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Background: Little is known about the full scope of emotional wellbeing of mothers up to one year postpartum, to adequately support women during transition to motherhood. Reduced emotional wellbeing (REW) affects women's adaption to the changes and challenges in becoming a mother. We aimed to increase the knowledge and understanding of mothers' emotional wellbeing and the influencing factors., Methods: This cross-sectional study includes 385 Flemish mothers up to one year postpartum. Online data were collected with the General Health Questionnaire-12, Postpartum Bonding Questionnaire, Personal Well-Being Index-Adult, The Basic Psychological Needs Scale, Sense of Coherence-13 and Coping Operations Preference Enquiry., Results: A total of 63.9% of the participants reported REW. Mothers with REW more often had (a history of) psychological problems compared to mothers with healthy emotional wellbeing (p = 0.007). Multiple linear regression analysis showed negative associations between emotional wellbeing and satisfaction (p = 0.002; p < 0.001), comprehensibility (p = 0.013) and positive associations between emotional wellbeing and bonding (p < 0.001), manageability (p = 0.033), problem solving (p = 0.030) and avoidance (p = 0,011) - with an explained variance of 55.5%., Limitations: Some limitations of our study are the GHQ-12 cut-off value, the nature and implication of (a history of) psychological problems and the self-selected population., Conclusion: It would be of worth for midwives to discuss with mothers (to be) what to expect. This - to support mothers in making sense of their life as a mother and how various factors might influence their emotional wellbeing. The high prevalence of REW is worrying, but needs to be interpreted with caution., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: Mental health of students in higher education was affected during the COVID-19 pandemic., Aim: To examine the emotional wellbeing of midwifery students in the Netherlands and Flanders (Belgium) during COVID-19., Methods: A cross-sectional online-based survey with 619 Dutch and Flemish midwifery students. Sociodemographic details were obtained. Anxiety and depression were measured twice (T1, T2) during the COVID-19 pandemic., Findings: Flemish students had significantly higher mean depression and anxiety scores than Dutch students during the total period of study (p < .001; p < .001). Total group mean depression and anxiety scores were significantly higher at T2 compared to T1 (p < .001; p < .001). In the Dutch student group, there was a significant increase of depression from T1 to T2 (p < .001). In the Flemish student group, both depression and anxiety scores significantly increased from T1 to T2 (p < .001; p < .001). A history of psychological problems predicted both depression and anxiety, irrespective of COVID-19 period or country (p < .001; p < .001). Being single (p.015) and having a job (p.046) predicted depression, irrespective of period or country. A history of psychological problems predicted depression (p.004; p < .001) and anxiety (p.003; p.001) during the total period of study. Being single also predicted depression during T2 (p.024)., Conclusion: These findings inform how emotional wellbeing of midwifery students was affected during the COVID-19 pandemic and identify those students that might need extra attention after the pandemic, during another pandemic or similar situations with social restrictions., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Funding Interreg 2 Seas Mers Zeeën https://www.interreg2seas.eu/nl [grant number 2S05-002, 2019], Province Antwerp Service for Europe, Department of Economy, Local Policies and Europe [grant number BBSPATH 1564468860780, 2019]., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Problem: Within maternity care policies and practice, pregnant migrant women are regarded as a vulnerable population., Background: Women's experiential knowledge is a key element of woman-centred care but is insufficiently addressed in midwifery practice and research that involves migrant women., Aim: To examine if pregnant migrant women's experiential knowledge of vulnerability corresponds with sets of criteria of vulnerability, and to explore how migrant women make sense of vulnerability during pregnancy., Methods: A sequential two-phased mixed-methods study, conducted in the Netherlands, integrating survey data of 89 pregnant migrant women and focus group data obtained from 25 migrant mothers - living in deprived areas according to the Dutch socio-economic index., Results: Criteria associated with vulnerability were reported by 65.2% of the participants and 62.9% of the participants reported adverse childhood experiences. On a Visual Analogue Scale, ranging from 0 (not vulnerable) to 10 (very vulnerable), participants self-reported sense of vulnerability showed a mean score of 4.2 (±2.56). Women's experiential knowledge of vulnerability significantly correlated with the mean sum score of clinical criteria of vulnerability (r .46, p .002) and with the mean sum score of adverse childhood experiences (r .48, p<.001). Five themes emerged from the focus group discussions: "Look beyond who you think I am and see and treat me for who I really am", "Ownership of truth and knowledge", "Don't punish me for being honest", "Projection of fear" and "Coping with labelling"., Conclusion: Pregnant migrant women's experiential knowledge of vulnerability is congruent with the criteria. Calling upon experiential knowledge is an attribute of the humane woman-midwife relationship., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Midwifery practice is in the process of continuing developments and contemporary working conditions asking for proactive behaviour, which could increase work-efficiency, job satisfaction, commitment and coping attitudes towards stress resistance. This study aims to provide an in depth exploration of midwives' perceptions of facilitators and/or barriers of proactive behaviour in midwifery practice., Methods: A qualitative descriptive study, using individual semi-structured interviews, was undertaken within a sample of 102 Flemish and Dutch midwives who were interviewed from September to December 2017 using a four-item topic-list., Results: Six influencing factors emerged from the data consisted of the causal, contextual and conditional factors faced by the midwives in order to show proactive behaviour in midwifery practice. Midwives elaborated the need for team consultations, a safe organizational culture, an appreciative midwifery leader and an attitude of lifelong learning. Furthermore, midwives are looking for a way to deal with both challenges in healthcare and the competitive societal system., Conclusion: This inductive study confirmed, supported and expanded previous deductive research and provided additional insights of proactive behaviour in midwifery. Providing midwives with knowledge of the influencing factors, required to successfully effecting proactive behaviour in midwifery, this study has subsequently merit for future research in the transfer of recommendation in daily midwifery practice, education and policymaking., (Copyright © 2019 Elsevier B.V. All rights reserved.)