Nursing Midwifery Commons^™

Journey To Baby-Friendly Designation: Standardizing Infant Feeding Education, Jasmine Geronimo Ibay

Master's Projects and Capstones

Problem The influence of formula companies in hospitals has caused a decrease in national breastfeeding rates, increasing risks of adverse health outcomes among infants. In response, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) launched the Baby-Friendly Hospital Initiative (BFHI) in 1991 to support breastfeeding practices for infant development and eliminate commercial interests of formula companies from hospitals. Context The quality improvement (QI) project was conducted at Hospital A’s Birth Center, serving a diverse population of patients in the greater East Bay of Northern California. The microsystem has 24 labor beds, 13 antepartum beds, and 33 …

Baby-Friendly Hospital Initiative: Becoming Baby-Friendly Designated, Krystal Angelique Mora

Master's Projects and Capstones

Section I: Abstract

Problem Despite efforts to increase breastfeeding rates, the influence of formula companies has contributed to the decrease in rates, affecting the health outcomes of infants. In response, the Baby-Friendly Hospital Initiative (BFHI) introduced standardized education for nursing staff to support infant growth and development. Context Hospital A Birth Center is a 33-bed culturally diverse unit that provides care to mothers in Northern California, delivering approximately 7,400 babies each year and helping patients transition into motherhood. Aim The quality improvement project aims to enhance the retention of BFHI-aligned education provided during hospitalization by 26.2%, raising retention rates among …

Efficacy Of M-Health Solution On The Paternal Postpartum Depression Affecting The Relationship Of The Couple: A Pilot Study In Four Hospitals Of Karachi, Pakistan, Syeda Sakina Mehdi, Naghma Rizvi, Saleema A. Gulzar, Nuruddin Badruddin Mohammed, Vardah Bharuchi, Syeda Aleena Abbas, Mehak Barolia

Journal of Asian Midwives (JAM)

Background: Postpartum depression (PPD) significantly impacts mothers and fathers, with paternal PPD (PPPD) affecting 28.3% of fathers in Pakistan. PPPD exacerbates maternal symptoms and disrupts family dynamics but remains underdiagnosed due to cultural stigmas and gender-specific presentations, such as aggression and stress. Socio-economic challenges, marital dissatisfaction, and limited support further heighten PPPD risks. Mobile health (mHealth) technologies offer accessible, stigma-free solutions for mental health support. This study explores PPPD health needs and evaluates an mHealth intervention for improving detection, support, and relationship outcomes among postpartum couples in Pakistan.
Methods: This exploratory sequential mixed-methods study will be conducted in two phases. …

Beyond Tradition: Exploring The Underlying Factors Of Delayed Cord Clamping, Sehar Aslam

Journal of Asian Midwives (JAM)

Delayed cord clamping (DCC) benefits mothers and infants by improving iron levels and neurodevelopmental outcomes while reducing neonatal complications. It is a crucial intervention, especially where iron-rich foods are scarce. Despite its advantages, DCC is often neglected due to medical complications, inconsistent policies, and clinical time constraints. Promoting DCC requires comprehensive education, clear protocols, interdisciplinary collaboration, and adequate skilled staffing. This paper emphasizes the importance of consistent DCC practices to enhance maternal and infant health and urges healthcare providers and parents to prioritize DCC in birth plans.

Knowledge And Attitudes Regarding Pubertal Changes Among Adolescent Males In Karachi: A Study Protocol, Sabah Muhammad Nazim, Saleema A. Gulzar, Hussain Maqbool Ahmed Khuwaja, Zohra Lassi

Journal of Asian Midwives (JAM)

Background: Adolescence (the period between childhood and adulthood) is characterized by significant changes in bodily functions, along with psychological and cognitive growth, which lays the foundation for future health. The unanticipated changes in that phase (especially related to sexuality) can cause adolescents embarrassment and distress, thus impacting their well-being and development. Despite the critical role of puberty in adolescents’ physical, psychological, and social development, research focusing on the knowledge and experiences of male adolescents going through puberty is limited, especially in urban Karachi, Pakistan. Several Pakistani studies have mainly focused on female adolescents and their experiences with puberty, leaving a …

“Time To Rebuild The Healthcare Workforce”: Addressing Socio-Cultural And Psychological Perspectives Of Men’S Presence In Nursing And Midwifery, Sarmad Muhammad Soomar, Salima Farooq, Sarosh Tahar Khymani, Nargis Asad

Journal of Asian Midwives (JAM)

Background: There is a global scarcity of healthcare workers, particularly nurses and midwives, who make up more than half of the current workforce associated with “care”, which is the essence of nursing and midwifery in patient and family care. This is always considered as a profession for women in most of the global workforce. In a patriarchal society, nursing and midwifery limits the choice to be adopted by men. Based on male nurses and midwives’ experiences and stories, it was aimed to explore the present literature to see the citations related to this area, which have been cited to address …

Indications And Outcomes Of Emergency And Elective Cesarean Section Deliveries In A Tertiary Care Hospital In Karachi, Pakistan: A Retrospective Study, Bakhtawar Muhammad Hanif Khowaja Bk, Sabahat Naz, Komal Valliani, Aqsa Nizar Maknojia, Asfa Anwer Ali, Mahek Zaheer Maknojia, Tabish Ali Shalwani, Sheikh Irfan Ahmed, Farida Mughal

Journal of Asian Midwives (JAM)

Background: This study identified major determinants of Cesarean-sections and the outcomes in one referral center.
Methods: A retrospective study was conducted at a tertiary healthcare facility and all women who had cesarean section between January 2020 to July 2021 were enrolled. A chi-square or independent t-test was used to compare maternal and pregnancy characteristics, and neonatal outcomes between emergency c-sections (EmCS) and elective c-sections (ElCS) groups. A multivariable logistic regression analysis compared indications and outcomes between the two groups.
Results: Among 767 women, there were 417 (54.4%) emergency and 350 (45.6%) elective cesarean sections. A multivariable logistic regression revealed that …

Impact Of Climate Change On Maternal Health In Pakistan: A Review Paper, Ihsan Ullah, Kiran Mubeen, Dilshad Begum, Rafat Jan

Journal of Asian Midwives (JAM)

Pakistan is one of the country’s most susceptible to the effects of climate change. Recent floods, heavy snowfall and rain have significantly impacted maternal and infant health. Indigenous women of child-bearing age especially those in rural areas are among the most vulnerable, facing food insecurity, disruptive food systems, rising food prices, and disrupted food production due to climate change. This review highlights a critical gap in research on indigenous women's maternal nutrition in the context of climate change, particularly in low- and middle-income countries. It emphasized the necessity for culturally responsive approaches and a deeper understanding of how climate change …

Maternal Care Providers’ Perspectives Of Selective Vs Routine Episiotomy, Uzma Akhtar, Salma Rattani, Rahila Meghani, Nadeem F. Zuberi

Journal of Asian Midwives (JAM)

Background: Normal Vaginal delivery is considered the favorable mode of delivery, but perineal trauma due to episiotomy is a significant concern in obstetric care nowadays. Although, routine episiotomy practice is discouraged because there is no evidence regarding its benefits, the rate of episiotomy is very high especially in lower-middle-income countries as compared to recommended rate given by the World Health Organization (WHO) which is 10% of all normal vaginal deliveries.
Method: Utilizing Preferred Reporting Items for Systematic Reviews and Meta-Analyses. (PRISMA) guidelines, the study searched for appropriate literature on Investigating Healthcare Professionals' Views on Selective versus Routine Episiotomy. Significant databases: …

Editorial – Dec 2024, Edwin Van Teijlingen, Abeer Musaddique, Rafat Jan

Journal of Asian Midwives (JAM)

No abstract provided.

Enhancing Respiratory Health With Post-Yoga Exercises During Pregnancy, Hiromi Ito-Kaneko, Masayuki Uehara

Journal of Asian Midwives (JAM)

Pregnancy results in enlarged uterus and diaphragm elevation, which may cause shallow breathing. These changes often cause nocturnal dyspnea, chest discomfort, and difficulty breathing, especially late pregnancy. Training of pregnant women for extending their exhalation reduces suffocation during movement, increasing comfort during pregnancy. In prenatal yoga, deep breathing is practiced and has a relaxing effect.
The purpose of this study is to determine whether yoga exercises during pregnancy improves exhalation length.
We enrolled 152 pregnant women and used a chronograph to measure their exhalation length pre- and post-yoga exercises and compared exhaled breath length by gestational age group. The pre-yoga …

The Role Of Midwives In Achieving The Global Sustainable Development Goals, Bakhtawar Muhammad Hanif Khowaja Bk, Elizabeth K. Darling

Journal of Asian Midwives (JAM)

The sustainable development goals (SDGs) provide a comprehensive framework for global development. Midwives are playing an important role in achieving the targets of the world’s priority agendas. They are actively involved in achieving the targets of SDG#2 by providing education to women on their nutritional requirements, supporting postnatal women with breastfeeding, and educating communities on the use of clean water, sanitation, and hygiene management. Beyond counseling and educating communities on nutrition and hygiene management, they are also involved in improving other health-related outcomes that are indicators for SDG#3, such as improving maternal and child immunization, counseling mothers on tobacco …

Factors Influencing Colostrum Avoidance In Developing Countries: Insights From A Literature Review, Muhammad Zeeshan Aslam, Jonathan Johnson, Marina Baig, Abeer Musaddique

Journal of Asian Midwives (JAM)

Introduction: Colostrum is a thick, sticky, clear and yellowish-coloured milk produced after the first few hours of birth until day 3. It consists of vitamin A, proteins, lipids, potassium, and maternal antibodies, including lactoferrin, immunoglobulin, growth factors and antimicrobial factors. Colostrum avoidance is the practice of squeezing out, pumping, and discarding the first milk. Various studies have reported colostrum avoidance worldwide, but its prevalence is higher in developing countries. Every day, approximately 3000 to 4000 infants die due to diarrhea and respiratory infections in developing countries, and one of the leading causes is colostrum avoidance. Infants are unable to take …

Compassionate Care In Times Of Loss: Unraveling Nurses’ And Midwives’ Perspectives To Assess Preparedness In Stillbirth: A Review Article, Nabila Salim Ali, Arusa Lakhani, Salma Rattani, Sidrah Nausheen

Journal of Asian Midwives (JAM)

Perinatal death, including stillbirth, is a tragic event that significantly impacts holistically the well-being of affected families, particularly in low-middle-income countries (LMICs), where the incidence is alarmingly high. This paper explores the profound effects of stillbirth on parental mental health, emphasizing the associated risks of mental health challenges and examining the crucial role of nurses and midwives in managing stillbirth, from providing immediate emotional support to facilitating long-term coping strategies. Despite their essential role, they face significant challenges, including inadequate training, emotional burdens, and the need for culturally sensitive care practices. Through a comprehensive review of the literature, this paper …

Improve The Referral System Of Health Care Organizations In Rural Community Settings Of Pakistan Using Health Information Technology (Hit) - A Protocol, Saleema A. Gulzar, Alishah Aziz Gulzar, Zahid Ali Faheem, Ayesha Arif, Aamir Sarfaraz

Journal of Asian Midwives (JAM)

Pakistan is a developing country, with 65% of the population residing in rural areas. The rural population is considered vulnerable mainly due to several factors, including poverty. Climate change and the area's topography limit their access to basic human needs such as basic healthcare, affecting their quality of life. Most people lack basic information about the location and availability of healthcare facilities, including hospitals, diagnostic centres, pharmacies, and general clinics. Hence, the rural healthcare system lacks primary care physicians, nurses, midwives and allied health professionals. Inappropriate infrastructure makes it challenging to retain qualified professionals. A non-profit and non-governmental entity aims …

Kolcaba’S Comfort Theory: A Framework For Understanding The Significance Of Skin-To-Skin Care After Childbirth, Aqsa Nizar Ali

Journal of Asian Midwives (JAM)

Despite the WHO recommendations and evidenced-based results of skin-to-skin contact, it is quite an uncommon practice witnessed after childbirth. Compared to research conducted in low and middle-income nations, the majority of the studies conducted in high-income countries revealed greater rates of SSC [11]. Skin-to-skin contact, a nurturing practice, has gained significant recognition as a cornerstone of early infant care. Beyond its physiological benefits, skin-to-skin contact fosters a profound sense of comfort and connection between mother and infant. Kolcaba's theory of comfort, a comprehensive framework for understanding and promoting comfort, provides a valuable lens to explore the multifaceted benefits of skin-to-skin …

An Evaluation Of The Effectiveness Of An Updated Pre-Service Midwifery Curriculum Integrated With Emergency Obstetric And Newborn Care In Kenya: A Cluster Randomised Controlled Trial, Duncan N. Shikuku, Catherine Mwaura, Peter Nandikove, Alphonce Uyara, Helen Allott, Lucy Waweru, Lucy Nyaga, Edna Tallam, Issak Bashir, Eunice Ndirangu

School of Nursing & Midwifery, East Africa

Introduction Quality midwifery education is central to improving midwifery service delivery and maternal and newborn health outcomes. In many settings, midwifery educators insufciently prepared for their teaching role and defcient curriculum compared to international standards afect the quality of healthcare provided by the midwifery graduates. This study assessed the efectiveness of an EmONC enhanced midwifery curriculum delivered by trained and mentored midwifery educators on the quality of education and student performance in Kenya.

Methods A cluster randomised controlled trial in 20 midwifery colleges (12 intervention, 8 control colleges). Educators in both arms received training in teaching/EmONC skills to deliver the …

Factors Associated With Quality Of Postnatal Care In Kenya: An Analysis Of The 2022 Kenya Demographic And Health Survey, Lilian Nuwabaine, Angella Namulem, Quraish Sserwanja, Joseph Kawuki, Earnest Amwiine, Mathius Amperiize, Grace Nakate, John Baptist Asiimwe

School of Nursing & Midwifery, East Africa

Introduction: Despite the significant contribution of postnatal care (PNC) to maternal and newborn survival, few studies have explored the concept of the quality of PNC received by mothers in Kenya. Therefore, this study aimed to determine the prevalence and factors associated with the quality of PNC in Kenya.

Methods: Secondary data from the Kenya Demographic and Health Survey (KDHS) of 2022 were analyzed, comprising 11,863 women who were aged 15 to 49 years. The quality of PNC was indicated as receiving all components of PNC in the first two days after childbirth. Multivariable logistic regression was conducted to determine the …

Quality Of Newborn Care And Associated Factors: An Analysis Of The 2022 Kenya Demographic And Health Survey, John Baptist Asiimwe, Earnest Amwiine, Angella Namulema, Quraish Sserwanja, Joseph Kawuki, Mathius Amperiize, Shamim Nabidda, Imelda Namagembe, Lilian Nuwabaine

School of Nursing & Midwifery, East Africa

Kenya one of the African countries has pledged to reduce neonatal death as per the 2030 World Health Organization target. Providing high-quality newborn care is critical in minimizing neonatal mortality. This study aimed to determine the factors that influence the quality of newborn care in Kenya. Secondary data from 11,863 participants of the 2022 Kenya Demographic and Health Survey (KDHS) were analyzed. The participants were chosen using two-stage stratified sampling. The quality of newborn care was operationalized as receiving all components of newborn care after childbirth, as reported by the mother. Using SPSS (version 29), univariate and multivariable logistic regression …

Benefits To Swaddle Bathing, Brenna Dotson, Kori Redden, Cassidy Payne

Scholars Week

Swaddle bathing is a technique that entails bathing an infant while they are comforted in a swaddle. This technique is rarely seen in everyday hospital practice, even though there is ample evidence of its benefits and advantages. Our project aimed to combine research proving the effectiveness of swaddle bathing through scoring methods that consider pain, vital signs, temperature, crying duration, and more. The research is combined to support the impact that swaddle bathing can have on not only infants but parents as well. Parents implementing the swaddle bath enjoy improved confidence and attachment, along with decreased stress. The evidence was …

Should I Stay Or Should I Go? Nursing And Midwifery Academics Intention To Stay In Or Leave Academia: A Scoping Review, Marion Tower, Rachel Muir, Peta Anne Zimmerman, Amanda G. Carter, Robyn Maude, Kathy Hollaway, Lynore Geia, Debbie Massey, Elizabeth Elder

Research outputs 2022 to 2026

Background: There is a chronic lack of appropriately qualified nurses and midwives being attracted into and remaining in the academic workforce. Reasons for this are not well understood but have been linked to stressful work environments related to balancing multiple roles in sometimes unsupportive environments, resulting in overload and demoralisation. Aim: To illuminate factors associated with nursing and midwifery academics' intention to remain in academia and factors associated with intention to leave. Design: A scoping review was undertaken to provide a comprehensive and broad analysis of the related literature. This was guided by Arksey and O'Malley. A search strategy was …

Where's My Baby? A Feminist Phenomenological Study Of Women Experiencing Preventable Separation From Their Baby At Caesarean Birth, Linda J. Deys, Valerie Wilson, Sara Bayes, Shahla Meedya

Research outputs 2022 to 2026

Problem: Separating women and babies immediately after birth contributes to poor birth experience and reduced satisfaction. Background: A negative birth experience can impact a woman's transition to motherhood and emotional well-being beyond the newborn period. Separating women from their baby at birth is known to reduce birth satisfaction and is more likely to happen at caesarean section births. Question: What is the experience of women who are separated from their baby after caesarean section birth without medical necessity? Methods: Unstructured, in-depth phenomenological interviews were conducted with fifteen women who had been separated from their well-baby at caesarean section birth. Data …

Factors Influencing Abortion Care-Seeking Outside Of Formal Healthcare Settings: Lived Experiences From Rwandan Young Women, Jean Pierre Ndayisenga, Assumpta Yamuragiye, Abe Oudshoorn, Godfrey Katende, Aimable Nkurunziza, Olive Tengera, Jean Bosco Henri Hitayezu, Justine Bagirisano, Jeanne D’ Arc Ayinkamiye, Gilbert Uwitonze

School of Nursing & Midwifery, East Africa

Background: Informal abortions, commonly known as unsafe abortions, refer to all induced abortions that occur outside of formal healthcare settings conducted without the assistance of a licensed, trained healthcare provider. Despite the legalization of safe induced abortion care services, informal abortions continue to be among the major causes of maternal mortality and morbidity among young women in Rwanda living in rural areas with limited or no access to safe abortion care services. The purpose of this qualitative study was to gain an in-depth understanding of the lived experience of seeking informal abortions from the perspective of young women in …

Vaccine Decision-Making Among Pregnant Women: A Protocol For A Cross-Sectional Mixed-Method Study In Brazil, Ghana, Kenya And Pakistan, Jessica Schue, Prachi Singh, Berhaun Fesshaye, Emily Miller, Shanelle Quinn, Ruth Karron, Renato Souza, Maria Laura Costa, Ferdinand Okwaro, Marleen Temmerman

Centre of Excellence in Women and Child Health

Maternal immunization is a critical strategy to prevent both maternal and infant morbidity and mortality from several infectious diseases. When the first COVID-19 vaccines became available during the pandemic, there was mixed messaging and confusion amongst the broader public and among those associated with health care systems about the recommendations for COVID-19 vaccinations in pregnancy in many countries. A multi-country, mixed-methods study is being undertaken to describe how vaccine decision-making occurs amongst pregnant and postpartum women, with a focus on COVID-19 vaccines. The study is being conducted in Brazil, Ghana, Kenya, and Pakistan. In each country, participants are being recruited …

Using Interpretive Description To Facilitate Women's Contributions To Maternity Care: Experiences And Views Of Obstetric Fistula Prevention, Lydia Babatunde Bulndi, Sara Bayes, Deborah Ireson, Esther Adama

Research outputs 2022 to 2026

Background/AimsInterpretive description is a qualitative methodology that combines detailed descriptions with thoughtful interpretation. This approach is especially effective for producing practical insights and deepening the understanding of phenomena in clinical or practice-based settings. The aims of this study were to explore how interpretive description could be used to research the experiences and views of women with obstetric fistula. MethodsInterpretive description was used to explore the experiences and views of 15 purposively selected women affected by obstetric fistula. Participants were recruited via the Evangel Vesico Vaginal Fistula Centre of Bingham University Teaching Hospital. Data were collected via in-depth interviews and concurrently …

Determinants Of Quality Antenatal Care Use In Kenya: Insights From The 2022 Kenya Demographic And Health Survey, John Baptist Asiimwe, Angella Namulem, Quraish Sserwanja, Joseph Kawuki, Mathius Amperiize, Earnest Amwiine, Lilian Nuwabaine

School of Nursing & Midwifery, East Africa

Provision of quality antenatal care (ANC) is important to reduce maternal and newborn fatalities worldwide. However, the use of quality ANC by women of reproductive age and associated factors remain unclear in many developing countries. Therefore, this study aimed to determine factors associated with receiving quality ANC in Kenya among women of reproductive age. We analyzed secondary data from the 2022 Kenya Demographic Health Survey, which included 11,863 women. Participants were selected using two-stage stratified sampling. Univariate and multivariable logistic regression analyses were used to analyze the data. Of the 11,863 participating women, 61.2% (95% confidence interval (CI): 59.7%–62.6%) received …

Assessing Nurse Educators' Competencies For Adopting Blended Learning In The Skills Labs In Uganda's Public Nursing Schools, Eva Kakonge Nampiima, Mathias M Bwanika Ulumba, Musisi Badru, Grace Nakate

School of Nursing & Midwifery, East Africa

Blended learning has become an integral part of nursing education, offering a blend of online and face-to-face instruction that enhances learning experiences, particularly within skills labs. However, the effectiveness of blended learning largely depends on the competencies of nurse educators in utilizing digital tools and methodologies. This study assessed the competencies of nurse educators in Uganda's public nursing schools concerning blended learning adoption. Data was collected from 40 randomly selected nursing educators in 4 public nursing schools in Uganda. The findings indicate significant inadequacies: only 25% are proficient with Learning Management Systems (LMS) like Moodle, 20% can effectively use platforms …

A Survey Of Students’ Experiences Of Returning To Midwifery Studies After Maternity Leave: A Pilot Survey, Liz Mcneill, Elaine Jefford, Michelle Gray, Dianne Bloxsome, Terri Downer, Jessie Johnson-Cash, Lyn Ebert

Research outputs 2022 to 2026

Aim: To identify the barriers and facilitators having an impact on the progression and completion of studies for students who give birth during their midwifery program. Background: Balancing the demands of pregnancy and new motherhood with the rigorous academic requirements of a tertiary-level midwifery program is challenging for students wishing to progress and complete their studies. Understanding the barriers and facilitators students face when resuming midwifery studies following birth can assist universities in providing educational environments that support students in achieving their midwifery education. Design: Social media online Qualtrics survey with closed and open questions. Method: Participants were Australian midwifery …

The Lived Experience Of Midwives’ Transitioning From A Clinical Role Into Teaching In Higher Education In One Jurisdiction Of Australia: A Pilot Study, Michelle Gray, Annie De Leo, Melanie Baker, Elaine Jefford

Research outputs 2022 to 2026

Aim: The aim of this pilot study was to explore clinician's experience of transitioning from midwifery clinical practice into university in an academic teaching role within one jurisdiction in Australia. Background: There is a dire shortage of midwifery academics globally. In Australia the shortage is symbiotic with the persistent deficit in the midwifery clinical workforce, which is the predominant recruitment pool for universities. The midwifery workforce cannot be replenished without sufficient academics to provide education. Design: Phenomenology was selected as the most appropriate research approach for the study seeking to illuminate the lived experiences of clinicians as they transition into …

A Systematic Review Of The Use Of Routine Versus Selective Episiotomy For Vaginal Birth, Nour A. Alrida, Amal Ababneh, Khawla Al-Sharif, Diana Arabiat, Jafar Alshraidah, Basheer Al-Zu'bi

Research outputs 2022 to 2026

Episiotomy is a common obstetric surgical procedure involving an incision to enlarge the vaginal opening, facilitating the delivery of the fetus during the second stage of labor. Hence, the current review was conducted to assess the impact of using selective versus routine episiotomy during vaginal birth on birth outcomes. This systematic review used the Joanna Briggs Institute (JBI) methodology for systematic reviews and research syntheses. PubMed, the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and SCOPUS were searched for relevant studies. Two reviewers independently screened and extracted data from relevant studies. Four studies met the eligibility …