Nursing Midwifery Commons^™

Training Traditional Birth Attendants In Sub-Saharan Africa, Lindsey J. Smith

Senior Honors Theses

Even after many adjustments, recommended practice regarding traditional birth attendants (TBAs) and their contribution to lowering the maternal mortality rate (MMR) continues to be disputed among various stakeholders. Sub-Saharan Africa continues to see high maternal mortality rates, despite various attempts by the World Health Organization (WHO) and others at utilizing the formal health care system (Prata, et al., 2011). Considering all factors and variables behind the reason for this problem in Sub-Saharan African, it is reasonable to conclude that training traditional birth attendants (TBAs) in evidence-based practice, in conjunction with developing longer-term strategies, is an appropriate approach for the short …

A Pilot Study Of A 6-Week Parenting Program For Mothers Of Pre-School Children Attending Family Health Centers In Karachi, Pakistan., Yasmeen Khowaja, Rozina Karmaliani Professor, Shela A. Hirani, Asif Raza Khowaja, Ghazala Rafique, Judith Mcfarlane

School of Nursing & Midwifery

BACKGROUND:

Recently, parenting programs to address behavioural and emotional problems associated with child maltreatment in developing countries have received much attention. There is a paucity of literature on effective parent education interventions in the local context of Pakistan. This study aimed to assess the feasibility of offering a 6-week parenting program for mothers of pre-schoolchildren attending family health centres (FHCs) in Karachi, the largest metropolitan city of Pakistan.

METHODS:

A pilot quasi-experimental trial was conducted. Two FHCs were selected, one as the intervention and the second as the control. A total of 57 mothers of pre-school children (n = 30 …

Breastfeeding Effects With Early Intervention For Ankyloglossia (Tongue-Tie), Hope L. Adams

All Electronic Theses and Dissertations

Background: Anklyoglossia or tongue-tie in infants often goes undiagnosed primarily due to the lack of knowledge for assessing tongue-tie thus disrupting a successful breastfeeding experience. Education, diagnosis, and treatment of ankyloglossia are vital in order to create a successful breastfeeding outcome. Purpose: To determine the effects of breastfeeding with early intervention for ankyloglossia (tongue-tie). Theoretical/Conceptual Framework: Benner’s concept of Novice to Expert allows nurses to develop skills over time through education and personal experiences. Weidenbach’s concept of The Helping Art of Clinical Nursing applies to direct patient care, teaching, and advice. Methods: Cumulative Index to Nursing and Allied Health Literature …

Birth Centers And Underserved Populations, Michelle M. Dabrowski

All Electronic Theses and Dissertations

Background: Disadvantaged women in the United States experience disparities in prenatal and birth related health outcomes. Purpose: The purpose of this literature review is to answer the question, “Can freestanding birth centers (FBC) improve outcomes for disadvantaged populations?” Results: FBCs do improve outcomes for disadvantaged populations in mode of delivery, low birth weight, prematurity, breastfeeding continuance, enhanced social support, and decreased familial stress, without additional risk for adverse outcomes. FBCs showed a demonstrable financial benefit through decreased facility fees, delivery charges, and fewer costs associated with the adverse health outcomes of cesarean sections, low birth weight, and premature infants. Conclusion: …

Centering Pregnancy: The Maternal And Neonatal Benefits Of Group Prenatal Care, Trisha Lynn Nelson

All Electronic Theses and Dissertations

Background/Purpose: Centering Pregnancy is a type of group prenatal care that allows women to meet and receive their prenatal care together. The groups meet ten times during the pregnancy and focuses on different aspects of prenatal care. This critical review of the literature focuses on maternal and neonatal benefits of group prenatal care over traditional one-on-one care. A secondary analysis looks at how group prenatal care affects adolescents, women of low socioeconomic status, and minority ethnicities. The Social Learning Theory by Albert Bandura was utilized to look at Centering Pregnancy. The Social Learning Theory states that learning in a group …

Non-Pharmacologic Antenatal Interventions To Reduce Or Prevent Postpartum Depression, Jenny Rebecca Olson

All Electronic Theses and Dissertations

Background/Purpose: The purpose of this paper is to critically examine the literature in order to identify whether there are non-pharmacologic antenatal interventions that are effective in reducing or preventing postpartum depression. Theoretical Framework: Cheryl Beck’s theory, Teetering on the Edge: A Substantive Theory of Postpartum Depression, was the theoretical framework used in this paper. Beck’s theory was based on 18 months of studying women with postpartum depression from symptom onset thru the recovery process. During her research, Beck identified four stages to describe the progression of postpartum depression: Encountering terror, dying of self, struggling to survive, and regaining control. Methods: …

Delayed Cord Clamping Impact On Transitional Outcomes Of The Newborn, Ann E. Rice

All Electronic Theses and Dissertations

Background: Currently in the United States, after a baby is born, the umbilical cord is immediately clamped; this is a routine obstetric procedure despite lack of evidence supporting this practice (Elchenbaum-Pikser, 2009). The practice of cord clamping varies with each provider from immediate cord clamping, to delayed cord clamping (which can vary from 1 to 5 minutes) to cord clamping after pulsation of the cord ceases. The procedure of cord clamping is a practice choice made by each medical provider and is based largely on personal preference, not evidence. Purpose: The purpose of this review and synthesis of literature is …

Safety For Women Opting For Tolac Versus An Elective Repeat Cesarean Section, Nicole Marguerite Rothgarn

All Electronic Theses and Dissertations

Background/Purpose: TOLAC is the trial of labor after cesarean. VBAC is the successful birth after cesarean. The aim of this paper is to establish safety for women opting for the trial of labor after a primary cesarean. The purpose is to be able to determine how we can better counsel our women opting for TOLAC to improve the worldwide cesarean rate. Theoretical/Conceptual Framework: Imogene King’s theory of goal attainment is used to show the correlation between the patient and the midwife thorough the journey of pregnancy. The ultimate goal is to use the four paradigm’s Imogene describes to achieve a …

The Potential Benefits And Risks Of Antidepressant, Antipsychotic And/Or Mood Stabilizing Medications Use In Pregnancy: A Critical Review Of The Literature, Brittany Kaye Schultz

All Electronic Theses and Dissertations

Background: Medication use in pregnancy walks a fine line between safety of the mother and adverse effects in the developing fetus. Medications are prescribed to either help the mother maintain mental stability or they are discontinued out of fear of fetal harm. Many providers hope that the shift in hormones during pregnancy will fulfill the medications requirement in the non-pregnant state but this is not always the case. Is a discontinuation in medications upon a positive pregnancy test warranted? Purpose: To determine if antipsychotics, mood stabilizers, and antidepressants should be continued or discontinued during pregnancy or if they negatively impact …

The Use Of Supplemental Progesterone In Preventing Preterm Birth In High-Risk Women: A Critical Review Of The Literature, Leah Marie Schroeder

All Electronic Theses and Dissertations

Background: Twelve percent of births in the United States occur before 37 weeks of gestation and therefore are considered preterm births (Norwitz, 2015). While the ability to identify women at risk for preterm birth has improved dramatically over the past three decades, the application of primary and secondary interventions has failed to reduce the incidence of preterm delivery, which has actually been on the rise (Norwitz, 2015). Preterm birth is a phenomenon that needs to be reduced not only in the United States, but also across the world. Purpose: To determine to what extent the use of supplemental progesterone in …

The Benefits Of Hydrotherapy During Labor, Karen M. Sonnenburg

All Electronic Theses and Dissertations

Background: There are many holistic options available to help women cope with the discomforts of labor including pain and anxiety. The use of hydrotherapy during labor is supported by The American College of Nurse-Midwives (2014) due to its many benefits including providing alternative pain relief measures to women during their labor and actual birth (Harper, 2014). Purpose: The purpose of this critical review of the literature is to identify and analyze the benefits of the use of hydrotherapy during labor including the use of showers, water immersion (immersion to the nipple line) and regular bathtubs. Results: Nineteen articles were selected …

Non-Antibiotic Alternatives For Reducing Antepartum Group B Streptococcus Colonization, Rebecca M. Smith

All Electronic Theses and Dissertations

Background: Streptococcus agalactiae (known as Group B strep, or GBS) is a bacterium that resides in the gastrointestinal tract and/or vaginal canal and is typically benign, but during pregnancy and birth it can potentially colonize the neonate, causing early-onset group B streptococcal disease (EOGBSD) of the neonate. The use of antibiotics has reduced the morbidity and mortality associated with neonatal infections, but it is not an entirely effective means of preventing the infections and the development of antibiotic resistance may render antibiotics ineffective for this purpose. Alternative methods of preventing GBS colonization are in use by consumers and out-of-hospital birth …

The Use Of Nitrous Oxide In The Management Of Labor Pain: Safet And Effiacy, Jennifer Ruth Christensen

All Electronic Theses and Dissertations

Background: All women will experience pain while going through childbirth. The pain is caused by pressure and stretching on the uterus and visceral organs, lack of oxygen during uterine contractions, and musculoskeletal and perineal stretching. Difficulty coping with pain leads to an increase in catecholamines, which further complicates the labor process and can contribute to long term psychological consequences. Up to 75% of women in other countries use nitrous oxide, a colorless odorless gas, to manage their labor pain. In the United States, the options for managing labor pain have consisted of non-pharmacological methods such as massage, breathing and relaxation …

An Ethnographic Investigation Of The Maternity Healthcare Experience Of Immigrants In Rural And Urban Alberta, Canada., Gina M. Higginbottom, Jalal Safipour, Sophie Yohani, Beverly O’Brien, Zubia Mumtaz, Patricia Paton, Yvonne Chiu, Rubina Barolia

School of Nursing & Midwifery

BACKGROUND:

Canada is among the top immigrant-receiving nations in the world. Immigrant populations may face structural and individual barriers in the access to and navigation of healthcare services in a new country. The aims of the study were to (1) generate new understanding of the processes that perpetuate immigrant disadvantages in maternity healthcare, and (2) devise potential interventions that might improve maternity experiences and outcomes for immigrant women in Canada.

METHODS:

The study utilized a qualitative research approach that focused on ethnographic research design and data analysis contextualized within theories of organizational behaviour and critical realism. Data were collected over …

Integration Of Health Promotion Into Nursing Practice: A Case Study In Pakistan., Muneerah Vastani, Rozina Karmaliani Professor, Pammla M. Petrucka

School of Nursing & Midwifery

The purpose of this study was to understand the concept of health promotion and perceptions related to the integration of health promotion in nursing practice in Pakistan. The study utilized the qualitative single case study approach to explore and describe the concept of health promotion, its significance and ways to integrate health promotion strategies in nursing practice. The data were collected from three different sources; focus group discussion among final year Post-RN BScN students, key informant interviews of practicing nurses, faculty, and MScN students, as well as a document review of the Post-RN BScN curriculum. Data analysis included a content …

The Effect Of Alternative Labor Positions Versus The Lithotomy Position On Birthing Outcomes: An Integrative Literature Review, Kelsey Gaffka

Honors Undergraduate Theses

Traditionally, the lithotomy position is the most commonly used birthing position in western cultures. The purpose of this literature review was to examine the differences in maternal and neonatal outcomes when alternative labor positions are used. Implications for future use of alternative labor positions were explored. Peer reviewed, English-language research articles published from 2009 to 2015 were included for synthesis. Study results revealed that the lithotomy position is linked to multiple negative maternal outcomes. Birthing in a water pool or in a lateral position has been linked to more optimal maternal and neonatal outcomes compared to other positions. Health care …

Pelvic Floor Muscle Training In Management Of Postpartum Pelvic Floor Dysfunctions: A Literature Review, Rebecca S. Tanner

Honors Undergraduate Theses

Women can face a wide range of pelvic floor dysfunctions following pregnancy, ranging from urinary incontinence to pelvic pain. Unfortunately, these problems are not routinely checked for in postpartum check-ups and women do not always bring it to the physician’s attention. Strengthening of the pelvic floor muscles may be able to help women prevent these disorders and improve these women’s lifestyles.

The purpose of this thesis was to review and analyze different trials to determine if different pelvic floor dysfunctions (urinary incontinence, sexual dysfunction, and pelvic girdle pain) can be treated using pelvic floor muscle training in the postpartum. After …

Experiences Of Adopting Blended Pedagogies In Health Assessment Course In Post Rn Baccalaureate Program Of Nursing In Karachi, Pakistan, Shanaz Hussein Cassum, Saleema Allana, Jacqueline Maria Dias

School of Nursing & Midwifery

Purpose: There is little known about whether faculty and students in a resource constricted context experience a change in learning due to the adoption of blended learning (BL) pedagogies in a lab based course. The study aimed to understand the experiences of faculty and students’ related to the adoption of BL pedagogies in health assessment course.
Design: An action research design was used in this study to integrate planning, action and research in the setting where the change is required. The study sample consisted of year 1 Post RN BScN students enrolled at the Aga Khan University School of Nursing …

Low Self-Esteem Leads To Depression Among Elderly: Case Study Of Nursing Home, Savera Aziz Ali, Nadir Suhail, Sumera Aziz Ali

School of Nursing & Midwifery

Background: Self-esteem is defined as “how we value our self”; it affects our trust and relationships in every part of life. Person with low self-esteem may feel powerless and incompetent about himself/herself. Moreover, low self-esteem operates as a risk factor for depression, which is most common disorder among elderly people both in developed and developing countries, causing multiple behavioral changes as well as may increase the chances of depression and suicide among the elderly people. Objective: The objective of this case study was to understand the problems faced by elderly people in the nursing home and to relate the self-esteem …

Educated Birth: Beliefs Vs. Outcomes, Lauren Presley

Human Nutrition and Hospitality Management Undergraduate Honors Theses

“Our infant mortality rate is a national embarrassment.”¹ The words seem shocking and harsh across the headline of a 2014 Washington Post article. The thought of America not only not being the best at something, but falling upsettingly behind, is a foreign concept to many who view America as a nation inferior to none. However, the statistics on infant mortality rate tell the stark truth that of 26 “wealthy” countries, the U.S. ranks last, with a sobering 6.1 deaths per 1,000 live infant births.²

Part of the Healthy People 2020 Objectives is to reduce the rate of infant …

Enhancement Of Knowledge And Skills Of Community Midwives In Sindh, Pakistan, Sadia Abbas Ali, Arusa Lakhani, Rafat Jan, Shahnaz Shahid, Marina Baig, Farzana Adnan

Journal of Asian Midwives (JAM)

With a maternal mortality rate of 276 deaths per 100,000 live births, Pakistan is one of the countries with a large share in the percentage of world’s maternal mortality. As an intervention for the Millennium Development Goals (MDG) 4 and 5, the World Health Organization (WHO) strongly suggests that skilled care before, during, and after childbirth can save the lives of women and newborn babies. One of the interventions to ensure care to mothers and babies by skilled care providers is the capacity building training of Community Midwives (CMWs) aiming to improve their midwifery competency.

One such training intervention was …

Another Year Over …., Rafat Jan, Edwin Van Teijlingen

Journal of Asian Midwives (JAM)

No abstract provided.

The Effect Of Bereavement Counseling On Women With Psychological Problems Associated With Late Pregnancy Loss, Christy Simpson, Pramila Lee, Jessie Lionel

Journal of Asian Midwives (JAM)

Pregnancy is most often a joyful experience and a woman’s plans and dreams are shattered when the death of an unborn or newborn infant occurs. Studies have reported that these women experience psychological problems such as grief, depression, and anxiety which can be minimized by counselling. Hence, this study was undertaken to assess the effect of bereavement counseling on women with psychological problems associated with pregnancy, focusing on Roy’s adaptation theory. An experimental design, with pre-test and post-test, was used with randomly allocated experimental and control groups. Women were randomly allocated to the experimental and control groups with 45 women …

Conflict Between Paternalism And Autonomy., Amber Hussain Sayani

School of Nursing & Midwifery

In the past, paternalism played an important role in making decisions at the end of life. However, in the modern era its significance has become unpopular as it require physicians to decide what is good or bad for the patient without considering patients wish and interest. This commentary article is based on a case study of a woman whose life was lost due to complications of pregnancy. The paper critically reviews this case study, and attempts to provide a reasonable and systematic framework to make sound decisions in similar cases.

Common Factors In Unplanned Cesarean Section, Lauren C. Compton

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Obstetrical delivery by cesarean section is a prevalent form of delivery. Whether clinically indicated or by maternal request, cesarean delivery rates in the United States have risen to account for over a third of all deliveries. Cesarean section procedures are often clinically indicated and occur because of fetal factors, but they can also be elected by maternal request. The aims of this study are to analyze the frequency of the factors in the study questions that are associated with unplanned cesarean section procedures and to compare the frequency of these factors per cesarean section with the time of day the …

News & Events

Journal of Asian Midwives (JAM)

No abstract provided.

Knowledge And Perceptions Regarding Sexual And Reproductive Health Among High School Students In Kathmandu, Nepal, Magdalena Mattebo, Rebecka Elfstrand, Ulrika Karlsson, Kerstin Erlandsson

Journal of Asian Midwives (JAM)

Background: Nepal recently began teaching sexual education in the school system and has established youth friendly services in order to meet the need of increased sexual and reproductive knowledge among the youth.
Objective: To examine the sexual and reproductive knowledge and perceptions among young people attending schools in Kathmandu.
Method: A written questionnaire was distributed to 160 students, in a classroom environment, in four schools in Kathmandu.
Results: Two thirds of the females and nearly 60% of the males knew that it was possible to get sexually transmitted infection (STI) during one sexual encounter and more than half of the …

International Cooperation: Strengthening Midwifery In Central Asia, Meike Kolfenbach, Karen Birdsall

Journal of Asian Midwives (JAM)

Even 25 years after their independence, the Central Asian States (Kyrgyzstan / Tajikistan / Uzbekistan) are facing enormous challenges in the health system. Several years ago it became obvious that the MDG 4 and 5 would not be fully achieved. This led to an increased support of the health systems of the concerned countries by Germany’s International Cooperation. The GIZ Regional Health Programme in Central Asia placed great emphasis upon increasing the number of births attended by health professionals, including midwives. The strengthening of midwifery as a model of a sustainable maternal and child health relies on a broad based …

Community Based Midwives Practice In Patriarchal Social System, Yasmeen Jan Mohammad, Rafat Jan

Journal of Asian Midwives (JAM)

It is well accepted globally, that midwives can save the lives of mothers and their new-born successfully, if the community stakeholders provide support and freedom for full scope of practice. Recognising this many countries deploy midwives in the community as an intervention to achieve the MDGs (Millennium Development Goals) 4 and 5 targets set for decreasing maternal and neonatal mortality, respectively.

However, high-income countries’ reports show very good results, in achieving MDGs 4 and 5 while the low-income countries lag behind in this regard. The situation in high-income and low-income countries is different because midwives practising in the community in …

The Rates Of Mothers Who Continually Breastfeed After Implemented Breastfeeding Teaching, Katherine L. Moore

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Many mothers are unaware of the benefits of breastfeeding. This lack of knowledge leads to an inability to weigh the advantages and disadvantages of the potential source of nutrition their infant will receive during his or her first months of life. Many mothers never even attempt to breastfeed their infant. Even among the mothers who do initially choose to breastfeed, the majority deviate to other forms of feeding early in the postpartum period. Despite the fact that most major medical organizations encourage exclusive breastfeeding through the first six months of an infant’s life, the CDC report for 2013 claims the …