Labor Experience Research Articles

Australian women’s experiences of wearing a non-invasive fetal electrocardiography (NIFECG) device during labour

BackgroundContinuous electronic fetal monitoring devices can restrict women’s freedom of movement and choice of positioning during labour and birth. Despite the use of continuous electronic fetal monitoring for the past 50 years, little attention has been paid to women’s experiences of wearing different fetal monitoring devices in labour. AimTo explore women’s views and experiences of wearing a beltless continuous electronic fetal monitoring device, the non-invasive fetal electrocardiogram during labour. MethodsA qualitative descriptive approach was taken. Recruitment was via a larger clinical feasibility study. Some women who consented to take part in the clinical feasibility study also consented to being interviewed during the postnatal period. Transcripts were thematically analysed. FindingsWomen reported improved comfort when wearing the non-invasive fetal electrocardiogram device. They appreciated how it enabled freedom of movement and an ability to actively participate in labour. They compared their experience with previous use of cardiotocography which they felt compromised their bodily autonomy. All forms of continuous electronic fetal monitoring experienced by women resulted in the unwelcome experience of ‘Poking and prodding’ by the midwife. DiscussionContinuous electronic fetal monitoring can negatively impact women’s labour and birth experience, particularly when the measurement of fetal wellbeing is prioritised. ConclusionThe way in which continuous electronic fetal monitoring technology is designed and used is an important component of optimising physiological processes and positive experiences for women during labour and birth for women with complex pregnancies. Non-invasive fetal electrocardiograpy is a promising additional option for women.

Primiparous women’s expectations and experiences of early labour: A qualitative study

ObjectivesTo gain a deeper understanding of primiparous women’s preparation for early labour as well as their expectations and experiences of symptoms of onset of labour. MethodsA qualitative study using focus group discussion was conducted with n = 18 first-time mothers within the first six months of giving birth. Discussions were transcribed verbatim and coded and summarised into themes by two researchers using qualitative content analysis. ResultsThe statements of the participants revealed four themes: ‘Preparing for the unpredictable’, ‘Expectations and reality’, ‘Perception and wellbeing’ and ‘Experiencing the beginning of birth’. Many women could not distinguish the preparation for early labour from that for the whole birth. Relaxation techniques to prepare for early labour were found to be very helpful. For some women, it was a big challenge that expectations often did not correspond to the experienced reality. Pregnant women faced many different physical and emotional symptoms of onset of labour with striking variability. Emotions ranged from positively excited to having fears. Not being able to sleep for hours was a huge problem for the labour process of some women. While early labour at home was experienced positively, early labour in hospital was sometimes difficult, because women had the feeling of being in the second rank. ConclusionThe study clearly identified the individual character of experiencing onset of labour and early labour. The variety of experiences highlighted the need for individualised, woman-centred early labour care. Further research should investigate new paths for assessing, advising, and caring for women during early labour.

Women’s experience of early labour in a free-standing birth centre: Midwifing embodied labour

IssueWomen who present at hospital labour wards in early labour must often meet measurable diagnostic criteria before admission. BackgroundEarly labour is a phase of neurohormonal, emotional, and physical changes that are often not measurable. When admission to birthplace is based on results of diagnostic procedures, women’s embodied knowledge may be disregarded. AimTo describe the early labour experience of women with spontaneous onset of labour in a free-standing birth centre, as well as midwifery care when women arrived in labour. MethodologyAn ethnographic study was conducted in 2015 in a free-standing birth centre after receiving ethics approval. The findings for this article were drawn from a secondary analysis of the data, which included interview data with women and detailed field notes of midwives’ activities related to early labour. FindingsThe women in this study were instrumental in the decision-making process to stay at the birth centre. Observational data showed that vaginal exams were rarely conducted when women arrived at the birth centre and were not a deciding factor in admission. DiscussionThe women and midwives co-constructed early labour based on the lived experience of women and the meaning that this experience held for both. ConclusionGiven the growing concern about the need for respectful maternity care, this study provides examples of good practice in listening to women, as well as an illustration of the consequences of not doing so.

‘Never enough, never enough’: Institutional autobiography and gendered labour in contemporary North American women’s writing1

This article examines the gendered experience of labour in the North American university to theorize its implications for the production of autobiographical writing. Drawing on the work of Dodie Bellamy, Roxane Gay and Heidi Julavits, I make a specifically feminist argument about time, precarity and value in academia, arguing that the job of writing creatively in the academy is complicated by the invisibilization of education and administration as well as the preponderance of women and minorities in non-permanent and therefore precarious academic roles. The authors discussed in this article all play with supposedly marginal literary forms like the diary, personal essay or blog to trouble the institutional overvaluing of canonical work and destabilize what Sarah Sharma calls a ‘patriarchal temporality’ that designates their work and lives as marginal. With a particular focus on Bellamy, who documents her repeated denial of tenure in personal and often sexually explicit writing, I want to interrogate the peculiar circularity of narrating experiences of overwork, insecurity and discrimination in the body of a text that might be read by current or future employers, as women translate their personal and leisure time into new forms of workplace productivity and commit further areas of their life to the university without the promise of liberation from or reform of its oppressive structures.

COVID-19 threatens the progress of humanised childbirth: a qualitative study of giving birth during the pandemic in Brazil

The stressful nature of the early months of the COVID-19 pandemic severely impacted the quality of maternity care. The purpose of this study was to understand and explore the labour and delivery experiences for women who were diagnosed with COVID-19 in Brazil during this time. Between July and October 2020, we conducted 28 semi-structured interviews with postpartum women who tested positive for COVID-19 prior to delivering at a tertiary hospital in Fortaleza, Brazil. Interview transcripts were coded, and we carried out a thematic analysis using three domains of the World Health Organization’s model of intrapartum care for a positive childbirth experience as a framework. During labour and delivery, women experienced varying levels of respect, with many women reporting feeling mistreated by their healthcare team because of their COVID-19 diagnosis. Due to COVID-19 hospital protocols that denied companions or visitors, women reported feeling unsupported and isolated, especially during the mandatory quarantine. Women also experienced varying levels of effective communication, with some women citing they felt the staff were often fearful, and either avoidant or disrespectful. A minority of women reported that the staff appeared to be respectful and receptive to their needs. Our findings provide preliminary evidence that the strain of the COVID-19 pandemic on health professionals potentially results in ineffective communication and mistreatment during labour and delivery. Embedding respectful and humanised childbirth principles into emergency maternal healthcare protocols may improve the childbirth experience for women with COVID-19, as well as for women during future public health emergencies.

“It could not have been more different.” Comparing experiences of hospital-based birth and homebirth in Ireland: A mixed-methods survey

ProblemInternationally, little is known about the experiences of the minority who have birthed both in hospital and at home. This group are in a unique position to provide experiential evidence regarding perceptions of care under each approach. BackgroundObstetric care within the hospital setting is the hegemonic approach to birth in western cultures. Homebirth is at least as safe as hospital birth for those with low-risk pregnancies, yet access is strictly regulated. AimTo explore how those who have experienced both hospital and homebirth maternity care in Ireland perceived the care received, and experienced birth in each setting. Methods141 participants who birthed both in hospital and at home between 2011 and 2021 completed an online survey. FindingsParticipants’ overall experience scores were significantly higher for homebirth (9.7/10) than hospital birth (5.5/10). In hospital, midwifery-led care scored significantly higher (6.4/10) than consultant-led care (4.9/10). Qualitative data revealed four explanatory themes: 1) Regulation of birth; 2) Continuity of care and/or carer and establishing relationships; 3) Bodily integrity and informed consent; and 4) Lived experiences of labour and birth at home and in hospital. DiscussionHomebirth was perceived far more positively than hospital birth experiences across all aspects of care surveyed. Findings suggest that those who have experienced both models of care have unique perspectives and aspirations about childbirth. ConclusionThis study provides evidence regarding the need for genuine choices for maternity care and reveals the importance of care which is respectful and responsive to divergent ideologies about birth.

The association between adverse childhood experiences and peripartal pain experience.

Adverse childhood experiences (ACEs) are associated with altered ongoing and evoked pain experiences, which have scarcely been studied for the peripartum period. We aimed to investigate how ACEs affect pain experience in pregnancy and labor. For this noninterventional trial with a short-term follow-up, pregnant women were divided into a trauma group (TG) with ACEs (n = 84) and a control group (CG) without ACEs (n = 107) according to the Childhood Trauma Questionnaire. Pain experience in pregnancy and labor was recorded by self-report and the German Pain Perception Scale. Pain sensitivity prepartum and postpartum was assessed by Quantitative Sensory Testing and a paradigm of conditioned pain modulation (CPM), using pressure pain thresholds (PPTs) and a cold pressor test. The TG showed higher affective and sensory scores for back pain and a more than doubled prevalence of preexisting back pain. Pelvic pain differences were nonsignificant. The TG also exhibited increased affective scores (1.71 ± 0.15 vs 1.33 ± 0.11), but not sensory scores for labor pain during spontaneous delivery. There were no group differences in prepartum pain sensitivity. While PPTs increased through delivery in the CG (clinical CPM), and this PPT change was positively correlated with the experimental CPM ( r = 0.55), this was not the case in the TG. The association of ACEs with increased peripartal pain affect and heightened risk for preexisting back pain suggest that such women deserve special care. The dissociation of impaired clinical CPM in women with ACEs and normal prepartum experimental CPM implies at least partly different mechanisms of these 2 manifestations of endogenous pain controls.

Early labour experience and labour characteristics after introduction of an electronic early labour educational intervention

ObjectiveThe study’s aim was to compare first-time mothers’ experience of early labour and subsequent labour characteristics before and after introducing an online early labour educational intervention. This article also reports on further testing of the underlying structure of the of the Early Labour Experience Questionnaire (ELEQ) in a Norwegian setting. MethodsPre- and post-intervention cohorts were recruited. The ELEQ was translated into Norwegian, back-translated and distributed among primiparous mothers whilst in hospital. Confirmatory factor analyses were used to evaluate model fit, and the internal consistency of the scale was measured by Cronbach’s α coefficient. The relationship between cohorts and demographic characteristics were analysed using chi-square statistics and t-tests. ResultsConfirmatory factor analysis of the Swedish version of the ELEQ for primiparous women showed an acceptable fit. Neither the overall score nor the scores on the subscales for emotional well-being, emotional distress and perceptions of midwifery care differed significantly, but there was a significant difference between the groups on a few of the items. The cervix was significantly more dilated upon admission in the post-intervention group, and oxytocin use was significantly reduced. The number of telephone consultations increased significantly after the intervention was introduced. ConclusionThe intervention did not improve women’s experience with early labour. However, women who received the intervention were admitted in more advanced labour and required less oxytocin. The increased number of telephone consultations may indicate that an online early labour educational programme cannot replace women’s need to communicate directly with staff.

From global recommendations to (in)action: A scoping review of the coverage of companion of choice for women during labour and birth.

Women greatly value and benefit from the presence of someone they trust to support them throughout labour and childbirth ('labour companion of choice'). Labour companionship improves maternal and perinatal outcomes, including enhancing physiological labour and birth experiences. Despite clear benefits, implementation is slow. We conducted a scoping review to assess coverage and models of labour companionship, including quantitative studies reporting coverage of labour companionship in any level health facility globally. We searched MEDLINE, CINAHL, and Global Health from 1 January 2010-14 December 2021. We extracted data on study design, labour companionship coverage, timing and type of companions allowed, and recoded data into categories for comparison across studies. We included data from a maternal health sentinel network of hospitals in Latin America, using descriptive statistics to assess coverage among 120,581 women giving birth in these sites from April 2018-April 2022. In the scoping review, we included 77 studies from 27 countries. There was wide variation in the coverage of labour companionship: almost one-third of studies reported coverage less than 40%, and one-third of studies reported coverage between 40-80%. Husbands or partners were the most frequent companion (37.7%, 29/77), followed by family member or friend (gender not specified) (32.5%, 25/77), family member or friend (female-only) (13.0%, 10/77). Across nine sentinel hospitals in five Latin American countries, there was variation in coverage, with no companion at any time ranging from 14.9%-93.8%. Despite the well-known benefits and factors affecting implementation of labour companionship, more work is needed to improve equitable coverage. Concerted efforts are needed to engage with communities, health workers, health managers, and policy-makers to establish policies, address implementation barriers, and integrate data on coverage into perinatal records and quality processes to ensure that all women have access. Harmonized reporting of labour companionship would greatly enhance understanding at global level.

보육교사의 노동경험과 감정노동: 대전시 어린이집 보육교사의 사례를 중심으로

본 연구는 보육교사들을 “노동자”로 정의하고, 이들의 노동조건 및 노동과정을 분석하는 것을 통해 감정노동 관련 피해사례가 만들어지는 구조적 원인 규명을 목적으로 한다. 이를 위해 대전광역시 어린이집에 재직중인 보육교사 1,421명에게 설문조사를 실시했고, 20명을 대상으로 5차례 FGI를 실시하였다. 분석 결과 보육교사는 열악한 노동환경과 과중한 업무 속에서도 책임감과 사명감, 전문성을 바탕으로 돌봄 노동을 수행했다. 그러나 이러한 보육교사의 노력에도 불구하고 이들에 대한 학부모의 욕설 및 폭언, 원장의 직장 내 괴롭힘은 이들의 감정노동을 심화시키는 요인으로 작용했다. 그리고 CCTV, 키즈노트 등의 노동 통제, 보육교사에 대한 부정적 사회인식의 확산은 이들의 노동환경을 더욱 열악하게 만들었으며, 이들이 노동을 수행하는 과정에서 더 감정표현을 억제하고 관리하도록 만들고 있었다. 이러한 열악한 노동환경에도 불구하고, 보육교사를 보호하고 지지해주는 공식적인 제도는 마련되어 있지 않아서 대부분 보육교사는 직장 내 사적 연결망을 통해 문제를 해결하는 것으로 나타났다. 보육교사가 겪는 문제를 해결하기 위해서는 전반적인 노동환경 개선과 함께 이들의 목소리를 대변해줄 수 있는 조직을 구성할 필요성이 있다고 하겠다.

Depressive symptoms and sleep disturbances in late pregnancy: Associations with experience of induction of labor with a catheter

ObjectiveDepressive symptoms and sleep disturbances have been found to be associated with negative labor experiences, particularly an increased level of pain. However, the associations between maternal depressive symptoms and sleep disturbances and the experience of induction of labor (IOL) remain unknown. In this study, we evaluated these associations with balloon catheter IOL. Study designA prospective study was conducted on 106 women with planned IOL. Depressive symptoms were evaluated with The Edinburg Postnatal Depression Scale (EPDS) and sleep disturbances with the Basic Nordic Sleep Questionnaire (BNSQ) at the beginning of IOL. The IOL experience was investigated both during the IOL and postpartum with the same nine visual analogue scale (VAS) questions. ResultsRegarding sleep disturbances, during the IOL, women with worse general sleep quality were less satisfied (P = 0.019), less relaxed (P = 0.008), experienced more pain in general (P = 0.002) and reported higher contraction frequency (P = 0.003). Furthermore, women who experienced difficulties falling asleep were less relaxed (P = 0.009), reported more general pain (P < 0.001) and contraction pain (P = 0.005), while those with more daytime sleepiness reported less contraction pain (P = 0.033). In postpartum, women with worse general sleep quality reported more general pain (P = 0.003), while women with longer sleep duration and those with higher sleep loss reported more anxiety (P = 0.009 and P = 0.024, respectively). Additionally, women who woke up too early in the morning were less satisfied (P = 0.042), less relaxed (P = 0.004) and reported more general pain (P = 0.018). However, those who experienced more frequent nocturnal awakenings reported being more relaxed (P = 0.014) and having less general pain (P = 0.033). Higher depressive symptoms were associated with a higher frequency of contractions during IOL (P = 0.030), but with less general pain in postpartum (P = 0.027). ConclusionsWomen with sleep disturbances during pregnancy were more likely to report more negative experiences during the IOL. Specifically, they reported more pain, feeling less relaxed and they were less satisfied with IOL. Conversely, the association between depressive symptoms and the experience of IOL seemed weaker. Thus, the quality of sleep of pregnant women is important for a better experience of IOL.

Key success factors analysis for improving cost performance of green retrofit infrastructure on the jetty project

Several rating definitions must be met following the envision's system. The envisioned system aims to develop the green building concept in the existing jetty building. These definitions are quality of life, leadership, resource allocation, nature, climate, and resilience. This sustainability is needed to initiate changes in the planning, design, and provision of sustainable infrastructure together with the company. This also applies to implementing long-term infrastructure investments that are more cost-effective, resource-efficient, and adaptable. The study uses a qualitative and quantitative method, where data is obtained by distributing questionnaires and simulating using Statistical Products and Solution Services (SPSS). The application of Value Engineering (VE) and Life Cycle Cost Analysis (LCCA) has been chosen by researchers on existing jetty buildings with the green jetty concept, with investment costs in economic green jetty buildings and a return on investment costs of less than four years. In achieving the ten most influential factors in improving cost performance in sustainable dock construction, the results of the SPSS simulation processing obtained the ten most influential factors, namely: Planning, Energy, Siting, Materials, Ecology, Community, Economy, Operation, and Maintenance Cost, Follow-up Inspection, and Labor Experience.

Aesthetic labour and diversity on the shopfloor: the experiences of women workers in fashion retail

PurposeThis paper explores the workplace experiences of aesthetic labour among racially diverse frontline women workers in a fashion retail store.Design/methodology/approachThis qualitative study is based on an ethnographic study, drawing on findings from participant observation and interviews with frontline workers at a fashion retail store in the UK.FindingsThis paper explores how the embodiments of aesthetic labour are perpetually produced and commodified through the discipline of management in a fashion retail store. It challenges the notion of phenotypical Whiteness as the beauty standard within fashion retail and demonstrates how embodiments differ according to race. While White women are continuously scrutinised by their appearance, the aesthetic demands for women of colour tend to focus on speech and racialised bodies to provide “authentically” exotic experiences for customers. Additionally, this study highlights how the mobilisation of aesthetic labour can create work humiliation and work alienation.Research limitations/implicationsDespite this study being based on an ethnographic study at one British fashion retailer, this paper seeks to give voices to an underrepresented group by exploring the lived experiences of racially diverse women workers.Originality/valueThis paper contributes to the intersection between aesthetic labour and race from an embodiment perspective, exploring the workplace experiences of racially diverse women workers in fashion retail and how their various forms of embodiment are racialised and commodified.

Immigrant women’s experience of labor and birth

RESUMO Objetivo: Descrever a experiência de parto de mulheres imigrantes em maternidades do sul do Brasil. Método: Estudo descritivo, qualitativo, método História Oral Temática Híbrida, em duas maternidades públicas de Curitiba-PR; entrevistas semiestruturadas coletadas de março a dezembro de 2020. Análise seguiu o método proposto. Resultados: As sete colaboradoras imigraram da Venezuela, Haiti e Tunísia. Emergiram como temas relevantes: 1) As surpresas e sentimentos durante o processo de parto, apontando preferências, desfechos de parto inesperados, fatores relacionados à maior incidência de cesariana e descrição de sensações e sentimentos; 2) O cuidado percebido pelas mulheres e as memórias de experiências no país de origem, com relatos de experiência prévia de parto, dificuldades no parto atual e percepções do cuidado recebido. Conclusão: O processo de parto foi experienciado com expectativa, acessando sentimentos e memórias. A experiência positiva de parto foi favorecida pelo cuidado da equipe, participação na tomada de decisão, assistência pré-natal bem-informada, vínculo com equipe assistencial, comunicação efetiva e práticas obstétricas baseadas em evidência. Foram percebidos desafios sobre sensibilidade cultural na assistência.

Immigrant women's experience of labor and birth.

To describe the childbirth experience of immigrant women in maternity hospitals in southern Brazil. Descriptive, qualitative study, Hybrid Thematic Oral History method, in two public maternity hospitals in Curitiba-PR; semi-structured interviews collected from March to December 2020. Analysis followed the proposed method. The seven interviewees - collaborators immigrated from Venezuela, Haiti and Tunisia. Relevant themes emerged: 1) Surprises and feelings during the childbirth process, pointing out preferences, unexpected birth outcomes, factors related to the higher incidence of C-section and descriptions of sensations and feelings; 2) The care perceived by women and memories of experiences in the country of origin, with reports of previous childbirth experience, difficulties in the current childbirth and perceptions of the care received. The childbirth process was experienced with expectation, accessing feelings and memories. The positive childbirth experience was favored by team care, participation in decision-making, well-informed prenatal care, bonding with the care team, effective communication and evidence-based obstetric practices. Challenges were perceived regarding cultural sensitivity in care.

“Trying to feel the right feeling for the job”: The emotional labour of English language teachers in state secondary schools in Italy

The emotional challenges English as a foreign language (EFL) teachers face and the efforts they deploy to manage their emotions in their day-to-day practice have attracted little scholarly interest in Italy, and yet they are central to any language teacher's working experience. Through semi-structured interviews, this qualitative study explores the experiences of performing emotional labour of eight (six female and two male) EFL teachers in state secondary schools in Italy. The collected data was analysed using Interpretative Phenomenological Analysis, the findings of which reveal that teachers routinely hide or suppress negative emotions and invoke positive feelings in order to perform their job satisfactorily. The teachers’ emotional labour experiences differed greatly depending on the type of school and the pupils’ pedagogical needs, with teaching in vocational schools emerging as particularly demanding. The study also revealed that age and professional experience acted as moderators on the intensity of the teachers’ emotional responses. In addition, the participants deplored the low socioeconomic status and weak social fabric in terms of recognition of teachers’ merit and personal qualities. This contrasted with a clear passion for their jobs, thus resulting in a pleasure-pain axis, which seems to have provided these participants with a disciplinary mechanism for tolerating difficult working conditions. The teachers further concurred on the necessity to be granted psychological support and the opportunity to overtly discuss their unavoidable emotional labour experiences.

Influencia de la calidad del diseño en el desperdicio de materiales en proyectos de edificación residencial

Este estudio tiene como objetivo identificar los principales factores que afectan la calidad del diseño, identificar los principales factores que afectan el desperdicio de materiales y abordar la relación entre la calidad del diseño y el desperdicio en los sitios de construcción en proyectos de edificación residencial en Palestina. Para identificar los principales factores de la calidad del diseño y el desperdicio de materiales, se realiza una encuesta. Quince (factores de calidad de diseño y 15 factores de desperdicio de materiales se identifican a partir de la revisión de la literatura y la retroalimentación de expertos locales. Se diseñó un cuestionario para incluir estos factores. La población objetivo incluyó contratistas y consultores que tienen experiencia en proyectos residenciales. Cuarenta y cinco contratistas y 35 consultores clasificaron los factores identificados según su importancia. El estudio revela que los principales factores de la calidad del diseño son: falta de experiencia del personal, tiempo inadecuado para el diseño, demora en los pagos por los servicios de diseño, licitaciones de adjudicación de los propietarios para el diseñador de bajo costo. Incluyen: errores de diseño, cambios tardíos en el diseño, reelaboración, falta de experiencia laboral y compra de materiales que no cumplen con las especificaciones. Datos recopilados de 33 proyectos de construcción, se establece un modelo predictivo que indica una buena relación entre el desperdicio de material y la calidad del diseño.

THE COST OF HIDDEN HISTORIES: CRITICAL PERSPECTIVES ON QUALITATIVE METHODS

Research tools can play a critical role in unearthing hidden and invisibilized narratives within the global equality discourse. In social anthropology, non-quantitative methods hold the key to yielding robust and universalizable insights. This is particularly relevant when attempting to equitably capture extra-economic phenomena like care labor, informal labor, and undocumented labor. By examining studies and literature within these vulnerable spaces, this paper aims to shed light on how marginalized groups often get overlooked in quantitative analyses of labor dynamics. The importance of taking into account their experiences and perspectives cannot be overstated, as it has direct implications for policymaking and social intervention. This study, through a comprehensive review of existing literature, intends to highlight the limitations of quantitative methods in capturing the nuances of these labor experiences and explore qualitative approaches that can help correct such oversights. By amplifying the voices and stories of those typically silenced, this research hopes to contribute to a more inclusive and comprehensive understanding of global equality

Effect of Therapeutic Touch on Maternal and Neonatal Outcomes in Primiparous Women: A Systematic Review and Meta-Analysis

Introduction: Childbirth is one of the most wonderful yet painful experiences in a woman’s life. Non pharmacological interventions like Therapeutic Touch (TT) can improve labour experiences in women. Aim: To assess the effect of TT on labour pain intensity, neonatal Appearance, Pulse, Grimace, Activity, Respiration (APGAR) score and admission to neonatal intensive care unit in primiparous women. Materials and Methods: In this review, PubMed-MEDLINE, Google Scholar, Cochrane CENTRAL databases were searched till February 2022, for prospective studies fulfilling inclusion and exclusion criteria. Randomised controlled trials comparing TT and massage therapy with usual intranatal care in primiparous women with singleton foetus and without any risk factors for pregnancy were included in this review. Two independent reviewers extracted data and assessed the quality of the trials. The results were presented in form of forest plots. Results: A total of 13 studies, including 1302 primiparous women, were included in the review for qualitative analysis. Amongst them ten studies involving 621 women included meta-analysis of labour pain intensity. Nine studies were included in the metaanalysis of the active phase of labour and four studies included in the transitional phase and one study in the fourth stage of labour. Eight studies used the Visual Analogue Scale (VAS) to assess pain intensity. Overall, there was a small reduction in pain intensity of primiparous women receiving massage/TT compared to routine care {SMD: -0.96 (95% CI: -1.33, -0.60)}. Significant reduction of pain intensity was found in active {SMD: -0.79 (95% CI: -1.26, -0.32)} and transitional phase of labour {SMD: -1.18 (95% CI: -1.67, -0.69)}. No significant reduction of neonatal admission to the intensive care unit and APGAR score &lt;7 at 5 minutes {RR: 0.71 (95% CI: 0.31, 1.62)} was found. Conclusion: TT has beneficial effect on reduction of Labour pain intensity in primiparous women. But no detectable effect was found for neonatal outcomes.

A qualitative case study on North Korean defectors' labor experience before entering South Korea and vocational education and training experiences at the beginning of their entry into South Korea

본 연구는 북한이탈주민의 남한 입국 전 노동경험에 대한 경험적·맥락적 분석을 통해서 이들의 경험에 대해서 이해하고 그 의미를 찾는데 목적이 있다. 또한 남한 초기 정착단계의 하나원 교육과 직업훈련에 대한 경험을 청취함으로써 노동시장에 본격적으로 진입하기 전 제공되는 서비스에 대한 제언을 제공하기 위함이다. 이러한 목표를 달성하기 위하여 북한이탈주민 8명을 대상으로 심층면담을 실시하여 질적사례 분석을 실시하였다. 분석결과 27개의 개념에서 6개의 범주와 4개의 주제가 도출되었다. 4개의 주제는 ‘나를 옭아매는 노동’, ‘살아남기 위한 노동’, ‘잡히지 않는 노동의 의미’, ‘노동의 새로운 의미 찾기의 시작점’으로 나타났다. 연구결과를 바탕으로 정착을 위하여 어떠한 전략이 필요한지 살펴보았는데, 그 대안으로 북한이탈주민을 위한 고용정책 수립 시 재북 시 일 경험과 제3국에서의 일 경험에 대한 고려, 초기정착을 위한 하나원에서의 교육 내용 및 방법을, 거주지보호기간 중 취업지원을 위해 취업보호담당관의 역할, 하나센터의 역할 및 접근성 제고 등을 제언하였다.