Practice Of Midwives Research Articles

How does place impact intrapartum practice for midwives and obstetricians?

BackgroundRising rates of labour and birth interventions are causing concern, having the potential to cause harm if used inappropriately. International evidence demonstrates that place itself influences birth outcomes, but evidence is limited as to how. In New Zealand there are differences in the rates of spontaneous vaginal births by place, along with differences when benchmarking uncomplicated primiparae birthing in hospital maternity facilities throughout the country. AimTo develop understanding of how place influenced midwives’ and obstetricians’ practice in relation to supporting physiological birth. MethodFor this Hermeneutic Phenomenological study participants were purposively selected and consisted of nine midwives (employed and self-employed) and three obstetricians, all practising in midwifery led units or hospital maternity facilities. Data was collected using semi-structured interviews. The method of analysis involved writing and rewriting to surface interpretive insights, drawing on philosophical notions from Heidegger and Gadamer. FindingsThe findings revealed that place influences what practitioners are attuned to, what is easier for them to achieve, and their ability to provide woman-centred care. Competing tensions and pressures within place can blur the perceived relationship between normality and risk, influencing what is considered to be safe. SummaryPlace is not neutral; it influences how midwives and obstetricians practise and shapes how they support physiological labour and birth. The findings of this research contribute to a deeper understanding of the barriers and enablers to supporting physiological birth within place.

THE RELATIONSHIP OF PREGNANT WOMEN'S KNOWLEDGE OF DENTAL AND ORAL HEATH MAINTENANCE WITH GINGIVITIS STATUS

Pregnant women are a group that requires special attention to their oral heath. Pregnant women often neglect their oral hygiene which wil cause plaque buildup on the teeth and gingival margin, this can cause gingival inflammation or gingivitis. One of the efforts that can be done to prevent gingivitis is to reduce eating cariogenic foods and brushing teeth properly and regulaly and what can be done by heath workers by providing education to increase their knowledge about gingivitis. Problems: The status of gingivitis among pregnant women at BPS (Private Practice Midwife). Objective: To know the relationship between knowledge of oral heath maintenance of pregnant women and gingivitis status. Method: This type of research is analytic research with cross sectional method, with a sample of 56 pregnant women. The data analysis technique uses a normality test, namely Kolmogorov-Smirnov after the Chi-Square test. Result: There is no relationship between the knowledge of dental and oral heath maintenance of pregnant women with gingivitis status.

The effect of using pregnancy exercise e-books on pregnant women's knowledge and skills in independent midwife practice

The effect of using pregnancy exercise e-books on pregnant women's knowledge and skills in independent midwife practice

Early Initiation of Breastfeeding (EIBF) Practices in Bener Meriah Regency, Aceh, Indonesia: A Cross-Sectional Study on the Role of Midwives in Reducing Infant Mortality

Early initiation of breastfeeding (EIBF) is critical for reducing infant mortality and improving child health outcomes. Midwives play a crucial role in promoting and supporting EIBF. This study investigated EIBF practices in Bener Meriah Regency, Aceh, Indonesia, focusing on the factors associated with midwives' knowledge, attitudes, and practices regarding EIBF. A cross-sectional study was conducted among 150 midwives in Bener Meriah Regency. Data were collected using a structured questionnaire that included items on sociodemographic characteristics, knowledge, attitudes, and practices related to EIBF. Descriptive statistics, chi-square tests, and logistic regression were used to analyze the data. The majority of midwives (87.3%) had good knowledge about EIBF. However, only 62.7% of midwives reported always assisting mothers with EIBF within one hour of birth. Factors significantly associated with midwives' EIBF practices included their age, years of experience, and place of work (urban vs. rural). While midwives in Bener Meriah Regency generally possess adequate knowledge about EIBF, there is a need to improve their practices in assisting mothers with EIBF, especially in rural areas. Targeted interventions, such as training programs and supportive supervision, are necessary to enhance midwives' skills and confidence in promoting and supporting EIBF.

Clinical supervision, a reflective intervention to support new graduate nurses and midwives enhance their person-centredness: qualitative evaluation

Person-centred care is an international healthcare priority. Strategies are needed to support nurses and midwives to understand the meaning of person-centredness and support them to embed this philosophy into practice. Clinical supervision has been proposed as a strategy to support this but requires more evidence. The aim of this research was to evaluate a newly developed model of clinical supervision, underpinned by person-centred practice theory, to enhance the person-centred practices of new graduate nurses and midwives. Design: Qualitative study (embedded within a mixed methods study) using focus groups Methods: Group, online clinical supervision (named C.A.R.E.) underpinned by the Person-centred Practice Framework was provided to 103 new graduate nurses and midwives once per month for one hour, over six months. The researchers used [Braun, V., & Clarke, V. (2022). Thematic analysis; A practical guide. SAGE]. Thematic Analysis to analyse data. Results: Twenty one participated in the qualitative evaluation. Four themes were identified (1) Person-centredness in Action (person-centredness experienced and delivered by the new graduates) (2) Enhancing the Transitioning Toolkit (professional and personal growth as an outcome of reflection and learning together) (3) The Transitioning Environment (care environment and C.A.R.E. environment) and (4) Challenges to C.A.R.E. (team and organisation, and personal). Conclusion: This supportive safe space allowed new graduates to explore their and other’s practices, in relation to person-centred practice theory. Through sharing their experiences, they increased their knowledge and confidence to incorporate new learning into their own practice. This clinical supervision model underpinned by the Person-centred Practice Framework provides person-centred benefits to the new graduates, patients and families. However, without organisational support the benefits will not be realised.

THE PRACTICALITY, EFFICIENCY, POSITIVE IMPACT AND EFFECTIVENESS OF THE "MIDWIFERY MANAGER" MANAGEMENT INFORMATION SYSTEM IN IMPROVING THE QUALITY OF MIDWIFERY SERVICES AT THE MIDWIFERY'S INDEPENDENT PRACTICE PLACE BANDUNG

Introduction. Health transformation in the digital era has brought fundamental changes in health services, including midwifery. About 80% of Midwife Independent Practices in Bandung City still use manual records. The management information system for Midwife Independent Practices, named "Midwifery Manager", is one of the innovations in the health sector. This study aims to analyze the increase in practicality, efficiency, positive impact, and effectiveness of the "Midwifery Manager" Management Information System in improving the quality of midwifery services at the place of practice of independent midwives. Method. The research was quantitative, with a pre-experimental design in the form of a pre-test and post-test design. The target population in this study were all midwives who had independent practice places in the Bandung City Region, which were 300 TPMB. The sampling technique in this study used proportionate random sampling, which amounted to 40 respondents. The data analysis techniques used are normality test, Wilcoxon test, and chi-square test. Result & Analysis. The results showed an increase in practicality, efficiency, positive impact, and effectiveness of the quality of midwifery services after the use of "Midwifery Manager", respectively with a value of p 0.000; p 0.000; p 0.00; and p 0.001 (<0.05) in the independent practice of midwives. Discussion. Using the Management Information System "Midwifery Manager" increases the practicality, efficiency, positive impact, and effectiveness of midwifery service quality, and effectiveness of midwifery service quality in the independent practice of midwives in the Bandung City area.

PENGARUH SPRAY GEL EKSTRAK BATANG BAJAKAH TAMPALA (SPATHOLOBUS LITTORALIS HASSK) TERHADAP PENYEMBUHAN LUKA PERINEUM PADA IBU NIFAS

Perineal laceration occurred during childbirth, either naturally or through episiotomy. One alternative for perineal wound healing was using a spray gel of Bajakah tampala stem extract, which had anti-inflammatory, antioxidant, and antibacterial benefits that helped accelerate perineal wound healing. The spray technique delivered the preparation directly to the wound without contact with cotton, reducing waste and preventing infection or contamination. This study aimed to determine the effect of Bajakah tampala stem extract spray gel (Spatholobus littoralis Hassk.) on perineal wound healing in postpartum women. The study was conducted at the Eka Setyowati midwife practice and Ngesrep Health Center from January to February 2024. It was a quasi-experiment with a pretest and posttest control group design. Using purposive sampling, 36 respondents were obtained and divided into two groups: the control group, which received dry clean wound care, and the intervention group, which was given Bajakah tampala stem extract spray gel three times a day for seven days with three sprays per application. The perineal wounds were measured using the REEDA scale (Redness, Edema, Ecchymosis, Discharge, Approximation) on the 3rd, 5th, and 7th days. The results showed a decrease in the REEDA score on post-test I (the 5th day), with an average score of 2.78 in the intervention group compared to the control group, which had an average REEDA score of 5.72. The administration of Bajakah tampala stem extract spray gel (Spatholobus littoralis Hassk.) affected perineal wound healing in postpartum women based on the REEDA score.

P24 - Transcendent moments in birthing and dying - A review of the literature exploring the practices of midwives and palliative care nurses

P24 - Transcendent moments in birthing and dying - A review of the literature exploring the practices of midwives and palliative care nurses

O78 - An exploration of the contraceptive counselling practices of midwives who provide postpartum care in Australia

O78 - An exploration of the contraceptive counselling practices of midwives who provide postpartum care in Australia

Midwifery assessment and interventions protocol for adolescent pregnancy: a Delphi method approach

Background: Adolescence pregnancy poses risks for both mothers and infants, often due to insufficient prenatal care resulting from societal stigmatization and lack of awareness. Around 16 million adolescents aged 15-19 years in the world give birth each year; in Indonesia, the first pregnant women aged <20 years are 45.10%, while in West Sumatra, it is 33.7%. To address this issue, integrated programs and midwifery care have been implemented. However, providing such care to adolescent mothers comes with its own set of challenges.Purpose: This study aims to conduct a midwifery assessment and intervention protocol for adolescent pregnancy.Method: Qualitative approach The Delphi method involved two rounds of evaluation, with twenty-one participants who were independent practice midwives, six midwives involved in the mother and child health program, and nine midwifery lecturers from accredited educational institutions A (excellent). Participants had at least five years of clinical experience and were selected using purposive non-probability sampling. Participants evaluated statements related to midwifery care during the Delphi process. The validity of these statements was determined by participants providing a minimum score of 3, and the Content Validity Ratio (CVR) was calculated. Statements with a CVR greater than 0.8 were considered valid.Results: Based on expert consensus, important assessments for adolescent pregnant women include addressing issues of gender equality and domestic violence, reproductive and sexual health, risks associated with smoking and substance abuse, maintaining a healthy pregnancy, and adequately preparing for labor and parenthood.Conclusion: Midwifery management and midwifery information were deemed valid dimensions of midwifery care; relational care had one invalid item.

National Nursing and Midwifery Commission Act, 2023 in India: Issues and the Way Forward.

With the recent enactment of the National Nursing and Midwifery Commission (NNMC) Act, 2023, significant changes are anticipated in the scope of practice and autonomy for registered nurses and midwives in India. However, alongside these anticipated advancements, concerns have emerged regarding various aspects of the Act, necessitating critical examination. In this article, we aim to explore expected changes in nursing education and service and concerns about the NNMC Act, providing insights into the implications of the NNMC Act on the regulation and advancement of the nursing and midwifery profession in India. The Act is anticipated to introduce uniform standards, implement entry and exit examinations, recognize midwifery as a distinct discipline, and determine the scope of practice for nurses and midwives. Moreover, the implementation of the Nurse Practitioner Program and guidelines for its limited prescribing authority is anticipated. Concerns exist regarding the composition of the commission and board members, adequate stakeholder representation, lacking provisions for ensuring continued competence, working conditions of nurses and midwives, nomenclature, integrating new terms, and clearly defining roles. These concerns emphasize the need for viable career pathways, uniform cadres, and a streamlined registration system, crucial for advancing nursing and midwifery profession in India. The coexistence of concerns and anticipation highlights the complexity of enacting regulatory reforms in nursing and midwifery. Policymakers can lay the foundation for a comprehensive, inclusive regulatory system that promotes excellence in nursing and midwifery practice, ultimately benefiting both healthcare providers and patients.

RELATIONSHIP OF PREGNANT WOMEN'S KNOWLEDGE OF DENTAL AND ORAL HEATH MAINTENANCE WITH GINGIVITIS STATUS

Pregnant women are a group that requires special attention to their oral heath. Pregnant women often neglect their oral hygiene which wil cause plaque buildup on the teeth and gingival margin, this can cause gingival inflammation or gingivitis. One of the efforts that can be done to prevent gingivitis is to reduce eating cariogenic foods and brushing teeth properly and regulaly and what can be done by heath workers by providing education to increase their knowledge about gingivitis. Problems: The status of gingivitis among pregnant women at BPS (Private Practice Midwife). Objective: To know the relationship between knowledge of oral heath maintenance of pregnant women and gingivitis status. Method: This type of research is analytic research with cross sectional method, with a sample of 56 pregnant women. The data analysis technique uses a normality test, namely Kolmogorov-Smirnov after the Chi-Square test. Result: There is no relationship between the knowledge of dental and oral heath maintenance of pregnant women with gingivitis status.

FAKTOR – FAKTOR YANG MEMPENGARUHI AKSEPTOR KB DALAM MEMILIH METODE KONTRASEPSI SUNTIK DI PRAKTIK MANDIRI BIDAN(PMB) ANNISA KOTA PRABUMULIH

Injectable contraception is a contraceptive in the form of a liquid that is injected into a woman's body periodically and contains hormones, then enters the blood vessels to be absorbed little by little by the body which is useful for preventing pregnancy. The aim of the study was to find out the factors that influence family planning acceptors in choosing the injection contraceptive method at the Independent Midwife Practice (PMB) Annisa Prabumulih. The research method is analytic in nature, using a Cross Sectional approach. The population of this study were all active family planning acceptors at Annisa Prabumulih's Independent Midwife Practice (PMB). Sampling in this study using a total sampling technique, namely as many as 57 respondents. Research instruments in the form of checklists and questionnaires. The results of the study based on biivariate analysis there is a significant relationship between education and the choice of family planning injection contraception with a Pvalue of 0.000 <? 0.05, there is a significant relationship between knowledge and the choice of family planning injection contraception with a Pvalue of 0.000 <? 0.05, there is a significant relationship between husband's support and selection of contraceptive injections with a Pvalue of 0.001 < ? 0.05.

Analyzing the Knowledge and Practices of Midwives in Turkey Regarding Cord Clamping Time

PURPOSE:This study aimed to evaluate the knowledge and practices of delivery room midwives on delayed cord clamping (DCC).METHOD:This descriptive study was conducted with a total of 1,274 delivery room midwives from five regions of Turkey between February 9, 2021 and September 26, 2022. The data were collected using a Google survey form.RESULTS:The highest cord clamping times of midwives ranged from 0 to 10 seconds in term and preterm newborns (34.7% and 54.8%, respectively). The rates of applying DCC were 17.6% and 5.3% in term and preterm newborns, respectively. Dealing with the mother, having a workload, considering that the newborn would have respiratory distress and get cold, preventing polycythemia and hyperbilirubinemia, and being afraid of dropping the newborn were the most common reasons for midwives not to apply DCC to newborns. The majority of the midwives reported that they had no DCC protocol in their institution (80.5%) and did not receive in-service training on DCC (76.5%).CONCLUSION:This study has concluded that most midwives who do not apply DCC correctly, have quite short cord clamping times, have no DCC protocol in their institutions, and do not receive in-service training.

THE RELATIONSHIP OF MOTHER'S AGE AND NEWBORN'S WEIGHT WITH PERINEUM RUPTURE

Perineal rupture is an injury to the birth canal that occurs during birth due to tissue damage due to pressure on the baby's head and shoulders during the birth process. The aim of the research was to determine the relationship between maternal age and newborn weight with perineal rupture at the Independent Midwife Practice (PMB) Irma Suryani, Prabumulih City in 2023. The research method was analytical, using a cross sectional approach. The population of this study were all mothers giving birth at the Independent Midwife Practice (PMB) Irma Suryani, Prabumulih City. The sample taken in this study used the Random Sampling technique method, namely 149 people. The research instrument is a checklist. The results of the study based on univariate analysis showed that of the 149 respondents there were 64 respondents (43%) who were diagnosed with perineal rupture and 85 respondents (57%) who were diagnosed with not perineal rupture, there were 52 respondents (34.9%) who were of high risk age and 97 respondents (65 .1%) who had a low risk age, there were 35 respondents (23.5%) who had a high risk birth weight and 114 respondents (76.5%) who had a low risk birth weight. Of the 52 respondents with a high risk age, there were 38 respondents (25.5%) who were diagnosed with perineal rupture. Of the 97 respondents who had a low risk age, there were 26 respondents (17.4%) who were diagnosed with perineal rupture and of the 35 respondents who had a heavy newborn baby. At high risk births, there were 31 respondents (20.8%) who were diagnosed with perineal rupture, while of the 114 respondents who had low risk birth weights, there were 33 respondents (22.1%) who were diagnosed with perineal rupture. Conclusion: There is a significant relationship between maternal age and perineal rupture with a P value of 0.000 < ? 0.05 and there is a significant relationship between the weight of the newborn and perineal rupture with a P value of 0.000 < ? 0.05. Keywords : Perineal rupture incidence, maternal age, weight of newborn Bibliography : 18 (2017-2023)

EFFECTIVENESS OF RED BETEL (PIPER CROCATUM) EXTRACT ON LEUCORRHEA IN WOMEN OF CHILDBEARING AGE

Introduction: Reproductive health problems exist in Asia; 76% of women experience vaginal discharge. Vaginal discharge symptoms are also experienced by women of childbearing age (around 31.8%). Women of childbearing age are more at risk of fluor albus, which can be a trigger for reproductive organ infections. One of the treatments is to use betel leaves, which contain natural antiseptics and antibiotics. Objectives: This study aimed to determine the effectiveness of red betel leaf extract (Piper crocatum) against leucorrhea in women of childbearing age. Method: This research method uses a quasi-experiment design with one pre-and post-test design technique group. The research was conducted at the Independent Midwife Practice in Bandung City. The population in the study were all women of childbearing age in Bandung City. The sample consisted of women of childbearing age, according to the inclusion criteria of 36 people. The data obtained were primary data from the measurement of vaginal pH with Neco test litmus paper. The data analysis used was the Wilcoxon test to test the difference in pH scores before and after the intervention. Result: The results showed a significant difference in the use of 0.5% red betel leaf extract in women of childbearing age before and after the intervention. Conclusion: Red betel leaf extract 0.5% is effective in reducing the incidence of leucorrhea. There is a decrease in vaginal pH before and after the use of red betel leaf extract 0.5% by 1.78 (p <0.05).

Pre-implementation context and implementation approach for a nursing and midwifery clinician researcher career pathway: A qualitative study.

To describe the pre-implementation context and implementation approach, for a clinician researcher career pathway. Clinician researchers across all health disciplines are emerging to radically influence practice change and improve patient outcomes. Yet, to date, there are limited clinician researcher career pathways embedded in clinical practice for nurses and midwives. A qualitative descriptive design was used. Data were collected from four online focus groups and four interviews of health consumers, nursing and midwifery clinicians, and nursing unit managers (N = 20) between July 2022 and September 2023. Thematic and content analysis identified themes/categories relating to: Research in health professionals' roles and nursing and midwifery, and Research activity and culture (context); with implementation approaches within coherence, cognitive participation, collective action and reflexive monitoring (Normalization Process Theory). The Pathway was perceived to meet organizational objectives with the potential to create significant cultural change in nursing and midwifery. Backfilling of protected research time was essential. The Pathway was seen as an instrument to empower staff, foster staff retention and extend research opportunities to every nurse and midwife, while improving patient experiences and outcomes. Clinicians, consumers and managers fully supported the implementation of clinician researchers with this Pathway. The Pathway could engage all clinicians in evidence-based practice with a clinician researcher leader, effect practice change with colleagues and enhance patient outcomes. This study adheres to relevant EQUATOR guidelines using the COREG checklist. Health consumers involved in this research as participants, did not contribute to the design or conduct of the study, analysis or interpretation of the data, or in the preparation of the manuscript.

Migration of Midwifery Care Documentation to Medical Records

Medical records are the key to documenting services for health workers who carry out independent practice, good documentation greatly affects the fulfillment of administrative aspects, legal aspects for midwives and patients and provides convenience in maintaining the quality of care documentation to patients. Medical records are very important for health care facilities including Independent Midwife Practices. The function of medical records is to record all health services that have been provided to patients in order to support the improvement of service quality. this study is to implement integrated midwifery care documentation using medical records. The purpose of this study was to implement integrated midwifery care documentation using medical records. This research is an RnD (Research and Development) study with a case study approach. Researchers conducted a data collection process with FGDs. The research was conducted in April-September 2023 at PMB Ummu Hani Bantul Yogyakarta. The object is the recording form that has been implemented. The data validation process used source and technical triangulation. The physical aspect of each form is A4 in size with a weight of 70mg, the paper used for the medical record folder is F4, glossy with cream-colored paper type ivory 260gram. The content aspect includes the division of data items, grouping of data, sequent and how to fill in based on the woman's life cycle, namely grouping the contents for data on pregnant women, maternity, postpartum and children. Obstetric documentation has used integrated documentation from pregnancy to postpartum and child growth and development which has become one document using a medical record folder.

Optimizing the Implementation of Foot Massage as an Effort to Increase Comfort and Reduce Pain After Labor

Childbirth is a maternal experience that often results in trauma for the mother. Pain before and after delivery is one of the factors that makes the mother uncomfortable. The mother's discomfort will make the mother stressed and will not make the mother comfortable with her new assignment. Foot massage is one method that can be applied to postpartum mothers to reduce the pain and comfort experienced by most mothers in the early postnatal period. Comfort during postpartum will improve the mother's quality of life. The location of the service activity was at the Nining Independent Midwife Practice, Deli Serdang Regency with a total of 14 participants. The target of this activity is postpartum mothers and mothers' companions during treatment. The activity methods used are lectures, role plays and simulations. The activity was carried out twice, namely on 16 and 23 May 2024. The activity consisted of preparation, implementation and evaluation. The results of this service show that most of the participants were >35 years old, female and had a high school education. There is a change in knowledge regarding optimizing foot massage to reduce pain and comfort after childbirth. Before being given health education, the majority of participants had knowledge, namely less than 78.57% and those who had sufficient knowledge were 21.42%. After being given education, the majority of participants had good knowledge about foot massage (57.14%) and 4 participants (28.57%) had good knowledge about foot massage. The presentation of increased knowledge after being given health education was 78.57%. It is hoped that foot massage education can be optimally implemented for postpartum mothers during the postpartum period so that it can help mothers reduce the pain and discomfort that occurs during the postpartum care period.

Knowledge Contestation of Midwives and TBAS: Study of Patterns of Domination, Hybridization, and Coexistence in Childbirth

Purpose: This study aims to analyze the contestation between the medical knowledge of midwives and the local knowledge of traditional birth attendants in accompanying pregnant women to delivery in the Gowa Regency. We also investigate the contestation between the medical knowledge of midwives and the local knowledge of traditional birth attendants in postnatal and infant care. Method: The research method uses a qualitative approach with case studies and data collection through interviews, observation, and documentation. Results and conclusion: The results identified three patterns of knowledge contestation between midwives and shaman uncles, namely domination, hybridization, and coexistence. Domination occurs in the context of pregnancy, where the knowledge of the shaman Pamana dominates the midwife, while hybridization occurs during the delivery process with collaboration between the midwife and the shaman Pamana. The pattern of coexistence illustrates that the knowledge of midwives and shaman Pamana is present together without interfering with each other in postnatal care. Research implications: This research is relevant to the maternal and newborn health system in Gowa Regency with the following implications: 1) Integration of medical and local knowledge is needed in the practice of midwives and birth attendants, emphasizing the need for holistic training for health service providers; 2) Collaboration between midwives and traditional birth attendants can improve the safety of mothers and babies; 3) Cultural awareness is important to improve quality of care; 4) Culturally sensitive practice guidelines are necessary for safe and effective practice; 5) Public advocacy and education can increase awareness of appropriate care. Originality/value: This research reveals the dynamics of contestation between medical and local knowledge in maternal and neonatal health services, providing new insights into their interactions. These findings support the development of more effective interventions, contribute to the reproductive health literature, and provide insights for more inclusive policies.