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BACKGROUND:In addition to improving maternal and neonatal mortality and morbidity, the World Health Organization now additionally requests that maternity care providers provide high-quality respectful care to childbearing women. Within this study, providing respectful care surrounds helping women make decisions about whether or not to have their labor induced, which encompasses providing good care provider interaction(CPI) within a considerate and empathetic interface. With this in mind, we wanted to explore what prior studies report about women’s experiences of CPI when deciding whether or not to have their labor induced.METHOD:A narrative systematic review of qualitative literature was conducted.RESULTS:Nine articles published between 2010 and May 2022 met the inclusion criteria, from which four themes were identified: (a) involvement in the decision-making process; (b) risk awareness; (c) sources and format of the information; and (d) trust in the care provider. The synthesis of data showed that many women feel uninvolved in decision-making processes surrounding their induction of labor (IOL) and perceive that they were provided with minimal choice. While most women have high levels of trust in their care provider, risks surrounding continuing the pregnancy often remain undiscussed. Additionally, women sometimes feel rushed into making a decision, with a lack of information provided in the right format regarding potential risks that might be involved.CONCLUSIONS AND RECOMMENDATIONS:In full recognition that maternity care professionals are motivated to communicate effectively with women, it is important that the risks of having IOL are fully discussed. The information provided needs to be tailored in both content and format according to individualized needs. Women require to explore their options and be afforded time to ask questions prior to deciding whether or not to have their labor induced.

BACKGROUNDSatisfaction with the birth experience is increasingly recognized as critical to the well-being of mother and baby and thus accurate assessment of this key dimension is essential. The Birth Satisfaction Scale-Revised (BSS-R) has been shown to be a robust, valid, and reliable measure of birth experience. The current study sought to develop an Urdu version of the measure to be used in Pakistan.METHODSFollowing translation, a cross-sectional design was used to examine the measurement properties of the Pakistan (Urdu)-BSS-R (P-BSS-R). Participants were a purposive sample of Pakistani postnatal women (n= 200). Key psychometric properties were examined using Confirmatory Factor Analysis (CFA), internal consistency evaluation, and known-groups discriminant validity testing.RESULTSThe majority of measurement parameters for clinical application of the P-BSS-R were found to be acceptable with good known-groups discriminant validity and data fit to the tri-dimensional theoretical model of the BSS-R observed. However, some idiosyncratic observations were highlighted, including unexpected low internal consistency.CONCLUSIONSThe P-BSS-R was found to be a generally valid and reliable measure of the experience, a caveat being low internal consistency warranting further investigation.

BACKGROUNDBehavioral and medical science is currently in the grip of a “replication crisis,” circumscribed by the failure to replicate a large proportion of key studies and a consequential impact on confidence in the veracity of the scientific method. Given the contemporary nature of the debate it is surprising that the psychometric properties of commonly used outcome measures have not been evaluated in this context, despite the obvious potential for the measurement characteristics of the measures themselves to be a source of error within a study.The current investigation sought to replicate the original validation study of the Australian version of the 10-item Birth Satisfaction Scale—Revised (A-BSS-R) with respect to key psychometric aspects and the issues of replicability.METHODSA replication study of all quantitative aspects of Jefford et al. (2018) with an increased sample size. Participants were a purposive sample of Australian postnatal women (n= 445).RESULTSMost key quantitative aspects of the original validation study were found to be replicable and consistent with Jefford et al. (2018), the A-BSS-R was found to have excellent psychometric properties fundamentally mirroring the measurement characteristics observed previously. However, a small number of instances of nonreplicability were found.CONCLUSIONSThe A-BSS-R is a valid and reliable measure of birth satisfaction. Replicability, at least in part, is influenced by participant group characteristics, statistical power and sample size. More focus is required on the influence of self-report measures themselves on the germane aspects of successful study replication.

Turner syndrome (TS) is a cross-cultural genetic disorder that affects around 1 in 2500 women and is predominately associated with short stature and infertility. Classic TS occurs when one sex chromosome is missing (written as 45, X). In mosaic TS, there is a mix of cells, some with 45 chromosomes—missing one X chromosome, and some with all 46 chromosomes—missing part of the X chromosome. TS is characterised by short stature and non-functioning ovaries, which leads to impaired pubertal development and infertility. The majority of women with TS present with no behavioural or physical attributes that would distinguish them as different to the general population, and can be expected to live long and healthy lives. A midwife may have to care for a woman whose fetus has been diagnosed with TS, recognise and manage a newborn with TS, or manage a woman with TS who is pregnant with a donor ovum. To equip midwives with relevant knowledge, the objectives of this paper are to explain what TS is, how it may be recognised, and discuss medical and midwifery management of events.

Quality of life measures can be used by health professionals to assess effectiveness of nutritional interventions administered to palliative care patients. Stabilizing, maintaining and attempting to increase weight in palliative care patients through the support of oral feeding, and provision of artificial feeding, has been shown to mediate the metabolic and physical wasting effects of the disease process and improve general comfort. A quality of life instrument is a multi-dimensional questionnaire that health professionals can use to measure domains relating to physical, psychological and social aspects of living, and health and disease outcomes. There are three instruments specifically designed to assess quality of life in patients receiving palliative care. These are: The Palliative Care Quality of life Instrument, The Assessment of Quality of Life at the End of Life (AQEL), and The Spitzer Quality of Life Index (SQLI). General use quality of life measures are multifaceted; however, for use with palliative care patients, they have added dimensions of spirituality, existential issues (purpose and meaning of life), family members' perceptions of quality of care, symptom control and family support. Use of quality of life scales provides health professionals and organizations with an ideal measure for planning, targeting and evaluating health interventions.

Midwives are required to develop effective and constructive communication skills for use within the workplace. When a student is on placement, the Nursing and Midwifery Council (NMC) essential skills clusters for care, compassion and communication are the first skills students are required to demonstrate to their mentor. Communication is an idiom that both students and staff sometimes find difficult to assimilate, with communication problems identified in vague terms. Accordingly, methods of clearly defining and assessing attainment are commonly requested of midwifery lecturers. To facilitate students, midwives, managers and lecturers with an instrument to assess good communication, the technique of transactional analysis (TA) is proposed.

Bullying and harassment is a significant predicament that midwives face on a regular basis. Bullying and harassment may be characterized by unpleasant, threatening, malevolent or offensive behaviour. It involves abuse or misuse of power intended to undermine, humiliate, denigrate or harm the recipient. Deliberate bullying and/or harassment can have a major impact upon physical and mental health, as well as function within role. There are consequences for the persecutor, victim and institution in terms of health, cost and reputation. The objective of this paper is to provide managers with solutions to diminish levels of bullying and harassment within maternity units. To this effect, a bullying and harassment protocol has been written to guide managers to use appropriate strategies to diminish the intensity of bullying and harassment within their unit. To audit success, a Bullying and Harassment Scale (BAHS)has been devised to measure effectiveness of interventions targeted at reducing the problem.

The aim of this article is to relate basic findings from research papers to identify the effects that valsalva manoeuvre (‘purple pushing’) has upon maternal and fetal wellbeing. Analysis of 16 papers revealed four main consequences from purple pushing. These include: an increase in fetal distress; maternal distress; and perineal trauma, when compared with spontaneous pushing. Valsalva manoeuvre also makes little difference to length of second stage. Key conclusions from this literature review are that women should be encouraged to push instinctively, which often embraces natural vocalization. Restrictions of time should not be imposed when mother and fetus are well. Awaiting instinctive behaviour reduces the incidence of urinary system, pelvic floor and perineal trauma. These findings should facilitate midwives to critically understand research that underpins the Royal College of Midwives (2007) second stage of labour guidelines.

If women are to be empowered to make choices for childbirth, it is important that midwives explore and discuss their wishes and feelings about the delivery options available. Providing practical and sensible information should facilitate women with constructing a more accurate picture from which realistic hopes, fears and expectations can be formulated about impending labour. To facilitate midwives with this process, a flexible framework for a birth plan has been proposed. This easy to complete template can be used to assist childbearing women with assimilating their ambitions and desires regarding labour. Birth planning is important, since studies that compare women's expectations of childbirth with actual experience present contrasting accounts, with disappointment, guilt and failure compared with delight, pride and success. Since experiences differ it is recommended that midwives audit birth satisfaction against women's birth plans. Results would inform auditors of whether there is satisfaction with a woman's birth experience and the quality of care that she perceived she received. Women's articulated wishes about birth would facilitate understanding of why satisfaction/dissatisfaction occurs.

The aim was to develop a scale—the Birth Participation Scale (BPS)—which midwives can use to measure fathers' attitudes and needs in relation to birth participation. The objectives were to use the BPS to: detect whether fathers genuinely want to be present at the birth; identify localized perceptions and fears fathers may have about birth participation; and ascertain whether being present at the birth was a rewarding experience. A quantitative survey was carried out with data collected from York District Hospital Maternity Unit (UK). The participants were a stratified sample of first-time (n= 42) and second-time fathers (n= 36). Measurements and findings: the BPS was issued at two observation points: prior to birth participation and post birth participation. Difference in scores between conditions assessed the fathers' attitudes towards birth participation in a positive or negative direction. Scores post birth showed a small shift in attitude in a positive direction for first-time (p= 0.01) and second-time fathers (p= 0.02) with only 4% finding birth partnering more difficult than they had anticipated. Key conclusions are that midwives are facilitating the majority of fathers towards a positive birth experience. Implications for practice are that the BPS may prove useful for: identifying whether fathers genuinely want to be present at the birth; ascertaining fathers' personal concerns in relation to birth participation; and tailoring birth preparation to meet fathers individualized needs.

In some instances midwives find it difficult to implement research into practice (Albers, 2001). For example, evidence informs of the benefits of providing continuous support during labour (Hodnett et al, 2003), yet one midwife to one woman is not compulsory in every maternity unit in the UK. Olsen (1997) meta-analyzed research that relates to the relative safety of home birth compared to hospital birth. Results found no difference in survival rates between babies born at home and those born in hospital. Amniotomy is still a common procedure, yet contra-indicated since fetal heart abnormalities are more likely in the healthy term fetus (Fraser et al, 1993). Such examples serve to sharpen awareness that some research is being overlooked. Consequently ideas about how to narrow the theory–practice gap become salient. With this in mind a model is proposed to help midwives implement change into practice. Changing behaviour is possible when logical structured approaches are taken at a number of levels.