Positive Childbirth Experience Research Articles

Adequate cardiorespiratory fitness during pregnancy for a better quality of childbirth

Inadequate Cardiorespiratory Fitness (CRF) during childbirth can lead to potential problems, including preterm birth, hypertensive disorders of pregnancy, pain and discomfort during pregnancy, cesarean birth, and postpartum weight gain. This study aimed to assess the relationship between cardiorespiratory fitness during pregnancy and the quality of childbirth. An observational analytic study with a prospective cohort design was conducted among 52 pregnant women in their third trimester of gestation. Respondents were selected based on the purposive sampling technique. The variables - cardiorespiratory fitness, indicated by VO2max value, and the quality of childbirth - were respectively measured using the six-minute walk test and the Quality Childbirth Questionnaire, modified from the Pregnancy and Childbirth Outcome Set (PCB), the Childbirth Experience Questionnaire (CEQ), and the Birth Satisfaction Scale (BSS), which were declared valid and reliable. Data analysis used descriptive and bivariate analysis with the Chi-Square test with a Risk Ratio (RR). The results showed a p-value of less than 0.001, confirming the hypothesis. There is a meaningful link between high VO2 max scores and improved childbirth experiences, with a RR of 6.882 at a 95% confidence interval. This suggests that pregnant women with better cardiorespiratory fitness are 6.882 times less likely to have an adverse labor and delivery outcome. Improving cardiorespiratory fitness through strategic antenatal physical activity with aerobic exercises is recommended to gain a positive childbirth experience.

Reported respectful maternity care received during childbirth at health facilities: A cross sectional survey in Eastern province, Rwanda

BackgroundRespectful maternity care (RMC) fosters positive childbirth experiences and ensures safe motherhood. While past Rwandan studies on childbirth predominantly focused on negative experiences, our research delved into positive experiences. This study aimed to assess the RMC level experienced by women during childbirth in health facilities of Eastern Province of Rwanda. MethodologyWe conducted a cross-sectional survey on 610 mothers at their discharge across five public hospitals. We used a 15-items RMC questionnaire developed by White Ribbon Alliance, version of 2019. To manage the right-skewed data, we employed a median cut-off, categorizing experiences into binary outcome (low and high RMC score). We performed stepwise backward elimination logistic regression model to identify predictors of high RMC. FindingsThe majority (70.2%) reported experiencing RMC. The most acclaimed RMC items (over 90%) included allowance of food and fluid intake (98.5%), non-discrimination (96.2%), receipt of necessary services (96.1%), and privacy (91.3%). The chi-square analysis showed an association between reported high RMC and marital status (p-value = 0.006), occupation (p-value = 0.001), and mode of delivery (p-value = 0.001). Caesarean section delivery was associated with high RMC in multivariate logistic regression with a p-value of 0.001, the adjusted odds ratio was 2.11 with a CI [1.40–3.17]. ConclusionThe reported RMC items and care appreciated at high level should be sustained. Regardless of mode of delivery, all mothers should experience consistent, utmost respect throughout the childbirth and should receive RMC at maximum level.

Factors related to a positive childbirth experience – a cross-sectional study

ABSTRACT Background/aims Giving birth is a life-changing experience for women. Most previous studies have focused on risk factors for a negative childbirth experience. The primary aim of this study was to assess childbirth experience in a sample of postnatal Swedish women. The secondary aim was to analyse demographic and clinical determinants associated with a positive birth experience. Design/Methods A digital survey including the instrument Childbirth Experience Questionnaire 2 (CEQ2) was answered by 619 women six to 16 weeks postpartum. Regression analyses were made assessing the impact that different factors had on the overall childbirth experience and the four subscales of CEQ2: Own Capacity, Perceived Safety, Professional Support and Participation. Results Overall, women were satisified with their birthing experience. Several factors contributed to a positive childbirth experience. Having a vaginal mode of birth (without vacuum extraction) together with not having ongoing mental health problems were the factors with the most influence on the total childbirth experience. Not having maternal complications postpartum and receiving much support from a trusted birth companion were two other important factors. Conclusion Although Swedish women tend to express satisfaction with their childbirth experiences, there is a necessity to advocate for a childbirth approach that optimises the chance of giving birth vaginally rather than with vacuum extraction or acute caesarean section, and reduces the risk for complications whenever possible. During pregnancy, mental health problems should be appropriately addressed. Healthcare professionals could also more actively involve the birth companion in the birthing process and equip them with the necessary tools to effectively support birthing women.

Labour Care Guide implementation as a decision-making tool for monitoring labour among healthcare providers in Uganda: protocol for a mixed-methods study

IntroductionThe new WHO Labour Care Guide (LCG), also regarded as the ‘next-generation partograph’, is a core component of 2018 WHO consolidated guidelines on intrapartum care for positive childbirth experience. The...

Evidence-based intrapartum care during vaginal births: Direct observations in a tertiary care hospital in Central Sri Lanka

BackgroundEvidence-based practice (EBP) is an effective approach to improve maternal and newborn outcomes at birth. ObjectiveThis study aimed to assess the current intrapartum practices of a tertiary care hospital in Central Province, Sri Lanka, during vaginal births. The benchmark for this assessment was the World Health Organisation's (WHO) recommendations on intrapartum care for a positive childbirth experience. MethodsAn observational study was conducted at the delivery room of Teaching Hospital, Peradeniya with the participation of 196 labouring women who were selected using systematic random sampling. A non-participant observation checklist covering labour room admission procedures, management of the first, second, and third stages of labour, and immediate care of the newborn and postpartum mother was used for the data collection. The care interventions implemented throughout labour and childbirth were observed and recorded. The data analysis was done using SPSS version 22. ResultsWHO-recommended practices such as providing privacy (33.2%), offering oral fluids (39.3%), and opioids for pain relief (48.5%) were found to be infrequent. Encouraging correct pushing techniques (77.6%), early breastfeeding (83.2%), regular assessment of vaginal bleeding (91.3%), skin-to-skin contact (93.4%), and using prophylactic uterotonics (100.0%) were found to be frequent. However, labour companionship, use of upright positions during labour, women's choice of birth position, and use of manual or relaxation techniques for pain relief were not observed in hospital intrapartum care. ConclusionThe findings of the study indicate that additional attention and monitoring are required to align the current intrapartum care practices with the WHO recommendations. Moreover, the adoption of evidence-based intrapartum care should be encouraged by conveying the standard evidence-based intrapartum care guidelines to the grassroots level healthcare workers to avoid intrapartum interventions.

Effect of childbirth experience on the psychological well-being of postpartum women in Accra, Ghana

ABSTRACT Background Women’s experience of childbirth can affect their mental health outcomes, many years after the delivery. Consequently, the World Health Organisation has provided recommendations to ensure women receive positive birth experiences during intrapartum care. Yet, negative childbirth experience is widespread in Ghana. This study examined the association between women’s childbirth experience (i.e. own capacity, professional support, perceived safety, and participation) and their psychological well-being, and whether or not perceived social support and resilience moderate the childbirth experience – psychological well-being relationship. Methods Mothers (N = 117) who had given birth in the past month and were receiving postnatal care at two health facilities in the Greater Accra Region of Ghana provided the data for the current analysis. Data were collected using the Childbirth Experience Questionnaire, WHO-5 Well-Being Index, Multidimensional Scale of Perceived Social Support, and Brief Resilience Scale. Hierarchical Linear Regression was used to analyse the data. Results Results showed that childbirth experience domains of own capacity and perceived safety were significantly, and positively associated with psychological well-being. The domains of professional support and participation were not associated with psychological well-being in this sample. Perceived social support and resilience did not moderate the association between childbirth experience and psychological well-being. Conclusion The results suggest that efforts by birth practitioners (i.e. midwives, obstetricians, and gynaecologists) to give Ghanaian women positive childbirth experiences through the encouragement of personal control over the birthing process as well as ensuring the safety of the birthing procedure and environment would provide women with optimal mental health outcomes.

Efficacy of Educational Intervention on Decision Conflict

Background: Decision conflict usually occurs from poor patient involvement in decision making which may cause regrets about the options that were chosen. Health professionals should impart antenatal education to enhance a mother’s belief about her birthing. Objective: To assess the effect of supportive educational intervention on decision conflict among primipara mothers with a fear of childbirth (FOC). Methods: An randomized controlled trial (RCT) was conducted on 205 primipara mothers with an FOC attending Gynae OPD. At 24–28 weeks of pregnancy, mothers were screened for FOC WDEQ-A and then randomly allocated to the experimental (103) and control group (102) and assessed for decision conflict by using a decisional conflict scale. The experimental group was given Supportive educational intervention. At 37–38 weeks of pregnancy, both groups were again assessed for decision conflict. Three participants from the experimental and two from the control group were lost to follow up and the final post-test was completed by 200 participants. Data analysis was done by calculating frequency, mean, standard deviation, Fisher Exact test, chi-square, t-test and F-test using SPSS version 18. Results: There was a significantly lower post-intervention decision conflict score in the experimental group as compared to the control group ( p < .001). No difference was observed in the pre-test score in both groups. Conclusion: Supportive educational intervention was effective in primipara mothers for reducing decision conflict. Improving antenatal emotional well-being will lead to a positive childbirth experience with better perinatal outcomes.

The Childbirth Experience: A Systematic Review on Prenatal and Intrapartum Supportive Interventions

Background: The incidence of challenging delivering experiences varies among societies and is impacted by various factors. The primary goal of this review was to assess the effect of supportive interventions pre- and during delivery on the likelihood of a positive childbirth experience. Methods: This study reviewed articles related to childbirth experience in international databases, such as PubMed, Cochrane, and ScienceDirect. A total of 1433 articles were found using the PRISMA guideline. Review research emphasized the supporting interventions during labor and women's subjective experience. Quality assessment was conducted using the modified Jadad scale. Results: Overall, fifteen studies passed the eligibility criteria. The effective approaches to develop a favorable understanding of the whole birthing process encompassed the following supportive interventions: yoga exercise during pregnancy, antenatal hypnosis program, continuous supportive care during labor, family companion during labor, massage during labor, therapeutic touch program, acupressure during labor, birth ball exercise during labor, warm showers during the first stage, and dancing with music during the active phase of labor. Conclusion: Various supportive interventions related to childbirth may reduce pain and anxiety, build confidence, encourage, and serve as valuable psychosocial interventions for childbirth. Becoming a mother is not a frequent occurrence for all women, contributing to an overall experience in childbirth. Our study recommends interventions, such as yoga exercises during pregnancy, an antenatal hypnosis program, continuous supportive care during labor, a family companion during labor, massage during labor, a therapeutic touch program, acupressure during labor, birth ball exercise during labor, warm showers during the first stage, and dancing with music during the active phase of labor.

Exploring Women’s Childbirth Experiences in Labor Induction versus Expectant Management: A Systematic Review and Meta-analysis

Background: Negative childbirth experiences impact the well-being of women and their families. With rising induction of labor (IOL) rates and the inconsistent evidence regarding its impact on childbirth experiences, we conducted a systematic review and meta-analysis to estimate the overall effect of IOL versus expectant management on women’s childbirth experiences, defined as a woman’s self-assessment of her lasting memories of the childbirth event. Methods: We searched databases (PubMed, Embase, Cochrane Library, Science Direct, ProQuest and EBSCO) for RCTs and observational studies from 1970 to September 2023. Inclusion criteria covered women aged 19 and older with live, singleton, cephalic pregnancies at 37 0/7 until 41 6/7 weeks gestation. Quality was assessed using the Jadad and Newcastle-Ottawa Scales. RevMan 5.4 software and random-effects meta-analysis were used, adhering to PRISMA guidelines. Results: Of the 1.467 screened articles, we included nine studies from five European countries. Six studies (2.376 women) used the Childbirth Experience Questionnaire (CEQ). Overall CEQ scores showed no significant IOL vs. expectant management differences (MD = 0.01 [95% CI -0.06, 0.08]; p=0.78; I2 = 65%). Subgroup analyses favored IOL in RCTs (MD = 0.07 [95% CI 0.02, 0.13]; p=0.006; I2 = 0%) and studies with ≥500 participants (MD = 0.09 [95% CI 0.02, 0.15]; p=0.006; I2 = 0%). Conversely, four studies (48.324 women) using the Childbirth Experience Visual Analogue Scale (VAS) favored expectant management (OR = 0.73 [95% CI 0.63, 0.85]; p<0.001; I2 = 86%). Conclusion: VAS assessments suggest a more positive childbirth experience with the expectant management group. Improvements in the IOL process, transfer to delivery, and pain relief administration may benefit the IOL group. In contrast, the overall CEQ scores did not significantly differ between groups. Clinical practice should consider individualized approaches that align with patient needs and medical contexts. Limitations, such as variability in study quality and data heterogeneity, should be acknowledged. PROSPERO registration number: CRD42023464153

Need of integrated care model for positive childbirth experience in Indian maternity care services.

Integrated care (IC) models are an emerging trend in healthcare reforms worldwide, especially in the maternal healthcare system. This research focuses on the scope of an integrated model for intrapartum care of women and explores the experience of birth under two intrapartum care models-biomedical and midwifery models, respectively. The term positive childbirth experience (PCE) is a concept defined by the World Health Organization (WHO) in the recommendations on intrapartum care for a PCE. This study is convinced to employ a qualitative approach to explore how birth is experienced by women under maternity healthcare services in Kerala. A semi-structured interview was conducted to tap into the lived reality of birthing of sixteen first-time mothers (primipara) aged between 20 and 30 years under these two models. Furthermore, five participants have been specifically interviewed after their vaginal birth after a C-section (VBAC) experience. To achieve a systematic cross-case thematic analysis, systematic text condensation (STC) has been employed as a data analysis method. Four main categories were identified through the analysis as follows: (1) information and knowledge, (2) confidence, (3) quality of care, and (4) health-promoting perspective. These central themes evolved from 11 subthemes. The data analysis reveals both negative and positive experiences under two care models. It emphasizes the urgent need to reframe the biomedical-focused care model and adopt an integrated approach that aligns with the global intrapartum care model proposed by the World Health Organization (WHO) in 2018 and the definition of IC mentioned in the paper.

Measurement of safe and respectful maternity care in exit interviews following facility childbirth at the Lwala Community Health Centre

Background: Respectful maternity care is essential for ensuring positive childbirth experiences for women. It emphasizes moral values and respect for human rights and encourages behavior that considers women's preferences and needs for pregnant women, newborns, and their families. Maternity exit interviews conducted at Lwala Hospital assessed women's experiences during labor and delivery. Methods: A survey tool, Kobo Collect, was used for data collection among women who delivered at Lwala Hospital. 64 women of an age range of 17 and 36 years who delivered between October 1, 2023, and November 30, 2023, were interviewed. All the women had already given birth at least once. Results: Most of the women in the survey felt that they were given sufficient information to make informed decisions and felt comfortable during their delivery process. 86% strongly agreed that they were encouraged to have some light food, warm fluids, or tea during labor and birth. 72% of women said staff members talked to them about the advantages, disadvantages, and alternatives to treatments or procedures. Only 49% received information about caring for their babies. 13% felt they received information about where to get follow-up care. 96% felt the staff always protected their privacy at all stages. 80% said that the staff never scolded, shouted at, insulted, or made disrespectful comments. 91% said they were never touched by a staff member in a way that caused pain or felt inappropriate or non-consensual. 95% of women said all the staff care about what matters to the mother and her family. 85% of women were encouraged to feel confident in their ability to give birth. Despite 86% of the women feeling that the staff were active during labor, only 68% of women felt competence from the staff members during labor. Conclusion: Interviews underscore the importance of maternity exit interviews in assessing and enhancing the quality of maternity care. The outcomes of this research will inform future interventions and reinforce the commitment to providing respectful and equitable maternity care.

What matters to migrant women during labor and birth: Chinese mothers’ experiences in Switzerland

BackgroundIn Switzerland, foreigners account for 25.3% of the permanent resident population, and the fertility rate of migrant women is higher than that of Swiss women. However, migrant women from non-European countries are more likely to report having negative childbirth experiences than Swiss women. For example, during pregnancy, Chinese migrant mothers often felt dissatisfied with the follow-up pregnancy complications and lacked information on medical procedures and prenatal courses. In this paper, we explored their childbirth experiences in Swiss hospitals and how Swiss healthcare providers supported them.MethodA qualitative study employing in-depth, semi-structured interviews was conducted with 14 Chinese mothers and 13 family members. All interviews were audio-recorded, transcribed, and translated into English for data analysis. Thematic analysis was employed to generate a detailed description.ResultsThree main themes were extracted from the transcripts: (1) Sense of security, (2) Intrapartum care, and (3) Postpartum needs.ConclusionsOur study shows Chinese migrant mothers prioritized giving birth in a physically and psychologically safe environment, with pain control and practical and emotional support from their intimate partners. They desired a physiological labor and birth with minimal obstetric interventions. Our research also reveals their postpartum needs, emphasizing the importance of postpartum support and obtaining culturally sensitive care during their postpartum hospital stay. The study adds new knowledge of specific migrant studies in Switzerland, as called for by the Swiss Federal Office of Public Health. The results call for the transcultural care skills training of Swiss healthcare providers to enable migrant women to have a more positive childbirth experience.

Factors intervening in the childbirth experience: a mixed-methods study

ObjectiveTo analyze the childbirth experience focusing on the intervening factors and on the delivery method.MethodA sequential and explanatory mixed-methods study guided by the World Health Organization document for positive childbirth experiences. The participants were puerperal women in a maternity teaching hospital from inland São Paulo (Brazil). The first quantitative stage involved descriptive analysis with Poisson regression of 265 answers to the “Termômetro da Iniciativa Hospital Amigo da Mulher e da Criança” (“Women- and Baby-Friendly Hospital Initiative Thermometer”) questionnaire. The second stage, qualitative, thematically analyzed the interviews conducted with 44 puerperal women who took part in the first stage. Data integration was by connection.The results and discussionThe analysis by connection showed that among the factors that restricted the positive experience, C-section was predominant (61.9%), understood as an option due to fear of pain, the treatment modality and previous traumas. Restrictions referring to the presence of a companion (99.6%), not having privacy (83%), disrespectful situations (69.5%), too many touches (56.9%) and the absence of skin-to-skin contact (55%), among others, potentiated fear, loneliness, concern, shame, the perception of disrespect and insecurity with the assistance provided. The promoting factors were as follows: choosing the companion (95.4%) for collaborating in the safety perception, not having infections (83.9%), having continuous team monitoring (82.2%) and pain relief methods (78.9%), which were valued by the women.ConclusionThe intervening factors that promoted positive experiences were related to clinical and protocol-related issues and to service availability. The restrictive factors were associated with excess interventions, deprivation of rights and of choice, absence of privacy and restriction referring to the presence of a companion. Women with a normal postpartum period felt more insecure and disrespected when compared to those subjected to C-sections, whose choices were considered, although they had lower prevalence of skin-to-skin contact. There is an urgent need to apprehend women's experiences and turn them into actions that guarantee their lives in a safe and respectful way.

Fatores que interferem na percepção de segurança materna no pós-parto

Abstract Objectives: to identify the factors and variables that interfere with the maternal perception of security at postpartum. Methods: a cross-sectional study, carried out in three Portuguese hospital units, with a non-probabilistic sample of 352 puerperal women, recruited from the postpartum units on the day of hospital discharge after delivery. Maternal sociodemographic and obstetric characteristics, as well as data on monitored pregnancy, childbirth and infant feeding, were collected through the application of a questionnaire developed by the researchers. For the analysis of maternal perception of security, the instrument “Parents’ postnatal sense of security” (PPSS) was used. Descriptive and inferential statistics were used for data analysis. Results: women who lived with their partner (t (349) = - 2.34, p=0.020), were multiparous (t (349) = - 2.26, p=0.025), had pregnancy monitored (t (349) = -3.25, p=0.001), had a positive childbirth experience (F (1, 351) = 7.07, p=0.008) and those who exclusively breastfed during hospitalization (F (2, 351) = 11,43, p<0.001), presented greater perception of security at postpartum. Conclusions: the factors that affect the maternal perception of security at postpartum are cohabitation with a partner, parity, monitored pregnancy, childbirth experience and infant feeding. Defining which factors interfere with maternal security at postpartum may contribute to the construction of intervention programs that promote the maternal perception of security at the time of hospital discharge after delivery.

Jordanian Women’s Experiences of Natural Childbirth Using a Midwife-Led Care Unit: A Qualitative Study

Background: Midwives can play a pivotal role in promoting natural-birth experiences. However, limited information is available about Jordanian laboring women’s experiences of natural childbirth guided by midwives. Understanding women’s experiences of natural birth can inform healthcare providers and policymakers to improve the care provided for laboring women. Purpose: This study aims to explore women's experiences of natural childbirth in a midwife-led care unit. Methods: A qualitative descriptive approach guided the study protocol. Data was collected through in-depth, semi-structured telephone interviews with 10 Jordanian women who experienced natural childbirth in a midwife-led care unit. Results: Two main themes emerged: “The journey of empowerment “and “being prepared for natural childbirth". The first theme consisted of two sub-themes: Making an informed decision, and being supported. The second theme consisted of three sub-themes: The power of the place, being satisfied with natural-childbirth practices, and feeling relieved. Conclusion: Women had positive childbirth experiences shaped by having autonomy in decision-making, perceived support, and being satisfied with the midwife-led care unit. Women’s positive experiences emphasize the need for social and political change to promote natural childbirth. Implications for Nursing: This paper provides evidence that supports the incorporation of midwife-led units to promote natural childbirth. New data will play a critical role in strengthening the responsibilities of nurses and midwives by raising public awareness and calling for policy changes to promote natural childbirth. Keywords: Midwife-led care unit, Natural childbirth, Women’s experiences.

Person-centered maternity care during childbirth and associated factors among mothers who gave birth at public health institutions of Debre Markos town, Northwest Ethiopia, 2022: A cross-sectional study.

Person-centered maternity care is a crucial scheme for a positive childbirth experience. It enhances facility-based delivery, improves patient-provider communication, and increases women's satisfaction. However, there is limited evidence on the magnitude of person-centered care and certain variables were missed in Ethiopia. Therefore, this study assessed the magnitude of person-centered maternity care during childbirth and associated factors at health institutions of Debre Markos town, Ethiopia. Institution-based cross-sectional study was conducted at public health institutions of Debre Markos town. Participants were enrolled using systematic random sampling technique. Data were collected through face-to-face exit interviews, cleaned, coded, and entered into Epi-Data version 3.1 then exported to SPSS version 25 for analysis. After generating simple linear regression analysis, variables with p-value ⩽ 0.25 were fitted into multivariable linear regression model and p-value < 0.05 was declared statistically significant with 95% CI for β. Finally, study findings were presented using texts, tables, and figures. In this study, 380 women participated, with a response rate of 98.19%. The respondent's mean person-centered maternity care score was 56.83 with 95% CI: (55.83, 57.83). Mean score for sub-scale was 15.08 for dignity and respect, 14.42 for communication and autonomy, and 27.33 for supportive care. Commencing antenatal care during third trimester (β = -4.86, 95% CI: -8.22, -1.49), caesarean delivery (β = -5.78, 95% CI: -7.68, -3.87), college and above educational level of women (β = 3.75, 95% CI: 1.11, 6.39), being multiparous (β = 3.69, 95% CI: 1.85, 5.55), and health center delivery (β = 6.59, 95% CI: 4.17, 9.02) were factors significantly associated with person-centered maternity care. This study showed person-centered maternity care was low compared with World Health Organization standards. This informs local policymakers, district health offices, institutional healthcare administrators, and healthcare professionals of the discrepancies in achieving international standards of quality care.

Effects of Using Sitting Position versus Lithotomy Position during the Second Stage of Labour on Maternal and Neonatal Outcomes and the Childbirth Experience of Chinese Women: A Prospective Cohort Study.

Existing research concerning the effects of the sitting birth position during the second stage of labour on maternal and neonatal outcomes remains controversial, and there is a lack of studies to explore its effect on the childbirth experience. The objective of this study is to explore whether the sitting birth position would influence maternal and neonatal outcomes, as well as the childbirth experience. The prospective cohort design was conducted in the study from February to June 2023, a total of 222 women (including primiparous women and multiparous women) were enrolled in our study, and they were divided into the sitting position cohort (n = 106) or the lithotomy position cohort (n = 116). The pre-designed questionnaire and Childbirth Experience Questionnaire (CEQ) were used for data collection during hospitalisation. Chi-square, Fisher's exact test, t-tests, or the Mann-Whitney U test were utilised to assess differences between groups. Multivariate linear regression and logistic regression were employed to control possible confounders. The study found that primiparous women in the sitting position cohort had a shorter duration of the second stage of labour, higher spontaneous vaginal birth rates, lower episiotomy rates, and a better childbirth experience (p < 0.01). After adjusting for confounding factors through multiple linear and logistic regression analyses, the results remained consistent with those reported above. No neonate in each cohort had Apgar scores at 1 min and 5 min postpartum less than 7 or a Cord artery pH less than 7.00, regardless of parity. Based on the findings, we recommend that women could take the sitting birth position into account when giving birth for a positive childbirth experience, especially for primiparous women. The study could also serve as a reference for healthcare providers in the management of childbirth positions and the development of high-quality maternal care.

Impact of trauma, support, and control perceptions during childbirth on post-traumatic stress disorder among Syrian immigrant adolescent pregnant women

ObjectiveThe probability of experiencing mental health problems in the perinatal period is high for adolescent women. Immigration is a complicated phenomenon that increases the risk of encountering temporary or permanent psychological problems. This study aims to determine Syrian immigrant adolescent women's support and control perception levels during childbirth, birth trauma levels, and posttraumatic stress disorder incidence and affecting factors. MethodsThis study used a prospective cohort design and was conducted in a hospital in Adana, a city in southern Turkey, between February and April 2022. It included 122 Syrian adolescent immigrant women, and data were collected in two interviews. While the first interview was conducted within the first 24 hours following birth, the second interview was conducted one month after birth. Data were collected through structured interviews using standardized questionnaires, including the Personal Information Form, the City Birth Trauma Scale, the Support and Control in Birth Scale, and the Post-traumatic Stress Disorder Checklist for DSM-5. FindingsThe average age of participating women was 17.40±0.94. The participants’ Perceived Support and Control in Birth Scale total score was 100.55±20.12, the City Birth Trauma Scale total score was 43.11±13.29, and the Post-traumatic Stress Disorder Checklist total score was 30.36±16.86. Of all the participating women, 26% were found to have post-traumatic stress disorder symptoms in the postpartum period. A relationship was found between support and control perceptions during childbirth and post-traumatic stress disorder symptoms. ConclusionThis study found that immigrant adolescent women's support and control perceptions during childbirth were better than expected, and they had a high level of perceived trauma during childbirth. The presence of birth trauma emerged as a robust predictive factor for posttraumatic stress disorder, underscoring its critical role in maternal mental health. A positive childbirth experience, which is important for all women, has become an increasing need for immigrant women. There is a need for developing and sustaining health policies guaranteeing culturally sensitive care to prevent immigrant women from having a traumatic birth experience.

Barriers and facilitators of implementing the practice programme for upright positions in the second stage of labour: A mixed-method study.

To explore the possible barriers and facilitators to implementing the Upright Positions in the Second Stage of Labour (UPSSL) programme in Chinese healthcare settings. A mixed-method convergent design with the guidance of Consolidated Framework for Implementation Research (CFIR). An online survey study and semi-structured interviews were conducted between March and May 2023. Healthcare professionals were recruited from four hospitals in Shijiazhuang, China. One hundred and thirty-one participants completed the survey study, and 23 of them were interviewed individually. Descriptive statistics evaluated the possible barriers and facilitators of implementing the UPSSL programme within the CFIR framework quantitatively. Guided by the CFIR framework, qualitative data were analysed using directed content analysis to summarize healthcare professionals' perspectives on barriers and facilitators of the UPSSL programme. Multiple intersectional barriers and facilitators were identified from the survey and semi-interviews. Healthcare professionals believed that the UPSSL programme has a scientific evidence base, systematic contents, and possible benefits for women. However, various barriers existed at individual, system, and organizational levels. Major barriers included healthcare professionals and women's safety concerns towards the use of upright positions during childbirth, the healthcare professionals' unfamiliarity with assisting an upright position birth, poor adaptability of the programme protocol, inadequate facilities and staffing, and a lack of readiness to change in the clinical setting. To facilitate the implementation of the UPSSL programme in China, tailored antenatal education on upright positions, especially addressing safety-related issues, should be provided to pregnant women, their families, or peers to enhance their understanding of and familiarity with such positions. Healthcare professionals should also be offered adequate training opportunities and necessary facilities. Furthermore, national-level policy changes might be required to address midwifery workforce shortages. Additionally, further research is warranted to select, adapt, and test effective implementation strategies for programme adoption. What problem did the study address? The adoption of upright positions during the second stage of labour could promote better maternal and neonatal outcomes and a positive childbirth experience. However, the adoption of upright positions during the second stage of labour is suboptimal in healthcare settings in China. Barriers and facilitators of implementing upright positions during childbirth are unclear. What were the main findings? A range of barriers and facilitators within the CFIR framework to promote upright positions during childbirth from healthcare professionals' perspectives were identified, and the major barriers included safety concerns towards and unfamiliarity with an upright position birth, inadequate facilities and staffing, and a lack of readiness to change in the clinical setting. Where and on whom will the research have an impact? This study will enable a better understanding of the barriers and facilitators to promoting upright positions in the second stage of labour in China. The smooth and effective implementation of the UPSSL programme could help to promote better maternal and neonatal outcomes and improve women's childbirth experiences. The reporting of this study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) and Good Reporting of A Mixed Methods Study (GRAMMS) guidelines. In this study, healthcare professionals were involved in refining the topic guides and survey questions. Additionally, findings from the interviews were returned to them for comments and corrections.

Intrapartum care measures and indicators for monitoring the implementation of WHO recommendations for a positive childbirth experience: a scoping review

ObjectiveWe aimed to identify all available studies describing measures or indicators used to monitor 41 intrapartum care practices described in the 2018 WHO intrapartum care recommendations, with a view to...