of Breastfeeding, Sandra King

Doctor of Nursing Practice Projects

Background: The benefits of breastfeeding are commonly known; however, the rates of exclusive breastfeeding among the Black community are less than those of other ethnic groups. Providing breastmilk or formula to an infant is an individual decision. Influential factors such as cultural background, employment status, socioeconomic status, level of education, and availability of support from family members and health care providers correlate with the method a mother chooses to feed her infant. Increasing breastfeeding initiation immediately after birth is a necessary precedent for uptake in the exclusivity of breastfeeding.

Purpose: This Doctor of Nursing Practice project aims to improve prenatal …

Knowledge, Attitudes, And Preparedness For Managing Pregnant And Postpartum Women With Covid-19 Among Nurse-Midwives In Kenya, Rose Maina, Rachel Kimani, James Orwa, Bernard Mutwiri, Carolyne K. Nyariki, Sheila Shaibu, Valerie Fleming

School of Nursing & Midwifery, East Africa

Introduction: Globally, maternal morbidity and mortality have increased during the COVID-19 pandemic. Given the high burden of maternal and neonatal mortality in Kenya prior to COVID-19, front line health workers, including nurse-midwives, must be competent to ensure continued quality maternal services. Knowledge and awareness of COVID-19 transmission influence nurse-midwives risk perception and ability to implement prevention strategies.

Objective: We examined nurse-midwives’ knowledge, attitudes, and preparedness in managing pregnant and postpartum women with COVID-19 in Kenya.

Methods: A cross-sectional online survey was conducted among 118 nurse-midwives between July 2020 and November 2020. A 31-item survey comprising 15 knowledge, …

Jam – Summer 2022: One Crisis After Another…., Rafat Jan, Edwin Van Teijlingen, Kiran Mubeen

Journal of Asian Midwives (JAM)

No abstract provided.

Swot Analysis Of Community Midwifery Program In Pakistan, Bakhtawar Muhammad Hanif Khowaja, Anam Feroz, Farina Abrejo, Sarah Saleem

Journal of Asian Midwives (JAM)

The community midwifery program was launched in 2006 by the Government of Pakistan as a major initiative to provide skill birth attendance to women living in rural areas of Pakistan. The main purpose of the program is to extend maternal and newborn services to the communities, through the selection and training of community midwives (CMWs) from rural areas, and to deliver services to their local communities. However, there is a substantial difference between the number of CMWs trained and those working at their birthing stations. Therefore, this paper uses a SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis to evaluate the different …

Hidden Relationships: Perspectives On Leadership And Management In Afghan Maternity Services - An Ethnographic Exploration, Rachel Arnold, Edwin Van Teijlingen, Kath Ryan, Immy Holloway

Journal of Asian Midwives (JAM)

Introduction: Health system leaders have a vital role to play in ensuring the delivery of high-quality care. Improving the quality of healthcare, particularly in low-income countries often focuses on the performance of healthcare providers and the availability, acceptability, and uptake of services. The role that health service leaders play in facilitating effective care has received less attention in the literature. This study explored the perspectives of Afghan maternity care providers, managers and other stakeholders on leadership and the provision of quality maternity care.

Methods: This ethnographic study used semi-structured interviews, participant observation, and background interviews for data collection. …