This study intended to investigate barriers to implementing evidence-based intrapartum care during vaginal births, from maternity care providers' point of view. A descriptive qualitative study was conducted using in-depth interviews, with data analysed through thematic analysis. The labour room of a major tertiary care hospital in Central Sri Lanka. Purposively selected 17 maternity care providers including doctors, nurse managers, nurse-midwives and midwives. Three major themes and twelve sub-themes were generated: (1) barriers related to care providers (lack of human resources, negative attitudes of care providers, poor relationship among care providers, poor relationship between women and care providers, lack of knowledge on evidence-based practice in childbirth care); (2) barriers related to organisational environment (gaps in management, heavy workload, inadequate physical resources, insufficient in-service training and lack of availability/use of updated guidelines) and (3) barriers related to women's birth preparedness (women's limited knowledge on childbirth and intrapartum practices and women's limited engagement during labour and childbirth). Many maternity care providers perceived that prevailing challenges to implement evidence-based childbirth care were one of the major reasons that impacted the quality of current childbirth care in the labour room. The findings showed that an integrative approach may be essential to address the diverse barriers to the implementation of evidence-based intrapartum care. It is necessary to engage healthcare administrators, healthcare professionals and care recipients to enhance the quality of current childbirth care in the setting through the successful implementation of evidence-based care.

Validity and reliability of the quality of midwifery childbirth care from women's perspectives scale among Japanese women: a cross-sectional online survey.

Background: Syphilis or king lion disease is a sexually transmitted infection (STI) caused by the Treponema Pallidium bacteria. This disease begins with a painless sore, usually found on the genitals, rectum or mouth. Based on data from the Central Java Department, there were 368 cases of syphilis throughout 2024, Tegal Regency, which is a city in Central Java, contributed 4 cases of syphilis, 2 of which were in pregnant women who underwent examination at Kardinah Regional Hospital. Objective: The purpose of this study was to provide care and management of childbirth cases with reactive syphilis at Kardinah Regional Hospital according to standards. Research Method: The method in this study used a descriptive qualitative method with a case study approach through subjective, objective, assessment and planning elements. Data were collected through observation, in-depth interviews, physical and supporting examinations, KIA books, and medical records. The main informants were determined by purposive sampling technique, namely mothers giving birth with reactive syphilis who were giving birth at Kardinah Regional Hospital, while additional informants were husbands, families, midwives in the VK room and obstetricians. Results: Based on the care and management of childbirth with reactive syphilis cases, there was no significant difference in the assistance of normal vaginal delivery provided there were no vaginal lesions and scabs on the body or canker sores in the mouth or lips.

Knowledge, attitudes and practices of Brazilian obstetricians in relation to childbirth care.

BACKGROUND: Caesarean section (CS) in primiparity women is considered one of the important indicators in childbirth care. It is necessary to adopt effective strategies to reduce CS in primiparity women to maintain the health of the mother and baby. This study was conducted to determine the effective factors on the increase of CS in primiparity women from the point of view of service providers. MATERIALS AND METHODS: This cross-sectional study was conducted using a stratified sampling method on 412 midwives and gynecologists working in public hospitals of Mashhad University of Medical Sciences in 2022. The data were collected using an electronic questionnaire developed by the researcher and analyzed with SPSS-22 statistical software and descriptive and inferential statistical tests at a significance level of P < 0.05. RESULTS: The minimum age of primiparity women was 23 years, the maximum was 41 years, and their average age was 32.01 ± 4.66 years. From the point of view of gynecologists and midwifery personnel, factors influencing the increase in CS were, respectively: financial affairs, pregnant mothers, education and culturalization of natural childbirth, management and supervision of natural childbirth promotion program, and service providers. CONCLUSION: Health policymakers should consider implementing evidence-based strategies to reduce unnecessary CSs. Policymakers should also consider adopting the World Health Organization classification as an internationally applicable CS classification system to monitor and compare the CS rate. Therefore, the development of evidence-based care about nonclinical interventions to reduce unnecessary CSs in primiparous women is recommended to health policymakers.

The effect of perceptions of respectful maternity care on postpartum experience and birth memory: a cross-sectional study.

Accessibility and utilisation of reproductive healthcare services among women with disabilities in Lithuania: Insights from a mixed-methods study.

An ethnographic exploration of the lifeworld and clinical practices of Zambian Midwives: childbirth, postpartum and newborn care

With the objective of generating evidence of validity for a measure of the latent trait "level of satisfaction with childbirth", Item Response Theory (IRT) was used in a sample of 15,965 women who had hospital births in Brazil. Telephone interviews were conducted up to six months after childbirth with participants of the Birth in Brazil: National Survey into Labor and Birth in the five regions of the country. An 11-item questionnaire denominated the Hospital Childbirth Care Satisfaction Scale was used. The questions were incorporated into the IRT models, with Samejima's graded response model providing the best fit. The sample was randomly divided into dataset 1 (n = 7,982), adjusted using the graded response model, and dataset 2 (n = 7,983), for validation of the results. Reliability measures were Cronbach's alpha, McDonald's omega, and Spearman-Brown coefficient. Regarding construct validity, exploratory factor analysis of dataset 1 demonstrated a latent factor structure with three dimensions. The resulting structure was tested in dataset 2 using confirmatory factor analysis, obtaining a good fit of the model. Two items of the questionnaire were excluded from the measure for not discriminating the latent trait of interest. Thus, thefinal scale consisted of nine items. Based on IRT, a new version of the instrument with adequate psychometric properties was obtained. The associations between satisfaction with childbirth and external variables strengthen the validity of the scale.

Brazil is the third country that most receives Venezuelan migrants, with approximately 626,000 people. This migratory flow has increased demand on the Brazilian Unified National Health System, especially for care related to pregnancy and childbirth. The aim of the present study was to investigate access to healthcare on the part of Venezuelan migrant women and their perceptions of the care received in Brazil during their prenatal and childbirth care journey. A quantitative-qualitative study was conducted between 2021 and 2023 involving Venezuelan women who reside in the city of Manaus, Amazonas State. In the quantitative component, participant-driven sampling was used (n = 118), with calculation of absolute frequencies and prevalence rates with 95% confidence intervals. The qualitative component involved intentional sampling (n = 39) and Thematic Analysis. In the quantitative results, most participants received prenatal care (95%) mainly at public healthcare services beginning in the first trimester (83%) and with an adequate number of appointments (77%). The majority of births (58%) were natural and 95% of the women had an accompanier. Maternal and neonatal complications were reported in 14% and 21% of cases, respectively. The qualitative component identified difficulties in obtaining exams through the healthcare system and in forming a bond with the maternity ward during prenatal care, travelling from maternity to maternity, and cultural differences that influenced the perceptions of the care received. Language was also a factor that impacted the quality of care. In conclusion, care during pregnancy and childbirth was ensured in the Brazilian universal healthcare system, although challenges persist that require improvement based on the experiences of the migrant women.

Emergency and post-disaster conditions often disrupt essential midwifery services, directly affecting the safety of mothers and newborns. Limited access to health facilities, shortages of healthcare personnel, and weak referral systems are major barriers to maternal and neonatal care in disaster-prone areas. This Community Service Program was conducted in Nogosari Village, Pacet District, Pasuruan Regency, East Java, to strengthen the preparedness of midwifery services. The methods included cross-sector coordination, community education, capacity building for supporting personnel, mentoring of health cadres, and simulation of essential midwifery service pathways in crisis situations. The activities focused on the provision of basic midwifery services, continuity of care for pregnant women, childbirth, postpartum mothers, and newborns, as well as strengthening the referral system. The results showed increased knowledge, skills, and preparedness among community members, cadres, and volunteers in maintaining essential midwifery services during emergencies. In addition, a shared understanding was developed regarding the importance of continuity of midwifery care as a form of protection for vulnerable groups. This program strengthened the resilience of community-based midwifery service systems and supported efforts to reduce maternal and neonatal morbidity and mortality risks in disaster situations. Furthermore, the activity encouraged sustainable collaboration among healthcare workers, village authorities, and the community to maintain adaptive and responsive midwifery services in the future.

OBJECTIVES: This study aimed to translate and culturally validate the Physiological Practices Observation (PPO) tool into Italian version (PPO-ITA) to enable systematic observation of midwifery care practices that support physiological labor and birth in Italy. Given the high medicalization of childbirth in Italy, the availability of a culturally adapted tool is essential for evaluating and improving midwifery-led care. METHODS: The translation and adaptation process followed the five-step methodology proposed by Sousa and Rojjanasrirat: forward translation, synthesis, back translation, second synthesis, and cognitive debriefing. Two bilingual translators conducted independent forward and backward translations. A multidisciplinary expert panel reviewed discrepancies and ensured conceptual equivalence. Twelve Italian-speaking midwives participated in cognitive debriefing to assess clarity and content validity. Feedback informed revisions to produce the final PPO-ITA version. RESULTS: The translation process revealed challenges in conveying midwifery-specific concepts such as “advocates” and “praising,” which lack direct Italian equivalents. Inclusive language ( donna/persona assistita ) was adopted to reflect evolving gender awareness. Cognitive debriefing led to the revision of Domain 6, aligning it with Italian national guidelines on postpartum care. One item was removed and another revised, resulting in a final tool comprising 7 domains and 30 items. CONCLUSIONS: The PPO-ITA tool is a culturally adapted, linguistically validated instrument suitable for observing midwifery practices in Italy. It preserves the conceptual integrity of the original PPO while reflecting local clinical and cultural contexts. Its implementation may enhance research on physiological childbirth and support evidence-based midwifery care in diverse Italian settings.

The This study analyzes obstetric violence in Brazil and seeks to understand why the rights of pregnant women, although guaranteed in constitutional and infraconstitutional legislation, are still not effectively applied in childbirth care. The research addresses the central problem of identifying the factors that hinder the implementation of these rights and allow abusive practices to persist throughout the pregnancy and childbirth process. The general objective is to examine how such violations occur and why they remain within health institutions. A qualitative methodology was adopted, based on bibliographic and documentary research involving scientific articles, legislation, and official institutional documents. This approach enabled a critical-theoretical interpretation of the Brazilian obstetric scenario by comparing the normative framework with the reality observed in healthcare services. The findings indicate that, despite the existence of rights ensuring dignity, autonomy, and informed consent, their effectiveness is weakened by factors such as the normalization of abusive practices, social inequalities, insufficient professional training, inadequate oversight, and limited institutional accountability. Black women, young women, and users of the public health system emerge as the most vulnerable groups. It is concluded that overcoming obstetric violence requires transforming institutional practices, strengthening public policies, and expanding education on reproductive rights. Future research may further explore the role of the judiciary and the psychological impacts resulting from these violations.

An increasing body of evidence has revealed disrespectful and abusive care in facility-based childbirth as a barrier to maternal and child health. Providers have noted subpar work environments, inadequate staffing, and negative attitudes toward marginalized groups as barriers to respectful care. What has not been studied is the impact of disaster and violence on the delivery of respectful maternity care. The purpose of this study was to evaluate the state of obstetrical care in a maternity hospital in Odessa, Ukraine during a time of military invasion. We surveyed 202 maternity care providers who have worked at Odessa City Maternity Hospital № 5 for at least one year. Measurements and topics covered in the questionnaires included respectful care practices performed; types of disrespectful behaviors witnessed; the impact of war on the provision of respectful maternity care; post-traumatic stress; and attitudes about consent in obstetriccare. Fifty percent of respondents believed disrespect was an issue in the field of obstetrics. A slight majority (55.0 %) reported that the frequency of disrespect and abuse remained the same before and after the invasion, while 32.2 % reported a lower frequency and 9.4 % reported a higher frequency of disrespect. There was little change in reported performance of respectful maternity care before and after the full-scale invasion. Reported effects of war on respectful maternity care were minimal. However, the relatively low knowledge of disrespect and the large spread of frequency of reported respectful behavior indicate an opportunity for training.

- Background: Contemporary maternity care emphasizes not only maternal and neonatal safety but also the quality of women’s childbirth experiences. However, increasing medicalization of labor has been associated with diminished maternal autonomy, heightened anxiety, and negative birth experiences. Women-Centered Care (WCC) offers a midwifery-led approach that prioritizes respect, empowerment, partnership, and individualized care. Within this framework, relaxation techniques serve as non-pharmacological strategies to support physiological labor and enhance maternal wellbeing. Objective: This narrative review aims to examine current evidence on relaxation techniques used during labor and their role in reducing pain and anxiety while promoting positive childbirth experiences in alignment with women-centered care principles. Methods: A narrative review of recent literature was conducted using PubMed, Wiley, Cochrane Library, and Google Scholar. Studies published within the last five years were included without restrictions on study design, focusing on relaxation techniques applied during intrapartum care. Results: The findings indicate that various relaxation techniques—including breathing exercises, manual techniques, music therapy, aromatherapy, and hydrotherapy—are effective in alleviating labor pain and anxiety. These interventions support neuroendocrine processes essential for physiological labor, enhance women’s sense of control, and improve overall childbirth satisfaction. Relaxation techniques also reinforce key components of WCC by fostering autonomy, comfort, and active participation in the birthing process. Conclusion: Relaxation techniques are effective, safe, and feasible interventions that support the implementation of women-centered childbirth care. Their integration into intrapartum midwifery practice can enhance maternal wellbeing, promote positive birth experiences, and strengthen respectful and holistic maternity care.

This article explores the shifting and competing ways in which childbirth, obstetrics, and maternity care were represented during the first two decades of television in Sweden. While childbirth on screen has a much longer history in both educational film and commercial cinema, the introduction of public service television in the late 1950s created a new space in Sweden for both educational and critical representations of reproduction, which had the potential of reaching a much larger national audience than was previously possible. Analyzing various television formats dealing with and displaying births from the early 1960s to the mid-1970s, this article examines how pregnant and birthing bodies were made visible in the new medium of television and what role these programs played in the larger debates on maternity care, obstetrics, and the Swedish welfare state in this period. Centrally, the article discusses the shift from a mode of representation in which childbirth was depicted within the framework of sex education or information about the welfare society's support systems to feminist representations giving voice to women's experiences and criticizing the medicalized perspective on childbirth found in Swedish healthcare. In this way, the article highlights shifting historical discourses of childbirth within the frames of a public service institution and a Nordic welfare state and emphasizes the importance of moving images as both an art form and an influential communication tool in postwar discussions of healthcare issues.

Introduction: Perineal rupture is a common complication during childbirth that requires appropriate management to prevent further morbidity. The knowledge and skills of midwives and general practitioners in performing perineal tear suturing at primary health care centers are crucial to ensure optimal care and minimize the risk of complications while promoting faster recovery of patients. Objective: This community service activity aims to improve the knowledge and skills of midwives and general practitioners in suturing perineal tears through workshops and training at primary health facilities. Method: The workshop was attended by 40 participants, consisting of midwives and general practitioners, for 150 minutes. The activity included training on perineal anatomy, suturing techniques, post-repair management, and practical suturing simulation using a cow tongue model. Participants completed questionnaires covering demographic data, and pre- and post-tests consisting of 10 questions about perineal tear repair. Result: Most participants were women in the productive age range, with a majority holding bachelor's degrees. Only a few had prior experience attending suturing workshops. Pre-test results showed lower knowledge compared to post-test results. The mean rank for pretest was 26.18 while posttest was 54.83, with a p-value of 0.000, indicating a statistically significant improvement in participants’ knowledge after the intervention. Conclusion: The workshop were effective in enhancing the knowledge of midwives and general practitioners in managing perineal tears. The findings highlight the importance of routine technical training to elevate the quality of childbirth care in public health centers.

Background: Cesarean section remains a major contributor to maternal and neonatal complications, with repeat cesarean sections being a primary factor. Vaginal birth after cesarean (VBAC) offers a potential alternative, and its success and maternal satisfaction depend on structured, multicomponent interventions. Objectives: The present study aimed to determine the effect of a multicomponent prenatal intervention on maternal satisfaction following VBAC. Methods: A randomized controlled trial was conducted at Amin Hospital, Isfahan, Iran (March 2024 - March 2025). Eligible women with one prior cesarean and a gestational age < 24 weeks were randomly assigned to repeat cesarean section (control, n = 50) or VBAC (intervention, n = 50) groups via permuted block randomization. The intervention included eight individual/group counseling sessions, at least eight prenatal visits, one acupressure session, and delivery at a specialized center. Data were collected via a demographic questionnaire and the Birth Satisfaction Scale (BSS). The data were analyzed via descriptive statistics (means, standard deviations, frequencies, and percentages) and inferential statistics (independent t-tests and chi-square tests). Results: The VBAC success was achieved in 52% of the intervention group (26/50), with no VBACs in the control group (P < 0.001). Overall maternal satisfaction scores did not differ significantly between groups (control: 157.68 ± 20.45 vs. intervention: 163.15 ± 22.45), but significant improvements were noted in postpartum care (P = 0.003) and participation in childbirth (P = 0.018). Conclusions: Although overall maternal satisfaction did not differ significantly between groups, the multicomponent VBAC-focused intervention increased VBAC success and increased satisfaction with specific aspects of care.

Tribal communities remain under a constant threat of poor maternal health outcomes, including pregnancy and childbirth. Recognizing the considerable scope in enriching the existing knowledge, this qualitative study with an inductive approach was conducted among the Munda community in Odisha. The study adopted the Reflexive Thematic Analysis (RTA) approach in the data analysis process to interpret patterns and meanings within women’s own accounts of pregnancy and childbirth experience. The emerging themes highlight early and unplanned conception generally associated with neglected contraception practices and misconstrued perception of antenatal, childbirth and post-partum care. Furthermore, the study captures emotional distress and the influence of social support and the potential obstacles they face in experiencing healthy and positive maternity. The findings reveal that since pregnancy and childbirth include both subjective and collective factors, even an experience without medical complications can also be perceived as negative. Identifying traditional norms and socio-cultural context as indispensable, the study views that due attention to a multi-pronged approach holds relevance in enabling a healthy and desirable pregnancy and childbirth experience among women.

Background: Postpartum haemorrhage (PPH) remains a leading cause of maternal mortality, particularly in low-resource settings. Active Management of the Third Stage of Labour (AMTSL) is a critical intervention for reducing PPH, yet midwives in underserved areas often face challenges accessing updated, practical training.Objective: This study explored midwives’ perceptions of a digital micro-learning video intervention (m-AMTSLV) on AMTSL and its effectiveness in improving knowledge and clinical practice in southern Jordan.Methods: A qualitative descriptive design involving semi-structured interviews with 13 midwives from two government hospitals was used. Purposive sampling was used to recruit midwives who had completed the m-AMTSLV intervention, worked full-time on labour and postpartum units, and had direct care of childbirth. Data were analysed using thematic analysis based on Braun and Clarke’s six-phase framework. Results: Four major themes emerged. Theme 1: effectiveness of Digital Learning in Real-World Practice, subtheme 1: realistic simulation that boosted clinical confidence and improved maternal care outcomes, and subtheme 2: flexible, self-paced access via phone without disrupting work or family duties. Theme 2: suitability for remote and low-resource settings, subtheme 1: addressing training gaps, and subtheme 2: practical Implementation without advanced tools. Theme 3: user-centred design and language accessibility, subtheme 1: preference for Arabic or bilingual content, and subtheme 2: engaging scenario-based videos. Finally, theme 4: technical and logistical challenges, subtheme 1: internet connectivity issues, and subtheme 2: limited access to traditional training opportunities. Conclusion: The m-AMTSLV intervention was perceived as effective, accessible, and relevant for enhancing midwives’ clinical competence in managing PPH, particularly in areas with limited resources. Integrating such micro-learning tools into national midwifery education strategies could strengthen maternal care outcomes in underserved settings.