Majority Of Midwives Research Articles

Strategies to Improve Patient Care by Increasing Midwives' Knowledge of Postpartum Care

Postpartum care is critical in preventing and reducing maternal deaths. In Ghana, midwives are the primary maternity care providers; therefore, their knowledge of postpartum care determines the quality of care provided to women after childbirth. However, few studies have examined midwives’ knowledge of postpartum care in sub-Saharan Africa. This study explores knowledge of postpartum care among midwives in order to develop interventions to improve patient care after childbirth. Cross-sectional survey. Four hospitals in Tamale, Ghana. A convenience sample of midwives, 18 years and older, employed in the four hospitals. A cross-sectional survey of 246 midwives was conducted in the four main hospitals of Tamale, Ghana. Three of the hospitals were government facilities and one was a mission hospital. The study was guided by the Three Delays Framework, specifically focusing on Phase III delays of provision of adequate care at a health care facility. Data were collected using an anonymous postpartum-care knowledge questionnaire by the Johns Hopkins Program for International Education in Gynecology and Obstetrics. Data were analyzed in Stata statistical software using descriptive statistics. Most of the midwives were women (98%). The mean age of midwives was 31.87 years. About 40.4% had a certificate in midwifery, 46.9% had a diploma in midwifery, and 12.7% had a bachelor’s in midwifery. The percentage of midwives able to correctly answer each question are as follows: 41.63% on location of fundus, 46.53% on postpartum examination, 57.55% on care during the first 2 hours after birth, 62.04% on obtaining history during a postpartum visit, 67.67% on obtaining information on patient problems during a postpartum visit, 73.47% on timing of postpartum visits, 74.29% on infection-prevention practice, 75.92% on danger signs, 77.14% on breastfeeding, and 84.90% on nutrition for breastfeeding mother. Beside their midwife education, 42% of midwives had never received any continuing education or in-service training in postpartum care. Findings suggest that the majority of midwives are not knowledgeable about location of fundus, postpartum examination, and care during the first 2 hours after birth. However, most midwives are knowledgeable about breastfeeding. Findings suggest a need for refresher training to educate midwives on how to care for postpartum patients.

\u2018Birds of the same feathers fly together\u2019: midwives\u2019 experiences with pregnant women and FGM/C complications - a grounded theory study in Liberia

BackgroundIn Liberia, approximately 70% of the women of the North-Central and North-Western regions could have undergone female genital mutilation/cutting (FGM/C) in their childhood during a traditional ceremony marking their entrance into Sande, a secret female society. Little is known about FGM/C from Liberian women’s perspective. This study aimed to understand the health implications of FGM/C as perceived by qualified female midwives.MethodsThis qualitative study was conducted in 2017 in Monrovia, Liberia’s capital. Twenty midwives were approached. Of these, seventeen consented to participate in in-depth interviews. A thematic guide was used to gain insights about their knowledge on FGM/C and their experiences attending women victims of FGM/C. A feminist interpretation of constructivist grounded theory guided data generation and analysis.ResultsThe midwives participants described how clitoridectomy was the most common FGM/C type done to the girls during the Sande initiation ceremonies. Sexual impairment and intrapartum vulvo-perineal laceration with subsequent hemorrhage were described as frequent FGM/C-attributable complications that some midwives could be unable to address due to lack of knowledge and skills. The majority of midwives would advocate for the abandonment of FGM/C, and for the preservation of the traditional instructions that the girls in FGM/C-practicing regions receive when joining Sande. The midwives described how migration to urban areas, and improved access to information and communication technologies might be fuelling abandonment of FGM/C.ConclusionLiberian midwives need tailored training to provide psychosexual counseling, and to attend the obstetric needs of pregnant women that have undergone FGM/C. In spite of FGM/C being seemingly in the decline, surveillance at clinic-level is warranted to prevent its medicalization. Any clinic- or community-based training, research, prevention and awareness intervention targeting FGM/C-practicing populations should be designed in collaboration with Sande members, and acknowledging that the Liberian population may place a high value in Sande’s traditional values.

Infection Control Practices Associated with Puerperal Sepsis in Harare City Maternity Units

The time of childbirth are responsible for about ten percent of maternal deaths and contribute to severe morbidity as well as long-term disability among many women. Such infections are also termed puerperal sepsis and these are more prevalent in low to medium countries. Puerperal sepsis is preventable by simple and low cost solutions such as handwashing at the time of delivery, damp dusting and use of sterile equipment. The Harare City health department recorded puerperal sepsis as the third cause of maternal mortality, accounting for 18.1% of all maternal deaths recorded for the year 2016. The study sought to determine infection prevention and control practices associated with puerperal sepsis in Harare City maternity units. A descriptive cross-sectional research design was employed and data was purposively collected from 84 midwives from 12 polyclinics. Observational walks through visits were carried out to solicit infection control practices and availability of relevant inventory before recording on the checklist. Nurses had above average knowledge on infection and prevention control, however this did not translate to good infection and prevention control practices. The majority of midwives (83%) had not attend infection prevention and control trainings during the previous year and there was a major challenge of stock-outs of basic consumables and equipment such as surgical gloves and elbow taps.

Intrapartum Care Working Patterns of Midwives: The Long Road to Models of Care in Germany.

Midwifery models of care help to enhance perinatal health outcomes, women's satisfaction, and continuity of care. Despite the ubiquitous presence of certified midwives at births in Germany, no research has investigated the diversity of midwives' practice patterns. Describing the variety of working patterns through which midwives provide intrapartum care may contribute to improving the organisation of midwifery services. This cross-sectional survey took place in the region of Hannover and Hildesheim, Germany. Midwives attending births and practicing in hospitals and/or out-of-hospital were able to participate. Midwives who did not attend births were excluded. We assessed midwives' scope of services, practice locations, employment patterns, continuity of care, midwife-led births, and midwives' level of agreement with core values of midwifery care. The response rate of the survey was 32.7 % (69/211). We found that midwifery care services can be described according to midwives' employment patterns. The majority of midwives were employed in a hospital to provide intrapartum care (74.2 %, n = 49), and most also independently offered one or more antenatal and/or postpartum service/s. Only 25.8 % (n = 17) of midwives offered their services independently (laborist model of care). Independent midwives attended births in all three possible settings: hospital, free-standing birth centres and home. Significantly more independent midwives than employed midwives offered antenatal care and lactation consulting. Compared to employed midwives, significantly more independent midwives provided antenatal, intrapartum, and postpartum care to the same women, were more likely to know women before labour, and to offer one-to-one care during labour. The most common practice pattern among surveyed midwives was 'employment in a hospital' for provision of intrapartum care with additional postpartum and few antenatal services provided on an independent basis. Midwives who worked solely independently reported more continuity and one-to-one intrapartum care with women. Most midwives did not work in patterns that offered continuity of care or consistently provide one-to-one care. Future research should assess whether women in Germany desire more services similar to caseload midwifery.

Study of Awareness and Performance of Ahvazi Midwives about Physiologic Childbirth in Public Hospitals, 2016

Abstract Introduction: To promote normal childbirth the care during childbirth should be on evidence-based care. Evidence-based care practices promote physiological birth and midwives. This study studied midwives’ awareness and performance about physiological childbirth in Ahvaz publiv maternity services. Methods: This descriptive study was conducted on maternity units in which 128 midwives were recruited using census sampling. The researcher made questionnaire were used for self-reporting of awareness and performance of midwives. Results: Majority of midwives (86.7%) had Bachelor degree, had (1-7) year’s work experience (64.1) . This study showed that the Ahvazi midwives had relatively good awareness of physiologic labour items however the performance of them was not as ideal as their awareness. Conclusions: Iranian midwives are informed about evidence-based practice in childbirth which indicates that attempts to promote physiologic childbirth has been useful, however multifaceted implementation strategies are necessary to promote the use of evidence-based practice in clinical practice and health care decision making during labour childbirth.

Influential Factors of Mother-Infant Skin-to-Skin Contact Based on the Precede-Proceed Model from the Perspective of Midwives in Torbat Heydariyeh Hospitals

Background & aim: Skin-to-skin contact immediately after birth plays a pivotal role in proper breastfeeding and mother-infant interaction. Despite numerous benefits of mother-infant skin-to-skin contact, this health behavior is not performed by many midwives. This study aimed to evaluate the influential factors for mother-infant skin-to-skin contact based on the Precede-Proceed model from the perspective of midwives in Torbat Heydariyeh hospitals. Methods:This cross-sectional study was conducted on 50 midwives working in hospitals of Torbat Heydariyeh, Iran in 2015. Demographic data of all participants were collected, and Mother-Newborn Skin-to-Skin Contact Questionnaire was also used based on the Precede-Proceed model. Data analysis was performed in SPSS V.16 using descriptive statistics, tables and graphs. Results: In this study, 88.1% of the midwives had positive attitudes towards skin-to-skin contact, and 90.5% had high perceived self-efficacy in performing the procedure. Major obstacles against establishing proper skin-to-skin contact were neonatal diseases and maternal fatigue (83.3%) from the perspective of midwives. Moreover, 87.5% and 90.5% of the midwives emphasized the pivotal role of social support and motivation, respectively in implementing skin-to-skin contact. Also, more than 90% of the midwives considered training programs, service access and adequate facilities to be influential in the proper establishment of skin-to-skin contact. Conclusion: According to the results of this study, the majority of midwives believed that enabling and reinforcing factors had significant effects on the proper establishment of mother-infant skin-to-skin contact. Therefore, it is recommended thateducational interventions be planned for parents, their family members and health care personnel involved in processes of childbirth and infant care. Furthermore, organizational planning and executive procedures should be developed to study the structures and barriers associated with skin-to-skin contact.

The Relationship between Organizational Citizenship Behavior, Job Satisfaction, and Occupational Stress among Midwives Working in Healthcare Centers of Mashhad, Iran, 2014

Background & aim: Organizational citizenship behavior (OCB) is a voluntary, organizationally desirable action that is not part of the employee’s formal job requirements. Job satisfaction and stress can affect mental health of midwives, and investigating the relationship between these variables can improve the quality of healthcare services. This study, therefore, was conducted to identify the relationship between OCB, occupational stress, and job satisfaction in Iranian midwives. Methods:This descriptive-correlational study was performed on 122 midwives working at healthcare centers of Mashhad, Iran, in 2014. The participants were chosen using a census approach. The tools for data collection included a demographic questionnaire, Podsakoff’s OCB Questionnaire, Minnesota Satisfaction Scale, and Karasek’s Job Content Questionnaire. Data analysis was carried out using Spearman and Pearson’s correlation, one-way ANOVA, and student t test were by SPSS version 20. Results: The mean age of the midwives was 38.46±7.22 years. OCB had a significant direct correlation with job satisfaction (r=0.223) and a significant negative correlation with job stress (r=-0.270)(P<0.05) of midwives. Mean scores of OCB and its dimensions were higher than average. The majority of midwives (59.0%) were satisfied with their job and most of them (61.5%) had a moderate level of occupational stress. A significant direct correlation was found between OCB and occupational experience (P=0.034), while there was no significant correlation between OCB and demographic or job variables. Moreover, there was no significant correlation between job satisfaction, occupational stress, and demographic/job variables. Conclusion: OCB had a significant direct correlation with job satisfaction and an inverse correlation with occupational stress.

Publicly-funded home birth in Victoria, Australia: Exploring the views and experiences of midwives and doctors

Objectiveto explore midwives׳ and doctors׳ views and experiences of publicly-funded homebirthing models. Designcross-sectional survey implemented two years after the introduction of publicly-funded homebirthing models. Settingtwo public hospitals in Victoria, Australia. Participantsmidwives and doctors (obstetric medical staff). Main outcome measuresmidwives׳ and doctors׳ views regarding reasons women choose home birth; and views and experiences of a publicly-funded home birth program, including intrapartum transfers. Findingsof the 44% (74/167) of midwives who responded to the survey, the majority (86%) supported the introduction of a publicly-funded home birth model, and most considered that there was consumer demand for the model (83%). Most thought the model was safe for women (77%) and infants (78%). These views were stronger amongst midwives who had experience working in the program (compared with those who had not). Of the 25% (12/48) of doctors who responded, views were mixed; just under half-supported the introduction of a publicly-funded home birth model, and one was unsure. Doctors also had mixed views about the safety of the model. One third agreed it was safe for women, one third were neutral and one third disagreed. Half did not believe the home birth model was safe for infants. The majority of midwives (93%) and doctors (75%) believed that intrapartum transfers from home to hospital were easier when the homebirthing midwife was a member of the hospital staff (as is the case with these models). Key conclusions and implications for practiceresponding midwives were supportive of the introduction of publicly-funded home birth, whereas doctors had divergent views and some were concerned about safety. To ensure the success of such programs it is critical that all key stakeholders are engaged at the development and implementation stages as well as in the ongoing governance.

Evidence based Practice in Midwifery

To establish self-reported skill levels, behaviors and barriers in relation to evidence-based practice (EBP) among a nurses and midwives in senior roles. Capacity building interventions are needed among senior nurses and midwives, as the most prominent knowledge sources reported are non-evidentiary in nature and barriers to finding and reviewing evidence, along with barriers to making practice change, remain significant. Women with less access to resources, particularly those in rural areas, can face considerable obstacles in obtaining maternal health care Pregnant women in rural areas are more likely to receive delayed or no prenatal care and to receive less adequate care when it is available, factors that contribute to higher infant mortality. The vast majority of midwives in the United States (U.S.) are certified nurse-midwives (CNMs) and certified midwives (CMs). CNMs are licensed and have prescriptive authority in every state. CMs are licensed in five states. This growth of midwifery has been supported by published research that demonstrates midwifery care is associated with highquality and is comparable or in some studies, better outcomes than care provided by obstetrician/gynecologists. Recipients of care by midwives report high levels of patient satisfaction, and midwifery care results in lower costs due to fewer unnecessary, invasive, and expensive interventions.

Midwives' intrapartum monitoring process and management resulting in emergency referrals in Tanzania: a qualitative study.

BackgroundIn the United Republic of Tanzania, the maternal mortality ratio, and neonatal mortality rate have remained high for the last 10 years. It is well documented that many complications of pregnancy are avoidable by providing skilled midwifery care during and immediately after childbirth. However, there have been delays in providing timely and necessary obstetric interventions, most likely due to lack of proper monitoring during labor. Yet, there has been little research concerning how midwives monitor the process of childbirth. Therefore, this study aimed to describe how midwives monitored and managed the process of childbirth to achieve early consulting and timely referral to obstetricians.MethodsThe design was qualitative and descriptive, using data from comprehensive semi-structured interviews of midwives. The interviews were conducted at one hospital and one health center in Dar es Salaam, Tanzania’s largest city. Eleven participants were purposively recruited and interviewed about their experiences managing complicated intrapartum cases. After the interviews, data were analyzed using content analysis.ResultsDerived from the data were three activity phases: initial encounter, monitoring, and acting. During these phases, midwives noticed danger signs, identified problems, revised and confirmed initial problem identification, and organized for medical intervention or referral. The timing of taking action was different for each midwife and depended on the nature of the prolonged and obstructed labor case.ConclusionsFor the majority of midwives, the processing of assessments and judgments was brief and without reflection, and only a few midwives took time to continue to monitor the labor after the initial identification of problems and before taking actions. To make a final judgment that the labor was becoming prolonged or obstructed, midwives should consider taking time to review and synthesize all their findings.

Odgovornosti babice glede pregleda posteljice: raziskava o pristopih v slovenskih porodnišnicah

Uvod: Posteljica je začasen organ, a ključen za preživetje, rast in razvoj ploda. Porodi se med tretjo porodno dobo. Namen raziskave je bil pridobiti informacije o načinih vodenja tretje porodne dobe v slovenskih porodnišnicah ter o kompetencah babic pri rokovanju s posteljico.&#x0D; Metode: Raziskava je bila kvantitativno-deskriptivna, uporabljen instrument je bil strukturirani vprašalnik, tehnika zbiranja podatkov je bilo pisno anketiranje. Vzorec je bil namenski; vprašalnik je bil poslan v izpolnjevanje vodjem porodnih sob vseh štirinajstih porodnišnic v Sloveniji. Podatki so se zbirali od maja do junija 2012, obdelani so bili s programom SPSS 17. &#x0D; Rezultati: Odziv je bil 86%. Dve tretjini respondentov (67 %) navajata, da tretjo porodno dobo najpogosteje vodijo aktivno. Navadno posteljico porodi babica (83 %), vendar pri pregledu le-te ni samostojna, saj jo vedno preveri tudi zdravnik (83 %). Večina babic (86 %) ima strokovno samozavest (občutek znanja in volje), da bi pregled posteljice lahko opravile samostojno.&#x0D; Diskusija in zaključek: Za končen izid poroda je odgovoren zdravnik; zato v večini primerov babice niso popolnoma samostojne, čeprav spremljanje fiziološkega poroda spada pod kompetence babice in so le-te za to strokovno usposobljene.

The knowledge, practice and opinion of midwives' in the UK on their training in obstetric perineal repair.

To investigate the knowledge and practice of perineal repair by midwives' in the UK, as well as their perception of the adequacy of their training. An anonymous structured questionnaire survey was conducted. Standard statistical comparative analysis was performed between groups. Significant differences were quantified by calculating odds ratios and 95% confidence intervals. P < 0.05 was considered significant. Analysis of 592 responses revealed that midwives who believed that they had adequate training were ten times more likely to report that they have an adequate knowledge of pelvic floor anatomy (OR 9.8, 95% CI 6.4-14.9, P < 0.001), six times more likely to be aware of recommended techniques of perineal repair (OR 6.1, 95% CI 3.8-9.7, P < 0.001) and 16 times more likely to feel competent to perform a repair (OR 16.1, 95% CI 9.3-27.2, P < 0.001). Midwives who had formal hands-on perineal repair training were four times more likely to report that they have an adequate knowledge of pelvic floor anatomy (OR 4.1, 95% CI 2.8-5.8, P < 0.001) and four times more likely to feel competent enough to perform a repair (OR 3.6 95% CI 2.4-4.9, P < 0.001). The majority of midwives in the study sample report that they were unable to identify key perineal anatomy and believed that their pre-qualification training on perineal repair was inadequate. They also believed that midwives should routinely repair simple second-degree perineal tears.

Occupational exposure to maternal death: Psychological outcomes and coping methods used by midwives working in rural areas

Aimto explore the psychological outcomes of occupational exposure to maternal death and the coping methods used by midwives working in rural areas. Backgroundmaternal deaths are common in rural areas of developing countries because of the shortages of human and other resources needed for maternity services. When maternal deaths occur, midwives often experience emotional distress while striving to perform their work. This may have a negative impact on their well-being. MethodsDescriptive design. A self-administered questionnaire in the English language, comprising the Death Distress Scale and Brief COPE Scale, was used to collect data from 238 midwives working in two rural districts of Uganda. Findingsthe majority of participants were female (81%) and had a diploma in midwifery (36%). Mean age and years of professional experience were 34 [standard deviation (SD) 6.3] years and three (SD 1.3) years, respectively. The majority of participants (94%) had witnessed a maternal death. The results from the Death Distress Scale showed that the majority of midwives who had witnessed a maternal death had moderate to high death anxiety (93%), mild to moderate death obsession (71%) and mild death depression (53%). Most midwives coped with their distress using methods such as active coping, venting, positive reframing, self-distraction and planning. Conclusionmidwifery educational programmes and work settings need to understand the importance of maternal death from the midwives׳ perspective and their ability to cope with this detrimental experience. Implications for practicethere is a need for midwifery practice settings to provide respite care, education on coping with death experiences and counselling after traumatic experiences in order to maintain the well-being of midwives. As occupational exposure to maternal death can have a negative effect on the well-being of midwives, this can affect their professional quality of life and clinical practice.

Midwives׳ experiences of the factors that facilitate normal birth among low risk women at a public hospital in Australia

Backgroundnormal birth has major advantages for mothers and infants. Nonetheless, in the developed world, rates of normal birth have declined significantly over the past 20 years, and many women currently have caesarean section births for unclear reasons. Midwives are interested in ameliorating this trend and aim to facilitate women to have meaningful birth experiences and to achieve the best possible birth. Objectivesthis project aimed to explore midwives׳ experiences and views of the factors that facilitate or impede normal birth. Settingone maternity setting in Melbourne, Australia. Participantsa purposive sample of 22 midwives, all with recent birthing experience, participated in in-depth interviews. Methodsa qualitative study using an Interpretative Phenomenological approach. Interviews were audio-recorded and transcribed verbatim. Analysis was guided by Smith and Osborn׳s (2008) approach. Findingsmidwives identified a number of factors that complicated their task of facilitating normal birth. Barriers included: (1) time pressures; (2) a risk adverse culture, and; (3) women׳s expectations. Factors facilitating normal birth included: (1) a supporting environment, and (2) midwifery attributes and a desire to promote normal birth. Key conclusionsin Australia, most births take place in obstetric models of care, in which the majority of midwives are employed. The birth environment, in these units, is often risk-adverse with high rates of intervention and caesarean section. Midwives, wishing to promote normal birth in obstetric led units, face a number of challenges and often feel unsupported by senior colleagues. This situation causes conflict and gives rise to stress and unmet support needs.

Midwives confidence in the skills required for postnatal care: Results of anational survey

Women consistently report lower levels of satisfactionwith the care they receive postnatally compared to other areas of maternity care. Similarly midwives report frustration at not being able to provide appropriate support in the postnatal period. This paper presents a sectionof the results of anational survey thatwasundertaken in 2011–12 as part of the ChildHealth: ResearchingUniversal Health Services (CHoRUS) study. The survey aimed to describe the role that midwives play in supporting families and to investigate the feasibility of implementing a national approach to child and family health (CFH) and midwifery services in Australia. A survey was circulated to midwives across Australia, and potential participants were invited to fill in the form, either on-line or in hard copy. A total of 443 midwives responded and data was analysed in SPSS. The majority of midwives reported working in roles that included postnatal care. Midwives reported that they had the necessary skills to provide care for womenwith complex social issues. However they reported low levels of confidence in specific postnatal skills including: supportingmaternal-infant attachment; and reading infant cues such as tired signs; supporting breastfeeding with women with unwell or special care babies; using the EPDS; screening for domestic and family violence. Variation by state in the ratings for these items and comparisons with child and family health nurse responses on similar itemswill also be presented. The implications of thesefindings are significant and recommendations for midwifery education and health policy will be provided.

Childbirth climax: The revealing of obstetrical orgasm

Summary Context Some mothers report experiencing intense physical pleasure during childbirth, which conflicts with popular belief and cultural taboos. Purpose This study aims to draw attention to the existence of cases of physical pleasure experienced by mothers during obstetrical labor and to characterize this pleasure. Method An e-mail survey of midwives and mothers was used as the basis for a descriptive study and a case report. Results The personal accounts collected confirm that obstetrical pleasure exists. It resembles sexual stimulation and its existence is known to a majority of midwives. Discussion and conclusion Anatomical, neuroendocrine, psychological and cultural hypotheses may explain this unique link between pain and pleasure.

Midwives' knowledge of, attitudes towards and experiences of caring for women with intellectual disability during pregnancy and childbirth: A cross-sectional study in Sweden

Objectiveto investigate midwives' knowledge of, attitudes towards and experiences of caring for women with intellectual disability (ID) during pregnancy and childbirth. Design/settinga cross-sectional study among six hundred midwives working at antenatal care and labour wards in Sweden. Resultsmore than four out of five (81.5%) midwives had experience of caring for women with ID. Almost all midwives (97.1%) reported that caring for women with ID is different from caring for women without ID. Almost one-half (47.3%) had not received any education about pregnancy and delivery of women with ID, and a majority of the midwives (95.4%) requested evidence-based knowledge of women with ID in relation to childbirth. High proportion (69.7%) of the midwives were of the opinion that women with ID cannot satisfactorily manage the mother role, and more than one-third (35.7%) of the midwives considered that women with ID should not be pregnant and give birth at all. Most midwives partly/totally agreed that children of women with ID should grow up with their parents supported by the social authorities, but nearly one-fifth (19.1%) partly/totally agreed that the children should grow up in foster care. Conclusionseven if the majority of midwives had experience of caring for women with ID, they were uncertain about how to adapt and give advice and they needed more knowledge about these women. Some midwives had negative attitudes towards childbearing among women with ID. Health Service providers should encourage midwives to update their knowledge and provide supportive supervision in midwifery care for women with ID.

Prenatal healthcare providers’ Gaucher disease carrier screening practices

PurposeGaucher disease carrier screening is controversial in the medical community. The goal of this study was to explore current Gaucher disease carrier screening practices of prenatal healthcare providers. MethodsPrenatal healthcare providers were invited by email to complete an electronic-based survey. ResultsA total of 1,454 prenatal healthcare providers, including 209 genetic counselors, 450 midwives, and 795 physicians, completed the study. The majority of genetic counselors (n = 208/209, >99%), physicians (n = 415/450, 92%), and midwives (n = 634/795, 80%) currently offer Jewish ancestry disease carrier screening to couples in whom one or both partners are Jewish. Of providers who offer Jewish ancestry disease screening, the majority of genetic counselors (n = 199/208, 96%) and physicians (n = 352/415, 85%) always or sometimes offer Gaucher disease screening whereas the majority of midwives (n = 357/634, 56%) never offer Gaucher disease screening. ConclusionThis study presents the first report of Gaucher disease carrier screening practices of the prenatal healthcare providers in North America. Our results indicate that Gaucher disease carrier screening is being offered at a high rate within the scope of Jewish ancestry-based carrier screening. This may highlight a need to move away from the debate as to whether Gaucher disease carrier screening should be offered and, instead, focus on how best to provide Gaucher disease carrier screening services.Genet Med 2012:14(10):844–851

1771 Use of Oximeter in Clinical Assessment of Infants at Birth in Low Risk Deliveries after Home Birth in the Netherlands

BackgroundObjective assessment of infant’s condition at birth by oximeter is now recommended in resuscitation guidelines. However, midwives supervising home birth in primary care still use color and count heart rate...

Self-evaluation of Polish midwives’ health state

Introduction. Legal provisions enacting midwives’ works take for granted their ability to evaluate newborns’ and females’ health state in all stages of their lives. Aim. The work aimed at presenting a self-evaluation of health situation that midwives made, together with determinants for this self-evaluation. Material and methods. The research involved 3569 midwives from all over Poland. The research material was collected over one year. The data were collected by means of poll diagnostic method, and the questionnaire technique was used. Results. Over a half of the researched midwives – whatever region of Poland they came from (p&gt;0.05) – evaluated their health (57.44%) and physical condition (54.89%) as good. Only few midwives admitted their health state was bad and very bad (2.72%), and made the same evaluation of their physical condition (2.63%). The majority of midwives (63.35%) declared that their health state was comparable to that of their peers, whereas a group who thought it to be considerably worse was over tenfold smaller (6.33%). Midwives who evaluated their health state as very good mostly belonged to statistically significant, varied (p&lt;0.001) groups of individuals comprised: the youngest, aged under 30, single, childless, with higher education completed and a short work experience, highly appreciating their housing, material conditions and their life standards. Conclusions. Midwives who were very satisfied with their health state were the youngest unmarried people, childless with higher vocational education; they enjoyed a good material status and evaluated their health higher than their peers.