Nursing Midwifery Commons^™

Critical Social Determinants Of Childbirth Outcomes In Remote Mountains: Voices Of Women From Nepal, Sabitra Kaphle, Lareen Newman

Journal of Asian Midwives (JAM)

Objectives: Despite efforts made by the Government of Nepal to reduce maternal and newborn mortality nationally, the rate is still significantly higher in remote mountain areas. This research aimed to fill a gap by asking women about socio-cultural factors influencing childbirth outcomes in remote mountain areas of Nepal.
Methods: This study used a qualitative approach guided by the principles of social constructionist and feminist critical theories to derive factors influencing women’s experiences of giving birth and childbirth outcomes. In-depth interviews were conducted with 25 pregnant and postnatal women. A thematic approach was used for data analysis.
Results: Childbirth outcomes in …

Maternal Health Challenges During Covid-19 And Way Forward, Muskaan Dosani, Salima Muhammad Farooq, Shahnaz Shahid Ali

Journal of Asian Midwives (JAM)

The COVID-19 pandemic has affected nearly every country around the globe. Although every individual is at risk of getting the virus, maternal, fetal and newborn clients face specific and potentially unknown challenges which can make them highly compromised. The purpose of this paper is to discuss the maternal health challenges faced by women during COVID-19 and to propose possible strategies using the socio-ecological model (SEM) to promote the physical, social, and mental well-being of women and their infants during the perinatal period. SEM can be used as a framework to plan and implement strategies focusing on health promotion and disease …

Covid-19: The New Corona Virus Upsetting Our World, Rafat Jan, Edwin Van Teijlingen

Journal of Asian Midwives (JAM)

No abstract provided.

Reflections: Bravo Breastfeeding Mother! A Covid Positive Mother And Midwifery Instinct, Rafat Jan

Journal of Asian Midwives (JAM)

No abstract provided.

Developing And Piloting A Midwifery Audit Tool In Bangladesh’S Upazila Health Complexes (Uhcs), Achiya Khatun, Mahfuja Aktar Jhumu, Sarah Gregson, Joy Kemp

Journal of Asian Midwives (JAM)

Midwifery is a new profession in Bangladesh. Diploma-prepared midwives were first deployed in 2018. Recent studies suggest that newly qualified midwives in Bangladesh may not be able to fully perform their midwifery role due to a number of complex factors. This paper describes a pilot study of a midwifery audit undertaken in 2019 by the Bangladesh Midwifery Society, supported by the Royal College of Midwives. These two organisations are in a formal twinning partnership funded by UNFPA Bangladesh with support from UK-Aid, Sweden and Canada. The audit was successful in improving the quality of midwifery care and addressing health system …

Health Care Provider’S Perspectives On The Content And Structure Of A Culturally Tailored Antenatal Care Programme To Expectant Parents And Family Members In Nepal, Annika Ekström, Laxmi Tamang, Christina Pedersen, Ulrika Byrskog, Edwin Van Teijlingen, Kerstin Erlandsson

Journal of Asian Midwives (JAM)

Background: In Nepal childbirth is one of the most vulnerable periods of a woman's life and knowledge about the normal birth process, as well as danger signs, could be a life-saving intervention. Antenatal care programmes are therefore particularly relevant in Nepal where women deliver on their own in rural areas as well as in facility and hospital settings.

Aim: This study aimed to describe the relevant content and structure of a culturally tailored antenatal care programme in Nepal to be developed from the input of healthcare providers.

Methods: Qualitative semi-structured interviews with 26 health care providers were analyzed using Elo …

Can Cmws Sustain Quality Services And High Coverage As Private Providers In Chitral? A Three-Year Prospective Qualitative Study, Rafat Jan, Arusa Lakhani, Salma Rattani, Laila Lalji, Kiran Mubeen, Mehtab Q. Jaffer

Journal of Asian Midwives (JAM)

Background: The maternal and neonatal mortality ratesof Chitral district of Pakistan are among the highest in the country. One of the factors that found to havepositive impact on maternal and newborn health indicators is the availability ofquality skill birth attendance because the majority of the poor women cannot access facility-based maternity care. Therefore, in 2006, the Government of Pakistan (GOP) has initiated a program to train and deploy Community Midwives (CMWs) to support safe pregnancies and births. The Aga Khan Health Service’ Pakistan, initiated the Chitral Child Survival Program (CCSP) in partnership with the National Maternal Neonatal and Child Health …

Introducing Icm’S President – Author Of Editorial December, 2019, Rafat Jan, Franka Cadee

Journal of Asian Midwives (JAM)

No abstract provided.

Caesarean Section Rates In South Asian Cities: Can Midwifery Help Stem The Rise?, Sulochana Dhakal Rai, Amudha Poobalan, Rafat Jan, Malin Bogren, Juliet Wood, Ganesh Dangal, Pramod Regmi, Edwin Van Teijlingen, Keshar Bahadur Dhakal, Sahib Jan Badar, Farhana Shahid

Journal of Asian Midwives (JAM)

Introduction: Caesarean section (CS) is a life-saving surgical intervention for delivering a baby when complications arisein childbirth. World Health Organization recommends a rate of CS from 10% to 15%. However, CS rates increased steadily in recent decades and have almost doubled from 12.1% in 2000 to 21.1% in 2015. Therefore, this has become a global public health problem. The main purpose of the scoping review article is to give an overview and analysis of the rising CS use in four South Asian countries: Bangladesh, India, Nepal and Pakistan.
Methods: A scoping review was carried-out using several bibliographic electronic databases (MEDLINE, …

Male Involvement In Family Planning Among Squatter Settlement Residents Of Karachi, Fahmida Khowaja, Mehak Pervaiz, Naushaba Khatoon

Journal of Asian Midwives (JAM)

Background: Worldwide, the Contraceptive Prevalence Rate (CPR) increased from 54.8% to 63.3%. However, Pakistan’s current CPR is estimated to be 35%. Men can play an important role in increasing CPR by providing support to their partners, yet their role has been overlooked in targeted reproductive health strategies. The aim of this study was to assess the awareness and practices of married men regarding Family Planning (FP).
Material and Method: This cross-sectional study was conducted among 419 married men, residing in an urban squatter settlement of Karachi. Participants were selected through non-probability convenience sampling and a structured questionnaire was used to …

Higher Education In Midwifery In Pakistan: A Proposed Framework, Rafat Jan, Arusa Lakhani, Karyn Kaufman

Journal of Asian Midwives (JAM)

Access to a skilled professional midwife is the right of each woman. Research evidence shows that midwives prepared to international standards decrease rates of morbidity and mortality and promote health of both mothers and infants. At present, in Pakistan, there are several midwifery cadres, with different formal education levels, who provide maternal and child health services. There are currently three types of diploma programs each serving a different cadre. Until 2012, there was no opportunity to obtain higher education in midwifery in the country. This absence contributed to non-acceptance and invisibility of midwifery as a profession. As a result, midwives …

Cultural Assessment: A Study Of Midwives’ Knowledge, Attitude And Self-Reported Practice In Uganda, Mercy Muwema, Karen Drake, Pamela Friesen, Grace Edwards

Journal of Asian Midwives (JAM)

Background: Cultural assessment is critical due to the increased movement and resettlement of people across the globe, and diverse cultural groups in Uganda. This is putting the health care delivery systems serving the communities under pressure to recognize the different attitudes of people towards health and to develop care systems that are effective in meeting diverse needs. However, despite the importance of cultural assessment in nursing literature, little is known about the cultural assessment competence of Ugandan midwives. This study assessed the knowledge, attitude, and practice of midwives in this assessment process.

Methods: A descriptive correlational design was used to …

Asian Midwifery In 2019, Rafat Jan, Edwin Van Teijlingen

Journal of Asian Midwives (JAM)

No abstract provided.

Examining Clinical Indications For Cesarean Section In A University Hospital In Karachi, Pakistan, Zehra Kanji, Shannon D. Simonovich, Nida Najmi, Jessica Bishop-Royse

Journal of Asian Midwives (JAM)

Background and objectives: Current research reports that Pakistan exceeds the recommended percent of deliveries via cesarean sections, including both emergent and non-emergent. In order to better understand the high rate of cesarean sections in Pakistan we examined the medical and non-medical indications of these surgeries at a private university hospital in Karachi.

Methods: A retrospective analysis of patient medical record data was conducted from January 1st, 2018 to March 31st, 2018. The data collected was analyzed using SPSS 25.

Results: The total number of deliveries during the period was n= 1,211, out of which n=602 (49.70%) were CS. The top …

The Politics Of Abortion And Maternal Health: A Discussion Paper, Ihsan Ullah, Ayaz Ayub, Edwin Van Teijlingen

Journal of Asian Midwives (JAM)

Abortion should be legally allowed for women because it can save mothers from childbirth-related complications and death. Legal abortion is one of the safest methods to terminate a pregnancy when there is a risk to the mother’s health by childbirth or severe deformity of the fetus or it is unwanted. Unfortunately, approximately half of all abortions worldwide mostly in nations where abortion is severely restricted and are performed in dangerous settings. These risky abortions are a significant contributor to maternal morbidity and disability. Limiting a woman's access to an abortion does not stop abortion; rather, it just encourages more risky …

Effect Of Psychological Distress On The Emerging Cause Of Infertility, Faiza Kausar

Journal of Asian Midwives (JAM)

Background: Infertility is a growing issue of the recent era, and it represents significant crises for most couples. Psychological distress has often been suggested as a cause of unexplained infertility. Male infertility accounts for 40% of all infertility problems, while female infertility accounts for 40% of all infertility problems; others are unexplained. Previous studies have indicated that stress and depression negatively impact various infertility parameters in both partners. To determine the relationship between infertility and psychological distress and the level of different types of stress among infertile couples, and to relate the significant stressors responsible for worsening infertility or …

Labor Companionship: A Concept Of Doula Care, Arisha Amin, Rabab Vadivala

Journal of Asian Midwives (JAM)

A labor companion is a person who offers consistent individualized support to laboring women. Doula care is defined as the care which an individual provides of physical, social, and emotional support during pregnancy, labor, birth, and the postnatal period (1). Doulas help women ease their anxiety, and pain and address their concerns with comfort, care, and respect. Doulas help in cherishing a mother and child bonding helps in initiate breastfeeding and provide an emotional bond throughout the birthing time. It helps in reducing cesarean sections, and high-risk pregnancies and minimizes infant and maternal mortalities. The purpose of the study is …

Determinants Of Inadequate Provision And Utilization Of Post Abortion Care Services In Pakistan, Marina Baig, Kiran Mubeen

Journal of Asian Midwives (JAM)

Access to safe abortion services remain a challenge in many low and middle income countries like Pakistan. Evidence suggests that Pakistan shares a huge burden of abortion related morbidities and mortalities. Timely provision of Post Abortion Care (PAC) services could assist in preventing maternal deaths associated with unsafe abortions. However, there are certain socio-cultural, financial and political factors that restricts the provision and utilization of effective PAC services. This paper explores these determinants and suggest recommendations for policy and practice to promote PAC services in Pakistan.

Asian Midwifery In 2018, Rafat Jan, Edwin Van Teijlingen

Journal of Asian Midwives (JAM)

No abstract provided.

Relationship Of Family Members’ Support With Practice Of Community Midwives In Rural Sindh, Pakistan, Farida Shah, Farhana Shahid, Jamila Haider, Syfoor Ali, Bibi Ara, Misri Bano

Journal of Asian Midwives (JAM)

Background: Pakistan has one of the highest maternal mortality rates in the world. Community Midwives (CMWs) were introduced in 2006 as a new cadre of birth attendants who would bring midwifery services to rural areas by being based in designated communities. The CMWs face many obstacles and retaining them in practice is a challenge. This study aimed to examine whether there was a relationship between family support and CMWs retention in midwifery practice. We hoped to learn about influences on retention that might improve the Maternal Newborn and Child Health (MNCH) programme.
Methods: This was a cross-sectional survey conducted in …

Gender Inequalities And Childbearing: A Qualitative Study Of Two Maternity Units In Nepal, Lesley Milne, Jillian C M Ireland Ms, Edwin Van Teijlingen, Vanora Hundley, Padam P. Simkhada

Journal of Asian Midwives (JAM)

The role and status of women in South Asian countries like Nepal are widely recognised to be lower than that of men. This gender inequality can be found throughout all levels of society. Our study is about the influence of gender on pregnancy and childbirth, which are very much in the female domain in South Asia, both at home and in health facilities.
A mixed-method, qualitative research study was undertaken in two birthing facilities in Kathmandu Valley to examine barriers to women accessing these services from the perspective of hospital staff. Thematic analysis identified seven subthemes related to gender, namely: …

Jam – Winter 2018, Edwin Van Teijlingen, Rafat Jan

Journal of Asian Midwives (JAM)

No abstract provided.

Developments In Midwifery In Asia In 2017, Rafat Jan, Edwin Van Teijlingen

Journal of Asian Midwives (JAM)

No abstract provided.

Implementation Of A Bachelor’S In Midwifery Programme In Pakistan: Reflections Of Midwifery Faculty, Arusa Lakhani, Sadia Abbas Ali, Kiran Mubeen, Marina Baig, Shahnaz Shahid, Rafat Jan, Karyn Kaufman

Journal of Asian Midwives (JAM)

Introduction/Objective: There is an international consensus on the significant role of competent midwives in improving maternal and newborn health indicators. Midwives and midwifery education in the developing world including Pakistan have lagged behind in being part of higher education. To enhance the quality of maternal and newborn services through competency based higher education in midwifery, the first Bachelors of Science in Midwifery (BScM) programme was introduced in Pakistan. As part of a larger study about establishing this programme, this paper focuses on the reflective logs of midwifery faculty members who initiated this new programme in Pakistan.
Method: The team of …

Exploring The Fears Of Pakistani Primi Gravidas About Childbirth, Zohra Kurji, Amina Aijaz Khowaja, Zahra Shaheen, Yasmin Mithani, Naveeda Haq

Journal of Asian Midwives (JAM)

Background: Childbirth can be a very painful experience as it brings a lot of physiological and psychological changes in women’s lives. The literature demonstrates that anxiety and fear during the birthing process is related to a woman’s ability to give birth safely; fear can lead to complications such as emergency caesarean section and a reduced ability to tolerate pain. Therefore, health care professionals need to explore fears and educate expectant mothers, most especially primi gravidas, about the birthing process.
Method: A qualitative descriptive exploratory design was used to investigate fears about childbirth. Purposive sampling was used to recruit a …

Determinants Of Quality Of Care And Access To Basic Emergency Obstetric And Neonatal Care Facilities And Midwife-Led Facilities In Low And Middle-Income Countries: A Systematic Review, Preeti K. Mahato, Edwin Van Teijlingen, Padam P. Simkhada, Catherine Angell

Journal of Asian Midwives (JAM)

Background: Maternal mortality is a major challenge to health systems in Low and Middle-Income Countries (LMICs) where almost 99% of maternal deaths occurred in 2015. Primary-care facilities providing Basic Emergency Obstetric and Neonatal Care (BEmONC) facilities, and facilities that are midwife-led are appropriate for normal birth in LMICs and have been proposed as the best approach to reduce maternal deaths. However, the poor quality of maternal services that leads to decreased utilisation of these facilities is among the major causes of maternal deaths worldwide. This systematic review studied factors affecting the quality of care in BEmONC and midwife-led facilities in …

Building A New Generation Of Midwifery Faculty Members In Bangladesh, Malin Bogren, Sathyanarayanan Doraiswamy, Kerstin Erlandsson

Journal of Asian Midwives (JAM)

This paper presents an initiative to build a new generation of midwifery faculty in Bangladesh, with the ultimate objective of providing insight into how to build capacity in the midwifery faculty to best utilize the existing academic, health care and policy environment. The initiative focuses on a promising approach that starts with a new generation of midwifery faculty who can lead a chain of change when separating midwifery teaching from nursing. The initiative identified four different interdependent components of equal importance, namely the initiation of master’s and bachelor’s degrees, development of accreditation guidelines and tools, and a mentorship programme. Building …

News & Events

Journal of Asian Midwives (JAM)

No abstract provided.

Exciting Times In South-Asian Midwifery, Rafat Jan, Edwin Van Teijlingen

Journal of Asian Midwives (JAM)

No abstract provided.

Evaluating A Community Maternal Health Programme: Lessons Learnt, Sheetal Sharma, Padam Simkhada, Vanora Hundley, Edwin Van Teijlingen, Jane Stephens, Ram Chandra Silwal, Catherine Angell

Journal of Asian Midwives (JAM)

Using the example of a community-based health promotion intervention, this paper explores the important triangle between health promotion theory, intervention design, and evaluation research. This paper first outlines the intervention and then the mixed-method evaluation.

In 2007, a non-governmental organisation (NGO) designed and implemented an intervention to improve the uptake of maternal health provision in rural Nepal. A community-based needs assessment preceded this novel health-promotion intervention that empowered women with information on the benefits of seeking care. The intervention had a flexible design and, at several points, the intervention’s progress was assessed and, where necessary, changes were made. The intervention …