186 results on '"Downe, Soo"'
Search Results
2. ‘To be Informed and Involved’: Women's insights on optimising childbirth care in Lithuania
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Širvinskienė, Giedrė, Grincevičienė, Švitrigailė, Pranskevičiūtė‐Amoson, Rasa, Kukulskienė, Milda, Downe, Soo, Širvinskienė, Giedrė, Grincevičienė, Švitrigailė, Pranskevičiūtė‐Amoson, Rasa, Kukulskienė, Milda, and Downe, Soo
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Introduction The user expectations and experiences of healthcare services are acknowledged as components of the quality of healthcare evaluations. The aim of the study is to analyse women's experiences and views on childbirth care in Lithuania. Methods The study used the Babies Born Better (B3) online survey as the data collection instrument. The B3 is an ongoing longitudinal international project, examining the experiences of intrapartum care and developed as part of EU-funded COST Actions (IS0907 and IS1405). Responses to open-ended questions about (1) the best things about the care and (2) things in childbirth care worth changing are included in the current analysis. The participants are 373 women who had given birth within 5 years in Lithuania. A deductive coding framework established by the literature review was used to analyse the qualitative data. The framework involves three main categories: (1) the service, (2) the emotional experience and (3) the individually experienced care, each further divided into subcategories. Results Reflecting the experience and views regarding the service at birthplace women wished empowerment, support for their autonomy and to be actively involved in decisions, the need for privacy, information and counselling, especially about breastfeeding. In terms of emotional experience, women highlighted the importance of comprehensibility/feeling of safety, positive manageability of various situations and possibilities for bonding with the newborn. Individually experienced care was described by feedback on specific characteristics of care providers, such as competence, personality traits, time/availability and encouragement of esteem in women in childbirth. The possibilities of homebirth were also discussed. The findings reflected salutogenic principles. Key Conclusions The findings suggest that the Lithuanian healthcare system is in a transition from paternalistic attitude-based practices to a shift towards patient-oriented care. Impleme
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- 2023
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3. Decision‐making and future pregnancies after a positive fetal anomaly screen: A scoping review
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Shorey, Shefaly, Lalor, Joan, Pereira, Travis Lanz‐Brian, Jarašiūnaitė‐Fedosejeva, Gabija, Downe, Soo, Shorey, Shefaly, Lalor, Joan, Pereira, Travis Lanz‐Brian, Jarašiūnaitė‐Fedosejeva, Gabija, and Downe, Soo
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Aims and Objectives To examine and consolidate literature on the experiences and decision-making of parents following a screen positive result for a potential fetal anomaly and/or diagnosis of an actual anomaly in a previous pregnancy. Background Prenatal screening consists of any diagnostic modality that is aimed at acquiring information about a fetus or an embryo; however, the entire process is highly stressful for parents, especially if there was a previous screen positive result, but no abnormality was detected in the final result. Methods Eight electronic databases (PubMed, Embase, CINAHL, PsycINFO, Scopus, Web of Science, ProQuest Theses and Dissertations and ClinicalTrials.gov) were searched from each database's inception until February 2022. This scoping review was guided by Arksey and O'Malley's framework and was reported in accordance with the PRISMA-ScR checklist. Braun and Clarke's thematic analysis framework was utilised. Results Thirty-one studies were eligible for inclusion. Two main themes (reliving the fear while maintaining hope, and bridging the past and future pregnancies) and six subthemes were identified. Conclusions A fetal anomaly diagnosis in pregnancy had a mixed impact on the attitudes of parents toward a future pregnancy. Some parents were fearful of reliving a traumatic experience, while others were determined to have a healthy child and grow their family. Parents generally expressed a greater preference for non-invasive over invasive prenatal testing due to the procedural risks involved. Relevance to Clinical Practice There is a need for healthcare professionals to provide psychosocial and emotional support to parents so that they can achieve resolution for their previous pregnancy. Healthcare professionals' ability to provide informational support also enables these parents to make informed decision and understand their reproductive outcomes. Additionally, healthcare administration and policymakers should reconsider current neonatal or
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- 2023
4. Trends and motivations for freebirth: A scoping review
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Shorey, Shefaly, Jarašiūnaitė‐Fedosejeva, Gabija, Akik, Burcu Kömürcü, Holopainen, Annaleena, Isbir, Gozde Gokce, Chua, Jing Shi, Wayt, Carly, Downe, Soo, Lalor, Joan, Shorey, Shefaly, Jarašiūnaitė‐Fedosejeva, Gabija, Akik, Burcu Kömürcü, Holopainen, Annaleena, Isbir, Gozde Gokce, Chua, Jing Shi, Wayt, Carly, Downe, Soo, and Lalor, Joan
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Background Even when maternity care facilities are available, some women will choose to give birth unassisted by a professional (freebirth). This became more apparent during the pandemic of coronavirus disease 2019 (COVID-19), as women were increasingly concerned they would contract the virus in health care facilities. Several studies have identified the factors that influence women to seek alternative places of birth to hospitals, but research focusing specifically on freebirth is limited. Methods Eight databases were searched from their respective inception dates to April 2022 for studies related to freebirth. Data from the studies were charted and a thematic analysis was subsequently conducted. Results Four themes were identified based on findings from the 25 included studies: (1) Geographical and socio-demographic determinants influencing freebirth, (2) Reasons for choosing freebirth, (3) Factors hindering freebirth, and (4) Preparation for and varied experiences of freebirth. Discussion More women chose to give birth unassisted in low- and middle-income countries (LMICs) compared with high-income countries (HICs). Overall, motivation for freebirth included previous negative birth experiences with health care professionals, a desire to adhere to their birth-related beliefs, and fear of contracting the COVID-19 virus. Included studies reported that study participants were often met with negative responses when they revealed that they were planning to freebirth. Most women in the included studies had positive freebirth experiences. Future research should explore the different motivators of freebirth present in LMICs or HICs to help inform effective policies that may improve birth experiences while maintaining safety.
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- 2023
5. Women's negative childbirth experiences and socioeconomic factors: results from The Babies Born Better survey
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Vedeler, Carina, Eri, Tine Schauer, Nilsen, Roy Miodini, Blix, Ellen, Downe, Soo, van der Wel, Kjetil, Nilsen, Anne Britt Vika, Vedeler, Carina, Eri, Tine Schauer, Nilsen, Roy Miodini, Blix, Ellen, Downe, Soo, van der Wel, Kjetil, and Nilsen, Anne Britt Vika
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Introduction/Purpose: To investigate the association between women's socioeconomic status and overall childbirth experience and to explore how women reporting an overall negative birth experience describe their experiences of intrapartum care. Methods: We used both quantitative and qualitative data from the Babies Born Better (B3) survey version 2, including a total of 8317 women. First, we performed regression analyses to explore the association between women's socioeconomic status and labor and birth experience, and then a thematic analysis of three open-ended questions from women reporting a negative childbirth experience (n = 917). Results: In total 11.7% reported an overall negative labor and birth experience. The adjusted odds ratio (OR) of a negative childbirth experience was elevated for women with non-tertiary education, for unemployed, students and those not married or cohabiting. Women with lower subjective living standard had an adjusted OR of 1.70 (95% confidence interval [CI] 1.44–2.00) for a negative birth experience, compared with those with average subjective living standard. The qualitative analysis generated three themes: (1) uncompassionate care – lack of sensitivity and empathy, (2) impersonal care – feeling objectified, and (3) critical situations – feeling unsafe and loss of control. Conclusions: Important socioeconomic disparities in women's childbirth experiences exist even in the Norwegian setting. Women reporting a negative childbirth experience described disrespect and mistreatment as well as experiences of insufficient attention and lack of awareness of individual and emotional needs during childbirth. The study shows that women with lower socioeconomic status are more exposed to these types of experiences during labor and birth.
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- 2023
6. Decision‐making and future pregnancies after a positive fetal anomaly screen: A scoping review
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Shorey, Shefaly, primary, Lalor, Joan, additional, Pereira, Travis Lanz‐Brian, additional, Jarašiūnaitė‐Fedosejeva, Gabija, additional, and Downe, Soo, additional
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- 2023
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7. Trends and motivations for freebirth: A scoping review
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Shorey, Shefaly, primary, Jarašiūnaitė‐Fedosejeva, Gabija, additional, Akik, Burcu Kömürcü, additional, Holopainen, Annaleena, additional, Isbir, Gozde Gokce, additional, Chua, Jing Shi, additional, Wayt, Carly, additional, Downe, Soo, additional, and Lalor, Joan, additional
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- 2023
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8. Induction of labour and emergency caesarean section in English maternity services: Examining outcomes is needed before recommending changes in practice
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Seijmonsbergen‐Schermers, Anna, primary, Peters, Lilian L., additional, Downe, Soo, additional, Dahlen, Hannah, additional, and de Jonge, Ank, additional
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- 2022
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9. IMAgiNE EURO: Data for action on quality of maternal and newborn care in 20 European countries during the COVID‐19 pandemic
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Beňová, Lenka, primary, Lawn, Joy E., additional, Graham, Wendy, additional, Chapin, Elise M., additional, Afulani, Patience A., additional, Downe, Soo, additional, Hailegebriel, Tedbabe Degefie, additional, Lincetto, Ornella, additional, and Sacks, Emma, additional
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- 2022
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10. Routine vaginal examinations compared to other methods for assessing progress of labour to improve outcomes for women and babies at term
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Moncrieff, Gill, Gyte, Gillian ML, Dahlen, Hannah G, Thomson, Gillian, Singata-Madliki, Mandisa, Clegg, Andrew, and Downe, Soo
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Male ,Chorioamnionitis ,Labor, Obstetric ,Pregnancy ,Infant, Newborn ,Humans ,Infant ,Pain ,Female ,Pharmacology (medical) ,Gynecological Examination ,B720 ,Dystocia - Abstract
Routine vaginal examinations are undertaken at regular time intervals during labour to assess whether labour is progressing as expected. Unusually slow progress can be due to underlying problems, described as labour dystocia, or can be a normal variation of progress. Evidence suggests that if mother and baby are well, length of labour alone should not be used to decide whether labour is progressing normally. Other methods to assess labour progress include intrapartum ultrasound and monitoring external physical and behavioural cues. Vaginal examinations can be distressing for women, and overdiagnosis of dystocia can result in iatrogenic morbidity due to unnecessary intervention. It is important to establish whether routine vaginal examinations are effective, both as an accurate measure of physiological labour progress and to distinguish true labour dystocia, or whether other methods for assessing labour progress are more effective. This Cochrane Review is an update of a review first published in 2013.To compare the effectiveness, acceptability, and consequences of routine vaginal examinations compared with other methods, or different timings, to assess labour progress at term.For this update, we searched Cochrane Pregnancy and Childbirth Trials Register (which includes trials from CENTRAL, MEDLINE, Embase, CINAHL, and conference proceedings) and ClinicalTrials.gov (28 February 2021). We also searched the reference lists of retrieved studies.We included randomised controlled trials (RCTs) of vaginal examinations compared with other methods of assessing labour progress and studies assessing different timings of vaginal examinations. Quasi-RCTs and cluster-RCTs were eligible for inclusion. We excluded cross-over trials and conference abstracts.Two review authors independently assessed all studies identified by the search for inclusion in the review. Four review authors independently extracted data. Two review authors assessed risk of bias and certainty of the evidence using GRADE.We included four studies that randomised a total of 755 women, with data analysed for 744 women and their babies. Interventions used to assess labour progress were routine vaginal examinations, routine ultrasound assessments, routine rectal examinations, routine vaginal examinations at different frequencies, and vaginal examinations as indicated. We were unable to conduct meta-analysis as there was only one study for each comparison. All studies were at high risk of performance bias due to difficulties with blinding. We assessed two studies as high risk of bias and two as low or unclear risk of bias for other domains. The overall certainty of the evidence assessed using GRADE was low or very low. Routine vaginal examinations versus routine ultrasound to assess labour progress (one study, 83 women and babies) Study in Turkey involving multiparous women with spontaneous onset of labour. Routine vaginal examinations may result in a slight increase in pain compared to routine ultrasound (mean difference -1.29, 95% confidence interval (CI) -2.10 to -0.48; one study, 83 women, low certainty evidence) (pain measured using a visual analogue scale (VAS) in reverse: zero indicating 'worst pain', 10 indicating no pain). The study did not assess our other primary outcomes: positive birth experience; augmentation of labour; spontaneous vaginal birth; chorioamnionitis; neonatal infection; admission to neonatal intensive care unit (NICU). Routine vaginal examinations versus routine rectal examinations to assess labour progress (one study, 307 women and babies) Study in Ireland involving women in labour at term. We assessed the certainty of the evidence as very low. Compared with routine rectal examinations, routine vaginal examinations may have little or no effect on: augmentation of labour (risk ratio (RR) 1.03, 95% CI 0.63 to 1.68; one study, 307 women); and spontaneous vaginal birth (RR 0.98, 95% CI 0.90 to 1.06; one study, 307 women). We found insufficient data to fully assess: neonatal infections (RR 0.33, 95% CI 0.01 to 8.07; one study, 307 babies); and admission to NICU (RR 1.32, 95% CI 0.47 to 3.73; one study, 307 babies). The study did not assess our other primary outcomes: positive birth experience; chorioamnionitis; maternal pain. Routine four-hourly vaginal examinations versus routine two-hourly examinations (one study, 150 women and babies) UK study involving primiparous women in labour at term. We assessed the certainty of the evidence as very low. Compared with routine two-hourly vaginal examinations, routine four-hourly vaginal examinations may have little or no effect, with data compatible with both benefit and harm, on: augmentation of labour (RR 0.97, 95% CI 0.60 to 1.57; one study, 109 women); and spontaneous vaginal birth (RR 1.02, 95% CI 0.83 to 1.26; one study, 150 women). The study did not assess our other primary outcomes: positive birth experience; chorioamnionitis; neonatal infection; admission to NICU; maternal pain. Routine vaginal examinations versus vaginal examinations as indicated (one study, 204 women and babies) Study in Malaysia involving primiparous women being induced at term. We assessed the certainty of the evidence as low. Compared with vaginal examinations as indicated, routine four-hourly vaginal examinations may result in more women having their labour augmented (RR 2.55, 95% CI 1.03 to 6.31; one study, 204 women). There may be little or no effect on: • spontaneous vaginal birth (RR 1.08, 95% CI 0.73 to 1.59; one study, 204 women); • chorioamnionitis (RR 3.06, 95% CI 0.13 to 74.21; one study, 204 women); • neonatal infection (RR 4.08, 95% CI 0.46 to 35.87; one study, 204 babies); • admission to NICU (RR 2.04, 95% CI 0.63 to 6.56; one study, 204 babies). The study did not assess our other primary outcomes of positive birth experience or maternal pain.Based on these findings, we cannot be certain which method is most effective or acceptable for assessing labour progress. Further large-scale RCT trials are required. These should include essential clinical and experiential outcomes. This may be facilitated through the development of a tool to measure positive birth experiences. Data from qualitative studies are also needed to fully assess whether methods to evaluate labour progress meet women's needs for a safe and positive labour and birth, and if not, to develop an approach that does.
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- 2022
11. “Never waste a crisis”; a commentary on the COVID‐19 pandemic as a driver for innovation in maternity care
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Van Den Berg, Lauri M. M., Thomson, Gillian, Jonge, Ank, Balaam, Marie-Clare, Moncrieff, Gill, Topalidou, Anastasia, Downe, Soo, Van Den Berg, Lauri M. M., Thomson, Gillian, Jonge, Ank, Balaam, Marie-Clare, Moncrieff, Gill, Topalidou, Anastasia, and Downe, Soo
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The coronavirus (COVID-19) pandemic has resulted in rapid changes in many areas of health care worldwide.1 Some organisational and governance controls on innovation have been relaxed, to enable rapid adaptation to changing circumstances. The speed of innovation raises a range of ethical, governance and organisational issues. It is important to assess what changes have been instituted, which ones should be maintained, and how to encourage effective innovations in future. Maternity care provides an exemplar case within the broader health care setting, given the imperative to provide both safe and personalised care for optimal outcomes. Some pandemic-related changes in maternity services, such as restricting women’s opportunities for companionship during ultrasound scans or throughout labour, or limiting parental visiting to neonatal units, have been associated with psychological harm.2 Other changes provide more positive impacts, including reports of more individualised and efficient care associated with the increased use of telemedicine.3 We undertook a documentary analysis of national policy and service-user organisation responses to the pandemic in the United Kingdom (UK) and the Netherlands (NL), as part of the Achieving Safe and Personalised Maternity Care In Response to Epidemics (ASPIRE COVID-19) study. The overall aim of ASPIRE COVID-19 is to identify ‘what works’ in providing maternity care during the current and future pandemics, or similar health crises. The NL was chosen as the comparator to the UK because there were known differences in the organisation of maternity services during the COVID-19 pandemic between the two countries, especially for place of birth. Here we report on activities described as new or expanded innovations in 290 documents produced by seventeen key professional and service-user organisations in the NL and the UK between February and December 2020 (see Table 1). We included strategic papers, guidelines, protocols, and updates for hea
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- 2022
12. Informed consent should be obtained before vaginal birth AGAINST: Informed consent should not be obtained before vaginal birth
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Downe, Soo and Downe, Soo
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- 2022
13. What women emphasise as important aspects of care in childbirth - an online survey
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Vedeler, Carina, Nilsen, Anne Britt Vika, Blix, Ellen, Downe, Soo, Eri, Tine S., Vedeler, Carina, Nilsen, Anne Britt Vika, Blix, Ellen, Downe, Soo, and Eri, Tine S.
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Objective To explore and describe what women who have given birth in Norway emphasise as important aspects of care during childbirth. Design The study is based on data from the Babies Born Better survey, version 2, a mixed-method online survey. Setting The maternity care system in Norway. Study population Women who gave birth in Norway between 2013 and 2018. Method Descriptive statistics were used to describe sample characteristics and to compare data from the B3 survey with national data from the MBRN, using SPSS® software (version 20). The open-ended questions were analysed with an inductive thematic analysis, using NVIVO 12® software. Main outcome measures Themes developed from two open-ended questions. Results The final sample included 8,401 women. There were no important differences between the sample population and the national population with respect to maternal age, marital status, parity, mode of birth and place of birth, except for the proportion of planned homebirths. Four themes and one overarching theme were identified; Compassionate and Respectful Care, A Family Focus, Continuity and Consistency, and Sense of Security, and the overarching theme Coherence in Childbearing. Conclusions Socio-cultural and psychological aspects of care are significant for women in childbirth, alongside physical and clinical factors. Caring for the woman implies caring for her partner and having a baby is about ‘becoming a family or expanding the family’. Childbirth is a continuous experience in women’s lives and continuity and consistency are important for women to maintain and promote a coherent experience.
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- 2022
14. Induction of labour and emergency caesarean section in English maternity services: Examining outcomes is needed before recommending changes in practice
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Seijmonsbergen‐Schermers, Anna, Peters, Lilian L., Downe, Soo, Dahlen, Hannah, de Jonge, Ank, Seijmonsbergen‐Schermers, Anna, Peters, Lilian L., Downe, Soo, Dahlen, Hannah, and de Jonge, Ank
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- 2022
15. IMAgiNE EURO: Data for action on quality of maternal and newborn care in 20 European countries during the COVID-19 pandemic
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Behova, Lenka, Graham, Wendy, Chapin, Elise M., Afulani, Patience, Downe, Soo, Hallegebriel, Tedbabe Degefie, Lincetto, Ornella, Sacks, Emma, Behova, Lenka, Graham, Wendy, Chapin, Elise M., Afulani, Patience, Downe, Soo, Hallegebriel, Tedbabe Degefie, Lincetto, Ornella, and Sacks, Emma
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- 2022
16. Informed consent should be obtained before vaginal birth
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Downe, Soo, primary
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- 2022
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17. Impact of a quality improvement project to reduce the rate of obstetric anal sphincter injury: a multicentre study with a stepped-wedge design
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Scamell, Mandie, Thornton, Jim, Hales, Katherine, Renfew, Mary, Dahlen, Hannah, Jowit, Margret, Downe, Soo, Gillman, Lindsay, Grace, Nicky, Wiseman, Octavia, Forman, Jane, Davis, Deborah, Madeley, Anna-Marie, Chippington, Debbie, Lawther, Lorna, and Burns, Ethel
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RG - Published
- 2021
18. WHO next generation partograph: revolutionary steps towards individualised labour care
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Hofmeyr, G. Justus, Bernitz, Stine, Bonet, Mercedes, Bucagu, Maurice, Dao, Blami, Downe, Soo, Galadanci, Hadiza, Homer, Caroline S.E., Hundley, Vanora, and Et, Al
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B720 - Abstract
In 1972, two landmark papers in this journal described the partograph,1,2 a chart designed to provide finite referral criteria for midwives working in peripheral clinics who needed to refer women in labour to Harare Hospital, Zimbabwe (then Rhodesia). This innovation coincided with influential reports from the National Maternity Hospital in Dublin of the ‘active management of labour’ (early amniotomy, proactive use of oxytocin and one‐to‐one nursing care) with the objective of achieving birth within a limited time frame.3 The partograph was globally adopted, and has been used as part of the assessment of labour progress for nearly half a century. It was recommended by the World Health Organization (WHO) in the early 1990s as a routine tool for displaying the progress of labour. Despite its global acceptance, utilization and correct completion rates as low as 31% and 3% respectively, have been reported.
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- 2021
19. Cultural competence and experiences of maternity health care providers on care for migrant women: A qualitative meta‐synthesis
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Shorey, Shefaly, primary, Ng, Esperanza Debby, additional, and Downe, Soo, additional
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- 2021
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20. “Balancing restrictions and access to maternity care for women and birthing partners during the COVID-19 pandemic: the psychosocial impact of suboptimal care”
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Lalor, Joan, Ayers, Susan, Agius, Jean Celleja, Downe, Soo, Gouni, Olga, Hartmann, Katharina, Nieuwenhuijze, Marianne, Oosterman, Mirjam, Turner, Jonathan D., Et, Al, Lalor, Joan, Ayers, Susan, Agius, Jean Celleja, Downe, Soo, Gouni, Olga, Hartmann, Katharina, Nieuwenhuijze, Marianne, Oosterman, Mirjam, Turner, Jonathan D., and Et, Al
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The women’s right to respectful and dignified care during labour and childbirth is strategically accepted [1]. As management committee members of the EU COST Action CA18211 network (‘DEVOTION’) focused on traumatic childbirth (www.ca18211.eu), we are concerned with ensuring a positive birth experience for all. We work on a pan-European level to ensure women’s rights to give birth in a clinically and psychologically safe environment including during the current COVID-19 pandemic.
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- 2021
21. Cultural competence and experiences of maternity health care providers on care for migrant women: A qualitative meta-synthesis
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Shorey, Shefaly, Ng, Esperanza Debby, Downe, Soo, Shorey, Shefaly, Ng, Esperanza Debby, and Downe, Soo
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The United Nations Sustainable Development Goals 2030 aim to reduce health care inequity and maternal and infant mortality rates amongst marginalized populations. To provide adequate and culturally relevant maternity care for minority ethnic groups, it is imperative to examine health care providers' views on care for migrant women. We reviewed published accounts of views and experiences of maternity health care providers providing maternity care for migrant women as a way of exploring their cultural competency. A qualitative meta-synthesis was conducted. Systematic searches were conducted in five electronic databases from inception dates through February 2021. Qualitative data were analyzed using a framework thematic analysis based on Campinha-Bacote's five-component cultural competency model. Eleven studies were included. Findings were presented according to Campinha-Bacote's model: cultural awareness, cultural knowledge (personal responsibility, familial role and cultural influence, the influence of social and system factors, conflicting maternity care expectations), cultural encounter (language and communication), and cultural desire (establishing trust and going the extra mile, resources to boost culturally competent care). Our findings can inform the design of high-quality behavioral change, health care management, sociological, and other relevant studies, along with reviews of what matters to service users about cultural responsiveness. Our data also suggest that health system constraints can exacerbate the lack of cultural competency. Improving the quality of care for migrant communities will necessitate a joint effort between health care organizations, health care providers, policymakers, and researchers in developing and implementing more culturally relevant maternity care policies and management interventions. [Abstract copyright: © 2021 Wiley Periodicals LLC.]
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- 2021
22. A survey of university students’ preferences for midwifery care and community birth options in 8 high‐income countries
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Stoll, Kathrin H., Downe, Soo, Edmonds, Joyce, Gross, Mechthild M., Malott, Anne, McAra‐Couper, Judith, Sadler, Michelle, Thomson, Gill, Stoll, Kathrin H., Downe, Soo, Edmonds, Joyce, Gross, Mechthild M., Malott, Anne, McAra‐Couper, Judith, Sadler, Michelle, and Thomson, Gill
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Introduction Midwifery care is associated with positive birth outcomes, access to community birth options, and judicious use of interventions. The aim of this study was to characterize and compare maternity care preferences of university students across a range of maternity care systems and to explore whether preferences align with evidence‐based recommendations and options available. Methods A cross‐sectional, web‐based survey was completed in 2014 and 2015 by a convenience sample of university students in 8 high‐income countries across 4 continents (N = 4569). In addition to describing preferences for midwifery care and community birth options across countries, this study examined sociodemographic characteristics, psychological factors, knowledge about pregnancy and birth, and sources of information that shaped students’ attitudes toward birth in relation to preferences for midwifery care and community birth options. Results Approximately half of the student respondents (48.2%) preferred midwifery‐led care for a healthy pregnancy; 9.5% would choose to give birth in a birthing center, and 4.5% preferred a home birth. Preference for midwifery care varied from 10.3% among women in the United States to 78.6% among women in the United Kingdom. Preferences for home birth varied from 0.3% among US women to 18.3% among Canadian women. Women, health science students, those with low childbirth fear, those who learned about pregnancy and birth from friends (compared with other sources, eg, the media), and those who responded from Europe were significantly more likely to prefer midwifery care and community birth. High confidence in knowledge of pregnancy and birth was linked to significantly higher odds of community birth preferences and midwifery care preferences. Discussion It would be beneficial to integrate childbirth education into high school curricula to promote knowledge of midwifery care, pregnancy, and childbirth and to reduce fear among prospective parents. Communi
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- 2021
23. Restraint minimisation in mental health care: legitimate or illegitimate force? An ethnographic study
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Mckeown, Michael, Thomson, Gillian, Downe, Soo, Scholes, A, Edgar, F, Price, O, Baker, J, Greenwood, P, Whittington, R, Duxbury, J, Mckeown, Michael, Thomson, Gillian, Downe, Soo, Scholes, A, Edgar, F, Price, O, Baker, J, Greenwood, P, Whittington, R, and Duxbury, J
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Coercive practices, such as physical restraint, are used globally to respond to violent, aggressive and other behaviours displayed by mental health service users1. A number of approaches have been designed to aid staff working within services to minimise the use of restraint and other restrictive practices. One such approach, the ‘REsTRAIN Yourself’ (RYS) initiative, has been evaluated in the UK. Rapid ethnography was used to explore aspects of organisational culture and staff behaviour exhibited by teams of staff working within 14 acute admission mental health wards in the North West region of the English NHS. Findings comprise four core themes of space and place; legitimation; meaningful activity; and, therapeutic engagement that represents characteristics of daily life on the wards before and after implementation of the RYS intervention. Tensions between staff commitments to therapeutic relations and constraining factors were revealed in demarcations of ward space and limitations on availability of meaningful activities. The physical, relational and discursive means by which ward spaces are segregated prompts attention to the observed materialities of routine care. Legitimation was identified as a crucial discursive practice in the context of staff reliance upon coercion. Trauma informed care represents a potentially alternative legitimacy.
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- 2020
24. The role of midwifery and other international insights for maternity care in the United States: An analysis of four countries
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Kennedy, Holly Powell, Balaam, Marie-Clare, Dahlen, Hannah, Declercq, Eugene, de Jonge, Ank, Downe, Soo, Ellwood, David, Homer, Caroline S.E., Sandall, Jane, Vedam, Saraswathi, Wolfe, Ingrid, Kennedy, Holly Powell, Balaam, Marie-Clare, Dahlen, Hannah, Declercq, Eugene, de Jonge, Ank, Downe, Soo, Ellwood, David, Homer, Caroline S.E., Sandall, Jane, Vedam, Saraswathi, and Wolfe, Ingrid
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Background The United States (US) spends more on health care than any other high‐resource country. Despite this, their maternal and newborn outcomes are worse than all other countries with similar levels of economic development. Our purpose was to describe maternal and newborn outcomes and organization of care in four high‐resource countries (Australia, Canada, the Netherlands, and United Kingdom) with consistently better outcomes and lower health care costs, and to identify opportunities for emulation and improvement in the United States. Method We examined resources that described health care organization and financing, provider types, birth settings, national, clinical guidelines, health care policies, surveillance data, and information for consumers. We conducted interviews with country stakeholders representing the disciplines of obstetrics, midwifery, pediatrics, neonatology, epidemiology, sociology, political science, public health, and health services. The results of the analysis were compared and contrasted with the US maternity system. Results The four countries had lower rates of maternal mortality, low birthweight, and newborn and infant death than the United States. Five commonalities were identified as follows: (1) affordable/ accessible health care, (2) a maternity workforce that emphasized midwifery care and interprofessional collaboration, (3) respectful care and maternal autonomy, (4) evidence‐based guidelines on place of birth, and (5) national data collections systems. Conclusions The findings reveal marked differences in the other countries compared to the United States. It is critical to consider the evidence for improved maternal and newborn outcomes with different models of care and to examine US cultural and structural failures that are leading to unacceptable and substandard maternal and infant outcomes.
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- 2020
25. A Survey of University Students’ Preferences for Midwifery Care and Community Birth Options in 8 High‐Income Countries
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Stoll, K, Downe, Soo, Edmonds, J, McAra-Cooper, J, Mechthild, G, Sadler, M, Thomson, Gillian, Stoll, K, Downe, Soo, Edmonds, J, McAra-Cooper, J, Mechthild, G, Sadler, M, and Thomson, Gillian
- Abstract
Background: Midwifery care is associated with positive birth outcomes, access to community birth options, and judicious use of interventions. The aim of this study was to characterize and compare maternity care preferences of university students across a range of maternity care systems and to explore whether preferences align with evidence- based recommendations and options available. Methods: A cross-sectional, web-based survey was completed in 2014-2015 by a convenience sample of university students in 8 high-income countries across 4 continents (n=4,569). In addition to describing preferences for midwifery care and community birth options across countries, socio-demographic characteristics, psychological factors, knowledge about pregnancy and birth, and sources of information that shaped students’ attitudes towards birth were examined in relation to preferences for midwifery care and community birth options. Results: Approximately half of the student respondents (48. 2%) preferred midwifery-led care for a healthy pregnancy, 9.5% would choose to birth in a birthing center, and 4.5% preferred a home birth. Preference for midwifery care varied from 10.3% among women in the United States to 78.6% among women in England. Preferences for home birth varied from 0.3% among US women to 18.3% among Canadian women. Women, health science students, those with low childbirth fear, who learned about pregnancy and birth from friends (compared to other sources, e.g. the media) and those who responded from Europe were significantly more likely to prefer midwifery care and community birth. High confidence in knowledge of pregnancy and birth was linked to significantly higher odds of community birth preferences and midwifery care preferences Conclusions: It would be beneficial to integrate childbirth education into high school curricula, to promote knowledge of midwifery care, pregnancy and childbirth and reduce fear among prospective parents. Community birth options need to be expa
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- 2020
26. Restraint minimisation in mental health care: legitimate or illegitimate force? An ethnographic study
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McKeown, Mick, Thomson, Gill, Scholes, Amy, Jones, Fiona, Downe, Soo, Price, Owen, Baker, John, Greenwood, Paul, Whittington, Richard, Duxbury, Joy, McKeown, Mick, Thomson, Gill, Scholes, Amy, Jones, Fiona, Downe, Soo, Price, Owen, Baker, John, Greenwood, Paul, Whittington, Richard, and Duxbury, Joy
- Abstract
Coercive practices, such as physical restraint, are used globally to respond to violent, aggressive and other behaviours displayed by mental health service users.1 A number of approaches have been designed to aid staff working within services to minimise the use of restraint and other restrictive practices. One such approach, the ‘REsTRAIN Yourself’ (RYS) initiative, has been evaluated in the UK. Rapid ethnography was used to explore the aspects of organisational culture and staff behaviour exhibited by teams of staff working within 14 acute admission mental health wards in the North West region of the English NHS. Findings comprise four core themes of space and place; legitimation; meaningful activity; and, therapeutic engagement that represent characteristics of daily life on the wards before and after implementation of the RYS intervention. Tensions between staff commitments to therapeutic relations and constraining factors were revealed in demarcations of ward space and limitations on availability of meaningful activities. The physical, relational and discursive means by which ward spaces are segregated prompts attention to the observed materialities of routine care. Legitimation was identified as a crucial discursive practice in the context of staff reliance upon coercion. Trauma‐informed care represents a potentially alternative legitimacy.
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- 2020
27. The role of midwifery and other international insights for maternity care in the United States: An analysis of four countries
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Kennedy, Holly Powell, primary, Balaam, Marie‐Clare, additional, Dahlen, Hannah, additional, Declercq, Eugene, additional, Jonge, Ank, additional, Downe, Soo, additional, Ellwood, David, additional, Homer, Caroline S. E., additional, Sandall, Jane, additional, Vedam, Saraswathi, additional, and Wolfe, Ingrid, additional
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- 2020
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28. Postpartum hemorrhage care bundles to improve adherence to guidelines: A WHO technical consultation
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Althabe, Fernando, primary, Therrien, Michelle N.S., additional, Pingray, Veronica, additional, Hermida, Jorge, additional, Gülmezoglu, Ahmet M., additional, Armbruster, Deborah, additional, Singh, Neelima, additional, Guha, Moytrayee, additional, Garg, Lorraine F., additional, Souza, Joao P., additional, Smith, Jeffrey M., additional, Winikoff, Beverly, additional, Thapa, Kusum, additional, Hébert, Emmanuelle, additional, Liljestrand, Jerker, additional, Downe, Soo, additional, Garcia Elorrio, Ezequiel, additional, Arulkumaran, Sabaratnam, additional, Byaruhanga, Emmanuel K., additional, Lissauer, David M., additional, Oguttu, Monica, additional, Dumont, Alexandre, additional, Escobar, Maria F., additional, Fuchtner, Carlos, additional, Lumbiganon, Pisake, additional, Burke, Thomas F., additional, and Miller, Suellen, additional
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- 2019
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29. Restraint minimisation in mental health care: legitimate or illegitimate force? An ethnographic study
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McKeown, Mick, Thomson, Gill, Scholes, Amy, Jones, Fiona, Downe, Soo, Price, Owen, Baker, John, Greenwood, Paul, Whittington, Richard, Duxbury, Joy, McKeown, Mick, Thomson, Gill, Scholes, Amy, Jones, Fiona, Downe, Soo, Price, Owen, Baker, John, Greenwood, Paul, Whittington, Richard, and Duxbury, Joy
- Abstract
Coercive practices, such as physical restraint, are used globally to respond to violent, aggressive and other behaviours displayed by mental health service users.1 A number of approaches have been designed to aid staff working within services to minimise the use of restraint and other restrictive practices. One such approach, the ‘REsTRAIN Yourself’ (RYS) initiative, has been evaluated in the UK. Rapid ethnography was used to explore the aspects of organisational culture and staff behaviour exhibited by teams of staff working within 14 acute admission mental health wards in the North West region of the English NHS. Findings comprise four core themes of space and place; legitimation; meaningful activity; and, therapeutic engagement that represent characteristics of daily life on the wards before and after implementation of the RYS intervention. Tensions between staff commitments to therapeutic relations and constraining factors were revealed in demarcations of ward space and limitations on availability of meaningful activities. The physical, relational and discursive means by which ward spaces are segregated prompts attention to the observed materialities of routine care. Legitimation was identified as a crucial discursive practice in the context of staff reliance upon coercion. Trauma‐informed care represents a potentially alternative legitimacy.
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- 2019
30. Staff experiences and understandings of the REsTRAIN Yourself initiative to minimize the use of physical restraint on mental health wards
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Duxbury, Joy, Thomson, Gill, Scholes, Amy, Jones, Fiona, Baker, John, Downe, Soo, Greenwood, Paul, Price, Owen, Whittington, Richard, McKeown, Mick, Duxbury, Joy, Thomson, Gill, Scholes, Amy, Jones, Fiona, Baker, John, Downe, Soo, Greenwood, Paul, Price, Owen, Whittington, Richard, and McKeown, Mick
- Abstract
International efforts to minimize coercive practices include the US Six Core Strategies© (6CS). This innovative approach has limited evidence of its effectiveness, with few robustly designed studies, and has not been formally implemented or evaluated in the UK. An adapted version of the 6CS, which we called ‘REsTRAIN Yourself’ (RY), was devised to suit the UK context and evaluated using mixed methods. RY aimed to reduce the use of physical restraint in mental health inpatient ward settings through training and practice development with whole teams, directly in the ward settings where change was to be implemented and barriers to change overcome. In this paper, we present qualitative findings that report on staff perspectives of the impact and value of RY following its implementation. Thirty‐six staff participated in semi‐structured interviews with data subject to thematic analysis. Eight themes are reported that highlight perceived improvements in every domain of the 6CS after RY had been introduced. Staff reported more positively on their relationships with service users and felt their attitudes towards the use of coercive practices such as restraint were changed; the service as a whole shifted in terms of restraint awareness and reduction; and new policies, procedures, and language were introduced despite certain barriers. These findings need to be appreciated in a context wherein substantial reductions in the use of physical restraint were proven possible, largely due to building upon empathic and relational alternatives. However, yet more could be achieved with greater resourcing of inpatient care.
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- 2019
31. Postpartum hemorrhage care bundles to improve adherence to guidelines: A WHO technical consultation
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Althabe, Fernando, Therrien, Michelle NS., Pingray, Veronica, Hermida, Jorge, Gülmezoglu, Ahmet M., Armbruster, Deborah, Singh, Neelima, Guha, Moytrayee, Garg, Lorraine F., Souza, Joao P., Smith, Jeffrey M., Winikoff, Beverly, Thapa, Kusum, Hébert, Emmanuelle, Liljestrand, Jerker, Downe, Soo, Elorrio, Ezequiel Garcia, Arulkumaran, Sabaratnam, Byaruhanga, Emmanuel K., Lissauer, David M., Ogutu, Monica, Dumont, Alexandre, Escobar, Maria F., Fuchtner, Carlos, Lumbiganon, Pisake, Burke, Thomas F., Miller, Suellen, Althabe, Fernando, Therrien, Michelle NS., Pingray, Veronica, Hermida, Jorge, Gülmezoglu, Ahmet M., Armbruster, Deborah, Singh, Neelima, Guha, Moytrayee, Garg, Lorraine F., Souza, Joao P., Smith, Jeffrey M., Winikoff, Beverly, Thapa, Kusum, Hébert, Emmanuelle, Liljestrand, Jerker, Downe, Soo, Elorrio, Ezequiel Garcia, Arulkumaran, Sabaratnam, Byaruhanga, Emmanuel K., Lissauer, David M., Ogutu, Monica, Dumont, Alexandre, Escobar, Maria F., Fuchtner, Carlos, Lumbiganon, Pisake, Burke, Thomas F., and Miller, Suellen
- Abstract
Objective To systematically develop evidence‐based bundles for care of postpartum hemorrhage (PPH). Methods An international technical consultation was conducted in 2017 to develop draft bundles of clinical interventions for PPH taken from the WHO’s 2012 and 2017 PPH recommendations and based on the validated “GRADE Evidence‐to‐Decision” framework. Twenty‐three global maternal‐health experts participated in the development process, which was informed by a systematic literature search on bundle definitions, designs, and implementation experiences. Over a 6‐month period, the expert panel met online and via teleconferences, culminating in a 2‐day in‐person meeting. Results The consultation led to the definition of two care bundles for facility implementation. The “first response to PPH bundle” comprises uterotonics, isotonic crystalloids, tranexamic acid, and uterine massage. The “response to refractory PPH bundle” comprises compressive measures (aortic or bimanual uterine compression), the non‐pneumatic antishock garment, and intrauterine balloon tamponade (IBT). Advocacy, training, teamwork, communication, and use of best clinical practices were defined as PPH bundle supporting elements. Conclusion For the first response bundle, further research should assess its feasibility, acceptability, and effectiveness; and identify optimal implementation strategies. For the response to refractory bundle, further research should address pending controversies, including the operational definition of refractory PPH and effectiveness of IBT devices
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- 2019
32. “Catching your tail and firefighting”: The impact of staffing levels on restraint minimization efforts
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Mckeown, Michael, Thomson, Gillian, Scholes, Amy, Jones, Fiona, Baker, John, Downe, Soo, Price, Owen, Greenwood, Paul, Whittington, Richard, Duxbury, Joy, Mckeown, Michael, Thomson, Gillian, Scholes, Amy, Jones, Fiona, Baker, John, Downe, Soo, Price, Owen, Greenwood, Paul, Whittington, Richard, and Duxbury, Joy
- Abstract
Introduction: Safe staffing and coercive practices are of pressing concern for mental health services. These are inter-dependent and the relationship is under-researched. Aim: To explore views on staffing levels in context of attempting to minimise physical restraint practices on mental health wards. Findings emerged from a wider dataset with the broader aim of exploring experiences of a restraint reduction initiative Methods: Thematic analysis of semi-structured interviews with staff (n=130) and service users (n=32). Results: Five themes were identified regarding how staffing levels impact experiences and complicate efforts to minimise physical restraint. We titled the themes – ‘insufficient staff to do the job’; ‘detriment to staff and service users’; ‘a paperwork exercise: the burden of non-clinical tasks’; ‘false economies’; and, ‘you can’t do these interventions’. Discussion: Tendencies detracting from relational aspects of care are not independent of insufficiencies in staffing. The relational, communicative, and organisational developments that would enable reductions in use of restraint are labour intensive and vulnerable to derailment by insufficient and poorly skilled staff. Implications for Practice: Restrictive practices are unlikely to be minimised unless wards are adequately staffed. Inadequate staffing is not independent of restrictive practices and reduces access to alternative interventions for reducing individuals’ distress.
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- 2019
33. Provision and uptake of routine antenatal services: a qualitative evidence synthesis
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Downe, Soo, Finlayson, Kenneth William, Tuncalp, Ozge, Gulmezoglu, Ahmet Metin, Downe, Soo, Finlayson, Kenneth William, Tuncalp, Ozge, and Gulmezoglu, Ahmet Metin
- Abstract
Background Antenatal care (ANC) is a core component of maternity care. However, both quality of care provision and rates of attendance vary widely between and within countries. Qualitative research can assess factors underlying variation, including acceptability, feasibility, and the values and beliefs that frame provision and uptake of ANC programmes. This synthesis links to the Cochrane Reviews of the effectiveness of different antenatal models of care. It was designed to inform the World Health Organization guidelines for a positive pregnancy experience and to provide insights for the design and implementation of improved antenatal care in the future. Objectives To identify, appraise, and synthesise qualitative studies exploring: · Women’s views and experiences of attending ANC; and factors influencing the uptake of ANC arising from women’s accounts; · Healthcare providers’ views and experiences of providing ANC; and factors influencing the provision of ANC arising from the accounts of healthcare providers. Search methods To find primary studies we searched MEDLINE, Ovid; Embase, Ovid; CINAHL, EbscoHost; PsycINFO, EbscoHost; AMED, EbscoHost; LILACS, VHL; and African Journals Online (AJOL) from January 2000 to February 2019. We handsearched reference lists of included papers and checked the contents pages of 50 relevant journals through Zetoc alerts received during the searching phase. Selection criteria We included studies that used qualitative methodology and that met our quality threshold; that explored the views and experiences of routine ANC among healthy, pregnant and postnatal women or among healthcare providers offering this care, including doctors, midwives, nurses, lay health workers and traditional birth attendants; and that took place in any setting where ANC was provided.We excluded studies of ANC programmes designed for women with specific complications. We also excluded studies of programmes that focused solely on antenatal education. Data collectio
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- 2019
34. Restraint minimisation in mental health care: legitimate or illegitimate force? An ethnographic study
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McKeown, Mick, primary, Thomson, Gill, additional, Scholes, Amy, additional, Jones, Fiona, additional, Downe, Soo, additional, Price, Owen, additional, Baker, John, additional, Greenwood, Paul, additional, Whittington, Richard, additional, and Duxbury, Joy, additional
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- 2019
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35. Provision and uptake of routine antenatal services: a qualitative evidence synthesis
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Downe, Soo, primary, Finlayson, Kenneth, additional, Tunçalp, Özge, additional, and Gülmezoglu, Ahmet Metin, additional
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- 2019
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36. “Catching your tail and firefighting”: The impact of staffing levels on restraint minimization efforts
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McKeown, Mick, primary, Thomson, Gill, additional, Scholes, Amy, additional, Jones, Fiona, additional, Baker, John, additional, Downe, Soo, additional, Price, Owen, additional, Greenwood, Paul, additional, Whittington, Richard, additional, and Duxbury, Joy, additional
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- 2019
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37. Staff experiences and understandings of theREsTRAINYourself initiative to minimize the use of physical restraint on mental health wards
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Duxbury, Joy, primary, Thomson, Gill, additional, Scholes, Amy, additional, Jones, Fiona, additional, Baker, John, additional, Downe, Soo, additional, Greenwood, Paul, additional, Price, Owen, additional, Whittington, Richard, additional, and McKeown, Mick, additional
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- 2019
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38. Asking different questions: A call to action for research to improve the quality of care for every woman, every child
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Kennedy, Holly P., Cheyney, Melissa, Dahlen, Hannah G., Downe, Soo, Foureur, Maralyn J., Homer, Caroline S. E., Jefford, Elaine, McFadden, Alison, Michel-Schuldt, Michaela, Sandall, Jane, Soltani, Hora, Speciale, Anna M., Stevens, Jennifer, Vedam, Saraswathi, Renfrew, Mary J., Kennedy, Holly P., Cheyney, Melissa, Dahlen, Hannah G., Downe, Soo, Foureur, Maralyn J., Homer, Caroline S. E., Jefford, Elaine, McFadden, Alison, Michel-Schuldt, Michaela, Sandall, Jane, Soltani, Hora, Speciale, Anna M., Stevens, Jennifer, Vedam, Saraswathi, and Renfrew, Mary J.
- Abstract
Despite decades of considerable economic investment in improving the health of families and newborns world‐wide, aspirations for maternal and newborn health have yet to be attained in many regions. The global turn toward recognizing the importance of positive experiences of pregnancy, intrapartum and postnatal care, and care in the first weeks of life, while continuing to work to minimize adverse outcomes, signals a critical change in the maternal and newborn health care conversation and research prioritization. This paper presents “different research questions” drawing on evidence presented in the 2014 Lancet Series on Midwifery and a research prioritization study conducted with the World Health Organization. The results indicated that future research investment in maternal and newborn health should be on “right care,” which is quality care that is tailored to individuals, weighs benefits and harms, is person‐centered, works across the whole continuum of care, advances equity, and is informed by evidence, including cost‐effectiveness. Three inter‐related research themes were identified: examination and implementation of models of care that enhance both well‐being and safety; investigating and optimizing physiological, psychological, and social processes in pregnancy, childbirth, and the postnatal period; and development and validation of outcome measures that capture short and longer term well‐being. New, transformative research approaches should account for the underlying social and political‐economic mechanisms that enhance or constrain the well‐being of women, newborns, families, and societies. Investment in research capacity and capability building across all settings is critical, but especially in those countries that bear the greatest burden of poor outcomes. We believe this call to action for investment in the three research priorities identified in this paper has the potential to achieve these benefits and to realize the ambitions of Sustainable Development
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- 2018
39. WHO model of intrapartum care for a positive childbirth experience: Transforming care of women and babies for improved health and well-being
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Oladapo, O T, Tunçalp, Ö, Bonet, M, Lawrie, T A, Portela, A, Downe, Soo, Gülmezoglu, A M, Oladapo, O T, Tunçalp, Ö, Bonet, M, Lawrie, T A, Portela, A, Downe, Soo, and Gülmezoglu, A M
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Globally, there is a shift in the maternal, newborn and child health agenda from an exclusive focus on survival to the inclusion of drivers for thriving and transformation. This shift is in line with the third Sustainable Development Goal – ensuring healthy lives and promoting well‐being for all at all ages – and the new Global Strategy for Women's, Children's and Adolescents’ Health (2016‐2030). Through research and development of norms and standards, the World Health Organization (WHO) is supporting this global agenda by outlining a vision for high quality care for all pregnant women and their newborns, throughout pregnancy, childbirth and the postnatal periods.
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- 2018
40. The effect of medical and operative birth interventions on child health outcomes in the first 28 days and up to 5 years of age: A linked data population-based cohort study
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Peters, Lilian L, Thornton, Charlene, de Jonge, Ank, Khashan, Ali, Tracy, Mark, Downe, Soo, Feijen-de Jong, Esther I, Dahlen, Hannah G, Peters, Lilian L, Thornton, Charlene, de Jonge, Ank, Khashan, Ali, Tracy, Mark, Downe, Soo, Feijen-de Jong, Esther I, and Dahlen, Hannah G
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Spontaneous vaginal birth rates are decreasing worldwide, while cesarean delivery, instrumental births, and medical birth interventions are increasing. Emerging evidence suggests that birth interventions may have an effect on children's health. Therefore, the aim of our study was to examine the association between operative and medical birth interventions on the child's health during the first 28 days and up to 5 years of age. In New South Wales (Australia), population-linked data sets were analyzed, including data on maternal characteristics, child characteristics, mode of birth, interventions during labor and birth, and adverse health outcomes of the children (ie, jaundice, feeding problems, hypothermia, asthma, respiratory infections, gastrointestinal disorders, other infections, metabolic disorder, and eczema) registered with the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification codes. Logistic regression analyses were performed for each adverse health outcome. Our analyses included 491 590 women and their children; of those 38% experienced a spontaneous vaginal birth. Infants who experienced an instrumental birth after induction or augmentation had the highest risk of jaundice, adjusted odds ratio (aOR) 2.75 (95% confidence interval [CI] 2.61-2.91) compared with spontaneous vaginal birth. Children born by cesarean delivery were particularly at statistically significantly increased risk for infections, eczema, and metabolic disorder, compared with spontaneous vaginal birth. Children born by emergency cesarean delivery showed the highest association for metabolic disorder, aOR 2.63 (95% CI 2.26-3.07). Children born by spontaneous vaginal birth had fewer short- and longer-term health problems, compared with those born after birth interventions. [Abstract copyright: © 2018 the Authors. Birth published by Wiley Periodicals, Inc.]
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- 2018
41. Asking Different Questions: A Call to Action for Research to Improve the Quality of Care for Every Woman, Every Child
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Kennedy, Holly P., primary, Cheyney, Melissa, additional, Dahlen, Hannah G., additional, Downe, Soo, additional, Foureur, Maralyn J., additional, Homer, Caroline S. E., additional, Jefford, Elaine, additional, McFadden, Alison, additional, Michel-Schuldt, Michaela, additional, Sandall, Jane, additional, Soltani, Hora, additional, Speciale, Anna M., additional, Stevens, Jennifer, additional, Vedam, Saraswathi, additional, and Renfrew, Mary J., additional
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- 2018
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42. The effect of medical and operative birth interventions on child health outcomes in the first 28 days and up to 5 years of age: A linked data population‐based cohort study
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Peters, Lilian L., primary, Thornton, Charlene, additional, de Jonge, Ank, additional, Khashan, Ali, additional, Tracy, Mark, additional, Downe, Soo, additional, Feijen‐de Jong, Esther I., additional, and Dahlen, Hannah G., additional
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- 2018
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43. Factors that influence the provision of good-quality routine antenatal services: a qualitative evidence synthesis of the views and experiences of maternity care providers
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Downe, Soo, primary, Finlayson, Kenneth, additional, Tunçalp, Özge, additional, and Gülmezoglu, A Metin, additional
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- 2017
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44. Turning local knowledge and experience into innovative tools for quality care during labor and childbirth: The BOLD project experience
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Downe, Soo, primary and Gülmezoglu, A. Metin, additional
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- 2017
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45. “What matters to someone who matters to me”: using media campaigns with young people to prevent interpersonal violence and abuse
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Stanley, Nicky, primary, Ellis, Jane, additional, Farrelly, Nicola, additional, Hollinghurst, Sandra, additional, Bailey, Sue, additional, and Downe, Soo, additional
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- 2016
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46. Self-hypnosis for intrapartum pain management in pregnant nulliparous women: a randomised controlled trial of clinical effectiveness
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Downe, Soo, Finlayson, Kenneth, Melvin, C., Spiby, Helen, Ali, A., Diggle, P., Gyte, G., Hinder, S., Miller, V., Slade, P., Trepel, D., Weeks, A., and Whorwell, Peter
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Cost-analysis, epidural, group antenatal training, hypnosis, labour pain, psychological outcomes, randomised trial - Abstract
Objective: (Primary) To establish the effect of antenatal group self-hypnosis for nulliparous women on intra-partum epidural use. Design: Multi-method randomised control trial (RCT). Setting: Three NHS Trusts. Population: Nulliparous women not planning elective caesarean, without medication for hypertension and without psychological illness. Methods: Randomisation at 28–32 weeks’ gestation to usual care, or to usual care plus brief self-hypnosis training (two × 90-minute groups at around 32 and 35 weeks’ gestation; daily audio self-hypnosis CD). Follow up at 2 and 6 weeks postnatal. Main outcome measures: Primary: epidural analgesia. Secondary: associated clinical and psychological outcomes; cost analysis. Results: Six hundred and eighty women were randomised. There was no statistically significant difference in epidural use: 27.9% (intervention), 30.3% (control), odds ratio (OR) 0.89 [95% confidence interval (CI): 0.64–1.24], or in 27 of 29 pre-specified secondary clinical and psychological outcomes. Women in the intervention group had lower actual than anticipated levels of fear and anxiety between baseline and 2 weeks post natal (anxiety: mean difference −0.72, 95% CI −1.16 to −0.28, P = 0.001); fear (mean difference −0.62, 95% CI −1.08 to −0.16, P = 0.009) [Correction added on 7 July 2015, after first online publication: ‘Mean difference’ replaced ‘Odds ratio (OR)’ in the preceding sentence.]. Postnatal response rates were 67% overall at 2 weeks. The additional cost in the intervention arm per woman was £4.83 (CI −£257.93 to £267.59). Conclusions: Allocation to two-third-trimester group self-hypnosis training sessions did not significantly reduce intra-partum epidural analgesia use or a range of other clinical and psychological variables. The impact of women's anxiety and fear about childbirth needs further investigation.
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- 2015
47. 'What matters to someone who matters to me': Using media campaigns with young people to prevent interpersonal violence and abuse
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Stanley, Nicky, Ellis, Jane, Farrelly, Nicola, Hollinghurst, S, Bailey, S, Downe, Soo, Stanley, Nicky, Ellis, Jane, Farrelly, Nicola, Hollinghurst, S, Bailey, S, and Downe, Soo
- Abstract
Background: While media campaigns are increasingly advocated as a strategy for pre- venting interpersonal violence and abuse, there is little evidence available regarding their effectiveness. Setting and design: Consultation with experts and young people was used as part of a UK scoping review to capture current thinking and practice on the use of media cam- paigns to address interpersonal violence and abuse among young people. Three focus groups and 16 interviews were undertaken with UK and international experts, and three focus groups were held with young people. Main results: Participants argued that, although campaigns initially needed to target whole populations of young people, subsequently, messages should be “granulated” for subgroups including young people already exposed to interpersonal violence and lesbian, gay, bisexual and transgender young people. It was suggested that boys, as the most likely perpetrators of interpersonal violence and abuse, should be the primary target for campaigns. Young people and experts emphasized that drama and narrative could be used to evoke an emotional response that assisted learning. Authenticity emerged as important for young people and could be achieved by delivering messages through familiar characters and relevant stories. Involving young people themselves in creating and delivering campaigns strengthened authenticity. Conclusions: Practice is developing rapidly, and robust research is required to identify the key conditions for effective campaigns in this field. The emotional impact of cam- paigns in this field appears to be as important as the transmission of learning.
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- 2016
48. Factors that influence the uptake of routine antenatal services by pregnant women: a qualitative evidence synthesis
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Downe, Soo, primary, Finlayson, Kenneth, additional, Tunçalp, Özge, additional, and Gülmezoglu, A Metin, additional
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- 2016
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49. Self-Hypnosis for Intrapartum Pain management (SHIP) in pregnant nulliparous women: a randomised controlled trial of clinical effectiveness
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Downe, Soo, Finlayson, Kenneth, Melvin, Cathie, Spiby, Helen, Ali, Shehzad, Diggle, Peter, Gyte, Gill, Hinder, Susan, Miller, Vivien, Slade, Pauline, Treppel, Dominic, Weeks, Andrew, Whorwell, Peter, Williamson, Maria, Downe, Soo, Finlayson, Kenneth, Melvin, Cathie, Spiby, Helen, Ali, Shehzad, Diggle, Peter, Gyte, Gill, Hinder, Susan, Miller, Vivien, Slade, Pauline, Treppel, Dominic, Weeks, Andrew, Whorwell, Peter, and Williamson, Maria
- Abstract
Objective: (Primary): to establish the effect of antenatal group self-hypnosis for nulliparous women on intra-partum epidural use Design: Multi-method RCT Setting: Three NHS Trusts Population: Nulliparous women not planning elective caesarean, without medication for hypertension and without psychological illness. Methods: Randomisation at 28-32 weeks gestation to usual care, or to usual care plus brief self-hypnosis training (two x 90 minute groups at around 32 and 35 weeks gestation; daily audio self-hypnosis CD). Follow up at two and six weeks postnatal. Main outcome measures:- Primary: epidural analgesia Secondary: associated clinical and psychological outcomes; economic analysis. Results: 680 women were randomised. There was no statistically significant difference in epidural use: 27.9% (intervention), 30.3% (control), odds ratio (OR) 0.89 (95% confidence interval (CI): 0.64 to 1.24), or in 27 of 29 pre-specified secondary clinical and psychological outcomes. Women in the intervention group had lower actual than anticipated levels of fear and anxiety between baseline and two weeks post natal (anxiety: OR -0.72, 95% CI -1.16 to -0.28, P= 0.001); fear (OR -0.62, 95% CI -1.08 to -0.16, p = 0.009) Postnatal response rates were 67% overall at two weeks. The additional cost of the intervention per woman was £4.83 (CI -£257.93 to £267.59). Conclusions: Allocation to two third-trimester group self-hypnosis training sessions did not significantly reduce intra-partum epidural analgesia use or a range of other clinical and psychological variables. The impact of women’s anxiety and fear about childbirth needs further investigation. Trial registration: ISRCTN27575146 http://www.controlled-trials.com/ISRCTN27575146
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- 2015
50. Systematic mixed-methods review of interventions, outcomes and experiences for imprisoned pregnant women
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Shaw, Judith, Downe, Soo, Kingdon, Carol, Shaw, Judith, Downe, Soo, and Kingdon, Carol
- Abstract
Aims. To review published studies reporting maternity experiences and outcomes for pregnant incarcerated women and their babies. Background. Numbers of women in prison have increased in many countries. Imprisoned women who are pregnant are particularly vulnerable and marginalised. Little is known about their maternity care experiences, or outcomes. Design. Systematic mixed-methods review using a segregated approach. Data sources. The Cochrane Library, CINAHL, EMBASE, MEDLINE Psych INFO and PubMed were searched using the terms ‘mother’ and ‘prison’, (January 1995–July 2012). From July 2012–May 2014 possible new studies were identified through scrutiny of 50 relevant journal contents pages via Zetoc. Results. Seven studies met the review criteria and quality standards, all from the USA or UK. Four of the studies were quantitative; two were qualitative; and one used mixed methods. None reported the outcomes of an intervention. Examination of the quantitative data identified a complex picture of potential harms and benefits for babies born in prison. Qualitative data revealed the unique needs of childbearing women in prison, as they continuously negotiate being an inmate, becoming a mother, complex social histories and the threat of losing their baby, all coalescing with opportunities for transformation offered by pregnancy. Conclusions. There is very limited published data on the experiences and outcomes of childbearing women in prison. There appear to be no good quality intervention studies examining the effectiveness of interventions to improve wellbeing in the short or longer term for these women and their babies.
- Published
- 2015
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