Nursing Midwifery Commons^™

A Scoping Review Of Maternal Active Smoking During Pregnancy And Low-Birth Weight, Naomi Sondang, Nindi Oktavia, Qorinah Estiningtyas Sakilah Adnani, Lani Gumilang, Hadi Susiarno, Victor Abiola Adepoju

Journal of Asian Midwives (JAM)

Background: Low-birth weight (LBW; < 2.5 kg) infants are at increased risk of early mortality, impaired growth, neuro-developmental delay and chronic disease later in life. Maternal behavior, especially cigarette smoking, remains one of the most modifiable determinants of birth weight. We therefore synthesized recent evidence on the association between active maternal smoking during pregnancy and LBW.
Methods: Following PRISMA guidance, we systematically searched PubMed, Scopus and ScienceDirect for the period January 2020 to 31 January 2025 for English-language observational studies that quantified the relationship between active prenatal smoking and LBW. Risk of bias was appraised, and findings were summarized narratively.
Results: In total 26,650 papers were found and eight eligible studies (four cohort, three cross-sectional, one case-control) from Asia, Europe and the Middle East were included. Across all designs and exposure metrics—self-report, exhaled carbon-monoxide, urinary cotinine, and cord-blood DNA-methylation, active smoking was consistently associated with …

Exploring Factors Informing The Choice Of Caesarean Sections Among Couples, And Healthcare Workers: A Case Of The Nairobi Hospital, Kenya, Mercy Mukubwa

MSc in Advanced Practice Midwifery

Background: A caesarean section (C/S) is a lifesaving procedure to reduce maternal and newborn morbidity and mortality. It is associated with more risks compared to a vaginal birth. The rates of C/S have been on an upward trend globally and are expected to continue to rise further. C/S predisposes neonates to poor outcomes, some of which could be life-threatening compared to vaginal birth. Similarly, C/S mothers are at greater risk for serious complications.

Objective: The primary objective of this study was to investigate the factors influencing the decision to undergo a caesarean section among couples and healthcare workers …

Nurses’ And Midwives’ Job Satisfaction And Retention During Covid-19: A Scoping Review, Laura Hynes, Sadie Geraghty, Sheena Mcchlery, Aisling Smyth, Reeti Brar, Karen Clark-Burg

Research outputs 2022 to 2026

Background: The COVID-19 pandemic focused attention on the previously well-documented world-wide shortage of nurses and midwives. The pandemic accentuated this crisis, which resulted in nurses and midwives questioning their roles and their careers. The impact of the pandemic on job satisfaction and the intention of nurses and midwives to stay has not been adequately explored. Aim: The aim of this scoping review was to identify and map the literature that describes the intrinsic and extrinsic factors that influenced nurses’ and midwives’ job satisfaction and intent to stay or leave their employment or profession during the COVID-19 pandemic. Method: This scoping …

Delivering Optimal Weight Gain Advice To Pregnant Women By Lead Maternity Carer Midwives In A Real-World Setting To Optimise Health Outcomes (Dot Study): A Case Study Protocol, Kirsten J. Coppell, Nicole Mcgrath, Beverley Lawton, Kendall Stevenson, H. Mel Rackham, Katrina J. Sharples, Trudy Sullivan, Rosemary M. Hall, Helen Paterson

Research outputs 2022 to 2026

Background: Excess gestational weight gain (GWG) occurs in up to 70% of women who birth. Excess GWG increases the risk of adverse outcomes in both mother and baby including gestational diabetes, pre-eclampsia, postpartum weight retention, large for gestational age babies, and adiposity among children. Antenatal lifestyle interventions can limit excess GWG. However, successful translation of interventions into routine antenatal care are seldom, and interventions involving midwives are uncommon. Following a successful feasibility study, the main aims of this study are to determine if the Delivering Optimal weighT gain advice in pregnancy (DOT) intervention is acceptable to midwives, acceptable and accessible …

Women’S Experiences Of Declining Recommended Or Routine Maternity Care: A Systematic Review, Ilyana Mohamed Hussain, Kate Buchanan, Linda Sweet, Sara Bayes

Research outputs 2022 to 2026

Background Women have the right to decline recommended or routine maternity care. While informed choice is increasingly emphasised in maternity care, the experiences of women who decline recommended or routine care remain underexplored. Aims To synthesise evidence on women’s experiences of declining recommended or routine aspects of maternity care. Methods A systematic review was conducted using a structured approach informed by Joanna Briggs Institute (JBI) principles for qualitative synthesis. Eight studies were appraised using the Critical Appraisal Skills Programme (CASP) checklist. Data were analysed through a narrative synthesis process, developing categories and dimensions that were synthesised into overarching themes. Results …

Stakeholders’ Perceptions Of The Roles And Regulations Of Advanced Practice Nursing And Advanced Practice Midwifery, Constance Shumba, Benard Mutwiri, Denis Munene, Rachel Kimani, Beatrice May, Isabel Kambo, Colette Henderson, Irene Mageto, Daniela Lehwaldt, Eunice Ndirangu

School of Nursing & Midwifery, East Africa

Background Advanced practice nursing (APN) and advanced practice midwifery (APM) in Kenya are critical in healthcare system strengthening by expanding access to quality care, particularly in underserved regions. Globally, the International Council of Nurses (ICN) defines APN as a level of nursing practice that requires a minimum of a master’s degree, along with advanced clinical training and competency. Similarly, APM involves midwives with advanced training to provide specialized maternal and neonatal care. In Kenya, the APN and APM concepts were launched in 2020 and are still nascent, and their practice is determined by the context as provided by the country …

Palliative Care Conditions Managed At Home And Self-Reported Challenges Experienced By Informal Home-Based Caregivers In Rwanda: A Qualitative Study, Jean Claude Twahirwa, Madeleine Mukeshimana, Margaret Fitch, Godfrey Katende

School of Nursing & Midwifery, East Africa

Introduction: A greater dependency on informal home-based caregivers to assist patients in their homes stems from Rwanda’s rising palliative care needs and the burden of terminal illnesses. These caregivers play a critical role in addressing patients’ physical and emotional needs and assisting with daily activities. However, in low-resource settings like Rwanda, limited attention has been given to understanding their lived experiences and the challenges they face. This study primarily aimed to explore the lived experiences and caregiving challenges of informal home-based caregivers providing palliative care. A secondary aim was to describe the range of life-threatening conditions being managed at home …

Economic Factors Influencing Utilization Of World Health Organisation-Recommended Anc Visits Among Women In Jordan: An Analysis Of Jordan Population And Family Health Survey 2023, Lilian Nuwabaine, Joseph Kawuki, John Baptist Asiimwe, Benjamin Betunga, Mathius Amperiize, Angella Namulema, Imelda Namatovu, Shamim Nabidda, Patience Annet Nakalega, Quraish Sserwanja

School of Nursing & Midwifery, East Africa

Background: Antenatal care (ANC) is crucial for reducing maternal and neonatal mortality by identifying and managing complications early during pregnancy. In 2016, the World Health Organization (WHO) updated its guidelines, recommending a minimum of eight ANC visits to improve maternal health outcomes. Despite Jordan’s efforts to enhance maternal healthcare, disparities in ANC utilization persist, particularly among vulnerable populations such as refugees. This study aimed to assess the economic factors influencing utilization of the WHO-recommended eight ANC visits among women in Jordan.

Methods: The study used data from the 2023 Jordan Population and Family Health Survey (JPFHS). A two-stage sampling technique …

Peer Education Programme To Improve Adolescent Sexual And Reproductive Health In Rwanda, Aimable Nkurunziza, Michael Habtu, Germaine Tuyisenge, Nadja Van Endert, Godfrey Katende, Assumpta Yamuragiye, Justine Bagirisano, B.H. Jean Hitayezu, Olive Tengera, Edward Rwagasore

School of Nursing & Midwifery, East Africa

Background: A peer education programme was developed in response to the tendency of high school students in Rwanda to seek sexual and reproductive health information from peers who are often inadequately informed.

Aim: To assess the effect of Sexual and Reproductive Health Peer Education Programme (SRH PEP) on knowledge and the attitudes of SRH among high school adolescents in Rwanda. Setting: The study was conducted at selected high schools in Rwanda.

Methods: This pre-test and post-test design study was conducted in two selected high schools. The pre-test data were collected in February 2020, followed by the post-test data in May …

Woman-Centred Ethical Grid For Midwifery Education: A Content Analysis, Kate Buchanan, Darcie Bygraves, Emma Ritchie, Krystyl Toneycliffe, Sara Bayes, David Seedhouse

Research outputs 2022 to 2026

Background: Midwives across the world are required to practice in accordance with an internationally agreed set of ethical principles. Midwifery education for many students includes ethics theory content, but this does not necessarily provide them with the skills toward ethical competence in practice. Aim: To understand students' perception of ethical issues and to use these findings as foundational information with which to create an ethical deliberation tool for practice. Methods: Qualitative Content Analysis was used for this study. Purposive sampling provided twenty-one ethics-focused reflective assignments from one Western Australian university. Ethical considerations: Institutional review board approval was obtained. Findings: Three …

Global Perspectives Of Midwifery Ethics: Crucial Features For Practice Via An International Delphi Study, Kate Buchanan, Sara Bayes, Elizabeth Newnham, Mavis Kirkham, Marianne Nieuwenhuijze

Research outputs 2022 to 2026

Background: Practising ethically as a midwife is essential for providing high quality care during pregnancy, childbirth, and the postpartum period. Whilst midwives may have theoretical knowledge of ethics, applying ethical care in practice may be challenging. There is a gap in the literature that describes how midwives themselves conceptualise, interpret, and apply ethics in their practice. Aim: To describe midwives’ perceptions, and experiences of ethics in midwifery practice, and to determine the crucial features of midwifery ethics. Methods: Fifty participants from 21 countries participated in the study. A two-round Delphi approach was employed. Round Two required participants to enter the …

Co-Designing A Resilience-Based Mentoring Program For Novice Midwives: A Participatory Action Research Approach, Dianne Bloxsome, Tracy Martin, Kaoru Nosaka, Sara Bayes

Research outputs 2022 to 2026

Aim: To co-design a resilience-based mentoring program for novice midwives in Western Australia, informed by the experiences of past midwifery graduates and the perspectives of midwives in senior roles. Background: Effective workforce planning and retention strategies are essential in preventing the continued loss of midwives and in attracting newly qualified midwives to healthcare organisations. Transitioning from student to registered midwife is a known period of vulnerability that requires structured, evidence-informed support. Design: A Participatory Action Research (PAR) approach was adopted to collaboratively develop a mentoring program tailored to the transition needs of newly qualified midwives. Methods: Fourteen participants contributed to …

A Five-Country Comparison Of Midwifery Students' Confidence In Facilitating Normal Labor And Birth, Juliet Wood, Jalana Lazar, Barbara Baranowska, Clare Davison, Debora Dole, Cindy L. Farley, Jane Fry, Maria Healy, Felicity Agwu Kalu, Urszula Tataj-Puzyna, Emma Ritchie, Maria Wegrzynowska

Research outputs 2022 to 2026

Introduction: Midwifery students need confidence in recognizing and supporting normal birth, the backbone of the midwifery professional role. Developing this confidence in the face of decreasing rates of physiological birth worldwide is a critical challenge. Midwife researchers from Australia, England, Northern Ireland, Poland, and the USA investigated midwifery student confidence for supporting normal birth and explored enhancing and detracting factors. Methods: A cross-sectional survey design was undertaken with 570 midwifery students at 8 academic midwifery programs across 5 countries The Student Confidence for Supporting Normal Birth Questionnaire with free text and Likert-type questions on a 1 (least influential) to 4 …

Implementing A Pap Smear Tracking Tool For Increased Compliance, Meghan Marie Madea Msn, Cnm, Whnp-Bc, Katherine Ferrell Fouquier Phd, Cnm, Facnm, Bobby Bellflower Dnsc, Nnp-Bc, Faan, Faanp, Fnap

Doctor of Nursing Practice Projects

Purpose/Background

The Papanicolaou “pap” smear screens for cervical cancer in women ages 21-65 with a cervix. Inconsistent locations for lab results lead to a decrease in provider efficiency, and patients are unaware of results or recommended follow-up. This quality improvement project implemented a tracking tool within the electronic medical record (EMR) in a busy midwifery clinic. The outcomes are the identification of patients overdue for pap smears, scheduling the procedure, recording of results, and patient notification with recommended follow-up.

Methods

A one-month chart review was performed of fifty gynecology patients within a midwifery clinic. Results of pap smears were located …

Ready Or Not? An Autoethnography Of A Midwife’S Preparedness And Readiness Journey, Kristen Graham

The Qualitative Report

This emotive autoethnography explores my experiences working as an Australian midwife in low- and middle-income countries, which led to a Doctor of Philosophy journey exploring primary care midwives' preparedness and readiness in rural and remote communities in this context. I use the midwifery tradition of storytelling to explore personal experiences of preparedness and readiness as a way towards researcher reflexivity, understanding and meaning. Emerging themes of preparation for practice, resource limitations, heartache, and emotional resilience offer insights to inform midwifery education, research, and practice.

Association Of Covid-19 Status With Maternal And Neonatal Outcomes Among Pregnant Women At Mombasa County Referral Hospital, Kenya, Salome Mghoi Rajab

MSc in Advanced Practice Midwifery

Background: COVID-19 pandemic has raised global concern regarding maternal and neonatal health owing to physiological and immunological changes that may heighten disease severity. Despite the global evidence linking COVID-19 infection with unfavorable pregnancy outcomes, data from Sub-Saharan Africa remain limited. This leaves an essential vacuum in our understanding of how COVID-19 status affects maternal and neonatal outcomes in counties like Mombasa, where health-care system problems may alter risks. Vertical transmission remains a puzzle to be solved.

Aim: To assess the association of COVID-19 status on maternal and neonatal outcomes between March 2020 to March 2022.

Methodology: A …

Work While You Learn: Evaluating A Paid Employment Model For Postgraduate Midwifery Students In Diverse Contexts, Sadie Geraghty, Kirstie Balding, Sheena Mcchlery, Sarah Hay

Research outputs 2022 to 2026

Background: Postgraduate midwifery student employment models are lacking robust evaluation of how the paid employment model serves as a workforce strategy in Western Australia. Aim: The aim of this study was to evaluate a paid employment model for postgraduate midwifery students, that was implemented in metropolitan, rural, and regional areas in a Western Australian context. Methods: A convergent parallel design collected both quantitative and qualitative data. This study used a survey design with quantitative and qualitative questions within a well-established process evaluation framework. Results: All midwifery students reported benefits of the paid model of employment, which included financial stability while …

Reducing Nulliparous, Term, Singleton, Vertex Cesarean Birth Rate, Roseanna Juarez

Master's Projects and Capstones

Abstract

Problem: Cesarean birth rates for nulliparous, term, singleton, vertex (NTSV) pregnancies in the United States continue to exceed the Healthy People 2030 goal of 23.6%, resulting in preventable maternal and neonatal complications and higher healthcare costs.

Context: This quality improvement (QI) initiative was conducted in a high-acuity labor and delivery unit in California’s Central Valley, an area characterized by maternal health disparities, high rates of comorbidities, and limited access to prenatal care. The goal was to reduce the NTSV cesarean rate to 18.0% by July 31, 2025.

Interventions: Guided by Kotter’s 8-Step Change Theory and the Plan-Do-Study-Act (PDSA) framework, …

Navigating Childhood Asthma Care In Kenya: Barriers Identified By Children And Their Caregivers, Joan Ahimbisibwe, Roselyter Riang’A, Angela Migowa, Samuel Otido

Paediatrics and Child Health, East Africa

Background: Asthma is one of the most common chronic conditions in children, with significant morbidity and mortality, especially in Africa. Achieving adequate asthma control in children remains challenging because of gaps between standard recommended management strategies and actual treatment practices. This study explored barriers to asthma management as perceived by children and their caregivers in a private tertiary care setting in Kenya.

Methods: An exploratory phenomenological qualitative study was conducted at Aga Khan University Hospital (AKUH), Nairobi. Children aged 6–18 years with a confirmed diagnosis of asthma and their caregivers were recruited. The participants had been receiving treatment for at …

Exploring Available Admission Criteria For A Bachelor Of Science In Nursing/Midwifery: A Scoping Review, Jackline Estomihi Kiwelu, Aminieli Usiri, Gadiel Ketto, Tumbwene Mwansisya, Eunice Pallangyo

Libraries

Background: Nursing and midwifery are crucial professions in healthcare systems, and the availability of well-trained professionals in these fields contributes to achieving global and national health goals. The process of equipping nurses and midwives with professional knowledge and skills starts with selecting candidates that are suitable for the profession, and able to complete nursing/midwifery education and become lifelong learners.

Objective: This study aimed to identify and document currently available admission criteria for a Bachelor of Science (BSc) in Nursing/Midwifery.

Methods: This scoping review used Arksey and O’Malley’s five-stage framework to explore admission criteria for BSc in Nursing/Midwifery …

Measuring The Impact Of The Australian National Placement Evaluation Centre To Enhance Nursing And Midwifery Student Clinical Placements: A Multimodal Evaluation, Colleen Ryan, Robyn Cant, Areum Hyun, Debbie Procter, Louise Alexander, Dianne Bloxsome, Lynda Hughes, Fiona Bogossian, Simon Cooper

Research outputs 2022 to 2026

Aim: To evaluate the early impact of the Centre. Background: The educational quality of nursing and midwifery student clinical placement learning varies. The National Placement Evaluation Centre has a pivotal role in quality improvement by systematically collecting student and supervisor feedback on placement experiences. Design: Multimodal impact evaluation. Methods: Data were collected from website analytics and a survey shared via stakeholder registration emails and social media. The Impact Management Planning and Evaluation Ladder model was used to understand impact. Data were analysed using a sequential, hybrid inductive/deductive approach. Descriptive statistics summarised participant characteristics and qualitative data were themed. Results: Website …

The Lived Experiences Of Fathers With Postpartum Depression: A Qualitative Study, Rachael Elizabeth Schmitz

Nursing and Health Sciences

Background:

Although parents may joyfully anticipate the birth of a child, it's impossible for them to know ahead of time just how profoundly their lives will change. Postpartum depression (PPD) can result. While there is a substantial body of research regarding maternal PPD, paternal PPD has received far less attention and is neither adequately understood nor diagnosed. This is exacerbated by outdated but persistent sociocultural masculinity norms and the stigmas around mental health issues.

Purpose:

This study sought to explore the lived experiences of new fathers with PPD in order to provide greater insight into their experiences.

Methods:

This qualitative …

Compassionate Self-Care For Nurses And Midwives: A Sequential Explanatory Mixed Methods Study, Mary Steen, Shwikar Othman, Jennifer Fereday, Annette Briley, Qunyan Xu, Rachael Vernon

Research outputs 2022 to 2026

Background: Awareness of being kind and compassionate to yourself is often overlooked despite emerging evidence that high levels of self-compassion decrease levels of anxiety and improves well-being. Aim: To explore what being compassionate to yourself means to nurses and midwives and increase knowledge and understanding of how self-compassion may enhance well-being. Methods: Mixed methods study design was utilised to investigate and explore the influence of self-compassion on nurses and midwives' well-being. Phase 1 involved quantitative data collection and analysis. Phase 2 qualitative data were collected to expand on quantitative results. Results: Fifty-four participants responded to a pre-workshop questionnaire, 55 completed …

From Diagnosis To Conception: Managing Polycystic Ovary Syndrome-Related Subfertility With A Multimodal Strategy: A Case Study, Uzma Akhtar, Shafiq Ur Rahman, Rafat Jan, Sumaira Naz

Journal of Asian Midwives (JAM)

Polycystic Ovary Syndrome (PCOS) is a leading cause of infertility, primarily due to anovulation caused by hormonal imbalances, insulin resistance, and disrupted ovarian function. This paper describes a 28-year-old woman with PCOS who presented with subfertility after failing to conceive for 10 months. Initial treatment involved Metformin for insulin resistance, vitamin D, folic acid, and Dydrogesterone for cycle regulation. Ovulation induction with Letrozole was initiated but showed a suboptimal response in three cycles. Success was achieved in the fourth cycle by combining Letrozole with injectable Menotropins (HMG), leading to improved follicular growth, endometrial thickness, and successful conception. This case highlights …

Post-Natal Mother’S Perception Of Health Care Workers’ Attitude In Calabar Municipality, Nigeria: A Study In Maternity Care, Inyang E. Eko, Ngozi P. Ogbonnaya, Peace C. Alichie, Stehanie C. Osuorah, Ezioma Lordson

Journal of Asian Midwives (JAM)

This study explores post-natal mothers’ perceptions of health care workers’ attitudes in Calabar Municipality, Cross Rivers State, Nigeria.
Methods: A cross-sectional design was adopted in which the target population of the study involves all post-natal mothers in Calabar Municipality, which amounts to 57229 women and 440 mothers. These women and mothers were selected from the accessible population which included women carefully chosen from three public health facilities - the University of Calabar Teaching Hospital (UCTH), the General Hospital of Calabar (GHC), and a primary health center in Big Qua using multistage stage sampling techniques. Data were collected using a …

What Is Midwifery Work In Low And Middle-Income Countries? A Systematic Review To Enhance Midwifery Practices In Resource-Constrained Contexts, Qorinah Estiningtyas Sakilah Adnani, Ela Nurfitriyani, S. Tr. Keb, Niken Bayu Argaheni, Rufidah Maulina, Victor Abiola Adepoju, Maeve O’Connell

Journal of Asian Midwives (JAM)

Background: Midwifery plays a crucial role in enhancing maternal and newborn health outcomes in low- and middle-income countries (LMIC). This systematic review aims to provide a comprehensive and evidence-based evaluation of midwifery practice in LMIC, beyond specific outcomes and interventions.
Methods: A systematic literature search was conducted using electronic databases including PubMed, Embassy, Scopus, Web of Science, and CINAHL, covering the period from 2019 to 2023. The search strategy employed predefined keywords and Medical Subject Headings (MeSH) terms related to midwives, maternal health, newborn health, and LMIC. The findings were analyzed using a narrative synthesis approach to identify key …

Editorial – July 2025, Edwin Van Teijlingen, Abeer Musaddique, Rafat Jan

Journal of Asian Midwives (JAM)

No abstract provided.

An Exploration Of The Effect Of Covid Restrictions On Maternity Care In Uganda, Hellen Kyakuwaire, Grace Edwards, Ahmed Mohammed Sarki

Journal of Asian Midwives (JAM)

Background: Uganda responded aggressively to the worldwide spread of COVID-19 by imposing a total lockdown, which forbade movement of the whole population, including pregnant women and other vulnerable groups. This phenomenological study explored pregnant women’s experiences during the total lockdown in Uganda and identified factors that influenced the quality of healthcare for pregnant women during the lockdown.
Methods: Thirty-two newly delivered women were selected across a wide geographical area to represent rural and urban areas. The sample was selected from women who had given birth at the selected health facilities from March 18, 2020, to April 30, 2020. …

The Effects Of Midwifery Students’ Simulation Training In Perineal Repair: A Quasi-Experimental Study, Zahra Sadat Pajohideh, Solmaz Mohammadi, Fatemeh Keshmiri, Azam Honarmandpour, Azam Jahangirimehr

Journal of Asian Midwives (JAM)

Background: The decrease in normal deliveries and episiotomies in midwifery practice has reduced the experience of midwifery students in perineum repair. This study examined the effect of perineal repair simulation training on the clinical skills of midwifery students by designing, implementing and evaluating simulation models in procedural education.
Methods and materials: This quasi-experimental study was conducted on 60 midwifery students in intervention and control groups at Shoushtar, Iran, from September 2018 to August 2021. The intervention group received simulation training before entering the formal clinical education courses, while the control group took part in workplace-based training. The clinical repair skills …

The Impact Of The Covid-19 Pandemic On Maternity Care Services: Lived Experiences Of Midwives In Indonesia, Mergy Gayatri, Oluwadamilare Akingbade, Indhar Wahyu Wira Harjo, Adepegba Folasade Rebecca, Salako Faith Adebola

Journal of Asian Midwives (JAM)

Background: There have been fundamental changes in global maternity care in response to the COVID-19 pandemic across the globe. However, there are limited studies in Indonesia that have explored the changes experienced by midwives in various health facilities during the COVID-19 pandemic.
Method: A qualitative phenomenological study was conducted among midwives with at least three years of clinical experience in midwifery practice and practicing at different levels of healthcare. Semi-structured interviews were conducted through WhatsApp or Phone calls, as face-to-face interviews were impossible during the pandemic. Data were analyzed using thematic analysis.
Results: In total, 24 midwives …