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Background: The high maternal and neonatal mortality rate in sub‐Saharan Africa could be reduced by using navigation by means of mobile devices to increase the number of women who choose to give birth in a health center (HC) with a skilled healthcare practitioner. Methods: A quasi‐experimental design was used to test a midwife‐delivered navigation by means of mobile phone. A total of 208 women were randomized to two groups (intervention and control). Women in the intervention group received up to three navigation calls from midwives. Women in the control group received usual antenatal education during prenatal visits. Data were collected using semistructured questionnaires. Childbirth location was determined through medical records. Results: Overall, 180 (87%) women gave birth in a HC with a 3% advantage for the intervention group. A total of 86% (88/102) of the control group gave birth in a HC versus 89% (92/103) for the intervention group (Χ2 = 0.44, p‐value = 0.51), with an unadjusted odds ratio of 1.33 (95% CI: 0.57, 3.09). Among those with personal phones, 91% (138/152) had a birth in a HC versus 79% (42/53) in those without a personal phone (Χ2 = 4.89, p‐value = 0.03). Conclusions: The results of this study indicate that it is feasible to deliver phone‐based navigation to support birth in a HC; personal phone ownership may be a factor in the success of this strategy. [ABSTRACT FROM AUTHOR]

Aim: To clarify the factor structure of "expectant mothers of concern" for whom midwives anticipate difficulties in future childrearing. Methods: The participants were 2633 midwives working at hospitals and clinics in Japan. Data were collected using a 108‐item, five‐point Likert scale questionnaire about the behaviors, appearance, and family relationships of the expectant mothers of concern to the nurses. Items with a mean equal to or greater than 4.0 were selected as items considered relevant to expectant mothers of concern by midwives. Exploratory factor analysis, confirmatory factor analysis, and further secondary factor analysis were conducted. Results: The factor structure of the expectant mothers of concern as perceived by midwives comprised seven factors, including 23 items: "Suspected of being a victim of intimate partner violence," "Uneasy feeling about the expectant mother's marital relationship," "Perception that the expectant mother is conflicted about her pregnancy," "Uneasy feeling about the expectant mother's actions/behaviors concerning her medical checkups," "Engages in physically risky actions and behaviors," "Does not appear to be able to build relationships with children," and "Makes remarks that indicate possible bonding disorder" (goodness‐of‐fit index = 0.910, adjusted goodness‐of‐fit index = 0.879, comparative fit index = 0.939, and root mean square error of approximation = 0.070). Further, a secondary factor, "Expectant mothers who must urgently be connected to support," was extracted. Conclusions: The elucidation of the factor structure of the expectant mothers of concern could help midwives identify expectant mothers who may face difficulties in future childrearing. [ABSTRACT FROM AUTHOR]

Background: On 9 June 2021, the Australian Technical Advisory Group on Immunisation and Royal Australian and New Zealand College of Obstetricians and Gynaecologists recommended that pregnant women receive Comirnaty (Pfizer) messenger RNA vaccine at any stage of pregnancy. Aim: This multi‐centre study aimed to assess vaccine acceptance, reasons for hesitancy and determine if differences exist between health districts, to inform future policy strategies for COVID‐19 vaccination in pregnancy. Materials and methods: An online survey (developed based on the World Health Organization Behavioural and Social Drivers survey and modified for the pregnant population) was administered to a sample population of pregnant women attending antenatal clinics at two metropolitan hospitals (Westmead and Royal North Shore Hospital (RNSH)) in New South Wales between 15 September 2021 and 22 October 2021. Results: There were 287 pregnant women surveyed (Westmead 198 (69%), RNSH 66 (23%), no site 23 (8%)). There was a significantly lower Socio‐Economic Indexes for Areas score (5.66 vs 9.45, P = 0.001), fewer women born in Australia (37% vs 53%, P = 0.02) and higher number of children (0.77 vs 0.41, P = 0.01) among Westmead respondents. There was lower vaccination uptake (68% vs 86%, P = 0.01) and willingness to receive vaccine (68% vs 88% P = 0.01) at Westmead compared to RNSH. There was an increased proportion of respondents who were concerned that the vaccine could cause harm to the unborn baby at Westmead (38% vs 11%, P = 0.01). Conclusions: Along with healthcare provider recommendation for vaccination in pregnancy, materials should be targeted to specific safety concerns of pregnant women. [ABSTRACT FROM AUTHOR]

Objective: To measure satisfaction with general practitioner obstetrician‐led maternity care in Western Australia and to explore perspectives of maternity service users Design: Women were recruited at antenatal visits with their general practitioner obstetrician. Participants completed a validated three‐part survey about their satisfaction with antenatal, intrapartum and postpartum care. They were all offered a semi‐structured interview. Setting: Nine general practitioner obstetrician practices located in regional Western Australia. Participants: 155 women receiving general practitioner obstetrician‐led maternity care within the South West or Great Southern regions of Western Australia. 13 of these women also participated in an interview. Main Outcome Measures: We quantified satisfaction with aspects of antenatal, intrapartum and postpartum care using a Likert scale. Descriptive variables included demographic information and birth outcomes. Qualitative data described valued aspects of maternity care. Results: 116 women completed all 3 surveys. General practitioner obstetrician‐led care resulted in high rates of satisfaction across all 3 stages of care, with 78%‐100% agreement with positively worded satisfaction statements. Thematic analysis identified four key aspects of care women valued when receiving maternity care: the woman‐centred care experience, the skills of the general practitioner obstetrician, support from the health care team and the health care environment. Conclusion: General practitioner obstetrician‐led maternity care is a highly regarded model of maternity care, valued by rural women with high rates of satisfaction. [ABSTRACT FROM AUTHOR]

Background: Registered midwives in British Columbia (BC) are primary health care practitioners for healthy people throughout pregnancy and for approximately 6 weeks postpartum. BC registered midwives are authorized to prescribe and administer certain vaccines to adults under their care during the perinatal period and hepatitis B vaccine to high‐risk newborns. However, little has been documented about their recommendations for, and administration of, prenatal and infant vaccinations. This study surveyed midwives currently practicing in British Columbia to understand their vaccination practices. Methods: An online survey was administered to the members of the Midwives Association of BC in spring 2018. Outcome measures were the proportion of midwives who discussed, recommended, and administered the following vaccines: influenza, varicella, rubella, and infant hepatitis B. The proportion of midwives who discussed and recommended infant vaccines was measured. Barriers to discussion, recommendation, and administration of vaccines were captured. Results: Sixty‐three percent of 108 respondents administered vaccines to their clients. Hepatitis B and rubella were the most frequent vaccines administered. Logistical concerns were the greatest barrier to vaccine administration. This was followed by the perception that vaccine administration is not within the scope of practice of midwives, especially for influenza vaccine. Midwives who administered vaccines were significantly more likely to discuss and recommend vaccines to their clients and their infants. Conclusions: The majority of BC midwives discuss, recommend, and administer vaccines to their clients. Our survey highlighted key areas to address to strengthen midwifery capacity to discuss, recommend, and provide prenatal and infant vaccines. [ABSTRACT FROM AUTHOR]

Background: This prospective study aims to investigate whether severe fear of childbirth increases pain perceptions during birth and whether co‐occurring maternal health and birth factors as well as length and weight of the child explain the association. Methods: The study sample comprised women with a vaginal delivery and was drawn from the Akershus Birth Cohort. Data from the hospital birth's record and questionnaires at weeks 17‐19 and 32 of pregnancy and 8 weeks postpartum were used (n = 1649). Analysis of variance and analysis of covariance were conducted to examine whether ratings of labor pain differed significantly between women with and without severe fear of childbirth and which factors explained the difference. Results: Women with severe fear of childbirth experienced significantly more labor pain than women without severe fear of childbirth (P < .01). However, when controlling for symptoms of maternal depression and anxiety, use of epidural/spinal anesthetic or nitrous oxide gas, and menstrual pain, this difference was no longer significant (P = .09). Discussion: Although the results show that labor pain is related to multiple physiological and psychological factors in a complex manner, symptoms of maternal depression and anxiety seem to play a central role for the experience of labor pain, and should therefore be focused on by health practitioners. [ABSTRACT FROM AUTHOR]

Background For safety reasons an in-hospital birth center was replaced by a modified form of birth center care with the same medical guidelines and equipment as in standard care. The aim of this study was to investigate women's and men's satisfaction with modified care compared with standard care. Methods Women in both groups gave birth from July 2007 to July 2008. The same medical low-risk criteria during pregnancy applied to both groups. Of those invited to the study, 547 (82.7%) women in modified birth center care and 445 (66.7%) men returned a questionnaire posted 2 months after the birth, and 786 (71.6%) women and 639 (58.2%) men in standard care. Odds ratios ( ORs) for being satisfied were calculated with 95 percent confidence intervals ( CIs) and adjusted for possible confounders. We also explored the effects of different components of care on overall satisfaction. Results Adjusted ORs for being satisfied overall were approximately doubled in the modified birth center group compared with the standard care group: antenatal care- OR: 2.1 (95% CI: 1.6-2.7) in women and OR: 2.2 (95% CI: 1.5-2.8) in men; intrapartum care- OR: 2.2 (95% CI: 1.7-2.9) in women and OR: 1.7 (95% CI: 1.3-2.4) in men; and postpartum care- OR: 1.7 in women (95% CI: 1.4-2.2) and OR: 2.1 (95% CI: 1.6-2.8) in men. Important explanations of these differences included perception of the midwife as being more supportive, the presence of a calmer environment and atmosphere (intrapartum), and the option for fathers to stay overnight (postpartum). Conclusion In-hospital birth center with medical equipment on site increased overall satisfaction with all episodes of care compared with standard care. ( BIRTH 39:2 June 2012) [ABSTRACT FROM AUTHOR]