Nursing Midwifery Commons^™

Improving Interdisciplinary Communication And Collaboration With The Standardization Of Doula Care Through An Informatics Tool, Shela Le

Master's Projects and Capstones

Objective: The 22-bed Labor and Delivery (L&D) unit lacks a standardized model to introduce doulas, clarify their scope of practice, or communicate the value of the services they provide. To address this gap, the team implemented a standardized doula awareness poster that included each doula’s name, photo, years of experience, and personal interests. Aim: The goal is to enhance visibility and promote integration of doula support to strengthen team collaboration and patient engagement. Methods: A pre- and post-implementation survey was distributed exclusively to the volunteer doulas. After the doula awareness poster was displayed for a month, a post-survey assessed these …

Standardizing Care: Strengthening Dka Protocol Implementation Among Emergency Department Nurses, Toni Joy Angelique Biliran Miculob

Master's Projects and Capstones

Objective: The objective of this project was to address the inconsistent understanding and utilization of the Diabetic Ketoacidosis (DKA) protocol in a high-acuity emergency department within a large hospital system, where baseline survey results showed that 84% of nurses found the DKA order set confusing and only 15% felt “very comfortable” applying it.

Aim: The aim was to improve nurse clarity, confidence, and consistency in using the DKA protocol to support timely, evidence-based management of this high-risk, time-sensitive condition.

Methods: The intervention consisted of brief, targeted education delivered during pre-shift huddles across day and night shifts, focusing …

Matrescence: An Emerging Concept For Birth Worker Practice, Kelsey B. Green

DNP Qualifying Manuscripts

The maternal mental health (MMH) crisis, affecting up to 25% of birthing individuals, is exacerbated by significant gaps in perinatal support. While birth workers are uniquely positioned to provide care, they often lack specialized training beyond basic screening checklists to address the complex transition to motherhood, defined as matrescence. This clinical innovation proposal outlines a matrescence-informed educational curriculum, guided by the Comprehensive Model of Mental Health during the Perinatal Period. The intervention is designed to build tangible, implementable skills, training birth workers to: (1) operationalize matrescence as a psychoeducational tool to normalize distress; (2) use clinical differentiation to distinguish the …

Lived Experiences And Educational Needs Of Women With A History Of Preeclampsia: A Qualitative Phenomenological Study In Indonesia, Fitriana Fitriana, Ani Kristianingsih, Nopi Anggistaputri

Journal of Asian Midwives (JAM)

Background: preeclampsia (PE).\ is one of the leading causes of maternal morbidity and mortality worldwide Many pregnant women fail to recognize early warning signs of the condition despite attending antenatal care, for reasons such as limited understanding of PE symptoms and/ or inadequate communication of health information by healthcare providers. Women with a previous history of PE are particularly vulnerable and require targeted educational support during subsequent pregnancies.
Methods: Eight pregnant women with a documented history of PE in their second or third trimester participated in in-depth semi-structured interviews using an interpretative phenomenological technique.  To ensure credibility and reliability, the …

Too Young, Too Risky: Maternal And Neonatal Outcomes Of Teenage Pregnancy In Pakistan, A Scoping Review, Sumia Andleeb Abbasi, Noor E Marfa Shivji, Warisha Qamar, Tayyaba Riaz Abbasi, Abdullah Riaz Abbasi, Raja Adan Asif

Journal of Asian Midwives (JAM)

Introduction: Teenage pregnancy is a global concern that affects both the developed and developing regions. Adolescent pregnancy is associated with serious maternal and child health outcomes. This paper aims to identify the prevalence and patterns of maternal child health outcome of adolescent’s pregnancies.
Methods: This review utilized the PRISMA-ScR guidelines. To identify the outcomes of the adolescent pregnancies, a wide-ranging search strategy was implemented. Data were extracted from 15 eligible studies with a total population of 5692participants from Pakistan. The studies included maternal characteristics, mode of delivery, and neonatal outcomes. Only quantitative methods were included.
Results: The review of 15 …

Code Crimson Ob: A Lifeline For Maternal Health, Colleen Cowie, Elizabeth Barrera, Leah Williams-Jones, Mercy R. Banaszak, Leonor Ruiz, Arvinder Singh

Nursing & Health Sciences Research Journal

Introduction: Postpartum hemorrhage (PH) accounts for 12% of maternal deaths in the U.S. and affects approximately 5% of obstetric individuals. Despite available treatments, delays in recognition and response can lead to severe complications or death. The purpose of this evidence-based practice project was to improve maternal outcomes by implementing Code Crimson OB, a specialized obstetric rapid response team (RRT) for managing maternal hemorrhage.

Methods: An unannounced maternal hemorrhage drill revealed critical delays in mobilizing appropriate personnel. In response, the RRT protocol was revised to include Code Crimson OB, ensuring rapid, coordinated intervention. Hospital-wide education was conducted, and the protocol officially …

Effect Of Focussing On Anastatica Hierochuntica Flower On Labour Pain, Duration Of Labour And Perceived Fatigue During Labour: Randomized Controlled Study, Emine Koç, Şükran Başgöl, Sümeyye Bal, Sabire Kirtiloğlu

Journal of Asian Midwives (JAM)

Background: Maternal fatigue and pain during labour can adversely affect the health of the mother, fetus, and newborn. Anastatica hierochuntica is a plant traditionally used in some cultures during childbirth rituals. When placed in water, the dried flower gradually unfolds and symbolically represents the opening of the uterus and birth canal. This study aimed to investigate the effect of focusing on the Anastatica hierochuntica flower during labour on labour pain, duration, and perceived fatigue.
Methods: This randomized controlled trial was conducted in the delivery unit of a mother-friendly hospital with 119 participants 60 in control group and 59 in intervention …

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 …

Factors Associated With Preterm Premature Rupture Of Membranes: A Case-Control Study In A Tertiary Hospital In Kabul, Afghanistan, Atia Sharif Nadi, Freshta Sharif Tawakkuli, Zainab Sharif Ezadi, Sayed Murtaza Sadat Hofiani, Shoaib Murtaza Sadat Naeemi, Ahmad Komail Frogh

Journal of Asian Midwives (JAM)

Background: It is essential to identify preterm premature rupture of membranes (PPROM) and its associated risk factors to reduce its impact. This study aims to find the demographic, reproductive, and obstetric factors associated with PPROM among women in Kabul, Afghanistan.
Methods: This case-control study was conducted over six months in 2023 at a tertiary hospital in Kabul, Afghanistan. We included 40 cases of PPROM and 80 controls without PPROM in this study. We used structured questionnaires to collect demographic, reproductive, and obstetric characteristics of the participants. To find the factors associated with PPROM, Logistic regression was performed using IBM SPSS …

Editorial – Dec 2025, Edwin Van Teijlingen, Rafat Jan

Journal of Asian Midwives (JAM)

No abstract provided.

Midwife-Led Birth Debrief: A Concept Analysis, Kate Buchanan, Elliesha O'Reilly, Georgia Wilcox, Sara Bayes, Lauren Kearney, Linda Sweet, Hazel Keedle

Research outputs 2022 to 2026

Background: Psychological birth trauma (PBT) affects approximately 19 % of postnatal women, making its prevention a global priority. Midwives are responsible for providing psychosocial care during the postnatal period to foster the mother-infant relationship, provide education and screening and support positive transitions to parenting. However, the specific attributes of a birth debrief and the role of the midwife in a supporting a woman to review their birth experience is less well documented in regulatory frameworks or scientific literature. This has created significant ambiguity in both clinical practice among health professionals and in research contexts. The lack of a clear understanding …

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 …

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 …

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 …

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 …

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 …

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 …

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 …