Labor Care Research Articles

Audit of documentation accompanying referred maternity cases to a referral hospital in northern Ghana: a mixed-methods study

BackgroundEffective referral of maternity cases, which cannot be managed at the primary healthcare level, with detailed referral forms is important for reducing possible delays in the provision of higher-level healthcare. This is the first study to audit documentation or referral forms that accompany referred maternity cases to a referral hospital in the northern region of Ghana.Materials and methodsThis study employed an explanatory sequential mixed-method design, starting with a quantitative review of referral forms that accompanied all patients referred to four units (antenatal, antenatal emergency, labour and neonatal intensive care) of a referral hospital in northern Ghana. In-depth interviews were held with the heads of the four units afterwards. Descriptive statistics were computed for the quantitative data. The qualitative data was subjected to content analysis. Integration of the data occurred at the data interpretation/discussion level.ResultsA total of 217 referral forms were analysed. Nearly half of the cases were referred from the Tamale Metropolis (46.5%) and 83.9% were referred for advanced care, whilst 8.3% were referred due to a lack of medical logistics and equipment such as oxygen and skilled personnel (6%). Completion rates of the referral forms were as follows: < 50% completion (n = 81; 37.3%), 50–75% completion (n = 112; 51.6%) above 75% completion (n = 24; 11.1%). Some of the handwriting were not legible and were quite difficult to read. The key informants stated that incomplete forms sometimes delay treatment. The head of the antenatal care unit at the referral hospital suggested professional development sessions as a strategy for supporting clinicians to fill the forms as expected.ConclusionThe Ghana Health Service should conduct regular audits, develop job aides and provide incentives for health professionals who accurately complete referral forms. Completing forms and digitizing health records can help ensure further efficiencies in the health information system and sustain good maternity referral documentation practices.

Mothering in a Pandemic: Navigating Care Work, Intensive Motherhood, and COVID-19.

Even before COVID-19, women around the world performed more unpaid domestic labor, specifically unpaid care labor, than men. COVID-19 has only exacerbated the gender gap in this domestic labor. For Western women, especially mothers in the United States of America, the normative discourse of intensive motherhood and the gendered pressure inherent in the unrealistic standards set by the discourse have only increased the amount of unpaid domestic and care labor required of mothers. Using qualitative, in-depth interviews with 18 mothers during May–June 2020, this study examines privileged mothers’ perceptions of what they did well in parenting both before and during the early part of the COVID-19 pandemic. The mothers’ pragmatic adaptations during the pandemic posed challenges to the norms of intensive motherhood, as did emergent ideas about integrative mothering articulated before the pandemic’s onset. We find that while COVID-19 has increased expectations on mothers, it has also provided a turning point wherein expectations can be changed, as the participants suggested. Implications for intensive motherhood scholars, mothers, and communication researchers are discussed, along with future research.

Effectiveness of Placental Stage of Labor Care Protocol on Performance of Maternity Nurses

Effectiveness of Placental Stage of Labor Care Protocol on Performance of Maternity Nurses

Economic evaluations of maternal health interventions: a scoping review

Background Evidence on the affordability and cost-effectiveness of interventions is critical to decision-making for clinical practice guidelines and development of national health policies. This study aimed to develop a repository of primary economic evaluations to support global maternal health guideline development and provide insights into the body of research conducted in this field. Methods A scoping review was conducted to identify and map available economic evaluations of maternal health interventions. We searched six databases (NHS Economic Evaluation Database, EconLit, PubMed, Embase, CINAHL and PsycInfo) on 20 November 2020 with no date, setting or language restrictions. Two authors assessed eligibility and extracted data independently. Included studies were categorised by subpopulation of women, level of care, intervention type, mechanism, and period, economic evaluation type and perspective, and whether the intervention is currently recommended by the World Health Organization. Frequency analysis was used to determine prevalence of parameters. Results In total 923 studies conducted in 72 countries were included. Most studies were conducted in high-income country settings (71.8%). Over half pertained to a general population of pregnant women, with the remainder focused on specific subgroups, such as women with preterm birth (6.2%) or those undergoing caesarean section (5.5%). The most common interventions of interest related to non-obstetric infections (23.9%), labour and childbirth care (17.0%), and obstetric complications (15.7%). Few studies addressed the major causes of maternal deaths globally. Over a third (36.5%) of studies were cost-utility analyses, 1.4% were cost-benefit analyses and the remainder were cost-effectiveness analyses. Conclusions This review provides a navigable, consolidated resource of economic evaluations in maternal health. We identified a clear evidence gap regarding economic evaluations of maternal health interventions in low- and middle-income countries. Future economic research should focus on interventions to address major drivers of maternal morbidity and mortality in these settings.

The association between midwifery staffing levels and the experiences of mothers on postnatal wards: Cross sectional analysis of routine data

BackgroundWomen have consistently reported lower satisfaction with postnatal care compared with antenatal and labour care. The aim of this research was to examine whether women’s experience of inpatient postnatal care in England is associated with variation in midwifery staffing levels. MethodsAnalysis of data from the National Maternity Survey in 2018 including 17,611 women from 129 organisations. This was linked to hospital midwifery staffing numbers from the National Health Service (NHS) Workforce Statistics and the number of births from Hospital Episode Statistics. A two-level logistic regression model was created to examine the association of midwifery staffing levels and experiences in post-natal care. ResultsThe median Full Time Equivalent midwives per 100 births was 3.55 (interquartile range 3.26–3.78). Higher staffing levels were associated with less likelihood of women reporting delay in discharge (adjusted odds ratio [aOR] 0.849, 95% CI 0.753–0.959, p = 0.008), increased chances of women reporting that staff always helped in a reasonable time aOR1.200 (95% CI 1.052, 1.369, p = 0.007) and that they always had the information or explanations they needed aOR 1.150 (95% CI 1.040, 1.271, p = 0.006). Women were more likely to report being treated with kindness and understanding with higher staffing, but the difference was small and not statistically significant aOR 1.059 (0.949, 1.181, p = 0.306). ConclusionsNegative experiences for women on postnatal wards were more likely to occur in trusts with fewer midwives. Low staffing could be contributing to discharge delays and lack of support and information, which may in turn have implications for longer term outcomes for maternal and infant wellbeing.

Teaching Care During Covid-19: Reflective Assessment for Becoming-Historians

This article argues that the Emergency Remote Teaching (ERT) that took place during the Covid-19 pandemic in 2020 and 2021 left learners and teachers alike awash in feelings of helplessness, loss, and anguish. While online learning literacy and pedagogy have improved over the course of 2020 and 2021, and interesting and important innovations have been implemented and explored, the foundational inequalities have not lessened or disappeared. This article argues for the use of care as a necessary pedagogy in the virtual classroom using a case study of one class. The labour of care needs to be considered as part of the labour of pedagogy during Covid-19. I argue for care being built into both pedagogy and assessment as part of a radical pedagogy for this time. I explore reflective assessment embedded in a pedagogy of care as a way to, if not combat, recognise and respond to the inequalities embodied in ERT and the society it exists in, towards radical change. Active reflection draws out the impact that ERT has had on the “being” and “becoming” of pre-service History teachers.

Education as care labor: Expanding our lens on the work-life balance problem

Scholars have documented the challenges of combining wage work and care responsibilities in various societal contexts. National variations reveal that public policy and care infrastructure have major effects in shaping gendered patterns, class inequalities, as well as overall wellbeing of parents. Childcare centers and schools can enable people with children to pursue jobs and careers. Yet, as I show in this article, education systems’ demands can become a major component of parental care labor. Drawing on interviews with 92 parents in Singapore, I illustrate the ways in which education care labor impedes work-life reconciliation as well as deepens the significance of gender and class.

Prevalence and Reasons for Maternal Mortality: A Retrospective Study

Aim: To determine the prevalence and reasons for maternal mortality at a tertiary care hospital Study design: A retrospective study Place and duration: This study was conducted at Maternal and Child Care Center Hyderabad Pakistan from June 2018 to June 2020. Methodology: To gain access to the records, convenience sampling was utilized. A self-contained proforma was used to gather verified data on variables (age, year of death, cause of death, and domicile), Excel 2016 was used to examine the data and trend analysis was performed using Join point Analysis Software. Results: In three years, 279 maternal fatalities have been reported from "Hyderabad." With 29.4 % (CI= 0.68, SD= 10.42), hemorrhage remained the primary cause, subsequently, eclampsia 16.13 % (CI= 0.63, SD= 7.48), ruptured uterus 8.6 % (CI= 0.56, SD= 8) and sepsis 5.73 % (CI= 0.44, SD= 5.47). The highest rate of maternal fatalities was 40.50 % in women aged 26 to 30, followed by 25.1 % in women aged 15 to 25, 21.15 % in women aged 31 to 35, and 13.26 % in women aged 36 to 40. The P-value for post-partum bleeding was significant (0.003). Conclusion: Maternal mortality continued to increase in women of child bearing age, with principal reasons including hemorrhage, eclampsia, uterine rupture, and sepsis. To avoid these deaths, early referral, decreasing cesarean section rate, improved monitoring during labour and maternal care by skilled personals and community-based education are both in desperate need of improvement. Keywords: Maternal Mortality, Child-bearing age, Obstructed Labor, Eclampsia, Postpartum Hemorrhage, Ruptured uterus, Pulmonary Embolism.

COVID “death pits”: US nursing homes, racial capitalism, and the urgency of antiracist eldercare

Rampant COVID-19 outbreaks in US nursing homes have presented a massive biosecurity problem for the nation, bringing into stark relief the racialized stratification of eldercare administration and long-term care. This paper, by foregrounding the ways racial capitalism drives the chronic devaluation of nursing home residents and staff, provides an overview of how racism and ageism operate geographically through political ecologies of COVID in relation to the organization of the nursing home industry, medical scarcity, long-term care labor, and pandemic response to elderly populations. The inventory tracks some of the ways nursing homes condition race-based futures by arranging eldercare populations, workers, and spaces for extraction, abandonment, and blame for the pandemic. In doing so, it demonstrates the need for more equitable forms of aging and more just institutions of eldercare that put the social welfare of the aged, especially that of BIPOC elders and caregivers, above corporate compliance and financial performance that reproduce racial hierarchy and white supremacy in US healthcare. The article concludes by engaging with Black feminist data analytics and several policy efforts that challenge the structurally racist conditions of caregiving, pandemic response, and securitized segregation of the aged.

“Why Don’t They Just Use Cloth?” Gender Policy Vacuums and the Inequalities of Diapering

Drawing on feminist theories of parenting and the welfare state, I analyze experiences of diaper need as a case of how gender, class, and race inequalities shape the social organization of caregiving and limited policy responses. Data from in-depth interviews with 70 mothers who experienced diaper need and 40 diaper bank staff revealed obstacles low-income mothers face in managing lack of access to children’s basic needs and how gendered assumptions of parental responsibility thwart public diaper support efforts. I use this case to theorize gender policy vacuums: These occur when gender disparities and ideologies prevent systematic responses to structural problems. Empirically this study contributes to understandings of diaper need as a problem of the gender structure that cannot be solved with alternative diapering methods that assume middle-class, white, androcentric privileges. Theoretically it illuminates key mechanisms by which feminized care labor is devalued and rendered invisible and how this erasure rationalizes lack of redress for gendered inequalities and creates policy gaps around caregiving.

Application of Four Phases Teaching Method regarding Care of Labour among Nursing Students and its Effect on their Emotional Intelligence

Application of Four Phases Teaching Method regarding Care of Labour among Nursing Students and its Effect on their Emotional Intelligence

The Effect of Combination of Pelvic Rocking Exercise and Back Massage to Pain and Duration of Labor in Primigravidae

Background&#x0D; The combination of pelvic rocking exercise using a birth ball and back massage as non-pharmacological therapy needs to be investigated in relation to reducing pain and labor duration in primigravida mothers.&#x0D; &#x0D; Aim&#x0D; This study aims to determine the effect of a combination of pelvic rocking exercise using a birth ball and back massage on pain and labor duration in primigravida mothers. &#x0D; &#x0D; Methods &#x0D; The design of this study was quasy Experiment with the approach of non-equivalent control group 's. The research sample was 160 primigravida maternity mothers. The sample in the treatment group was given pelvic rocking intervention using a birth ball and back massage and the sample in the control group was given standard labor care such as touch, and taught labor positions that were in an upright position, providing encouragement and counseling. This research conducted in July–December 2020. &#x0D; &#x0D; Results &#x0D; Provided evidence that pelvic rocking using a birth ball and back massage offers safe, non-invasive treatment for pain management and duration during labor.&#x0D; &#x0D; Conclusion&#x0D; The results of this study provide an understanding that there is a significant effect of the combination of pelvic rocking exercise and back massage on pain and duration of labor in primigravida mothers.&#x0D;

The Labor of Care in Carceral Spaces: The Work of Resistance in the New York City Jails

The carceral history of Rikers Island, which now houses nine of the New York City jails, begins with garbage and forced labor. The Municipal Farm on Rikers Island, operated by the Department of Public Charities and Correction, opened in 1884 and served as a “prison farm.” Penal farms were common at that time, but what was not common was the simultaneous use of the island as a landfill. Most of the landmass that now comprises Rikers was formed from the refuse of New Yorkers. As the amount of garbage grew the initially productive farm became plagued by rats and other pests—not to mention fetid smells and poor air quality. This history is felt today on the island, as there are shunts into the earth that spew sickening steam, a constant reminder of its origins.

Justice as a Labor of Care: Self-Care, Collective Entanglement, and Feminist Activism in Caribbean Spaces

Justice as a Labor of Care: Self-Care, Collective Entanglement, and Feminist Activism in Caribbean Spaces

Neoliberal Capitalism, Older Adult Care and Feminist Theory

Classic feminist social theory highlights the exploitation of women’s labor in capitalist societies traditionally through an examination of how housework and childcare is perceived and organized, excluding an explicit analysis of older adult care work. In light of the surge in the demand for older adult caregiving over the last several decades, this paper uses older adult care work as a new lens to understand how gender, and its intersections with other critical identities such as race, ethnicity, and nativity, are a basis for continued exploitation and marginalization in modern capitalist systems. Building on Marxist feminism and Sylvia Wynter’s work on social value and domination, I argue that women’s care labor, both paid and unpaid, is an instrument of capital accumulation that differentially exploits women based on key intersectional identities. An examination of the system of older adult care work in the United States allows us to see the multilayered and complex system of exploitation that creates and institutionalizes existing social hierarchies as capitalism seeks to expand. The paper ends with a discussion of two potential family care paths America could conceivably pursue in the coming years; one toward increased commodification of care work in line with neoliberal capitalism, and the other toward more comprehensive social welfare policies that alleviate women’s reproductive labor burden and begin to break down gendered and racialized hierarchies.

Do Androids Dream of Care Labor? Rosa Montero's Bruna Husky Trilogy and its Lessons for Cyborg Feminism

Bruna Husky, the android protagonist of Spanish author Rosa Montero's Science Fiction trilogy, is often celebrated for her seeming alignment with Donna Haraway's cyborg feminism. While Montero's trilogy and Haraway's Manifesto are both deserving of celebration, in this essay, I explore Bruna's 'failures' rather than her 'successes' as a cyborg subject, as these offer valuable insight to feminist thought. Specifically, Bruna refuses to perform the sort of coalition-building political care labor that Haraway emphasizes as the key for resisting domination, and in doing so, invites us to reconsider models of feminist thought that place the burden of creating a better world on the shoulders of marginalized individuals.

Long-term Care Coverage and Labor Force Participation of Older Workers

Long-term Care Coverage and Labor Force Participation of Older Workers

Associated factors of neonatal near miss among newborns of adolescent mothers in Brazil.

To identify the associated factors of neonatal near miss among newborns of Brazilian adolescents and to compare their occurrence in young women aged 12 to 16 years and 17 to 19 years. Cross-sectional, hospital-based study, using data from the study Nascer no Brasil ("Birth in Brazil") on puerperal adolescents and their newborns in all regions of Brazil. Multiple and univariate logistic regression were employed to identify the associated factors of neonatal near miss. The following factors were found to be associated to neonatal near miss among newborns of adolescent mothers: public source of payment (OR = 4.57, 95% CI = 2.02-10.32), having to seek help in different maternity hospitals (OR = 1.52; 95% CI = 1.05-2.20), and maternal near miss (OR = 5.92; 95% CI = 1.94-18.05), in addition to a record of low weight in a previous pregnancy (OR = 3.12; 95% CI = 1.61-6.04) and twin pregnancy (OR = 7.49; 95% CI = 3.28-16.82). Neonatal near miss affected newborns of adolescent mothers in both age groups equally. Also, the determinant factors of neonatal near miss can be mostly reduced with qualified prenatal, labor, and birth care.

Guarantees of the realization of the right to work by disabled people in the Republic of Belarus

The article explores issues about the realization of the right to work by disabled people in the Republic of Belarus. The ratification by Belarus of the UN Convention on the Rights of Persons with Disabilities of December 13, 2006 made it possible to improve the system of medical and social expertise, the procedure for providing services in the field of rehabilitation of disabled people, issues of ensuring access of disabled people on an equal basis with other citizens to work, the physical environment, including transport, information and communications, to harmonize national legislation with international standards. The basics of legal regulation are noted, as well as the measures taken by the state to realize the right to work by disabled people. The article substantiates the provision on the expediency of fixing a written record of the refusal to implement the conditions of rehabilitation in the individual rehabilitation program of a disabled person personally by a disabled person or his legal representative when passing a medical and social examination in the presence of doctors of the medical and rehabilitation expert commission. The author concludes that it is necessary to bring into compliance the legislation on labor and health care in order to prevent unjustified exposure of the employer to legal responsibility in case of failure to comply with the conclusion of the medical rehabilitation expert commission and the individual rehabilitation program for a disabled person if the disabled person refuses to implement a set of rehabilitation measures. As a result, it seems appropriate to fix the norm in the Belarusian Labor Code that the written refusal of a disabled person or his legal representative from individual rehabilitation or labor rehabilitation, recorded by the disabled person or his legal representative in an individual rehabilitation program for a disabled person, is the basis for non-fulfillment of the program by the employer and his release from legal liability.

Assessment of women's satisfaction with labor and childbirth at a teaching hospital.

To assess the satisfaction of puerperal women regarding labor and childbirth. Analytical and cross-sectional research carried out with puerperal women at a teaching hospital. Data were collected from October to December 2020 by a sociodemographic and obstetric questionnaire and the Mackey Childbirth Satisfaction Rating Scale. The scale has 34 items divided into six domains, with a minimum score of 34 and a maximum of 170 points. The mean score was 141 points in a sample of 243 puerperal women, with a standard deviation of 16.8. There was high satisfaction among women in all domains of the scale and low adherence to the best practices in labor and childbirth care currently recommended. The women were satisfied upon the experience. The limitation of the health education process during prenatal care may reduce the parturient' discernment and critical judgment.