Birth Experience Research Articles

The French Ambulatory Cesarean Section: Safety and Recovery Characteristics

ObjectivesThe French AmbUlatory Extraperitoneal Cesarean Section (FAUCS) is aimed at improving patients’ birth experience and recovery. However, data are scarce regarding its maternal and neonatal safety. This study seeks to compare maternal and neonatal outcomes between FAUCS and conventional cesarean deliveries at term. MethodsThis was a retrospective cohort study involving women who underwent scheduled cesarean deliveries at term. We compared a total of 810 cases using the FAUCS technique with 217 cases using conventional cesarean deliveries. Surgical complications, adverse neonatal events, and maternal recovery parameters were compared. ResultsThe incidence of overall surgical complications was comparable between the 2 groups, with rates of 1.97% for FAUCS and 1.85% for the conventional cesarean deliveries. The rates of specific complications such as bladder injury (0.1%), bowel injury (0.1%), blood transfusion (1.35%), and postpartum hemorrhage (1%) were consistent with existing literature. Neonatal outcomes, including neonatal acidemia and admission rates to the neonatal intensive care unit, were comparable between the groups and demonstrated favourable comparisons with previously reported data. Notably, women in the FAUCS group required less analgesia, with only 0.8% receiving morphine, as opposed to 38% in the control group. Furthermore, the FAUCS group demonstrated significantly quicker recovery, with 86% achieving autonomy and early discharge at their discretion within 48 hours after operation, in contrast to only 17% in the control group. ConclusionsWhen performed by experienced practitioners, FAUCS proves to be a safe procedure, with no increased risk for maternal or neonatal complications. Its significant benefits in terms of enhancing maternal recovery are noteworthy.

‘Plan Z and then off the edge of a cliff’: An interpretative phenomenological analysis of mothers’ experience of living with a slow-to-heal Caesarean wound

BackgroundStudies indicate that complex postsurgical wound healing can significantly alter biopsychological markers responsible for recovery. Yet, there is a lack of research investigating women's experience of living with slow-to-heal Caesarean birth wounds. This is an important area of investigation considering the increase of factors associated with surgical births and poor wound healing in the UK and globally. AimThe aim of this study was to explore women's experiences of living with a slow-to-heal Caesarean wound. MethodSemi-structured interviews were conducted with seven women who had lived experience of slow-to-heal Caesarean wounds. Narratives were analysed using Interpretative Phenomenological Analysis (IPA) approach. ResultsAnalysis of women's narratives revealed three interlinking superordinate themes of 1) ‘Tied to that event’: healing physical and emotional wounds, 2) The ‘good mother’ and the ‘good patient’: negotiating being a carer and being cared for, and 3) ‘Adjusting to a new normality’. Overall, slow-to-heal wounds embodied women's perceptions of agency over their Caesarean birth experience and achievement of a new motherhood identity. Wherein, successful healing would encompass a sense of normality defined by subjective notions of regaining expected roles and daily activities, previous bodily functions, and maternal status within their families that became disrupted due to delayed wound healing. ConclusionWomen's narratives support discourse surrounding Caesarean birth and recovery as a biopsychosocial phenomenon. This has important ramifications regarding research and treatment programmes for postnatal women with complex healing that are largely described as ‘invisible’.

Визначення психологічного профілю вагітних, які бажають обрати альтернативний варіант розродження

One of the main indicators of the country's development is the health of women and children. Today in Ukraine, there is a significant decrease in the level of physical and moral health among young people, which negatively affects the course of pregnancy and childbirth. At the same time, the term “childbirth experience” is spreading in the obstetric community, which reflects the peculiarities of a woman's own feeling of the process of giving birth to a child, along with the spread of “non-traditional” methods of childbirth, such as vertical childbirth, childbirth in the knee-elbow position, childbirth in water, which aimed precisely at obtaining a positive birth experience. However, in the literature reviewed by us, we found only isolated information about the criteria for selecting patients to be involved in the attempt of alternative birth options. Aim - determine the psychological profile of pregnant women who wish to choose an alternative option for childbirth. Materials and methods. Surveyed 274 pregnant women at 11-12 and 36-37 weeks of pregnancy using a Google form containing 16 questions to determine the psycho-emotional state, mood, plans and fears about future childbirth. Results. The obtained results at 11-12 weeks outlined the psychological profile of pregnant women as a state of pleasure combined with insufficient knowledge about the course of childbirth. The results of the questionnaire at 36-37 weeks show a change in the psychological state in the direction of the development of fatigue with a significant increase in the number of women who are worried about the course of the upcoming childbirth, the pain associated with it, and want to involve close relatives/husband or an outside helper in childbirth. The majority of women have been found to have fear and uncertainty about their own condition during and after childbirth, which is the basis for an in-depth study of the psycho-emotional sphere. It was found that significantly more women want to try an alternative method of childbirth - water birth - 122 (44.5%). Conclusions. The psychological profile of pregnant women who wish to choose an alternative method of childbirth, including water birth, is characterized by a feeling of fear and anxiety before the upcoming birth, fears about the use of pharmacological methods of analgesia, as well as about possible aggression on the part of medical stuff. No conflict of interests was declared by the authors.

Medical ethics in childbirth: a structural equation modeling approach in south of Iran

BackgroundThe existence of a valid instrument to evaluate the attitude of mothers towards compliance with medical ethics during childbirth can lead to appropriate interventions to create a positive attitude. The purpose of this study is to determine the construct validity of the MEAVDQ (Medical Ethics Attitude in Vaginal Delivery Questionnaire).MethodsThe study was carried out with 350 women. The main research instrument was MEAVDQ. This 59-item questionnaire comprises three parts A, B, J. Part A is concerned with the first principles. Part B deals with the second and third principles and part J addresses the fourth principle of medical ethics. Structural Equations Modeling (SEM) was used to determine the construct validity of MEAVDQ.Results The results of SEM revealed that there was a positive correlation between structures A and B. The relationship between structures B and J was also positive and significant. On the other hand, there was a direct and indirect relationship between structures A and J. One-unit increase in structure A led to 0.16 (95% CI: 0.01, 0.33) direct increase in structure J. Also, one-unit increase score increases in structure A caused 0.39 indirect rise (95% CI: 0.26, 0.53) in structure J with the mediating role of the structure B.ConclusionsIt can be suggested to midwifery policy maker and midwives that respect for the first principle of medical ethics and autonomy is the most important principle of medical ethics in childbirth. By respecting the autonomy of mothers, a positive birth experience can be created for them.

Childbirth Experience and Pain Control: Expectation, Satisfaction, and Analgesia Myths.

In our days, increasing importance has been given to maternal satisfaction as a quality indicator in healthcare services. A positive childbirth experience should meet a woman's personal and sociocultural beliefs and expectations in every setting. This study aimed to evaluate childbirth experience regarding expectations, satisfaction, and myths around epidural analgesia. A cross-sectional survey designed was carried out in the Obstetric Department of a public hospital in Madeira-Portugal. Awell-structured questionnaire was applied to 101 post-partum women covering aspects such as sociodemographic details, childbirth expectations, overall satisfaction, and prevailing myths. IBM SPSS Statistics for Windows, Version 26.0 (IBM Corp., Armonk, NY) was used for data analysis. From the total of 101 participants, 32 (31%) women belonged to the 31-35 age group. Among the respondents, 58 (57%)had attained a high school diploma. The results showed that there was a positive experience with childbirth; out of the total women, 79 (78%) considered it exceeded their expectations. The majority of pregnant women (93, 92%)received neuraxial analgesia for labor, reporting the experience as good or excellent. The overall satisfaction related to the birth experience was good or excellent for 88 (87%) women. Regarding the myths, education level was significantly associated with the myth Epidurals often cause permanent back pain(P< 0.05), since women with higher education don't believe them. The result of this study proves that, despite the high level of satisfaction with the labor and delivery experience found in our maternity unit, satisfaction remains a complex and dynamic phenomenon.

Are expectations of labour and birth fulfilled? A qualitative investigation of first‐time parents

AbstractAimTo describe if first‐time parents' expectations of labour and birth, explored during the third trimester of pregnancy, were fulfilled or not when investigated 1 year following birth.DesignQualitative Husserlian phenomenological approach.MethodsThe sample comprises 10 parents (five couples), who participated in an online semi‐structured audio‐recorded individual interview conducted 1 year after birth, between September 2020 and October 2020. Parents' expectations of labour and birth, described throughout a focus group discussion on pregnancy, were compared with their experience explored 1 year after birth. A thematic analysis was adopted and member checking was used to validate participants' thoughts.ResultsParticipants gave birth in a II level maternity unit and one‐to‐one midwifery care was provided. Although during the focus group conducted in pregnancy, women reported being aware of the unpredictable nature of childbirth, they expressed sadness and failure after experiencing some unexpected interventions. The midwife was a reassuring guide, as expected; however, sometimes, the communication was not effective, and women perceived lack of support. Some women partly blame themselves for not being prepared to manage labour pain, which hurt more than expected. Feeling of uncertainty about events were experienced in relation to seeking care at an early stage of labour, which confirmed the fears expressed during pregnancy. During the antenatal focus group discussion, fathers doubted they could be helpful for the labouring women. This negative emotion was confirmed after birth. However, they understood the importance to be present and to support their partner.ConclusionsOne year after birth, participants had consistent memories of their birth experience. Professionals might identify fundamental components of quality maternity care that are meaningful for parents, with the potential to generate a long‐term positive health impact on them. Respectful maternity care should be ensured through a family‐centred approach, with the aim to promote satisfaction.Implications for the Profession and/or Patient CareThe study highlights the importance of taking parents' expectations into account when providing antenatal care to tailor individualized support that addresses their distinct needs and preferences. Healthcare professionals might consider initiating a post‐natal discussion with parents to assess whether their needs and perspectives have been addressed. This perspective may present valuable insights to achieve long‐term positive outcomes, provide high‐quality maternity care, address issues and make improvements.ImpactThe study showed that 1 year after birth, parents can accurately recall their birth. They might also give significant insights into fundamental components of care that they value as crucial to shape a positive birthing experience. Professionals should use this information to build solutions, promoting long‐term well‐being for parents. Respectful interactions and trusting relationships emerged as key elements in parents' experience. A midwifery care focused on parents' needs may contribute to the achievement of positive birth memories.Reporting MethodThis study used the Standards for Reporting Qualitative Research checklist.Patient or Public ContributionNo patient or public contribution.

BIRTH PHOTOGRAPHY AS A NORMAL MATERNITY FACILITY AT PMB

Birth photography is a new form of birth art, the emergence of birth photography as an expression of a woman's birth experience that is centered on women. Photos become a means of imaginative adventure for human experience, communication between humans and themselves, between people and even between generations. This birth memoir is a form of celebration and gift for future children, parents, or anyone else for the moment of childbirth which only happens once in a woman's life even if there are subsequent births. With current technological advances, birth documentation as a medium for capturing beautiful memories of childbirth can be easily done, using a camera or a smartphone. The data source in this study uses a literature review method which comes from several sources, both national and international journals, using published articles from Google Scholar, Radiation Oncology Journal, PubMed, and Elsevier. In this research, birth photography is used as a facility for mothers going through normal childbirth. The aim is to entice mothers to become more interested and brave in going through natural childbirth with professional midwives at PMB

The relationship between traumatic childbirth and first-time mothers’ social identity and wellbeing: a cross-sectional observational study

BackgroundExperiencing childbirth as traumatic is common and can have long-lasting negative consequences for women’s mental health. However, fostering a sense of social identity has been shown to protect psychological wellbeing and mental health during life transitions, such as entering parenthood. This study therefore investigated the relationship between traumatic childbirth and first-time mothers’ social identity and their psychological wellbeing, and more specifically whether strength of identity as a first-time mother protected psychological wellbeing following traumatic childbirth.MethodWomen over the age of 18 who were living in the UK and had given birth to their first child in the past nine months were recruited to the study from clinical and community settings. They completed digital self-report questionnaires about their birth experience, social identity, mental health, and psychological wellbeing. Women who perceived themselves to have had a traumatic birth (the trauma group; N = 84) were compared to women who did not perceive themselves to have had a traumatic birth (the control group, N = 39). T-tests and chi square tests assessed preliminary group differences before multivariate analyses of covariance controlled for covariates. Post-hoc tests identified the direction of differences. Multiple regression and moderation analyses analysed interaction effects.ResultsThe trauma group had significantly lower psychological wellbeing (mean = 41.5, 95% CI [39.4–43.7], p = .008, partial η2 = 0.059), compared to the control group (mean = 48.4, 95% CI [45.3–51.5]), but the two groups did not differ in the strength of their first-time mother identity, which was high across both groups. Strength of identity did not moderate the relationship between traumatic childbirth and psychological wellbeing. Giving birth by caesarean section independently reduced the strength of the first-time mother identity (p = .017, partial η2 = 0.049). All analyses controlled for emotional and practical support, perceptions of healthcare staff, and mode of birth.ConclusionsHaving a traumatic birth was associated with lower psychological wellbeing, and the strength of first-time mother identity does not appear to moderate this relationship. Factors such as mode of birth may be more important. Further research, including longitudinal designs, is needed to understand the relationship between these constructs and identify more effective ways of protecting first-time mothers’ mental health.

Translation and validation of the Polish-language version of the Birth Satisfaction Scale-Revised (BSS-R) and its relationship to the type of delivery and the baby’s Apgar score

BackgroundMaternal birth experience is being increasingly recognised as a key clinical outcome parameter. The Birth Satisfaction Scale-Revised (BSS-R) is a short self-report measure designed to assess birth experience. The current investigation sought to trans-late the BSS-R into Polish and validate this version of the BSS-R (PL-BSS-R).Participants and procedureThe BSS-R was translated into Polish by an expert panel using forward and backward translation. A complex within-subjects design with an embedded between-subjects component was used to determine the key psychometric characteristics of the PL-BSS-R. Two hundred ninety-four Polish-speaking women in Poland completed the follow-up component of the study where the PL-BSS-R was administered. The PL-BSS-R measurement properties were examined using confirmatory factor analysis, divergent, convergent validity analysis, internal consistency appraisal and investigation of known-groups discriminant characteristics.ResultsThe PL-BSS-R was found to have generally very good measurement properties and to be equivalent to the original English-language version across key validity indices. The PL-BBS-R was found to be significantly correlated with neonatal physical health immediately postpartum and differed across delivery modes.ConclusionsThe PL-BSS-R is a psychometrically robust measure of birth experience appropriate for clinical and research use within Po-land. Important associations were noted between subjective maternal birth experience and objective measures of neonatal physical health, indicating a critically important future research direction.

The experiences and outcomes of Gypsy, Roma, and Traveller pregnant people in pregnancy: A scoping review.

Within Europe, Roma, Gypsy, and Traveller groups have been marginalized and discriminated against by larger society. Persecution and displacement have resulted in high rates of unemployment, reduced access to education, and poorer health, with significantly increased risk of poverty compared with the general population. In pregnancy, there appears to be a gap in the literature surrounding the experiences and outcomes of pregnant people within these ethnic groups. The aim of this study was therefore to scope published research, specifically questioning "What is the experience of Roma Gypsy and Traveller pregnant people who access maternity care?" and "What are the obstetric outcomes within these groups?" This review followed frameworks proposed by Arksey and O'Malley, Levac, and the Joanna Brigg's Institute. The PRISMA extension for Scoping Reviews (PRISMA-ScR) tool was used. The search strategy and specific terms were chosen using the population-concepts-context framework. Titles and abstracts were reviewed independently by two reviewers. Inclusion and exclusion criteria were defined to set clear guidance for reviewers to identify appropriate studies. Five electronic databases were searched (CINAHL, EMBASE, MEDLINE [OVID] Web of Science and SCOPUS). A charting form was developed to record key characteristics systematically and uniformly from the studies. Five themes were identified: systemic issues, antenatal care, complications of pregnancy, birth experience, and postnatal care. Systemic issues included racism, barriers to care, and adapted antenatal care. Antenatal issues included teenage pregnancy, smoking, risk of venous thrombus embolism, dietary issues, risk of communicable diseases, domestic violence, and mental health concerns. Increased risks of congenital abnormalities, growth restriction, premature labor, and perinatal and early childhood mortality were identified. For Roma women, negative birth experiences were reported, whereas the experiences of Traveller women varied. The findings identified in this study serve to create a framework upon which healthcare providers can tailor the way in which pregnant people from a Roma, Gypsy, or Irish Traveller background are cared for. Using such a framework would hopefully begin to reduce the systematic marginalization and discrimination of these minorities.

Recommendations for data collection in cohort studies of preterm born individuals - The RECAP Preterm Core Dataset.

Preterm birth (before 37 completed weeks of gestation) is associated with an increased risk of adverse health and developmental outcomes relative to birth at term. Existing guidelines for data collection in cohort studies of individuals born preterm are either limited in scope, have not been developed using formal consensus methodology, or did not involve a range of stakeholders in their development. Recommendations meeting these criteria would facilitate data pooling and harmonisation across studies. To develop a Core Dataset for use in longitudinal cohort studies of individuals born preterm. This work was carried out as part of the RECAP Preterm project. A systematic review of variables included in existing core outcome sets was combined with a scoping exercise conducted with experts on preterm birth. The results were used to generate a draft core dataset. A modified Delphi process was implemented using two stages with three rounds each. Three stakeholder groups participated: RECAP Preterm project partners; external experts in the field; people with lived experience of preterm birth. The Delphi used a 9-point Likert scale. Higher values indicated greater importance for inclusion. Participants also suggested additional variables they considered important for inclusion which were voted on in later rounds. An initial list of 140 data items was generated. Ninety-six participants across 22 countries participated in the Delphi, of which 29% were individuals with lived experience of preterm birth. Consensus was reached on 160 data items covering Antenatal and Birth Information, Neonatal Care, Mortality, Administrative Information, Organisational Level Information, Socio-economic and Demographic information, Physical Health, Education and Learning, Neurodevelopmental Outcomes, Social, Lifestyle and Leisure, Healthcare Utilisation and Quality of Life. This core dataset includes 160 data items covering antenatal care through outcomes in adulthood. Its use will guide data collection in new studies and facilitate pooling and harmonisation of existing data internationally.

LBTQ parents’ needs for support postpartum following a complicated birth: A matter of reproductive justice

LBTQ people have increased risks of complications during birth, risks potentially driven by minority stress and increased levels of mental illness and fear of childbirth. With the aim of exploring reproductive injustices in postpartum care for LBTQ people, we analyzed qualitative interviews where 22 LBTQ birth and non-birth parents shared their experiences of support needs during the postpartum period after births where complications had arisen. Results point to the importance of providing an LBTQ safe space, which includes the need to feel safe regarding one’s gender or sexual identity, by avoiding cisheteronormative assumptions and using inclusive language. In the context of recently experiencing birth complications, parents needed a space where they were able to focus on physical and mental healing. The results further show the need for validation of the non-birth parent and inclusive breast/chest-feeding support. Results emphasize the need for more psychosocial support around the birth experience, including better medical support and information during the whole process of childbirth.

Association Between Age at First Birth and Long-Term Dental Caries Experience Among Women in the United States.

Background: Pregnant women are at a higher risk of caries compared to nonpregnant women, and higher parity is a risk factor for untreated caries and tooth loss. However, it is unknown whether the timing of birth is associated with dental caries experience over time. Materials and Methods: This study is a cross-sectional study using the National Health and Nutrition Examination Survey (NHANES), 2011-2018. The study population included nonpregnant women 20 years of age or older, who had available data on the oral health examination and age at first birth (AFB). Dental caries experience was defined as the DMFT score (sum of the number of decayed, missing due to caries, and filled permanent teeth). The associations between AFB and DMFT scores were assessed using Poisson regression to compute incidence rate ratios (IRRs) and the associated 95% confidence intervals (CIs). Results: This study included 6,553 women (mean age 53.4 years, SD 15.7). The mean DMFT index score was 13.1 ± 7.4, with younger AFB groups generally having higher mean scores. After adjusting for sociodemographic variables, time since last dental visit, and reproductive health factors, women with an AFB of <18 years (IRR, 1.10; 95% CI, 1.01-1.21) or 18-20 years (IRR, 1.11; 95% CI, 1.01-1.21) had significantly higher DMFT index scores compared to those with an AFB of 30-32 years. Conclusions: This study suggests that younger maternal AFB may be associated with greater dental caries experience. More rigorous studies are necessary to determine how to improve oral health outcomes during pregnancy and postpartum.

Intimate Partner Violence during pregnancy: Impact on women and children: A Review

Background: Intimate partner violence (IPV) is one of the major causes of anxiety, depression, and post-traumatic stress disorder and can have a negative impact on the mother during pregnancy. This review aims to understand the health consequences of IPV on maternal mental health so that effective interventions and policies can be developed and implemented to provide support to victims, promote gender equality, and prevent adverse maternal outcomes. Methods: A systematic search was conducted as per the PRISMA guidelines. Computer database researches were conducted using the following databases: Google Scholar, Psych INFO, Medline, Scopus, Web of Science, and PubMed. The literature was screened by titles and abstracts and by applying keyword search. The following keywords were searched: women, violence, domestic violence, intimate partner violence, IPV, pregnancy, antenatal, conception, maternal health, child health, mental health, and maternal mental health. The literature search was done from 2014 to 2024. Results: IPV not only poses adverse effects on the well-being of the victim but also disrupts the stability of the environment of the home. It impacts the health, nurturing care, and overall development of the child. Children born to mothers exposed to violence during pregnancy may have lower birth weights and experience higher rates of mortality, preterm births, and lower Apgar scores. The negative effects of IPV on child health also extend beyond the child's cognitive development, impacting the academic performance of their peers. Conclusion: A vast majority of the incidents involving IPV go unreported due to fear, shame, stigma, or lack of awareness. This can affect the accuracy of the actual data of prevalence. In addition, societal norms, gender stereotypes, and male dominance may add to the effects of IPV, making it difficult for the victims to seek help.

Introducing waterbirth in a university hospital setting in Sweden: A qualitative study of midwives' experiences.

Waterbirth is a popular and increasing care option in several countries but is still debated. In Sweden, there are challenges in the process of reintroducing waterbirth after decades of interruption invoked by a dissuasion. The aim of this study was to explore factors affecting midwives' provision of waterbirth at a university birthing clinic in Sweden. A qualitative research design was used with three focus group interviews with 18 midwives at three birthing units. The data were analyzed using the principles of inductive content analysis. The midwives in the study expressed positive attitudes and potentiality about waterbirth, contributing to their desire to support physiological birth. However, obstacles were also disclosed, maiming waterbirth evolvement. Hence, two categories emerged, promoting factors and obstructing factors. The subcategories were: Provides a good experience whilst promoting physiological birth; Increased knowledge and information about waterbirth; Support from management; Updated guidelines; Ergonomic challenges; Lacking practical conditions; Lack of knowledge; Paradigm conflicts; and Limiting guidelines. The study concluded that midwives recognized both promoting and obstructing factors affecting the provision of waterbirth. The predominant factor highlighted was the care-culture, with a clear distinction between a risk-focused, medicalized approach that inhibits waterbirth and a salutogenic perspective advocating for it. This dichotomy underscores the importance of providing opportunities that support women's choices to facilitate an empowering birth experience.

Effects of mother-infant skin-to-skin contact on mother-infant relationship and maternal psychology feelings: A qualitative study.

To explore the effects of mother-infant skin-to-skin contact on mother-infant relationship and maternal psychology feelings. An exploratory qualitative research design using semi-structured interviews. A total of 64 mother-infant pairs who met the inclusion criteria were selected as the experimental subjects to receive early and continuous intervention of mother-infant skin-to-skin contact (SSC). On this basis, the qualitative research method of procedural grounded theory was used to conduct semi-structured interviews with 18 puerperas before discharge from the hospital; the three-level coding method of procedural grounded theory and Graneheim & Lundman qualitative content analysis method were combined to conductinterview content analysis in Nvivo 12 software, so as to extractcore categories and condense the theme. (1) The data were coded to extract five core categories, namely, birth experience, role transition, contact perception, mother-infant connection and parental efficacy; (2) there were statistically significant differences in the number of coding reference points in five nodes before and after SSC, that is, mothers' positive feelings, newborns' physical characteristics noticed by their mothers, mother-infant connection, role transition and birth experience. The number of coding reference points after SSC was statistically significant greater than before SSC; (3) The coding interview results showed that SSC could promote the sense of happiness in nurturing.

Difference in the mode of delivery in obstetric patients who have experienced intimate partner or sexual violence compared to those who have not: A systematic review and meta‐analysis

AbstractBackgroundA history of intimate partner violence (IPV) and/or sexual violence may impact a patient's birth experience. Limited information is available on the potential for re‐traumatisation through routine obstetrical practices and the effect on mode of delivery.ObjectivesTo identify whether there is a difference in mode of delivery between obstetrics patients who have experienced IPV/sexual violence compared to those who have not.Search StrategyMEDLINE and EMBASE were searched through inception to February 2024 for terms related to obstetric mode of delivery, IPV and sexual abuse.Selection CriteriaPeer‐reviewed, retrospective and prospective studies that contained original data.Data Collection and AnalysisTwo authors independently conducted data extraction. A random‐effects meta‐analysis was used to pool outcomes. Cochrane's chi‐squared test and the I2 statistic was used to examine the statistical heterogeneity of pooled effect estimates. All studies were evaluated using the risk of bias in a non‐randomised study‐I tool.Main ResultsThirty studies (n = 280 864) were eligible for inclusion. The likelihood of caesarean delivery was significantly higher in those who had experienced IPV/sexual violence compared to those who had not: OR = 1.16, CI = 1.05–1.27; I2 = 71. Pooled analysis of reported operative delivery rates did not reveal any significant increase in operative delivery rate for those who had experienced IPV/sexual violence versus those who had not: OR = 1.14, 95% CI = 0.89–1.45, I2 = 77%. Risk of bias for the included studies were moderate to serious.ConclusionsObstetrics patients with a history of IPV/sexual violence appear to be more likely to deliver via caesarean section as compared to those who do not.

Parent experiences and perceptions of twin cobedding in the NICU and home - A qualitative descriptive study

Aims and objectivesTo explore parents of twins’ perceptions of, and experience with, twin cobedding across Neonatal Intensive Care Units and home settings in Australia. BackgroundTwin cobedding has been used by many parents over the decades however, practices vary globally as research surrounding benefit and risk has not been definitive enough to inform guidelines. There is a significant gap in the literature exploring what is involved in parental preferences, experiences, and decisions related to twin cobedding. DesignA qualitative descriptive design, using reflexive thematic analysis. MethodsData were collected through ten individual, semi-structured interviews with parents of twins who had been admitted to a Neonatal Intensive Care Unit (NICU) and discharged home. This paper is reported following the COREQ guidelines and checklist. ResultsFour themes were identified which spanned the experience of pregnancy, premature birth, NICU admission, and home. ‘Bonding’ focused on parents' perceptions of the importance of the twin bond and the use of twin cobedding to facilitate it; ‘Influence’ explored how information, the internet, and community influenced twin cobedding perceptions and decisions; ‘Impact’ of the NICU/SCN and separation on cobedding decisions and experiences; and ‘Coping’ focused on how the twin workload on decisions regarding sleeping arrangements. ConclusionsThis study identifies that decisions made by twin families to separate or cobed their twins, go beyond simply following guidelines, or even role-modelling hospital practices. The decision is multi-factorial, yet ultimately centers around facilitating a bond, the relationship between their twins, and which method best supports their twins’ sleep/feed routine. Implications for the profession and/or patient careFamilies of multiples would benefit from improved guidance and advice whilst in hospital that considers their unique needs. It is important for healthcare workers to consider the decisions twin parents make surrounding sleeping arrangements within the context of coping with the twin workload. Patient or public contributionNo patient or public contribution.

THE PSYCHOAFFECTIVE EXPERIENCE AND PSYCHOSOCIAL SUPPORT OF PARENTS OF PREMATURE NEWBORNS IN 267 CASES

Prematurity is a birth that occurs before the term of the pregnancy. It is a public health priority. Despite improvements in its management in recent years, prematurity remains a very worrying problem. The parental experience of premature birth can be traumatic, impacting on the quality of the parent-child relationship and requiring social support. The aim of this study is to apprehend the psycho-affective experience of parents of premature newborns and their relationships with the newborn, and with professionals using the eco-systemic approach. This is a prospective, descriptive and analytical study of 267 cases of premature newborns hospitalized in the neonatology department of Tangier University Hospital over a 12-month period from February 01, 2023 to January 31, 2024. Our study reflected the ambivalence of the parents, who oscillated between a feeling of happiness in 58 cases of the mothers (21.7%) versus 52 cases of the fathers (19.4%) for the child they were expecting, and a feeling of anxiety in 89 cases of the mothers (33, 3%) versus 82 cases of the fathers (30, 7%), as well as narcissistic wounding in 29 cases (10.8%), and guilt in 28 cases (10.4%) are more evoked in the mothers discourse compared to responsibility in 77 cases (28.8%) and unreality in 25 cases (9.3%) predominant in the fathers words. The most important source of social support, apart from the family in 214 cases (80%), was the nursing team in 33 cases (12.4%) and other relatives on the ward in 20 cases (7.4%).

Challenges to the implementation of a multi-level intervention to reduce mistreatment of women during childbirth in Iran: a qualitative study using the Consolidated Framework for Implementation Research.

Mistreatment during childbirth is a growing concern worldwide, especially in developing countries, such as Iran. In response, we launched a comprehensive implementation research (IR) project to reduce mistreatment during childbirth and enhance positive birth experiences in birth facilities. This study identified the challenges of implementing a multi-level intervention to reduce mistreatment of women during childbirth using the Consolidated Framework for Implementation Research (CFIR). An exploratory qualitative study, involving 30 in-depth interviews, was conducted between July 2022 and February 2023. Participants included a purposive sample of key stakeholders at different levels of the health system (macro: Ministry of Health and Medical Education; meso: universities of medical sciences and health services; and micro: hospitals) with sufficient knowledge, direct experience, and/or collaboration in the implementation of the studied interventions. Interviews were transcribed verbatim and coded using directed qualitative content analysis (CFIR constructs) in MAXQDA 18. The identified challenges were: (1) individual level (childbirth preparation classes: e.g., adaptability, design quality and packaging, cosmopolitanism; presence of birth companions: e.g., patient needs and resources, structural characteristics, culture); (2) healthcare provider level (integrating respectful maternity care into in-service training: e.g., relative priority, access to knowledge and information, reflecting and evaluating); (3) hospital level (evaluating the performance of maternity healthcare providers: e.g., executing, external policies and incentives); and (4) national health system level (implementation of pain relief during childbirth guidelines: e.g., networks and communications, patient needs and resources, executing, reflecting and evaluating). This study provides a clear understanding of the challenges of implementing a multi-level intervention to reduce mistreatment of women during childbirth and highlights potential implications for policy makers and practitioners of maternal health programs. We encourage them to take the lessons learned from this study and revise their current programs and policies regarding the quality of maternity care by focusing on the identified challenges.