Hospital Midwives Research Articles

The perceived determinants and recommendations by mothers and healthcare professionals on the loss-to-follow-up in Option B+ program and child mortality in the Amhara region, Ethiopia

BackgroundThe third United Nations Sustainable Development Goal includes a commitment to end AIDS-related death by 2030. In line with the Goal, Option B+ programs hold a great promise for eliminating vertical transmission of HIV. Option B+ was introduced in 2013 in Ethiopia. The Global Plan identified Ethiopia as one of 22 high priority countries requiring improvement in prevention of mother to child HIV transmission services. Despite HIV treatment being free in Ethiopia, only 59% of children are on treatment. The discrepancies in high uptake of Option B+ and low numbers of children in Ethiopia can be attributed to Loss-to-follow-up, which is estimated from 16 to 80%. While LFTU is expected in the region, no-to-minimal evidence exists on the magnitude and its determinants, which hampers the development of interventions and strategies to reduce LFTU. The purpose of this study is to explore perception of mothers and healthcare providers on determinants of and recommendations to reduce LTFU and HIV exposed infants’ mortality.MethodExplorative, descriptive qualitative study conducted in five zones of Amhara region. The sample consisted of mothers enrolled to the option B+ programs at the five referral hospitals PMTCT departments, nurses and midwives working in those departments, and HIV officers in zonal departments. Data were collected in 2019 using in-depth interviews. Data were analyzed using content analysis and deduced to themes.ResultsOverall, nine themes were identified from the interviews. Five themes represented the determinants of LTFU and mortality while four themes addressed the recommendations to reduce LFTU among mothers and their infant mortality. The determinants themes centered on apathy, stigma and discrimination, poor access to services, healthcare providers behavior and attitudes, and social determinants of health. While recommendations themes suggested that improving access, capitalizing on psychosocial support, education and awareness, and empowerment.ConclusionsSocial and structural issues are major contributors to low retention of mothers and death of children due to HIV. A multi-stakeholder approach, including structural changes, are required to support women and their children to ensure that individuals, communities and country enjoy the full benefits of option B+ and lead to an HIV free generation.

Psychological well-being of Australian hospital clinical staff during the COVID-19 pandemic.

Objective This study assessed the psychological well-being of Australian hospital clinical staff during the COVID-19 pandemic. Methods An anonymous online cross-sectional survey was conducted in a large metropolitan tertiary health service located in Melbourne, Australia. The survey was completed by nurses, midwives, doctors and allied health (AH) staff between 15 May and 10 June 2020. The Depression, Anxiety and Stress Scale - 21 items (DASS-21) assessed the psychological well-being of respondents in the previous week. Results In all, 668 people responded to the survey (nurses/midwives, n=391; doctors, n=138; AH staff, n=139). Of these, 108 (16.2%) had direct contact with people with a COVID-19 diagnosis. Approximately one-quarter of respondents reported symptoms of psychological distress. Between 11% (AH staff) and 29% (nurses/midwives) had anxiety scores in the mild to extremely severe ranges. Nurses and midwives had significantly higher anxiety scores than doctors (P<0.001) and AH staff (P<0.001). Direct contact with people with a COVID-19 diagnosis (P<0.001) and being a nurse or midwife (P<0.001) were associated with higher anxiety scores. Higher ratings of the health service's pandemic response and staff support strategies were protective against depression (P<0.001), anxiety (P<0.05) and stress (P<0.001). Conclusions The COVID-19 pandemic had a significant effect on the psychological well-being of hospital clinical staff, particularly nurses and midwives. Staff would benefit from (additional) targeted supportive interventions during the current and future outbreaks of infectious diseases. What is known about the topic? The outbreak of COVID-19 is having, and will have, a considerable effect on health services. No Australian data about the effect of COVID-19 on the psychological well-being of hospital clinical staff are available. What does this paper add? Australia healthcare providers have experienced considerable emotional distress during the COVID-19 pandemic, particularly nurses and midwives and clinical staff who have had direct contact with people with a COVID-19 diagnosis. In this study, nurses and midwives had significantly higher levels of anxiety, depression and stress during the pandemic than general Australian adult population norms, and significantly more severe anxiety symptoms than medical and AH staff. Despite a lower number of COVID-19 cases and a lower death rate than in other countries, the proportion of Australian hospital clinical staff experiencing distress is similar to that found in other countries. What are the implications for practitioners? Targeted well-being interventions are required to support hospital clinical staff during the current and future outbreaks of infectious diseases and other 'crises' or adverse events.

Health facility readiness and provider knowledge as correlates of adequate diagnosis and management of pre-eclampsia in Kinshasa, Democratic Republic of Congo

BackgroundHypertensive disorders in pregnancy are the second most common cause of maternal mortality in the Democratic Republic of Congo (DRC), accounting for 23% of maternal deaths. This study aimed to assess facility readiness, and providers’ knowledge to prevent, diagnose, and treat pre-eclampsia.MethodsA facility-based cross-sectional study was conducted in 30 primary health centres (PHCs) and 28 referral facilities (hospitals) randomly selected in Kinshasa, DRC. In each facility, all midwives and physicians involved in maternal care provision (n = 197) were included. Data on facility infrastructure and providers’ knowledge about pre-eclampsia were collected using facility checklists and a knowledge questionnaire. Facility readiness score was defined as the sum of 13 health commodities needed to manage pre-eclampsia. A knowledge score was defined as the sum of 24 items about the diagnosis, management, and prevention of pre-eclampsia. The score ranges from 0 to 24, with higher values reflecting a better knowledge. The Mann-Witney U test was used to compare median readiness scores by facility type and ownership; and median knowledge scores between midwives in hospitals and in PHCs, and between physicians in hospitals and in PHCs.ResultsOverall, health facilities had 7 of the 13 commodities, yielding a median readiness score of 53.8%(IQR: 46.2 to 69.2%). Although all provider groups had significant knowledge gaps about pre-eclampsia, providers in hospitals demonstrated slightly more knowledge than those in PHCs. Midwives in public facilities scored higher than those in private facilities (median(IQR): 8(5 to 12) vs 7(4 to 8), p = 0.03). Of the 197 providers, 91.4% correctly diagnosed severe pre-eclampsia. However, 43.9 and 82.2% would administer magnesium sulfate and anti-hypertensive drugs to manage severe pre-eclampsia, respectively. Merely 14.2 and 7.1% of providers were aware of prophylactic use of aspirin and calcium to prevent pre-eclampsia, respectively.ConclusionOur study showed poor availability of supplies to diagnose, prevent and treat pre-eclampsia in Kinshasa. While providers demonstrated good knowledge regarding the diagnosis of pre-eclampsia, they have poor knowledge regarding its prevention and management. The study highlights the need for strengthening knowledge of providers toward the prevention and management of pre-eclampsia, and enhancing the availability of supplies needed to address this disease.

Comparison of professionalism and job satisfaction between Korean midwives in birthing centers and midwives in hospitals.

PurposeMidwives working in hospitals (MWH) have limited roles in managing and assisting births independently. To find ways to successfully integrate midwifery into care systems, exploring midwives’ work-related perceptions might be the first step. The purpose of this study was to compare professionalism and job satisfaction between Korean midwives working in birthing centers (MWBC) and MWH.MethodsA descriptive comparative design was used, querying 19 MWBC and 53 MWH in Korea. Data were accrued from October to November 2017 using the Professionalism Inventory Scale and the Job Satisfaction Scale.ResultsAge, marital status, monthly income, length of career as a midwife, and length of career in the current workplace were significantly different between MWBC and MWH. The level of professionalism among MWBC showed significant differences by position at the birthing center (t=16.19, p=.001). Professionalism and job satisfaction among MWH showed significant differences depending on perceived professional performance (F=9.95, p<.001 and F=11.04, p<.001, respectively). Levels of professionalism and job satisfaction were higher for MWBC than for MWH.ConclusionEducational programs designed to enhance professionalism and expand the role of MWH are suggested. Also, policy changes that clearly define job roles and improvement of the legal system is required, so MWH in Korea can effectively perform their midwifery work and be properly reimbursed.

Nurses' and midwives' awareness of intimate partner violence-related mental healthcare and associated factors in Tanzania.

Although intimate partner violence (IPV) is a significant public health problem in Tanzania, the country's system to provide IPV-related mental healthcare is not sufficiently prepared to respond to IPV care needs. This study aimed to assess nurses' and midwives' awareness of IPV-related mental healthcare and associated factors to encourage care provision. A cross-sectional, anonymous, self-administered survey was conducted among nurses and midwives in health facilities in the Mbeya region, from December 2018 to January 2019. The questions gauged awareness of IPV-related mental disorders, availability of screening tools, confidence in providing IPV-related mental healthcare and the presence of a mental health focal/resource person, in addition to socio-demographic and institutional characteristics. Of 1,321 nurses and midwives in the region, 662 (50.1%) participated in the study, and the analysis included 568 (85.8%) responses without missing values. The median awareness score was 5 (range: 0-6), and 34.0% of the participants were aware of all six examined IPV-related mental health disorders. Separate logistic regression analyses were conducted for those working in hospitals and those working in health centres (HCs), assessing potential factors associated with nurses' and midwives' awareness of IPV-related mental disorders. Among nurses and midwives in hospitals, high professional education (adjusted odds ratio [AOR]: 1.207; 95% confidence interval [CI]: 0.787, 1.852; p=.045) and long work experience (AOR: 1.479; 95% CI: 1.009, 2.169; p=.007) were associated with high awareness of IPV-related mental disorders. For those in HCs, government ownership (AOR: 3.526; 95% CI: 1.082, 11.489; p=.037) and having a mental health focal/resource person (AOR: 3.251; 95% CI: 1.184, 8.932; p=.036) were associated with high awareness of IPV-related mental disorders. Appropriate distribution of mental health focal/resource persons is required for improving awareness of IPV-related mental healthcare provision among nurses and midwives in remote areas of Tanzania.

Knowledge and utilization of non-pneumatic anti-shock garment for the management of postpartum hemorrhage among Midwives in government hospitals in Ogun State, Nigeria

Objective: To assess the knowledge and determine the level of utilization of Non-Pneumatic Anti-Shock Garment (NASG) for the management of PPH among Midwives. Method: The study employed a descriptive cross-sectional study design, using a validated self-administered questionnaire. A total of 198 randomly selected midwives across three health facilities in Ogun State participated in the study. A 10-point knowledge scale was used to assess the knowledge of midwives on NASG. Descriptive statistics were used to determine the level of utilization of NASG among midwives, while Chi-square statistics were used to determine the relationship between the dependent and independent variables of interest at p&lt;0.05 level of significance. Results: Most (88.9%) of the respondents were female with a mean age of 40.2±5.6years. Most (48.5%) had a BNS degree. The majority (74.7%) of the respondents were aware of NASG. Close to a half (49.3%) of the respondents had fair knowledge scores, 34.5% had good knowledge scores, while 16.2% had poor knowledge scores. Only 22.7% of the respondents had ever used NASG in the management of PPH; 77.3% never used it before. Also, 67.2% of the respondents reported NASG was not available in their facilities. There was a significant influence of knowledge of NASG on the utilization among midwives (X2=37.151, P&lt;0.05, df=2). Conclusion: This study demonstrated that midwives in healthcare facilities were aware, but did not have good knowledge of NASG. The utilization of the garment for the management of PPH was also very poor, probably due to suboptimal knowledge and non-availability of the garment.

Prevalence of Percutaneous Injuries and Associated Factors Among a Sample of Midwives in Hunan Province, China.

Background: Percutaneous injuries and blood-borne-related infections pose occupational hazards to healthcare professionals. However, the prevalence and associated factors for these hazards among midwives in Hunan Province, China are poorly documented. Methods: A cross-sectional study was conducted among a sample of 1,282 eligible midwives in the cities of Yongzhou, Chenzhou, Hengyang, and Changsha in Hunan Province, China, from January 2017 to July 2017. The association of selected independent variables with percutaneous injuries was investigated using binary logistic regression. Results: 992 participants responded (77.3%), and within the previous 12 months, 15.7% experienced percutaneous injuries. In multivariate analysis, hospital size, age, length of employment as a midwife, weekly working hours, and three aspects of Hospital Safety Climate Scale were associated with percutaneous injuries. The risk of percutaneous injuries among the midwives working in hospitals with ≤399 beds was higher than that among those working in hospitals with ≥400 beds by nearly 3 times. Furthermore, the percutaneous injury prevalence of midwives decreased as age increased. Moreover, the probability of percutaneous injuries among the midwives with weekly working hours of >40 was 4.35 times higher compared with that among midwives with weekly working hours of ≤40. Conclusion/Application to practice: The prevalence of percutaneous injuries among midwives in the study hospitals was substantial. Our results further proved that risk mitigation strategies tailored to midwives are needed to reduce this risk. These strategies include ensuring a positive organizational climate, providing highly safe devices, and reducing the workload.

Influence of culture, religion and experience on the decision of Pakistani women in Lothian, Scotland to use postnatal contraception: a qualitative study

IntroductionEvidence suggests that Pakistani women may experience difficulty accessing postnatal contraceptive (PNC) services. The study aimed to identify experience and decision-making around PNC provision for Pakistani women in Lothian, and...

Neonatal mortality in the United States is related to location of birth (hospital versus home) rather than the type of birth attendant

Planned home births have leveled off in the United States in recent years after a significant rise starting in the mid-2000s. Planned home births in the United States are associated with increased patient-risk profiles. Multiple studies concluded that, compared with hospital births, absolute and relative risks of perinatal mortality and morbidity in US planned home births are significantly increased. To explore the safety of birth in the United States by comparing the neonatal mortality outcomes of 2 locations, hospital birth and home birth, by 4 types of attendants: hospital midwife; certified nurse-midwife at home; direct-entry ("other") midwife at home; and attendant at home not identified, using the most recent US Centers for Disease Control and Prevention natality data on neonatal mortality for planned home births in the United States. Outcomes are presented as absolute risks (neonatal mortality per 10,000 live births) and as relative risks of neonatal mortality (hospital-certified nurse-midwife odds ratio, 1) overall, and for recognized risk factors. We used the most current US Centers for Disease and Prevention Control Linked Birth and Infant Death Records for 2010-2017 to assess neonatal mortality (neonatal death days 0-27 after birth) for single, term (37+ weeks), normal-weight ( >2499 g) infants for planned home births and hospital births by birth attendants: hospital-certified nurse-midwives, home-certified nurse-midwives, home other midwives (eg, lay or direct-entry midwives), and other home birth attendant not identified. The neonatal mortality for US hospital midwife-attended births was 3.27 per 10,000 live births, 13.66 per 10,000 live births for all planned home births, and 27.98 per 10,000 live births for unintended/unplanned home births. Planned home births attended by direct-entry midwives and by certified nurse-midwives had a significantly elevated absolute and relative neonatal mortality risk compared with certified nurse-midwife-attended hospital births (hospital-certified nurse-midwife: 3.27/10,000 live births odds ratio, 1; home birth direct-entry midwives: neonatal mortality 12.44/10,000 live births, odds ratio, 3.81, 95% confidence interval, 3.12-4.65, P<.0001; home birth-certified nurse-midwife: neonatal mortality 9.48/10,000 live births, odds ratio, 2.90, 95% confidence interval, 2.90; P<.0001). These differences increased further when patients were stratified for recognized risk factors. The safety of birth in the United States varies by location and attendant. Compared with US hospital births attended by a certified nurse-midwife, planned US home births for all types of attendants are a less safe setting of birth, especially when recognized risk factors are taken into account. The type of midwife attending US planned home birth appears to have no differential effect on decreasing the absolute and relative risk of neonatal mortality of planned home birth, because the difference in outcomes of US planned home births attended by direct-entry midwives or by certified nurse-midwives is not statistically significant.

Performance of Male Midwives in the different Hospitals and Clinics in Kalinga

Performance of Male Midwives in the different Hospitals and Clinics in Kalinga

Improving service delivery using the self-reporting of errors by midwives and midwifery student.

INTRODUCTION:Reporting medical errors is one of the common methods for identifying and preventing mistakes in-hospital care. This study was conducted to identify the status of reporting and related factors in two groups of midwives and midwifery students.METHODOLOGY:This research was analytic correlational; it was conducted among all the midwives working in the midwifery and labor departments and midwifery students in Isfahan University of Medical Sciences. The data collection tool included a checklist of errors and the researcher-construed questionnaires of awareness and attitude toward reporting errors. The results were examined using descriptive and inferential statistics (ANOVA, Pearson and Spearman correlation coefficient, and independent t-test) by SPSS software version 20.RESULTS:In this research, the error reporting in midwifery staff was 79.1% and the most frequent error was related to the patient's process of testing; the error reporting among the students was 90% and the most frequent error occurred in the labor processes. The present study also showed that there was a direct relationship between awareness and attitude toward reporting medical errors (P < 0.001), while there was not a significant relationship between the midwifery students’ awareness and attitude toward reporting the medical errors (P = 0.31).CONCLUSION:According to the study, hospital midwives reporting is less than midwifery students. Accordingly, it is recommended to focus on the error and risk management committee to strengthen the reporting system.

Knowledge, attitude, and practice towards Hepatitis B infection among nurses and midwives in two maternity hospitals in Khartoum, Sudan

BackgroundHepatitis B virus (HBV) infection creates a global health burden with significant morbidity and mortality. Healthcare workers, including nurses and midwives, are at higher risk of acquiring the disease. While health-related behaviours are affected by different aspects of knowledge, attitude, and practices (KAP), there are few studies examining the KAP level of healthcare workers towards HBV infection in Sudan. The purpose of this study was to examine the KAP level of nurses and midwives towards HBV virus infection in Khartoum, Sudan.MethodsA cross-sectional descriptive hospital-based study was conducted in two public maternity hospitals (Saudi and Saad Abul-Eleella hospitals) in Khartoum state of, Sudan. A pre-tested structured questionnaire was constructed and implemented to examine KAP towards HBV infection. Statistical Package for Social Sciences (SPSS) version of 21 was utilized to conduct statistical analysis and examine the data at hand. Chi-square test was used implemented to determine the relationship between categorical variables.ResultsA total of 110 nurses and midwives from the both hospitals participated in this study. More than half of the respondents (58.2%) had an average level of knowledge, two-third of the respondents had a safe practice, and the majority of the respondents had a favourable attitude towards HBV preventive measures. Approximately half of the participants (51.8%) had a history of needle stick injuries. Half of the participants had inaccurate concepts about post exposure prophylaxis to HBV infection, while more than half of the nurses and midwives didn’t complete the vaccination schedule for HBV.ConclusionMost of the nurses and midwives in Saudi and Saad Abul-Eleella hospitals were aware of HBV infection. However, a significant proportion of the participants lack the requisite knowledge about post exposure management. The study revealed a low level of HBV vaccination coverage rate and a high rate of needle stick injuries. Further strategies for preventing workplace exposure, training programs on HBV infection, including post exposure prophylaxis, and increasing vaccination coverage rate of all HCWS are highly recommended.

Knowledge levels of midwives regarding the interpretation of cardiotocographs at labour units in KwaZulu-Natal public hospitals.

BackgroundThe primary purpose of cardiotocography is to detect early signs of intrapartum hypoxia and improve foetal outcomes. Intrapartum hypoxia remains the major cause of perinatal deaths during monitored labours. This is attributed to the midwives’ lack of knowledge and skills in the foetal implementation and interpretation of cardiotocographs.ObjectivesThis study aimed to establish midwives’ knowledge and interpretive skills of cardiotocography.MethodThe study employed a quantitative research approach with an explorative, descriptive, cross-sectional design. A total of 226 purposively selected participants were asked to complete a self-administered, structured questionnaire, of which 125 responded by completing the questionnaire. The study was conducted in labour wards in KwaZulu-Natal public hospitals in 2014. Data analysis was performed by means of descriptive and inferential statistics using analysis of variance.ResultsThe findings revealed that the midwives in KwaZulu-Natal public hospitals were found to be clinically lacking in knowledge of cardiotocography.ConclusionThe limited cardiotocographic knowledge of the midwives in KwaZulu-Natal public hospitals was possibly because of a lack of in-service training, as more than half of the participants (70%) indicated a need for this.

Are midwives in the Netherlands satisfied with their jobs? A systematic examination of satisfaction levels among hospital and primary-care midwives in the Netherlands

BackgroundJob satisfaction is generally considered to be an important element of work quality and workplace relations. Little is known about levels of job satisfaction among hospital and primary-care midwives in the Netherlands. Proposed changes to the maternity care system in the Netherlands should consider how the working conditions of midwives affect their job satisfaction.AimWe aimed to measure and compare job satisfaction among hospital and primary-care midwives in the Netherlands.MethodsOnline survey of all practising midwives in the Netherlands using a validated measure of job satisfaction (the Leiden Quality of Work Questionnaire) to analyze the attitudes of hospital and primary-care midwives about their work. Descriptive and inferential statistics were used to assess differences between the two groups.ResultsApproximately one in six of all practising midwives in the Netherlands responded to our survey (hospital midwives n = 103, primary-care midwives n = 405). All midwives in our survey were satisfied with their work (n = 508). However, significant differences emerged between hospital and primary-care midwives in terms of what was most important to them in relation to their job satisfaction. For hospital midwives, the most significant domains were: working hours per week, workplace agreements, and total years of experience. For primary-care midwives, social support at work, work demands, job autonomy, and the influence of work on their private life were most significant.ConclusionAlthough midwives were generally satisfied, differences emerged in the key predictors of job satisfaction between hospital and primary-care midwives. These differences could be of importance when planning workforce needs and should be taken into consideration by policymakers in the Netherlands and elsewhere when planning new models of care.

The Role of Organizational Justice in Nurses and Midwives’ Satisfaction with Performance-Based Payment (Qasedak Project) in Zanjan Educational Hospitals

BackgroundPerformance-based payment makes rewards and outcomes result in paid satisfaction , which leads to the success and promotion of employee value and alignment with organizational goals in the light of organizational justice.ObjectivesThis study aimed to assess The role of organizational Justice in Nurses and Midwives’ Satisfaction with Performance-Based Payment (Qasedak Project) in Zanjan Educational HospitalsMethodsThis descriptive cross-sectional correlation study was conducted on 149 nurses and midwives in educational hospitals with Cochran formula. The researcher-made questionnaires of satisfaction based on P4P and organizational justice of Moorman and Niehoff were used, and data were analyzed using SPSS software and descriptive and analytic statistics (independent t-test, regression, analysis of variance, and nonparametric Spearman correlation coefficient and cross-tabulation).ResultsNurses and midwives reported moderate organizational justice with an average of 55.7 and low merit pay satisfaction with an average of 13. There was a positive and significant correlation between organizational justice and job satisfaction (r = 0.65), the amount of merit pay and satisfaction (r = 0.33), and organizational justice and the amount of merit pay (r = 0.23). The results revealed that organizational justice with a standard beta of 0.58 had a positive effect on the satisfaction with the merit pay received and alone accounted for 33% of the changes.ConclusionSince there was a positive and direct correlation between organizational justice and nursing and midwifery staff satisfaction, it is recommended that managers accomplish exact and accurate evaluation of staff performance by means of increasing staff’s awareness of Qasedak project, providing timely feedback to them, and observing justice in the payment of rewards.

Barriers and facilitators of midwives' physical activity behaviour in hospital and community contexts in Scotland.

To investigate barriers and facilitators of physical activity in midwives in hospital and community environments. A sequential mixed-methods approach. Focus groups and subsequent questionnaire survey. Four focus groups were conducted in urban and rural areas with community and hospital-based midwives in Scotland in 2015. Topics were based on the behaviour change theories via the Theoretical Domains Framework. Findings informed development of a questionnaire, sent to midwives in 2016 in Scottish health boards via managers, or online survey. Thirty-three midwives participated in focus groups. Workplace environmental context and resources were both barriers and facilitators. Similarly, negative social influences were barriers, whereas positive social support facilitated physical activity. The questionnaire was completed by 345 midwives. Most (90%) were physically active with high levels of activity. Commonest activities included walking, swimming and housework. Physical activity facilitators included subsidized classes and protected breaks. Barriers included tiredness, stress, family responsibilities, unpredictable breaks and shift patterns. Interventions should address midwives' workplace context and resources and interpersonal factors such as stress and social support. Midwives' high levels of overweight/obesity and stress impact on their own health and delivery of patient care. More workplace physical activity could help. We found most were physically active but identified workplace barriers and facilitators, including resources, shift patterns and breaks. Findings could help midwifery managers to recognize and reduce barriers, thereby improving midwives' physical activity in the workplace, supporting weight management and enhancing their health and well-being.

Effect of Non-Pharmacological Pain Management Methods on Reduction the Duration of Labor Stages in Primigravida Women at AL-Elwyia Maternity Teaching Hospital

Objectives: To evaluate the effect of non-pharmacological pain relief methods on duration of labor stage.Methodology: A quasi-experimental study design was conducted during the period of (4th July 2018 through 24th October 2018) on non-probability of (60) women (30) of them were a control group and (30) were the study group whom admitted to Al-Elwyia Maternity Teaching Hospital suffering from labor pain. A questionnaire was used as a tool of data collection Descriptive&amp; Inferential statistical analyses were used to analyze the data.Result: The highest percentages of study and control groups were in age group (&lt; 20) years old, primary schools graduates, housewife, from "urban area", within low category of socioeconomic scale, at gestational age between (39 weeks – 40 weeks +6day), and have intact membrane status .Also there are highly significant differences concerning durations of the (1st, 2nd, and 3rd) stages of labor among study and controlled groups at (P=0.001),(P=0.002),&amp;( at (P=0.000) respectively.Recommendation: The study recommended to conduct structured training programmed for all midwives in maternity hospitals and primary health care centers to enable them to implement the non-pharmacological pain relief methods, in addition a simplified guideline for midwife should be disrupted and contains information about the proper use of non-pharmacological pain management methods and its advantages

The impact of rotating work schedules, chronotype, and restless legs syndrome/Willis-Ekbom disease on sleep quality among female hospital nurses and midwives: A cross-sectional survey

BackgroundDecreases in subjective sleep quality are prevalent among nurses and midwives engaged in rotating shift work. ObjectivesThe present study aimed to examine the relationship between differences in work schedules and subjective sleep quality among female nursing staff. DesignA cross-sectional survey design was used for descriptive and logistic regression analyses. Data collection was conducted from December 2016 to September 2017. SettingsParticipants were recruited from five regional core hospitals in Japan. ParticipantsA total of 1253 nurses and midwives were included in the final analysis. MethodsSubjective sleep quality was assessed using the Japanese version of the Pittsburgh Sleep Quality Index. Chronotype and social jet lag were calculated for both work day and work-free day. Symptoms related to restless legs syndrome/Willis-Ekbom disease were assessed using the Japanese version of the Cambridge-Hopkins questionnaire short form 13. Participants with the urge to move their legs, though not fulfilling the restless legs syndrome/Willis-Ekbom disease criteria, were classified as having leg motor restlessness. Logistic regression analyses for poor sleep were adjusted for age, body mass index, smoking, drinking, menstruation status, the presence of premenstrual syndrome, and the presence of a spouse. ResultsRates of poor sleep (Pittsburgh Sleep Quality Index score ≥6) among those working, day shifts, rotating 12.5 hour night shifts, rotating 16 hour night shifts, and three-shift rotations were 41.2%, 51.1%, 44.5%, and 60.4%, respectively. Approximately 40% of three-shift rotation workers experienced difficulty initiating sleep. Shift workers tended to exhibit evening chronotype, delayed sleep phase, and high social jet lag. The prevalence of restless legs syndrome/Willis-Ekbom disease was 2.5%. Leg motor restlessness was observed in. 15.5% of participants. The adjusted odds ratios (95% confidence interval) of three-shift work (vs. day shift), evening chronotype (vs. morning chronotype), and the presence of leg motor restlessness (vs. no leg motor restlessness) for those with poor sleep were 2.20 (1.47–3.30), 1.95 (1.29–2.94), and 1.66 (1.15–2.39), respectively. ConclusionsRegardless of the working schedules, rates of poor sleep were high among female hospital nurses and midwives. Our findings suggest that poor sleep quality is influenced by three-shift rotation, the evening chronotype, and leg motor restlessness.

Women’s experiences of perceived traumatic vaginal birth in Australian maternity settings

Objective: Before the beginning of medicalisation in Australia during the 1950s, childbirth was the sole domain of women. Contemporary birthing practices have posed a more medicalised technological environment on women resulting in both good and bad outcomes. In recent surveys, 45.5% of Australian women reported experiencing birth as traumatic; with nearly 20% experiencing postnatal depression. While there have been some studies on women’s trauma experiencing a caesarean section, minimal research has been completed into perceived traumatic experiences related to normal vaginal births.Methods: This study utilized a qualitative methodology to explore psychological and emotional impact of women’s experiences with perceived traumatic normal births. The research used an in-depth semi-structured interview and analysed the data within the phenomenological paradigm. The data analysis revealed nine themes: I was determined to birth naturally; Not telling me what they were doing; I just had to force her to be born; it was really horrific; I know that is just what the system is like. . . they’re hospital midwives. . . they’re medical; I didn’t feel connected to them; She stood up for me; After the birth, just horrible; I deserve a better birth.Results: Although the rates are unclear, these findings highlight that some women suffer trauma from their experience of a normal vaginal birth. The perceived causes include: midwives not always being with women and supporting physiological childbirth; women not being fully informed; power asymmetries and hegemony inside the birthing room; and a fetocentric model of care that left women feeling disrespected, disempowered and objectified.Conclusions: The findings indicate a need for midwives to truly be with women and provide continuity of care, as well as supporting the physiological process of childbirth, medical and midwifery professional education on trauma awareness following birth, a rethinking of antenatal education programs to include coping strategies and greater midwifery support in the hospital post-natal stay.

Communication Skills and Its Related Factors Among Medical Staff

Background: Communication skills are the main features in health care. Objectives: The current study aimed at determining communication skills and its related factors among medical staff. Methods: The current cross sectional study was conducted on 302 medical staff of hospitals (physicians, nurses, midwives, and paramedics) in 2014, Hamadan city, Iran. The subjects were randomly selected from each hospital proportional to population size. Demographic information and the Burton communication skills (verbal, listening, and feedback) were completed using questionnaires. For all of the communication skills, scores 6 to 14 were low, 15 to 22 moderate, and 23 to 30 were considered high. Collected data were analyzed with SPSS version 22 using descriptive tests, Kruskal-Wallis test, t-test, and regression analysis. Results: Subjects gained 19.22, 17.50, and 19.20 average of communication skills including verbal, listening and feedback, respectively. Medical staff communication skills were at moderate level. There was a significant difference between the scores of feedback skills (P = 0.001) and verbal skills in different educational levels (P = 0.018). Also, the verbal and feedback skills in the group of midwives were more than those of the others (P &lt; 0.001). Conclusions: The levels of communication skills among medical staff were not high. Communication skills training should be done at the time of recruitment and for vocational retraining