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BackgroundIn neonatal care, assessment of the temperature of the neonate is essential to confirm on-going health, and as an early signal of potential pathology. However, some methods of temperature assessment involve disturbing the baby, disrupting essential sleep patterns, and interrupting maternal/infant interaction. Thermal imaging is a completely non-invasive and non-contact method of assessing emitted temperature, but it is not a standard method for neonatal thermal monitoring. To examine the potential utility of using thermal imaging in neonatal care, we conducted a comprehensive systematic scoping review of thermal imaging applications in this context.MethodsWe searched EMBASE, MEDLINE and MIDIRS.ResultsFrom 442 hits, 21 met the inclusion criteria and were included in the review. A significant number (n = 9) were published in the last 8 years. All the studies were observational studies, with 20 out of 21 undertaken in North America or Europe. Most of them had small cohorts (range 4–29 participants). The findings were analysed narratively, to establish the issues identified in the included studies. Five broad themes emerged for future examination. These were: general thermal physiology; heat loss and respiratory monitoring; identification of internal pathologies, including necrotising enterocolitis; other uses of thermal imaging; and technical concerns. The findings suggest that thermal imaging is a reliable and non-invasive method for continuous monitoring of the emitted temperature of the neonates, with potential for contributing to the assurance of wellbeing, and to the diagnosis of pathologies, including internal abnormalities. However, the introduction of thermal imaging into everyday neonatology practice has several methodological challenges, including environmental parameters, especially when infants are placed in incubators or open radiant warmers.ConclusionIn conclusion, although the first attempt at using thermal imaging in neonatal care started in the early-1970s, with promising results, and subsequent small cohort studies have recently reinforced this potential, there have not been any large prospective studies in this area that examine both the benefits and the barriers to its use in practice.

Background: In most high and middle income countries across the world, at least 1:4 women give birth by cesarean\ud section. Rates of labour induction and augmentation are rising steeply; and in some countries up to 50 % of laboring\ud women and newborns are given antibiotics. Governments and international agencies are increasingly concerned about\ud the clinical, economic and psychosocial effects of these interventions.\ud \ud Discussion: There is emerging evidence that certain intrapartum and early neonatal interventions might affect the\ud neonatal immune response in the longer term, and perhaps trans-generationally. Two theories lead the debate in this\ud area. Those aligned with the hygiene (or ‘Old Friends’) hypothesis have examined the effect of gut microbiome colonization\ud secondary to mode of birth and intrapartum/neonatal pharmacological interventions on immune response and epigenetic\ud phenomena. Those working with the EPIIC (Epigenetic Impact of Childbirth) hypothesis are concerned with the effects of\ud eustress and dys-stress on the epigenome, secondary to mode of birth and labour interventions.\ud \ud Summary: This paper examines the current and emerging findings relating to childbirth and atopic/autoimmune\ud disease from the perspective of both theories, and proposes an alliance of research effort. This is likely to accelerate\ud the discovery of important findings arising from both approaches, and to maximize the timely understanding of the\ud longer-term consequences of childbirth practices.

Background\ud \ud Freebirthing or unassisted birth is the active choice made by a woman to birth without a trained professional present, even where there is access to maternity provision. This is a radical childbirth choice, which has potential morbidity and mortality risks for mother and baby. While a number of studies have explored women’s freebirth experiences, there has been no research undertaken in the UK. The aim of this study was to explore and identify what influenced women’s decision to freebirth in a UK context.\ud Methods\ud \ud An interpretive phenomenological approach was adopted. Advertisements were posted on freebirth websites, and ten women participated in the study by completing a narrative (n = 9) and/or taking part in an in-depth interview (n = 10). Data analysis was carried out using interpretative methods informed by Heidegger and Gadamer’s hermeneutic-phenomenological concepts.\ud Results\ud \ud Three main themes emerged from the data. Contextualising herstory describes how the participants’ backgrounds (personal and/or childbirth related) influenced their decision making. Diverging paths of decision making provides more detailed insights into how and why women’s different backgrounds and experiences of childbirth and maternity care influenced their decision to freebirth. Converging path of decision making, outlines the commonalities in women’s narratives in terms of how they sought to validate their decision to freebirth, such as through self-directed research, enlisting the support of others and conceptualising risk.\ud Conclusion\ud \ud The UK based midwifery philosophy of woman-centred care that tailors care to individual needs is not always carried out, leaving women to feel disillusioned, unsafe and opting out of any form of professionalised care for their births. Maternity services need to provide support for women who have experienced a previous traumatic birth. Midwives also need to help restore relationships with women, and co-create birth plans that enable women to be active agents in their birthing decisions even if they challenge normative practices. The fact that women choose to freebirth in order to create a calm, quiet birthing space that is free from clinical interruptions and that enhances the physiology of labour, should be a key consideration.