Attitudes Of Midwives Research Articles

Knowledge and Attitude Towards Utilisation of Partograph among Midwives in Selected Hospitals in Gombe State, Nigeria

Maternal mortality (MM) has remained high in developing countries including Nigeria. Various interventions for labour care like partograph are known to contribute to the reduction of MM, but reports show that they are not well utilized. Also, there is dearth of information on knowledge and attitudes of midwives towards the use of partograph. Therefore, the study assessed knowledge and attitude of midwives in Gombe state, towards the use of partograph. A cross-sectional descriptive design was adopted and 63 participants from three selected hospitals were recruited using purposive sampling technique. A self-administered questionnaire was used for data collection. Descriptive data were presented using frequency tables. Hypotheses were tested using Chi-square statistic at p≤ 0.05. The mean age of respondents was 37.2±7.6 years, and 77.8% were married. Majority, 96.8% had good knowledge, 70.6% had a positive attitude towards the use of partographs while only 44.4% utilised it regularly. Also, (57.1%) never attended any workshop on partograph post-graduation. There was no significant association between knowledge of partograph and its utilization (x2=0.026, p=0.103). Factors such as shortage of manpower, poor management support and time constraints were found to negatively influence the partograph utilisation. Despite their good knowledge, partograph utilization was not consistent. It is recommended that hands-on training on the use of partograph be organized periodically and an audit system put in place to ensure its effective use.

A qualitative study on midwives’ ethics of self forgiveness ın traumatic obstetric events: perfect guilt

This qualitative study was conducted to examine the self-blame and self-forgiveness attitudes of midwives who experienced traumatic obstetric events. The sample for this study consisted of 16 midwives who were actively working in obstetrics clinics. Data was collected using an Introductory Information Form and a Semi-structured Interview Form. The data was analysed using MAXQDA 2022 for content analysis. Colaizzi’s phenomenological interpretation method was used during data analysis. As a result of the analysis of qualitative data, 4 themes and 12 sub-codes were created. The mean age of the midwives participating in the study was 27.56 + 3.38 years and the mean monthly working hours were 176.00 + 19.43. It was determined that midwives questioned themselves in terms of effective communication (43.8%), adequacy in care (37.5%), meeting expectations (25%), empathy (18.8%) and ethics/professional ethics (18.8%) during care practices. It was determined that religious beliefs (43.8%), the permanence of the damage in the patient (18.8%) and the time elapsed after the event (18.8%) affected the midwives’ self-forgiveness after the obstetric traumatic events. In line with our study findings, it was determined that midwives blamed themselves because they felt ethically and morally responsible even in the absence of malpractice.

An Evaluation Postgraduate Midwives’ Attitudes Towards Postgraduate Education: Türkiye Example

Objective: To determine the academic and professional profiles of midwives studying at the Department of Midwifery in Türkiye, to examine their attitudes towards graduate education and related factors. Methods: This study was carried out descriptive and cross-sectional study with 190 midwives actively continuing their postgraduate education and who met the inclusion criteria. The study was conducted between April 2021 and July 2021. Descriptive Information Form and Attitude Scale Towards Postgraduate Education were used to collect data. Results: Thinking about becoming an academician in the future, being satisfied with the performance of the academicians in postgraduate education, thinking that clinical experience is necessary before postgraduate education were determined as the factors affecting the attitudes of midwives towards postgraduate education. Conclusion: It is thought that determining the attitudes, expectations and problems of midwives towards graduate education and developing solutions for problems will increase positive attitudes towards graduate education.

Midwives’ attitudes towards the use of cardiotocography in Greece

Introduction: Cardiotocography was designed to monitor the condition of the fetus during childbirth, but is now widely used in the prenatal period and the test is especially important in high-risk pregnancies, as it can detect reduced fetal placental function in conditions such as preeclampsia, hypertension, Rhesus sensitization etc. Aim: The aim of the research is to evaluate and highlight the attitude of Midwives regarding the use of cardiotocography in Greece prenatally and during childbirth. Material and Method: Data were collected using a questionnaire that included questions about the attitude of midwives to the use of cardiotocography. The sample was random and the questionnaires were distributed electronically via google forms. Results: It was found that 82% of the respondents consider the existence of a cardiotocograph necessary in an emergency and 76.7% express a positive opinion regarding its use in general and during childbirth, 49% state that with cardiotocography during childbirth, the mother's anxiety increases but at the same time 50.5% believe that the cardiotocograph does not spoil the beauty of childbirth. Also, 71.8% of the respondents do not consider that their skills are undermined by the use of cardiotocography and 52.4% state that the caregivers are not distracted by the mother. In addition, 71.8% of the respondents do not consider that their skills are undermined by the use of cardiotocography and also 52.4% state that the caregivers are not distracted from the mother. In addition, 43.7% state that their own judgment outweighs the ECG results but in cases where the ECG gives false indications, 36.9% state that they do not trust their judgment. Finally, 61.6% believe that cardiotocography is often used unnecessarily. Conclusions: Midwives in Greece are positive about the use of cardiotocography prenatally and during childbirth and do not consider that their knowledge and skills are undermined through the examination, with the majority of respondents (82%) to consider the existence of a cardiotocograph necessary in an emergency.

Knowledge and attitudes of midwives towards collaboration with traditional birth attendants for maternal and neonatal healthcare services in rural communities in South Africa

ObjectivesWe assessed the knowledge and attitude of registered midwives towards collaborating with traditional birth attendants for maternal and neonatal healthcare services in rural communities. DesignA descriptive cross-sectional survey was followed in this study. ParticipantsRegistered midwives in selected clinics in the City of Tshwane Municipality. Participants were recruited by stratified random sampling. Data was collected at the Thirty-four primary healthcare facilities in Gauteng province, South Africa. Measurement and resultsA self-assessment questionnaire was administered to 304 registered midwives. Two-hundred and sixty respondents returned the questionnaire representing a response rate of 86.6 % which was statistically significant. The majority of Midwives in South Africa displayed a low level of knowledge (mean = 41.8, SD=1.7) on the role and practices of traditional birth attendants). Only 30.8 % (n = 80) of midwives knew of the roles of traditional birth attendants for maternal and neonatal healthcare (MNH) services. With respect to knowledge, there was significant associated with the Professional category (p < 0.015). In terms of attitude, registered midwives displayed negative attitudes towards collaborating with traditional birth attendants (mean = 46.8, SD=2.1). Approximately half (54.2 %, n = 140) of midwives were amenable towards collaborating in the provision of antenatal care, and 70.4 % (n = 183) of midwives agreed to collaborate with traditional birth attendants for extended roles such as accompanying women to health facilities. Association of demographic data and level of attitude showed there was significant relationship (p < 0.05) between registered midwives’ level of education and their attitude towards collaboration. Key conclusionsMidwives demonstrated positive attitude towards collaborating with traditional birth attendants at the antenatal care level only. Midwives were not amenable to collaboration at the level of intrapartum and postpartum care. Implications for practiceBased on our results, collaboration should be at antenatal care level to allow for early detection, treatment, and prevention of antenatal complications thus reducing maternal mortality and morbidity.

Factors Associated with Febrile Treatment-Seeking Behaviour among Expectant Mothers in Ssekanyonyi, Uganda

Background: Malaria fever is a serious health problem that contributes greatly to morbidity and mortality in Uganda. In Mityana District where 4 in 10 pregnancy deaths are malaria related mothers who do not seek treatment in health facilities when they experience febrile illnesses. Therefore, a study was undertaken to identify factors associated with treatment-seeking behavior among pregnant women suffering from febrile illnesses suspected to be malaria in Ssekanyonyi Sub-County in Mityana District, Uganda.&#x0D; Methods: A cross-sectional study in which questionnaires and key informant guides were administered to 198 expectant mothers to generate data on their socio-demographics and treatment seeking behaviour. SPSS software version 20.0 was used for data analysis and a Logistic Regression model was fitted to identify factors that independently influenced their health-seeking behavior.&#x0D; Results: Out of the198 expectant mothers enrolled in the study, 42.9% were aged 15-25 years, 73.7% had achieved Secondary education, and 46.5% were married. The treatment-seeking behavior was found to be standing at only 56.6%. Among the different factors studied, health education on malaria (AOR = 3.68, P = 0.000), the attitude of midwives (AOR = 1.45, P = 0.003), patient care (AOR = 0.33, P = 0.030), and attitude of the pregnant mother (AOR = 5.38, P = 0.000) were found to be statistically significantly associated with treatment-seeking behavior among pregnant mothers with febrile illnesses.&#x0D; Conclusion: The study concludes that health education on malaria, attitude of midwives and pregnant mothers are the most important in positively affecting treatment seeking behavior among pregnant mothers with febrile illnesses.&#x0D; Recommendations: Health education on malaria, attitude of midwives, patient care and attitude of pregnant mothers need to be given attention in a bid to reduce febrile illnesses. The Ministry of Health and other responsible stakeholders need to reinforce awareness programs on health education among women of reproductive age about the danger of febrile illnesses during pregnancy and also help midwives address issues related to their attitude towards pregnant mothers

Interprofessional survey on knowledge and attitudes of midwives regarding oral health, in France.

Oral health is essential for psychosocial well-being and general health. For expectant mothers, pregnancy increases the risk of oral diseases and has a subsequent impact on the oral health of a child once born. Midwives are in charge of pregnancy monitoring, childbirth and newborns' first days of life. They could have an important role in prevention. However, limited studies evaluating the knowledge, attitudes and practices on oral health among midwives have been conducted in Europe. We performed a cross-sectional study using a self-administered questionnaire. Two local midwifery associations sent out the questionnaire by email and social media networks to all registered midwives and practicing in the department of Herault (n=613), between April and May 2022. Statistical analyses on quantitative data and descriptive analyses of qualitative free-text responses were performed. In total, 167 midwives were included. We found a lack of knowledge on many oral health topics and this was stated as the main reason that only 29% of midwives provided oral health information to their patients. Only 30% of the midwives had a training module on oral health during their initial training, and less than half of them considered the training adequate. To improve their lack of knowledge, participants expressed a preference for digital communication methods for themselves; however, they favored in-person interaction for public interventions. This study showed a lack of training and knowledge about oral health among midwives and a lack of oral health discussion with expectant mothers who are a high-risk population for oral diseases.

Knowledge, Attitudes, and Anxiety of Midwives Toward Maternal Care During the COVID-19 Pandemic: A Descriptive Study on Midwives Who Experience the Perinatal and Breastfeeding Phases.

People all over the world, including pregnant women, have experienced stress and anxiety due to the coronavirus disease 2019 (COVID-19) pandemic. Providing services during the pandemic is something that midwives in primary health care cannot avoid. This study assesses a midwife's knowledge, attitude, and anxiety toward providing maternal care during the pandemic. A cross-sectional design was used in this study, which involved 183 midwives who provided midwifery services at hospitals and health centers and had experience with the perinatal and breastfeeding phases. Using the Google Forms tool, respondents completed a questionnaire regarding their knowledge, attitudes, and anxiety toward maternal care during the COVID-19 pandemic. One hundred eighty-two midwives (99.50%) understood maternal care well during the COVID-19 pandemic. In addition, the maternal care provided during the COVID-19 pandemic was viewed favorably by almost all the participants. The percentage of midwives working in primary care in the perinatal phase who had moderate-to-severe anxiety levels during the COVID-19 pandemic was 17 women (27.42%). The knowledge and attitudes of midwives about the COVID-19 pandemic in this study were good, and there was a smaller percentage of midwives with an extreme level of anxiety.

Analisis Faktor Yang Berhubungan Dengan Tingkat Kepuasan Pada Ibu Bersalin Di Puskesmas Tanara Kabupaten Serang

Introduction: The ability of the health center to meet the needs of patients can be a measure of whether or not patients are satisfied with the services provided. Some of the factors causing low patient satisfaction include psychological factors which include service quality and attitude, as well as physical factors including room facilities. Methods: This is a quantitative analytic study with a cross-sectional design. Samples were all women who gave birth at the Tanara Health Center in Serang Regency with a total of 63 samples with a total sampling technique. The research instrument used a questionnaire. Primary data were analyzed using the chi-square statistical test. Results: The results of the univariate analysis showed that 76.2% of delivery women experienced satisfaction, good service quality was 77.8%; good attitudes of midwives was 69.8%; and 85.7% had good room facilities. The results of the bivariate analysis showed that there was a significant relationship between service quality (p = 0,000); attitudes of midwives (p = 0,000) and room facilities (p = 0,000) with maternal satisfaction. Discussion: The attitude of midwives has the highest chance of satisfaction with the delivery women with an OR of 120.400. It is hoped that midwives can improve their performance, especially in giving attention and being more friendly and friendly.

Knowledge and Attitudes of Midwives Concerning the Interpretation and Use of Cardiotocographs in Jordan

Introduction: A midwife needs to know how to assess fetal heart rates, recognize and interpret fetal heart patterns, report any substandard patterns, and initiate supportive measures as necessary. Objective: This study aims to assess the knowledge and attitudes of midwives concerning the interpretation and use of cardiotocographs. Materials and Methods: This cross-sectional study involves 183 midwives working in maternity units across all Jordanian regions. An online survey was used to collect data, including 6 demographic questions, 10 questions about knowledge, and 25 questions about attitude. The data were analyzed using descriptive statistics (Mean±SD, No. [%]), ANOVA, and the Pearson correlation tests. The significance level was set to be &lt;0.05. Results: Most participants were 21 to 30 years old, and most midwives (59.6%) had no more than six years of experience. The result showed that the total scores for the knowledge and attitude regarding cardiotocographs (CTGs) interpretation and usage were 68.7% and 73.0%, respectively. There is a significant relationship between the knowledge about the interpretation and use of CTGs and the years of experience (P=0.003), with higher knowledge scores among midwives with fewer than 6 years of experience. Furthermore, there is a significant relationship between the knowledge of CTGs and level of education (P=0.002), indicating higher knowledge scores among midwives with a degree. The knowledge about classifying the CTG traces was significantly correlated with the region of work (P=0.018), with higher scores among midwives from the southern region. Finally, there was a positive correlation between knowledge and attitude (r=0.007, P&lt;0.05). Conclusion: Based on the study result, the participant’s knowledge and attitudes are not satisfactory; thus, comprehensive education and training should be prioritized to improve midwives’ knowledge and attitudes toward using cardiotocograph.

Relationship Of Pregnant Mother Satisfaction In Antenatal Care Services With Motivation To Do Antenatal Care

Quality of health services provided by the government still has not or does not meet the expectations of patients and the public. This study aims to determine the relationship between the satisfaction of pregnant women at antenatal care with the motivation to do antenatal care. This research is an analytical study, which uses cross sectional design. The population in this study of pregnant women who do antenatal care in rural Puskesmas Gayaman Kabupaten Mojokerto is 58 people. The sample size in this study were 30 respondents. The sampling technique with a non-probability sampling techniques with the type of accidental sampling. Data collection techniques using primary data in the form of questionnaires and secondary data obtained from the KMS pregnant women. Techniques used in data analysis is Spearman Rank correlation. The study was conducted in Puskesmas Gayaman Kabupaten Mojokerto village on June 15 to June 29, 2022. The results of this study showed that pregnant women who feel very satisfied that as many as 23 respondents (76.7%), and pregnant women who have good motives as much as 26 respondents (86.7%). From the analysis of the data by Spearman Rank test, the result shows that the calculated ρ ρ table 0.5468 and 0.364, the price can be seen that ρ greater than ρ count table that means there is a correlation between the satisfaction of pregnant women at antenatal care with the motivation to do antenatal care.          Satisfaction of pregnant women in antenatal care of pregnant women affect the motivation to perform antenatal care. A good midwife services, facilities, friendly attitude of midwives, midwives skills in responding quickly to face the problems of patients so that respondents are motivated to come back. The motivation is called extrinsic motivation, namely the stimulation comes from outside or other people. Conclusions from this study are doing antenatal care satisfaction related to the motivation of doing antenatal care. Suggestions for health services in accordance with the result expected service quality can be maintained and further enhanced.

Strengthening midwives' competencies for addressing maternal and newborn mortality in Tanzania: Lessons from Midwifery Emergency Skills Training (MEST) project

IntroductionIn Low- and Middle-Income Countries (LMICs), maternal and infant mortality remains a significant problem. Inadequate healthcare provider competencies, including those of midwives, are cited as one of the major contributors to the high maternal and newborn mortality rates. Thus, enhancing the skills of midwives is a prerequisite for enhancing positive maternal and newborn health outcomes. This study describes the lessons learned from a Midwifery Emergencies Skills Training (MEST) project implemented in Tanzania between 2013 and 2018. MethodsAn exploratory qualitative study was used to purposefully recruit and interview twelve health facility in-charges and eighteen midwives from twelve selected health facilities in six districts of Tanzania mainland to discover their perceptions about the midwifery practice after MEST training. The data were transcribed verbatim and analysed with qualitative content analysis. ResultsFour categories were generated from the analysis (i) enhanced knowledge and skills in the provision of midwifery care and management of obstetric emergencies, (ii) improved midwives’ communication skills, (iii) increased trust and support between midwives and community and (iv) transformed attitudes of midwives toward continued professional development (CPD). ConclusionMEST enhanced the knowledge and skills of midwives in the management of obstetric emergencies and referral protocol practice. However, notable gaps remain in the capacity of midwives to provide human rights-based respectful maternity care. Continued professional development for nurses and midwives through training, mentorship and supervision programs is recommended for improving maternal and newborn health.

Perceptions and attitudes of midwives on respectful maternity care during childbirth: a qualitative study in three district hospitals of Kigali City of Rwanda.

Respectful Maternity Care (RMC) is "a universal human right for every childbearing woman". In Rwanda, few studies conducted on RMC assessed how women perceive care provided during childbirth, yet little is known about providers' perspectives. We investigated the perceptions and attitudes of midwives towards the provision of RMC to complement women's viewpoints. this qualitative study used individual in-depth interviews in Kinyarwanda language. A purposive sampling method was used to reach out to twenty-eight midwives from three district hospitals in Kigali City. Transcribed interviews were translated into English and thematic content analysis was performed using Atlas Ti, version 7. The University of Rwanda College of Medicine and Health Sciences Institutional Review Board (Ref: 363/CHMS/IRB/2019) ethically approved this study before data collection. the majority of participants revealed that they have knowledge on RMC and perceive that they provide maternal health care based on women´s rights. Positive attitudes towards providing RMC were reported by midwives, however, a considerable number of participants reported the existence of abusive practices. The majority of midwives reported facing many challenges affecting their ability to provide respectful maternal care. midwives understand the seven rights of women and have a positive attitude towards providing RMC. However, abusive practices still exist while providing RMC with considerable challenges, including overload and lack of labour monitoring materials. The adjustment of the ratio of midwives to clients and the availability of essential materials in labour monitoring is recommended to improve the quality of healthcare received by women during childbirth.

Exploration moving beyond medical facility walls: opportunities, challenges and attitudes of midwives towards planned homebirth: a qualitative study

Exploration moving beyond medical facility walls: opportunities, challenges and attitudes of midwives towards planned homebirth: a qualitative study

Moving beyond medical facility walls: opportunities, challenges and attitudes of midwives towards planned homebirth

Moving beyond medical facility walls: opportunities, challenges and attitudes of midwives towards planned homebirth

Kanguru Bakımına Yönelik Görüş, İnanış ve Tutum: Ebe ve Hemşire Perspektifi

Amaç: Ebe ve hemşirelerin kanguru bakımına yönelik görüş, inanış ve tutumlarının incelemek amacıyla yapıldı.Yöntem: Araştırma bir kamu ve iki özel hastanede çalışan 214 ebe ve hemşire ile Haziran-Temmuz 2021 tarihleri arasında yapılmıştır. Veriler, araştırmacılar tarafından oluşturulan “Veri Toplama Formu” ve “Kanguru Bakımı Görüş İnanış ve Tutum Envanteri” kullanılarak çevrimiçi anketler aracılığıyla toplanmıştır. Bulgular: Araştırmaya katılan katılımcıların %56.5’inin hemşire olduğu, %46.3’ünün yenidoğan yoğun bakımda çalıştığı, meslekteki yıllarının 7.71±7.27 yıl olduğu, Kanguru Bakımı Görüş İnanış ve Tutum Envanteri (KBGİTE), tutum, görüş ve inanış boyutları arasında toplam puan ortalamaları arasında pozitif yönde korelasyon olduğu saptandı (p=0.000). KBGİTE toplam puan ortalaması ile eğitim durumu, meslek, çalışılan birim ve daha önce kanguru bakımı eğitimi alma durumu ile ilişkili olduğu bulundu (p&amp;lt;0.005). Envanterin Chronbach’s alpha güvenirlik katsayısı 0.975 olduğu belirlendi.Sonuç: Ebe ve hemşirelerin eğitim durumu, kanguru bakımı ile eğitim almaları kanguru bakımı kanguru bakımına yönelik görüş, inanış ve tutum ile ilişkili olduğu ve kanguru bakımı ile ilgili olumlu görüş ve inanışları arttıkça tutumlarının da arttığı görüldü.

Antenatal Care Utilization of Mothers in Selected Cities in Bicol Region: A Quantitative Study

Background. Antenatal Care (ANC) is an essential mandatory preventive care service freely given to pregnant women by the Philippine government. Despite the available ANC services in the country, not all pregnant women still avail of the service.Objective. The study determined the socio-demographic profile of mothers, their ANC services utilization, and the different problems encountered during their antenatal care.Methods. A descriptive research design was used. Purposive sampling was employed to identify the population of the study: women of reproductive age, 18-45 years old, and who had a live birth for the last three years regardless of utilization, partial utilization, or non-utilization of ANC services. Mothers who were currently pregnant and had a history of abortion or stillbirth delivery were excluded from participation. Proportionate sampling was computed to get the sample size: 334 mothers from Iriga City and 392 from Tabaco City. The survey questionnaire was based on the ANC guidelines of the DOH. The statistical treatment used was frequency counting, percentage, and ranking in data analysis.Results. The mothers in Iriga City and Tabaco City were ages 23-27 years old who had 1-3 children, were single but living with partners, and in a nuclear type of family with 4-6 members, were unemployed/housewives, and belonged to a low-income family with &gt;P7,890 family income. In Iriga City, the majority were high school graduates, while in Tabaco City, most were graduates of vocational courses; and elementary and high school undergraduates. There were excellent assessments for history-taking, physical examination, and care provisions in both cities, except for oral health care examination, tests for syphilis, stool examination, acetic acid wash, safe sex education, and oral health checkups and prophylaxis. The identified problems were financial constraints, lack of support system, busy taking care of the kids, sickness, forgetfulness, unwanted pregnancy, drunkard husband, difficult first trimester, bad attitude of midwives, nurses, doctors, and unequal treatment of poor patients.Conclusions. Mothers in both cities were young adults with a low education level who lived with their partners in a poor small nuclear family. Not all ANC services were excellently utilized. Among these were the poor utilization of the tests for syphilis, stool, acetic acid wash; oral health care examination; safe sex education; and oral health checkups and prophylaxis. There were various problems that mothers encountered when seeking ANC services, the most common of which were financial and personal issues.

Midwives' personal and professional attitudes towards women's delivery choices, interventions and neonatal care.

Caesarean section (CS) rates in middle- and high-income countries are rising partly due to maternal request. This study aimed to explore the personal and professional attitudes of midwives and nurses towards women's delivery choices, interventions and neonatal care. Midwifery and nursing staff at the Coombe hospital were asked to complete a questionnaire concerning decisions for elective CS and neonatal care. The midwives' responses were divided into multiparous and nulliparous according to their own parity. Multiparae and nulliparae did not differ on their personal preferences for their own baby. Only 3% wanted an elective CS in a normal, healthy pregnancy but this increased to 80.2% when there was a breech presentation and 42% if the estimated fetal weight was >4.5kg. These numbers and trends were very close to the midwives' professional recommendations under the same circumstances. The lower threshold for full resuscitation and ICU care was at 23 and 24weeks gestation for both personal and professional recommendations. In the case of severely premature babies or babies with a poor prognosis, 54% stated that the approach to neonatal care was correct. Overall, midwives' professional views reflected what they would want for themselves and their babies. Only 3% recommended an elective CS in a normal, healthy pregnancy making it unlikely that midwives' attitudes are driving the rise in CS rates in Ireland.

Challenges Associated with Midwifery Practice and Education in Northern Nigeria:Way Forward

Midwifery practice has continued to gain recognition as a result of its influence on the health of mothers and newborns. However, the practice of midwifery in Nigeria is associated with numerous challenges leading to negative health indicators in the region. This paper examined the challenges associated with midwifery practice and education in Northern Nigeria with a view of exploring the way forward. Relevant literatures of stakeholders ’ reports and studies conducted globally and locally were searched and reviewed. Findings from the reviewed literatures showed that midwifery workforce is short of the ideal number required globally and specifically in Northern Nigeria. This shortage of midwives could be linked to the poor performance of Nigeria in achieving MDGs and now SDGs leading to outrageous Maternal Mortality Rate (MMR) in Northern Nigeria. Other highlighted challenges affecting midwifery practice and education in the region include; usurping of midwives’ roles/duties by doctors lack of comprehensive data on midwives, poor attitude of midwives, poor remuneration, negative patient’ s perception of midwives, feminization of midwifery profession and lack of resources and equipment. The paper therefore recommends that there should be continuous training of midwives as well as a need to review of the curriculum, code of ethics, scheme of service and entry qualification for midwives.

Knowledge, experiences and attitudes of midwives in maternity care in encounters with pregnant women with obesity - are adverse childhood experiences understood and explored as a contributing factor?

ObjectiveTo explore knowledge, experiences and attitudes of midwives in maternity care in encounters with pregnant women with obesity, and whether they investigate adverse childhood experiences as a contributing factor to the weight challenges. DesignSemi-structured interviews were undertaken to explore midwives’ experiences of providing maternity care for women with obesity. For data analysis, Malterud's systematic text condensation was used, a method for thematic cross-case analysis of qualitative data with an inductive approach. Participants and settingNine midwives working in maternity care in Central Norway. The interviews were conducted online or at the midwives’ workplace. FindingsThe midwives routinely investigated pregnant women's childhood, but few saw a link between adverse childhood experiences and obesity. Pregnant women with obesity were perceived by the midwives as particularly vulnerable, which led to a sensitive, individualised approach focusing on trust and relationship building. This approach, in addition to pointing out complications that can occur with obesity, was described as a balancing act. The midwives described preventative healthcare as a natural task, but hectic days with many competing tasks were seen as an obstacle. The women's motivation for lifestyle change was experienced differently by the midwives; some described strong motivation while others mentioned poor motivation. The midwives found it reassuring to have experience to draw on in broaching difficult topics. Key conclusions and implications for practiceMidwives’ many years of experience enable them to approach obese pregnant women in an individual and careful way. Their mission in public health could be better utilised if they explored negative childhood experiences in relation to pregnant women's weight challenges.