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Background: Retaining midwives and registered nurses in the Obstetrics and Gynecology department/unit (OB/GYN) is not just a matter of organizational effectiveness and financial wellness. It's a crucial aspect of ensuring quality healthcare delivery. This study aimed to discuss the degree to which midwives and nurses in OB/GYN departments are structurally empowered, resilient, and committed to remaining at the organizations and to examine whether nurses' and midwives'sense of structural empowerment and resilience is a good predictor of their decision to stay with the organization. Methods: This study employed a unique convergent parallel mixed methods approach. The research was conducted in two distinct phases. The first phase involved a cross-sectional quantitative survey with a convenience sample of 200 midwives and nurses in OB/GYN departments. The second phase was a qualitative study utilizing semi-structured, open-ended interviews. Eighteen nurses and midwives, specifically chosen as the target population, were invited to participate in individual interviews. The data collection took place at three major hospitals in Saudi Arabia, starting in January 2023 and concluding in February 2023. Results: The study results revealed that structural empowerment and resilience were statistically significant predictors of the intent to stay in the organization (F = 35.216, p < 0.001), with 26.3% variation, the structural empowerment is higher predictor (β = 0.486, p < 0.000) to intent to stay if compared to resilience (β = 0.215, p < 0.008). Five major themes emerged from the narratives of the nurses and midwives: the nurturing of the physical and physiological, the development of the psychological, the managing finances, the restructuring of the organization, and the enrichment of the professional and occupational. Conclusion: The study's findings have significant implications for healthcare organizations. They highlight the importance of cultivating a culture of empowerment and resilience, which can serve as a powerful tool to encourage registered nurses and midwives to remain in their organizations. This insight empowers healthcare administrators, human resource managers, and obstetrics and gynecology professionals to take proactive steps toward improving retention rates. [ABSTRACT FROM AUTHOR]

Aim Background Methods Data Sources Results Conclusions Implications for the Profession and/or Patient Care Impact Reporting Method Patient or Public Contribution To describe the pre‐implementation context and implementation approach, for a clinician researcher career pathway.Clinician researchers across all health disciplines are emerging to radically influence practice change and improve patient outcomes. Yet, to date, there are limited clinician researcher career pathways embedded in clinical practice for nurses and midwives.A qualitative descriptive design was used.Data were collected from four online focus groups and four interviews of health consumers, nursing and midwifery clinicians, and nursing unit managers (N = 20) between July 2022 and September 2023.Thematic and content analysis identified themes/categories relating to: Research in health professionals' roles and nursing and midwifery, and Research activity and culture (context); with implementation approaches within coherence, cognitive participation, collective action and reflexive monitoring (Normalization Process Theory).The Pathway was perceived to meet organizational objectives with the potential to create significant cultural change in nursing and midwifery. Backfilling of protected research time was essential.The Pathway was seen as an instrument to empower staff, foster staff retention and extend research opportunities to every nurse and midwife, while improving patient experiences and outcomes.Clinicians, consumers and managers fully supported the implementation of clinician researchers with this Pathway. The Pathway could engage all clinicians in evidence‐based practice with a clinician researcher leader, effect practice change with colleagues and enhance patient outcomes.This study adheres to relevant EQUATOR guidelines using the COREG checklist.Health consumers involved in this research as participants, did not contribute to the design or conduct of the study, analysis or interpretation of the data, or in the preparation of the manuscript. [ABSTRACT FROM AUTHOR]

Abstract Background Retaining midwives and registered nurses in the Obstetrics and Gynecology department/unit (OB/GYN) is not just a matter of organizational effectiveness and financial wellness. It’s a crucial aspect of ensuring quality healthcare delivery. This study aimed to discuss the degree to which midwives and nurses in OB/GYN departments are structurally empowered, resilient, and committed to remaining at the organizations and to examine whether nurses’ and midwives’sense of structural empowerment and resilience is a good predictor of their decision to stay with the organization. Methods This study employed a unique convergent parallel mixed methods approach. The research was conducted in two distinct phases. The first phase involved a cross-sectional quantitative survey with a convenience sample of 200 midwives and nurses in OB/GYN departments. The second phase was a qualitative study utilizing semi-structured, open-ended interviews. Eighteen nurses and midwives, specifically chosen as the target population, were invited to participate in individual interviews. The data collection took place at three major hospitals in Saudi Arabia, starting in January 2023 and concluding in February 2023. Results The study results revealed that structural empowerment and resilience were statistically significant predictors of the intent to stay in the organization (F = 35.216, p

Objective: The Newborn Individualized Developmental Care and Assessment Program (NIDCAP) has been developed to create a common point to enhance the parameters of neonatal health by Als et al. This research was planned to determine the knowledge level about NIDCAP of midwives working in the delivery room. Methods: The research is descriptive, which a sample consists of 385 midwives estimated with sampling method with the known universe. The ethical approval was obtained. Midwives’ consent was obtained. Data was collected with the questionnaire form that was prepared by researchers and five expert opinions. Numerical values and percent values were analyzed in the statistical evaluation and data were analysed with Chi-Square Test. Results: It was determined in our study that 59.2% of midwives didn’t know NIDCAP. The midwives answered correctly each of the questions about neonatal care in keeping with NIDCAP. Besides there was a significant relationship between “midwives who had foreknowledge” and “midwives who worked in Neonatal Intensive Care Unit (p=0.001), think that NIDCAP is implemented in their hospital (p=0.001) and think that their friends support NIDCAP (p=0.001)”. This result shows that getting information about NIDCAP has increased midwives’ awareness of NIDCAP. Even though the vast majority of midwives had no education, the care given by the midwives was found quite accordant with the physiology of the neonatal. Conclusion: It is important to provide training for NIDCAP and to enhance the education programs about NIDCAP for enhancing the quality of neonatal care and promoting neonatal health.

Doğum, kadınların hayatını fiziksel, ruhsal ve sosyal yönden etkileyerek kadınlara ömür boyu canlı anılar bırakan önemli bir deneyimdir. Genel olarak doğum deneyimi travay süreci, komplikasyonlar, ağrı deneyimleri, destek, kontrol duygusu ve kadının doğum beklentilerinden etkilenmektedir. Ancak, son zamanlarda kadınların olumlu doğum deneyimi edinmeleri için doğum ortamının öneminden sıkça bahsedilmektedir. Ülkemizde dâhil, son 100 yılda çoğu ülkede doğum yapılan yerin evden hastane olarak değişiklik göstermesi, doğum ortamının tasarımında ve bakım sunumunda genellikle tıbbi bir paradigmanın hâkim olduğu anlamına gelmektedir. Medikalize bir doğum ortamı, kadınların hem doğumlarında otonomisini kaybetmesi hem de fizyolojik ve psikolojik ihtiyaçlarını karşılayamaması ile ilişkilendirilmektedir Oysa ki, tüm memeli canlılar gibi kadınlar da içgüdüsel olarak her zaman güvenli, emniyetli ve özel olarak algılanan bir ortamda doğum yapmayı seçmişlerdir. Doğum sürecindeki kadınların hem komplikasyon risklerini en aza indiren yüksek kaliteli bir bakıma hem de tanıdık, sakin, güvenli ve emniyetli bir ortama ihtiyaçları vardır. Bu şekilde temel ihtiyaçları karşılanan kadınların hormonal sistemi en iyi şekilde çalışabilir; fizyolojik ve sağlıklı bir doğum süreci gerçekleşebilir. Son yıllarda doğum ortamında tasarımın önemini vurgulayan kanıta dayalı bilgiler hızla artış göstermekte olsa da ideal doğum ortamı tasarım özellikleri ve tasarımın doğum sonuçlarına etkileri hakkında daha fazla bilimsel sonuçlara ihtiyaç duyulmaktadır. İdeal doğum ortamında doğumu destekleyen fiziki şartların sağlanmasının yanı sıra sosyal desteğin, özellikle doğumun yegâne destekçileri ebelerin niteliği ve desteği oldukça önemlidir. Ebelerin empati ve şefkate dayalı iletişim becerileriyle olumlu doğum atmosferi ortaya koyması ideal doğum ortamı temel yapı taşlarındandır. Bu çalışma ile amacımız; literatür ışığında doğum ortamının önemine dikkat çekerek, fiziksel, ruhsal ve sosyal yönlerden ideal doğum ünitelerinin özelliklerini incelemektir.

Objective: The aim of the study was to assess the experiences of midwives in providing childbirth care to women with coronavirus disease 2019 (COVID-19). Methods: This qualitative study was conducted with 25 midwives who worked in a public hospital for at least one year and actively provided childbirth care to women with COVID-19 between 15-30 January 2021.The data were obtained through one-to-one video conference interviews using a semi-structured interview form consisting of seven open-ended questions prepared by the researchers and analyzed thematically. Results: Four main themes were identified. Theme 1: ‘Change in midwifery care performance’ describes the performance of midwives in providing childbirth care to women with COVID-19 and the influencing factors. Theme 2: ‘Unusual labour and delivery’ explained the isolation processes of midwives in labour and birth, the changes they experience regarding the acceptance of a birth partner during the birth, and the way they handle the increasing number of cesarean section decisions. Theme 3: ‘Strict policies that disrupt postpartum care’, explained the practices of midwives in the postpartum period, which changed with political decisions. Theme 4: ‘Emotional problems’ explain the emotional problems directly experienced from a professional and human perspective. Conclusion: In the COVID-19 period, midwives preserved their compassion and empathy, but had difficulty providing woman-centered care. They defended natural birth, but could not have their say in the changes. Anxiety, fear, increased stress, and burnout significantly affected the professional quality of life.

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Background & Aim: The high prevalence of cesarean section in most developed countries, exceeding 50%, has led to detrimental effects on maternal and child health. Vaginal birth after cesarean (VBAC) is a beneficial way to reduce cesarean rates. This study aimed to determine the effect of theory of planned behavior-based training on the intention and behavior of VBAC in pregnant women with previous cesarean section. Methods & Materials: In this randomized controlled trial study, a convenience sample of 70 pregnant women with a history of cesarean section, referred to comprehensive health centers in Ardabil in 2020, were randomly assigned to either the intervention or control group. The intervention group received four weekly education sessions based on the theory of planned behavior structures, while the control group received standard care. Data were collected using a researcher-developed questionnaire at three time points: before, immediately after, and four weeks after the intervention. Data analysis was conducted using SPSS software version 16, employing independent t-test, Fisher’s exact test, chi-square test, and repeated measures ANOVA at a 95% confidence level. Results: Repeated measures ANOVA revealed significant differences in mean scores of attitude, subjective norm, perceived behavior control, intention, and awareness over time between the intervention and control groups (P

Abstract Background There are recommendations based on scientific evidence on care in the second stage of labor, but it is not known to what degree the professionals comply with these recommendations. Objective The aim of this study is to examine the variability in clinical practices among midwives during the second stage of labor, including positions, mobility, practices, and the maximum time allowed before initiating active pushing, and to assess their adherence to clinical practice guidelines. Methods A cross-sectional observational study. A self-designed questionnaire was developed and distributed online through scientific societies. The main variables studied were professional and work environment characteristics, maternal positions and mobility, practices during this stage, maximum time to start active pushing and duration of the second stage of labor. Descriptive statistics were calculated using SPSS 24.0. Results Regarding the woman’s position during childbirth, 80.3% (245) of midwives frequently or always allow the woman to choose her birthing position. Furthermore, 44.6% (136) of professionals prefer using side-lying positions for the mother. Regarding drinking fluids during childbirth, 51.1% (156) of midwives allowed the woman to drink the amount of liquids she wanted, whereas 11.1% (34) said that they would allow them to do so however, this was against the protocol of their hospital. When inquiring about the Kristeller maneuver, it was reported to be excessively performed in 35.1% (107) of cases for fetal bradycardia, 33.1% (101) for maternal exhaustion, and 38.4% (117) to avoid instrumental birth. Finally, a great variability was observed in the time criteria used for the initiation of active pushing and the maximum duration of the second stage of labor. Conclusions Certain practices, such as the Kristeller maneuver, are overused among midwives, with great variability in the use of certain procedures, the waiting times to initiate pushing and completion of the second stage of labor. Further training and awareness campaigns are needed for professionals to apply evidence-based care.

Abstract Background Women of childbearing age feel great about giving birth, but the pain could be excruciating depending on their pain tolerances. Midwives requires obstetrical knowledge and skills such as pain management during labour and safety. We explored midwives’ perspectives on the utilisation of pharmacological pain alleviation interventions during labour in selected hospitals in Matjhabeng Municipality, Free State province, South Africa. A qualitative study was undertaken, involving a sample of ten midwives, using a semi-structured interview guide. The interviews were audio-recorded and transcribed verbatim. Tesch’s open coding data analysis method was applied to analyse the data. The midwives were restricted to use Pethidine and Phenergan prescribed by doctors for labour pain relief, which disrupted labour pain management and obliged them either to wait for a physician or follow telephone instructions. According to the midwives, women taking Pethidine and Phenergan encountered adverse effects and discomfort. Midwives identified high workload, inadequate personnel, lack of skill and knowledge, lack of medication availability, and lack of infrastructure as the primary challenges of administering pharmacological methods to women in labour. The lack of standing orders, which delays the administration of medications pending a physician’s prescription, constituted an additional difficulty. In the instance that Pethidine and Phenergan were unavailable or ineffective for some women, the midwives recommended that women be administered alternative pharmacological pain relievers. They also advocated for institutionalization of pharmacological guidelines allowing them to use their discretion when treating labour pain. Midwives can only utilise a few standardised and regulated pharmacological medications for labour pain management. The midwives’ ability to administer pharmacological pain relief during labour was hampered by a high workload burden, insufficient staff, lack of skill and understanding, drug unavailability, and inadequate infrastructure. Midwives advocated for supported guidelines that would allow them to treat labour pain at their discretion. Intersectoral stakeholders are required to improve midwife skills and attitudes. Health facilities need to train and supply analgesics to midwives. Midwives ought to be familiar with pharmacological pain relievers.

Objective: This study aimed to translate and evaluate the psychometric properties of the Perinatal Missed Care Survey in China. Methods: The Perinatal Missed Care Survey was translated according to the guidelines of the cross-cultural debugging scale recommended by the American Academy of Orthopaedic Surgeons Evidence-Based Medicine Committee, including forward translation, back translation, cultural adaption, and content validation, and its Chinese version was used in a cross-sectional study conducted from February to April in 2023. A total of 491 midwives from 14 different level hospitals in southwest China were recruited through a convenience sampling method. The discrimination ability of the items was tested through item analysis, and construct validity was assessed through exploratory factory and confirmatory factor analyses. The content validity index and Cronbach’s α coefficients evaluated content validity and reliability, respectively. Results: The Chinese version’s item–total correlation coefficients ranged from 0.641 to 0.866 in part A and from 0.644 to 0.819 in part B (P

Background: The period of pregnancy is optimal for vaccination to prevent some diseases in women and newborns. Healthcare workers have a crucial role in informing women and recommending vaccinations. The aim of the study was to assess the knowledge, both theoretical and practical, and attitudes of Polish midwifes and nurses towards vaccination in pregnancy. Material and Methods: The study was conducted in 2019 among 263 medical practitioners (152 nurses and 111 midwives) who answered the authors' questionnaire. Results: A positive approach to maternal vaccination was more often expressed by the surveyed nurses than the midwives (p = 0.002). The mean score for assessing all participants' knowledge based on 12 questions was 5.92. The level of knowledge of participants with a positive attitude towards vaccination in pregnancy was statistically different from the groups with a neutral or negative attitude in the whole study group (p < 0.001). A positive correlation between knowledge and attitude was found in all participants (r = 0.360, p < 0.001). Logistical regression models also indicate the presence of a statistically significant relationship between the level of knowledge and the group, profession, attitude and own assessment of knowledge. Conclusion: Positive attitudes to vaccination were reported mainly among those surveyed on a scientific congress on vaccinations in Poland. Therefore, participation in different forms of education may have a supportive impact on the views of midwives and nurses, and consequently on their willingness to recommend vaccination to pregnant women. [ABSTRACT FROM AUTHOR]

Abstract Aim Different clinical practice guidelines include recommendations on how to prevent and repair obstetric perineal trauma, as well as the use of episiotomy. To evaluate the variability in midwives' professional practices for preventing and repairing perineal trauma, as well as the professional factors that may be associated with the restrictive use of episiotomy. Design Observational cross‐sectional study. Methods Three hundred five midwives completed an anonymous questionnaire developed by the authors and distributed across various midwifery scientific societies. The main outcomes measured were the frequencies of adopting specific practices related to perineal injury prevention and repair, episiotomy technique and restrictive episiotomy use (

Abstract Aim The purpose of this study was to analyse perinatal care managers' perspectives on the role of doulas in Poland and to consider how managers' perspectives might affect the opportunities for doulas to practice in individual hospitals. Design This is a qualitative descriptive study. Method The total of 17 hospitals was selected for the study. Semi‐structured interviews were conducted with 11 manager staff members. Results Three groups of facilities were identified: ‘0’ (n = 6) – refused to give interviews, ‘A’ (n = 8) – marginal experience in working with doulas, and ‘B’ (n = 3) – regular experience in working with doulas. The hospitals from Group A showed indifference towards working with doulas. Group B declared a positive attitude towards such cooperation. Attitudes towards doulas vary among executives and are related to the frequency of doula‐assisted births. Our results indicate factors that may influence the attitude of medical staff towards doulas and which may contribute to improve future initiatives meant to facilitate collaboration between midwives and doulas. Patient or Public Contribution This study explored the lived experiences of perinatal care managers.

Background: Obstetric complications are illnesses that develop during childbirth. Smartphones,which facilitate the use of prompt features in the early diagnosis of challenges and quick delivery ofrespectful maternity care, are one of the most recent advances in health technology. The key objectiveof this project is to evaluate the usability and quality of the “E-Midwife” mobile application for nursemidwives,which focuses on obstetric complications.Methods: This study is a component of a randomized controlled trial on nurse-midwives. This projectfollowed a four-step approach: content development phase, app design phase, app development phase,and usability testing phase. The app was developed using extensive flowcharts, a definition of thenavigational framework, a structured database, and user-friendly software. 140 out of the 196 nursemidwiveswere allocated to the intervention (n=70) and control group (n=70), using random allocation.The intervention group used the application for 8 weeks. Usability and quality of the application wereassessed using the system usability scale and the mobile application rating scale, respectively. SPSSstatistical software, version 17, was used to analyze the dataResults: The overall score of the usability testing of E-Midwife was 82.75±0.68 The total mean scoreof quality was 3.77±0.86. Therefore, it was shown to have good usability and quality.Conclusion: The E-midwife mobile application has a high usability and quality which makes its usageeffective and efficient. It is recommended that these similar mobile apps should be used along withother educational methods for educating the nurse-midwives.Trial Registration Number: CTRI/2022/03/040857.

Aim: This study assessed adolescents' satisfaction with services received during their most recent abortion and the factors associated with satisfaction at reproductive health centres in the Greater Accra region of Ghana. Design: A facility‐based cross‐sectional survey was used for this study. Methods: Overall, 254 adolescent girls aged between 15 and 19 years, who had an abortion within 1 week of the study period were recruited for the study. All the 254 respondents were recruited consecutively as they visited health facilities for abortion services from March 2019 to February 2020. Written informed consent was signed by respondents, and data were collected using the Patient Satisfaction with Nursing Care Quality Questionnaire, and the data were analysed using Stata version 15.0. Univariate, bivariate and multivariate logistic regression analyses were conducted. Results: A majority of adolescents reported being satisfied with the abortion services they received. Ample waiting space and the system of 'first‐come‐first‐served' were the highest rated elements of service satisfaction. Adolescents were least satisfied with the inadequacy of instructions and lack of information on medications received and their therapeutic or side effects. Ethnicity, having a stable intimate partner and perceived adequacy of staff were the factors associated with satisfaction with abortion services. Conclusion: Adolescents are unique group of people with peculiar health needs. If they are treated with respect and dignity, they are likely to be satisfied with services received from the reproductive health centres offering comprehensive abortion care. Impact: The study addresses adolescent satisfaction with abortion care received; if health providers treat adolescent seeking abortion care with respect, friendly and non‐judgemental attitude, it will enable adolescents to seek abortion care from qualified professionals instead of unskilled service providers to reduce maternal mortality. Patient's contribution: Patients from 11 reproductive centres responded to the questionnaire used for the data collection. [ABSTRACT FROM AUTHOR]

Background: Contribution of nursing is crucial for Universal Health Coverage and achieving Sustainable Development Goal 3. Tracer studies help evaluate accountability and demonstrate the impact of nursing educational institutions in a highly competitive job market. The study aimed at assessing the employability of nursing graduates, and perceived quality of the nursing program they pursued in a public tertiary institution in Ghana. Method: The study employed a descriptive cross-sectional survey. One hundred and ten (110) nursing graduates responded to a web-based survey. The data were gathered using a customized questionnaire based on the Tarlac State University Graduates Tracer Questionnaire. Data were collected via google forms, and analyzed using descriptive and inferential statistics. Results: Majority of the participants were females (n = 64, 58.2 %). Most of the participants had completed a Bachelor’s degree at the tertiary institution (n = 101, 91.8 %). A significant proportion of the participants were gainfully employed during the study period (n = 102, 92.7 %) with majority of them working in the public sector (n = 81, 79.4 %). The quality of the diploma or degree program obtained was rated good in most of the areas by over 50 % of the participants. There was no statistically significant association between the highest educational qualification of participants and their perceptions on the quality of the nursing program. Conclusion: There is the need to conduct this kind of tracer study on a regular basis to keep track of graduate’s progress and obtain feedback on the quality of programs being offered so as to meet the ever-changing needs of society.

Aim: The study aimed to describe the various ways in which Italian midwives reconcile their profession's philosophical views about labor with the use of epidural analgesia in clinical practice. Design: Interpretive description. Methods: A purposeful sample of 41 midwives and 12 midwifery students participated in the study. Information about their perceptions and experiences of the use of epidural analgesia and how this practice aligns with their professional values were explored through in-depth interviews (n = 10 focus groups; n = 1 one-to-one interview). The constant comparative method was used to analyze the data. Results: With respect to aligning midwifery care with the administration of epidural analgesia, two midwifery positions were identified: the midwife that acted "in harmony" and the "disoriented midwife", defined by three dimensions: 1) the midwife's conception of her professional role; 2) the woman's attitude towards labor and; 3) the midwife's relationship and comfort with other professionals in the labor room. Conclusion: The results of this research highlight how difficult it can be for a midwife to reconcile a specific philosophical view of labor with the use of epidural analgesia. These findings can provide useful insights to help midwives in the challenging task of combining epidural analgesia with their philosophical view of labor to offer a better birth experience to women.

Abstract Background Restricting parturient women in healthcare facilities from choosing positions that provide the greatest comfort and benefit during labor is a global barrier. Several complex factors, including caregiver preference and medical intervention, shape the limitation. Therefore, a practical need exists to train midwives on the knowledge and skills to change this condition. Methods The study used a parallel, single-blind, randomized controlled trial at a provincial maternity and child health hospital in Fujian, China, from June 1 to December 31, 2019. The midwives in a birth suite were selected and randomly enrolled in a one-month simulation-based hybrid training or face-to-face teaching in September 2019. The four-level Kirkpatrick’s model, including reaction, learning, behavior, and results, was used to evaluate training effects before and after the program. Data were analyzed with SPSS 25.0 using Student’s t-test, Spearman’s correlation test, Mann–Whitney U test, Wilcoxon signed-rank test, and chi-square test analysis of variance. The significance level was set at p 0.05). The virtual simulation group demonstrated an increase in non-supine birth rate (p = 0.030) and a decrease in perineal incision rate among primiparas compared to pre-intervention (p = 0.035). Moreover, knowledge performance was associated with the duration of virtual simulation (r = 0.664, p = 0.001). Conclusions Virtual simulation is a fascinating innovation that enables midwives to develop birthing positions without practicing on real pregnant women and is one solution to achieve work competency within a shortened training period.

Amaç: Araştırma kadın doğum ve jinekoloji kliniklerinde çalışan hemşire ve ebelerin pandemi dönemindeki algılarını, deneyimlerini ve bu deneyimi etkileyen faktörleri belirlemek amacıyla gerçekleştirilmiştir. Yöntem: Bu araştırma nitel yöntemle yapılmıştır. Çalışmanın, katılımcı grubunu bir ilde iki hastanenin kadın doğum ve jinekoloji kliniklerinde görev yapan 20 hemşire ve ebe oluşturmuştur. Veriler Eylül- Kasım 2020 tarihleri arasında kişisel bilgi formu ve yarı yapılandırılmış görüşme formu ile yüz-yüze ve derinlemesine bireysel görüşme yöntemi ile toplanmıştır. Verilerin değerlendirilmesi için içerik analizi kullanılmıştır. Bulgular: Katılımcıların yaş ortalaması 35,30 ±6,62 yıl, %80 (n=16)’i ebe ve %20 (n=4)’si ise hemşiredir. Araştırmada “pandemiyi algılama”, “pandemide bakım hizmetlerinde yaşanan değişimler”, “güçlükler” ve “kazanımlar” temaları ortaya çıkmıştır. Katılımcıların Covid 19’un kendilerine ve yakın aile üyelerine bulaşması ile ilgili endişe ve stres yaşadıkları, çalışma koşulları ve yönetimsel nedenlere bağlı yorgunluk, değersizlik ve öfke hissettikleri belirlenmiştir. Bu süreçte hemşire ve ebelerin izlem ve takiplerinin, hasta eğitimlerinin farklılaştığı görülmüştür. Pandemide hemşire ve ebelerin günlük yaşam aktiviteleri, yönetimsel, kişisel koruyucu ekipman kullanımına bağlı güçlükler yaşadıkları bununla beraber krizi yönetebilme becerisinden dolayı mesleki benlik saygılarının güçlendiği belirlenmiştir. Sonuç: Pandeminin aşılama öncesi döneminde gebe, yenidoğan ve jinekoloji hastasına yönelik bakım hizmetlerinde değişimler gerçekleşmiştir. Bu süreçte kadın doğum ve jinekoloji kliniklerinde çalışan hemşire ve ebeler fiziksel, psikolojik ve sosyal yönden etkilenmiştir.

Aim: This descriptive qualitative study provides information on research dealing with women's opinions, experiences, and attitudes toward menopause. Design: A descriptive qualitative study. Methods: Individual semi-structured in-depth interviews were used for qualitative research into this topic. The research group consisted of 17 women aged 40 to 55 years. Thematic data analysis was used to analyze the data obtained. Results: Based on the thematic analysis, the following categories were created: 1) Association with the period of menopause; 2) Experiencing menopause; and 3) Education. The results showed that women viewed menopause as a transitional phase of life. The main symptoms included hot flashes, night sweats, disturbed sleep, mood swings, and weight gain. Prior to the study, participants were not interested in additional information on the issue. Conclusion: As estrogen levels decline later in life, women transition from the reproductive to the post-reproductive phase of their lives. For women to experience healthy menopause, they must understand the process before they begin to experience the consequences of estrogen deficiency.

Background and Objective: One of the important problems of midwifery is high job stress and its consequences. Having the ability to manage stress is one of the basic requirements of this profession that can reduce midwifery mistakes in the workplace. Although job stress exists in all jobs, midwives face higher levels of stress due to the nature of their job, and this issue can lead to a decrease in service quality. The present study was conducted to determine the relationship of stress management with the level of perceived job stress and the quality of services provided by midwives working in the maternity department of hospitals in Hamedan province, Iran. Materials and Methods: The statistical population of this descriptive cross-sectional study consisted of 210 midwives working in hospitals with obstetrics and gynecology departments in Hamedan province. The random sampling method was used to select the samples. The required data for this study were collected using a demographic information form, Cobin's Stress Management Questionnaire, Hospital Stress Scale, and Maternity Care Quality in Maternity Unit Scale. Data were analyzed in Stata-13 software using Kolmogorov-Smirnov statistical tests and multivariate linear regression. The significance level was considered less than 0.05. Results: The findings showed that 81.4% of midwives had a high level of stress management ability. Moreover, 65.7% of midwives perceived moderate-level job stress, and 79% of midwives provided good quality services in the delivery room. Based on the results, was a moderate and inverse relationship between stress management and perceived job stress (beta=-0.47), and a moderate and direct relationship between stress management and the quality of provided services (beta=0.56). It was also found that perceived job stress had a weak and inverse relationship with the quality of provided services (beta=-0.25). Conclusion: The results revealed that having the ability to manage stress and control job stress could improve the quality of services provided by midwives. It is necessary for midwife managers to improve the process of providing quality services by holding stress management workshops.

Abstract Background Clinical decision-making is considered an essential behaviour in clinical practice. However, no research has been done to examine the associations among midwives’ clinical decision-making, work environment and psychological empowerment. Thus, this study aimed to determine the influence of work environment on midwives’ clinical decision-making and confirm the mediating role of psychological empowerment. Method This study was designed as a multicentre cross-sectional study, and included 602 registered midwives from 25 public hospitals in China. A sociodemographic questionnaire, Work Environment Scale, Psychological Empowerment Scale and Clinical decision-making Scale were applied. A structural equation model was conducted to estimate the hypothesis model of the clinical decision-making among midwives and explore the potential mediating mechanism of midwives’ clinical decision-making. This model was employed maximum likelihood estimation method and bootstrapping to examine the statistical significance. Results The mean score of clinical decision-making among midwives was 143.03 ± 14.22, at an intermediate level. The data of this hypothesis model fitted well, and the results showed that work environment positively affected psychological empowerment, which in turn positively affected clinical decision-making; psychological empowerment partly mediated the relationship between work environment and clinical decision-making among midwives. Conclusions Midwives’ clinical decision-making could be promoted directly or indirectly by providing a healthy work environment and improving psychological empowerment. It is essential for hospital managers to pay attention to the assessment of the midwives’ work environment and actively improve it, such as establishing a supportive, fair and just workplace, and maintaining effective communication with midwives. Furthermore, managers can also promote midwives’ clinical decision-making behaviour by enhancing their psychological empowerment via enhancing job autonomy.

ABSTRACT Objectives: to evaluate the outcomes of Interval Copper Intrauterine Device (IUD) insertion performed by certified midwives and obstetric nurse practitioners at a Peri-Hospital Birth Center. Methods: a cross-sectional study was conducted involving 75 women who underwent IUD insertion between January 2018 and February 2020. Data collection was carried out using medical records and telephone interviews. Results: no instances of uterine perforation were observed. Expulsion rates of the devices were 1.3% within 30 to 45 days of use and 5.3% within the first year of use. The follow-up removal rate was 4.0%. The average pain score reported was 4.2 (SD = 3.3). Among those who continued using the device, 93.1% expressed satisfaction. Conclusions: the findings demonstrate that IUD insertion by certified midwives and obstetric nurse practitioners is a safe procedure, yielding outcomes comparable to those reported in the existing literature.

Abstract Background Midwives and nurses are crucial in breastfeeding support. Few studies have explored appropriate language for nursing education on breastfeeding. We assessed the impact of the language used on breastfeeding attitudes among midwives and nurses. Methods A quasi-experimental study was conducted online in Japan among 174 midwives and nurses who had work experience in obstetrics or pediatrics. Participants were allocated to three groups to receive different text messages as the intervention (the benefit of breastfeeding for Group 1; the risk of formula feeding for Group 2; the importance of childcare for Group 3 as the comparison). The Japanese version of the Iowa Infant Feeding Attitude Scale (IIFAS-J) was used to assess breastfeeding attitudes before and after reading the texts. Also, participant reactions to the text were assessed by their responses to three statements. ANOVA, the chi-square test, and the t-test were used for outcome assessments. Results The post-test IIFAS-J score was significantly higher than the pre-test score only for Group 1 (p

Abstract Background and aim Effective support given by a midwife during labor and childbirth is associated with numerous positive outcomes. Yet the delivery of such support can be hindered by negative workplace cultures. The purpose of the current study was to examine the relationship between attitude and self-efficacy of labor support and labor supportive behaviors from the perspectives of midwives working in Iran. Methods Midwives (n = 213) employed in the labor wards of selected hospitals in an urban area of Iran participated in this cross-sectional study. Participants were recruited via convenience sampling from December 2016 to September 2017. The data were collected using a personal characteristics tool, the Labor Support Questionnaire, the Self-efficacy Labor Support Scale, and attitudes toward the Labor Support Questionnaire. Descriptive statistics along with multiple linear regression was used for data analysis. Results Participants had a supportive behavior score of 74.98 for mean (SD ± 13.39). The informational support dimension had the highest reported score of the supportive behaviors, whereas the tangible support dimension had the lowest score. The mean scores of attitude and self-efficacy toward labor support were 24.79 (SD ± 4.14) and 79.83 (SD ± 13.82). There were also statistically significant correlations between attitude and self-efficacy, and labor support behaviors and its dimensions. Multiple linear regression analysis results indicated that interests in occupation, attitude, and self-efficacy were predictors of labor supportive behaviors. Conclusion Midwives’ level of interest in the profession, attitude, and self-efficacy of labor support were significantly associated with labor support behaviors. Thus midwives’ interest in their profession, along with their attitudes and self-efficacy could usefully be developed to enhance their supportive behaviors during labor.

The infant mortality rate in the Magelang Regency Health Office area will increase in 2020-2022 from 6.34/1000 KH to 7.38/1000 KH with details of the cause of death due to asphyxia neonatorum 27%. In handling neonatal asphyxia, the role of village midwives is needed to help reduce infant mortality. This study aims to determine the factors that influence the performance of midwives in the service of neonatal asphyxia in the Health Office of Magelang Regency. The type of research used is observational which is analytic in nature with a cross sectional approach. Data collection was carried out by interviews using a structured questionnaire that had been tested for validity and reliability. Sixty five respondents were selected purposively with inclusion and exclusion criteria. The analysis used is the Chi Square test and multiple logistic regression. The average age of the respondents was 38 years, 96.9% of the respondents had Diploma III in Midwifery. Most of the respondents (72.3%) had less knowledge, 55.4% had less attitude, 50.8% had less motivation. Most (80%) of the support resources (funds, facilities, infrastructure) are good. Respondents' perception of supervision (52.3%) is good. Most of the respondents (60%) had poor performance in handling neonatal asphyxia. The results of the bivariate analysis showed that knowledge (p = 0.001), attitude (p = 0.0001), motivation (p = 0.0001), perceptions of supervision (p = 0.0001) were related to the performance of village midwives. Multivariate analysis showed that there was a joint relationship between knowledge (Exp.(B) 7.723) and motivation (Exp.(B) 8.324) and the performance of village midwives in handling neonatal asphyxia. The Health Service needs to provide technical guidance on a regular basis in the management of neonatal asphyxia and increase motivation by giving awards to midwives who work well in the service of neonatal asphyxia.

Amaç: Toplumsal cinsiyet eşitsizliği birçok alanda görülmekte ve ekonomik kültürül ve sosyal birçok alanı etkilemektedir. Bu araştırma, toplumsal cinsiyet ve şiddet konusunda farkındalığı artırmak amacıyla verilen eğitimin ebelik öğrencilerinin toplumsal cinsiyet algı ve tutumuna etkisini incelemek amacıyla yapılmıştır. Yöntem: Araştırma, deneysel araştırma tasarımlarından randomize olmayan gruplarda ön test-son test yarı deneysel olarak planlanmıştır. Araştırmada örneklem seçimine gidilmemiş olup, araştırmaya dâhil edilme kriterlerine uyan 41 ebelik öğrencisi ile yürütülmüştür. Veriler, tanıtıcı bilgi formu, Toplumsal Cinsiyet Rolleri Tutum Ölçeği, Toplumsal Cinsiyet Algısı Ölçeği ile toplanmıştır. Katılımcılara çalışmanın amacı aktarılarak, gönüllülük ilkesi doğrultusunda veriler toparlanmıştır. Verilerin analizinde, tanımlayıcı istatistikler için sayı, yüzde, ortalama ve standart sapma kullanılmıştır. Karşılaştırmalı tekrarlı ölçümlerde tek faktörlü varyans analizi ve korelasyon analizi kullanılmıştır. Bulgular: Katılımcıların toplumsal cinsiyet rolleri tutum ölçeği ön test puan ortalamasının 60,02 ± 8,49, son test puan ortalamasının 58,93 ± 7,96 olduğu belirlenmiştir. Toplumsal cinsiyet algı ölçeği ön test puan ortalamasının 111,00 ± 10,50, son test puan ortalamasının ise 110,51 ± 12,07 olduğu bulunmuştur. Katılımcıların eğitim öncesi ve sonrası toplumsal cinsiyet rolleri tutum (p = 0,2929) ve toplumsal cinsiyet algı (p = 0,771) puan ortalamaları karşılaştırıldığında anlamlı fark olmadığı belirlenmiştir. Uygulamada Kullanım: Toplumsal cinsiyet ve şiddete yönelik eğitim sonrası ebelik öğrencilerinin toplumsal cinsiyet tutum ve algılarının değişmediği belirlenmiştir. Toplumsal cinsiyet ve şiddet üzerine etki edecek farklı bölüm, müfredat, eğitim programı içeriği bakımından karşılaştırmalı çalışmalar planlanması önerilmektedir.

Background and Objective: Nausea and vomiting during pregnancy are one of the most common complaints of pregnant women. The present study aimed to assess the effect of counseling based on the model of continuous midwife-led care on nausea and vomiting during pregnancy. Materials and Methods: This two-group clinical trial study was performed on 60 pregnant women aged 8-12 weeks in 2020. Participants in the intervention group received three face-to-face counseling sessions based on the continuous midwife-led care model, while the control group received routine prenatal care. The severity of nausea and vomiting was assessed using the Pregnancy-Unique Quantification of Emesis (PUQE) questionnaire three days before the commencement of the study and two weeks during the study. Data analysis was performed in SPSS software (version 22) using the Chi-square test, one-way analysis of variance, and analysis of covariance. A p-value less than 0.05 was considered statistically significant. Results: In the intervention group, after the midwife-led consultation, compared to before, the mean scores of nausea and vomiting, as well as the overall severity of nausea and vomiting, decreased during two weeks (P0.05), the difference between the two groups in the second week of the study was significant in terms of overall severity of nausea and vomiting based on the overall score of the PUQE questionnaire (P

Background: Midwives and nurses are crucial in breastfeeding support. Few studies have explored appropriate language for nursing education on breastfeeding. We assessed the impact of the language used on breastfeeding attitudes among midwives and nurses. Methods: A quasi-experimental study was conducted online in Japan among 174 midwives and nurses who had work experience in obstetrics or pediatrics. Participants were allocated to three groups to receive different text messages as the intervention (the benefit of breastfeeding for Group 1; the risk of formula feeding for Group 2; the importance of childcare for Group 3 as the comparison). The Japanese version of the Iowa Infant Feeding Attitude Scale (IIFAS-J) was used to assess breastfeeding attitudes before and after reading the texts. Also, participant reactions to the text were assessed by their responses to three statements. ANOVA, the chi-square test, and the t-test were used for outcome assessments. Results: The post-test IIFAS-J score was significantly higher than the pre-test score only for Group 1 (p < 0.01). The percentage of participants who agreed with the content of the text was 70.7% in Group 1 and 48.3% in Group 2. The percentage of participants who reported discomfort with the text was 34.5% in Group 1 and 55.2% in Group 2. No significant difference among groups existed regarding interest in the text. In all three groups, participants who agreed with the text had a higher post-test IIFAS-J score than those who disagreed with the text (6.85 points higher, p < 0.01 in Group 1; 7.19 points higher, p < 0.01 in Group 2; 8.00 points higher, p < 0.02 in Group 3). Discomfort with the text and interest in the text were associated with a significantly higher post-test IIFAS-J score in Group 1 and Group 2 but not in Group 3. Conclusions: "Benefits of breastfeeding" language, which conveys the information in a positive manner, appears to be more appropriate than "risks of infant formula" language for creating a positive attitude toward breastfeeding in nursing education. Trial registration: This study was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000023322). Registered 05/08/2016. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim of this study was to explore healthcare managers' perceptions about older nurses' and midwives' and their contribution to the workplace. Design: A qualitative descriptive methodology. Method: Twenty healthcare managers working in Australia participated in semi‐structured interviews. Data were collected between April 2019 and April 2021. Interviews were recorded, transcribed and then analysed using thematic analysis. Results: All healthcare managers said older nurses and midwives contributed to the workplace through their experience and knowledge. Managers viewed them as a different type of worker and while there were some positive aspects to this, it was mostly negative. Although managers identified a broad age range for the older nurses or midwives, there was a common perception that if they were no longer able to perform their duties, they should leave the workforce. Conclusion: Healthcare managers' perceptions towards older nurses and midwives are mostly negative, and their understanding of older workers' contribution is contradictory and poor. These negative views co‐exist with the lack of agreement on who is the older worker, which explain the reluctance of healthcare organizations to invest in their older workforce. Future research is needed to better understand the unique contribution of older nurses and midwives in healthcare and how they can be supported at work. Impact The global ageing population will result in a rise in complex age‐related health issues and will require an experienced and knowledgeable workforce. Given the greater experience of older nurses and midwives they are an important part of the health workforce. Yet managers' perception of the contribution by older nurses and midwives were often negative. The findings of this study highlight the need for organizational change so that the contribution of older nurses and midwives is recognized and supported by managers. [ABSTRACT FROM AUTHOR]

condition that often occurs in neonates. This condition is important to note, because if the bilirubin levels are too high, it can lead to several complications in the brain, such as encephalopathy and cerebral palsy in infants.Objective: The objective of this study is to analyze which maternal and neonatal risk factors can cause hyperbilirubinemia in neonates. Methods: This study is an analytical study with a cross sectional approach. Population samples was taken from the perinatology room Dr. Rumkital. Ramelan Surabaya in January 2018 - December 2019, there were 252 samples and 122 samples who experienced hyperbilirubinemia. Data analysis using Chi Square test and logistic regression. Results: It was found that the type of delivery with cesarean section was the largest percentage with a p value of 0.106;; Most LBW with p value 0.038; male at most with a p value of 0.046. From the results of multivariate analysis, it was found that the variable birth weight had a greater influence on the incidence of hyperbilirubinemia compared to other variables with a significance value of p value 0.00 on alpha 5%. Conclusion: There is a significant relationship between type of gestational age, sex and birth weight with the incidence of hyperbilirubinemia, while the type of delivery and parity have no significant relationship with the incidence of hyperbilirubinemiia. Keywords: Hyperbilirubinemia, Neonates, Risk Factor

Aims: To investigate women's childbirth experiences and their relation to self‐esteem development in the postpartum year. Design: A mixed methods study. Methods: Women (N = 125) completed survey questionnaires regarding their self‐esteem and childbirth experiences at three time points in 2020–2021: third trimester of pregnancy (T1), 4–8 weeks postpartum (T2) and 1 year postpartum (T3). The survey results were analysed using qualitative thematic and quantitative path analyses with latent change factors. The open‐ended answers of the women who demonstrated a change in self‐esteem between T2 and T3 were then compared. The STROBE checklist was used as the reporting guideline. Results: The quantitatively measured childbirth experiences predicted statistically significantly and positively the changes in self‐esteem in the following year. The women described their childbirth stories through three main themes: childbirth as a lived experience, childbirth as a relational event and childbirth as a medical event. On the basis of the thematic analysis, we propose that the relationship between childbirth experience and self‐esteem development might only hold for women with extremely positive or negative childbirth experiences. There were mixed results for those women who had mixed experiences, indicating that other factors probably contributed to the changes in self‐esteem. Conclusion: Childbirth is a pivotal event that may have lasting effects on the mother's self‐esteem after childbirth. Especially women with traumatic experiences deserve attention because they are at risk of the most negative consequences. Impact Perinatal services and policy makers must recognize the importance of childbirth experiences in women's well‐being and improve their practices. Different cultural models of childbirth should be recognized and supported to facilitate good experiences and prevent traumatic ones. Patient or Public Contribution: Service users recruited in Finnish Child Health Centers responded to surveys that were used as data for this study. [ABSTRACT FROM AUTHOR]

Introduction. The history of recommendations by the Polish Federation for Education in Diabetology dates back to 2006, when guidelines for nurses/midwifes working with diabetic patients were first drawn up. However, the development of nurses and midwifes? competences requires stronger actions that foster a transition from experience-based towards evidence-based practice. Aim. The aim of this publication is to present a set of procedures describing nursing interventions in diabetes care, including currently available scientific evidence and clinical experience of specialists involved in the care of diabetic patients. Material and methods. The study involved a literature review of selected areas of nursing practice in diabetes care. When compiling the material, the priority was to use data from (in order of significance): randomized controlled clinical trials and their meta-analyses, observational studies and other studies with lower levels of evidence. Results. Based on an analysis of the collected material, 15 procedures and 2 guidelines have been developed, describing selected aspects of nursing interventions in diabetic patients. Each of the procedures details key recommendations on diabetes care, arranged in accordance of the significance ascribed to the scientific evidence analyzed. Conclusions. The 2023 PFED guidelines on nursing diabetes care are the effect of the evaluation of the previous versions and comprise an updated, considerably more extensive, comprehensive and evidence-based set of practices. The major asset of these guidelines is their interdisciplinarity, reflected in the fact that the final version of the publication was approved by consultants in numerous nursing fields, a consultant in diabetology, and the President of the Polish Federation for Education in Diabetology, who all represent the medical community. The authors experience gained during work on international recommendations (New Insulin Delivery Recommendations) played an important role when formulating the present guidelines. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to understand the current situation and multiple factors affecting the core competence specializing in the maternal, neonatal and under‐five nursing in China. Background: Highly skilled nurses and midwives are essential worldwide for achieving the Sustainable Development Goals, especially in low‐ and middle‐income countries like China, due to the overwhelming COVID‐19 crisis. Method: The 890 nurses and midwives from 12 hospitals were investigated in this cross‐sectional study, with two questionnaires: the sociodemographic information and competency inventory for the registered nurses. Results: The participants reported a mean total score of 193.78 (±42.19) out of 220 and lowest in critical thinking and research ability (3.01 ± 0.82). The professional title, level, marital status, relationship quality, highest qualification, experience in specialist nurse training, participation in scientific research projects and publishing papers were the influencing factors (P <.05). Conclusions: The respondents' core competence needs improvement, especially critical regarding thinking and research ability. In addition, marriage and good or excellent relationship quality are factors that can potentially improve competence. Implications for Nursing Management: Targeted interventions for higher core nursing competence need to be implemented, especially focusing on nurses' marital status and emotional support from partners. [ABSTRACT FROM AUTHOR]

Aims: To synthesize qualitative studies of subjective experience of pregnancy in people with cystic fibrosis. Design: Thematic synthesis of qualitative studies. Data sources We searched PUBMED, CINAHL, EMBASE. PsicINFO and Social Sciences Citation Index for qualitative studies published in English, which reported on pregnancy in people with cystic fibrosis. Searches were carried out in March 2021, updated in June 2022. Review methods: Studies that met the inclusion criteria were appraised for quality using the Critical Appraisal Skills Programme (CASP) for qualitative research. Data were extracted from the studies, analyse and synthesise using thematic synthesis approach. Results: Thirteen studies were included in the review and 'Walking on a wire' framework was conceptualized. We found three analytical themes: (1) desire for information related to pregnancy in cystic fibrosis, (2) factors at play in decision‐making related to pregnancy for people with cystic fibrosis and (3) pregnancy experience and eight descriptive themes: (1) information topics, (2) CF healthcare team/PwCF as a provider of reproductive health information, (3) information timing, (4) barriers to information delivery, (5) barriers to decision‐making and stresses relating to the process of trying to conceive, (6) environmental factors, (7) coping with challenges, and (8) moving towards parenthood. Conclusion: For people with cystic fibrosis, pregnancy is a complex pathway: the amount of knowledge about cystic fibrosis and sexual and reproductive health, barriers to pregnancy and environmental factors provides the background to decision‐making. Moreover, coping with pregnancy is a challenging experience, where they have to mediate between the physical and emotional implications of planning a pregnancy and the limitations imposed by the chronic health conditions. Impact Understanding the psychological experiences of people with cystic fibrosis (PwCF) will improve future research and practice. Education about sexual and reproductive health and psychosocial care programmes are necessary to help PwCF deal with the challenges related to pregnancy. Hospitals should enhance the development of specific programmes to promote the well‐being of individuals with CF who are planning a pregnancy. [ABSTRACT FROM AUTHOR]

Background: Despite frequent recommendations from the World Health Organization (WHO), hand hygiene compliance (HHC) is an ongoing challenge among health care workers (HCWs). Objectives: This study aimed to evaluate the HHC in Iranian nurses and midwives during the COVID-19 pandemic. Methods: This observational study was conducted on 200 nurses and midwives working in two hospitals in Jiroft, Iran in 2021. Data were collected using a demographic information checklist and the WHO Hand Hygiene Observation Form. Data analysis was performed using the MannWhitney U, Chi-square, Kruskal-Wallis, and Spearman correlation coefficient tests. Results: The average percentage of HHC in the nurses and midwives was 51.3%. HHC before touching the patient and before doing a clean/aseptic procedure was at the lowest rate (33.5% and 49%, respectively) but was at the highest rate (81.8%) after a body fluid exposure risk. Conclusions: The HHC rates were low among nurses and midwives during the COVID-19 pandemic. It is essential to implement interventions to promote HHC in HCWs, especially in pandemic conditions.

Abstract Background In low and middle-income countries, nurses and midwives are the frontline healthcare workers in obstetric care. Insights into experiences of these healthcare workers in managing obstetric emergencies are critical for improving the quality of care. This article presents such insights, from the nurses and midwives working in Rwandan district hospitals, who reflected on their experiences of managing the most common birth-related complications; postpartum hemorrhage (PPH) and newborn asphyxia. Rwanda has made remarkable progress in obstetric care. However, challenges remain in the provision of high-quality basic emergency obstetric and newborn care (BEmONC). This study is a qualitative part of a broader research project about implementation of an mLearning and mHealth decision support tool in BEmONC services in Rwanda. Methods In this exploratory qualitative aspect of the research, four focus group discussions (FGDs) with 26 nurses and midwives from two district hospitals in Rwanda were conducted. Each FGD was made up of two parts. The first part focused on the participants’ reflections on the research results (from the previous study), while the second part explored their experiences of delivering obstetric care services. The research results included: survey results reflecting their knowledge and skills of PPH management and of neonatal resuscitation (NR); and findings from a six-month record review of PPH management and NR outcomes, from the district hospitals under study. Data were analyzed using hybrid thematic analysis. Results The analysis revealed three main themes: (1) reflections to the baseline research results, (2) self-reflection on the current practices, and (3) contextual factors influencing the delivery of BEmONC services. Nurses and midwives felt that the presented findings were a true reflection of the reality and offered diverse explanations for the results. The participants’ narratives of lived experiences of providing BEmONC services are also presented. Conclusion The insights of nurses and midwives regarding the management of birth-related complications revealed multi-faceted factors that influence the quality of their obstetric care. Even though the study was focused on PPH management and NR, the resulting recommendations to improve quality of care could benefit the broader field of maternal and child health, particularly in low and middle-income countries.

AimThis analysis assessed changes over time in skill and knowledge related to the use of evidence-based practices associated with quality of maternal and neonatal care during a nurse midwife mentoring intervention at primary health clinics (PHCs) in Bihar, India.DesignNurse midwife mentors (NMMs) entered live birth observation data into a mobile App from 320 PHCs.MethodsThe NMMs completed prompted questions in the App after every live birth witnessed. The App consisted of questions around three main themes, "What went well?", "What needed improvement?" and "What can be done differently next time?".ResultsObservational data from 5,799 births was recorded by 120 NMMs in 320 PHCs. Knowledge and skill during normal spontaneous vaginal deliveries and complicated deliveries with either a postpartum haemorrhage or non-vigorous infant all showed statistically significant improvement (p

Breast milk is perfectly adapted to the individual nutritional needs of the child. The World Health Organization recommends exclusive natural feeding of infants until they reach 6 months of age. Midwives provide women with lactation support before and after childbirth. Their care continues after discharge from hospital during home visits. Nowadays, most women experience breastfeeding difficulties, indicating the importance of the midwife’s role in lactation care. The role of midwives in antenatal care is to provide information on the physiology of lactation and to present the benefits of breastfeeding for the mother and child. An important element of antenatal education is the initial preparation of the pregnant woman for breastfeeding. The role of midwives after delivery is to ensure skin-to-skin contact of the newborn and its mother. They teach the correct way to latch the baby onto the breast and help to choose a proper position for feeding. The community midwife takes care of the women after discharge from hospital. They visit the mother and the baby in their home environment. During home visits, the midwife assesses the newborn’s and the mother’s health, the newborn’s physical development and weight gain, and provides lactation support. The midwife’s lactation advice is based on the following: medical interview, observation of the mother’s general and mental condition, breast examination, suckling assessment, and evaluation of the breastfeeding efficiency. The midwife provides lactation advice, taking into account the anatomical conditions in the structure of the mother’s breast and the child’s oral cavity.

Abstract Aim To evaluate factors associated with parental separation during the parenthood transition. Design Prospective, longitudinal and explorative. Methods This is a quantitative longitudinal study of N784 subjects throughout the pregnancy journey with multivariate regression analysis of survey data derived from three validated measurement scales; the Sense of Coherence scale, the Multidimensional Scale of Perceived Social Support and the Perceived Quality of the Dyadic Relationship scale conducted 2014–2016. Results N17 participants separated at 2 years. Parental separation was significantly greater for those women and partners with low or changing sense of coherence, perceived social support and perceived quality of the parental‐couple relationship indexes. Partners with a change in sense of coherence (p: .003) and perceived quality of the parental‐couple relationship (p: .020) between 1 week and 2 years were at greater risk for separation. Attending professional preparatory support with a partner for women (p: .013) and attending the “Inspirational Lecture” for partners (p: .046) were, to a lesser extent, associated with a risk of parental separation.

Aim: To determine the knowledge and attitudes of nurses and midwives working in obstetrics clinics regarding legal responsibilities in medical errors. Method: This descriptive study was performed with 42 nurses and 67 midwiwes working in the Obstterics, and Gynecology Clinic of a University Hospital. The data were obtained by using an Individual questionnaire, Information Form of Nurses and Midwives Regarding Legal Liability in Medical Errors and the Scale of Attitudes towards Medical Errors. Results: A statistically significant difference was found between nurses and midwives in terms of medical malpractice (p

Background: While the COVID-19 pandemic has spread across nations in significant terms, midwives who play a crucial role in offering maternal and child care amid the pandemic stand a high risk of being infected. Examining their level of compliance with the standard precautions amid the pandemic is important. Purpose: To assess the level of compliance of midwives in Indonesia with Personal Protective Equipment (PPE) usage and hand washing. Methods: In June 2020, an online cross-sectional survey was conducted on 1520 midwives in Indonesia during the early onset of the COVID-19 pandemic. Data were analyzed using Statistical Package for the Social Sciences version 26. Association between demographic variables and compliance with standard precautions was measured using Chi-square test. Results: Approximately 74% of midwives used PPE and masks when outside while more than 40% of them did not always wash their hands after they touch an object outside home. A significant association was found between level of education (p =.001), region (p =.000) and mask usage. However, association between ethnicity and mask usage; region and handwashing were not significant. Conclusion: Majority of the midwives in Indonesia complied with PPE usage, but majority did not adhere to hand washing. This highlights the need for appropriate interventions to improve compliance to standard precautions in a bid to curtail further spread of the pandemic.

Introduction: Midwifery is a profession characterized by physical and psychological stressors. It is mostly practiced by women. Midwifery is one of the essential elements of community health. Besides, midwives’ health and performance are important in their self-care, improve service delivery, and encourage other women to engage in health-promoting behaviors. Analyzing factors affecting self-care by exploring midwives’ experiences can be a step towards improving their health and ultimately community health.Methods: The present study was conducted using a qualitative approach. The data were collected through 22 semi-structured individual interviews with midwives working in hospitals or health centers. Sampling was continued until data saturation. The collected data were analyzed using a conventional content analysis approach and simultaneously with sampling. The four criteria proposed by Lincoln and Guba were used to establish rigor in this study and validate the findings.Results: Two themes (health as a self-care outcome and different perceptions of health) and 5 main categories were extracted from the data in this study. The first theme was subdivided into three categories including the desire for a healthy life, preferring prevention over treatment, and inefficient self-care, which explains midwives’ awareness of and positive attitudes towards self-care and facilitators of self-care. The second theme (different perceptions of health) was divided into two categories including lack of risk perception and disregard for health behaviors that can account for barriers to midwives’ performance.Conclusion: To promote midwives’ health, special self-care programs need to be developed by policymakers by taking into account midwives’ motivation for self-care and existing job barriers.

Introduction: Nurse-midwifery allows expectant mothers to have autonomy during their pregnancy and birth, but it is not currently recognized as a profession; however, the legal resolution 3280 of 2018 defines the technical and operational guidelines of the Comprehen-sive Health Care Pathways for the Maternal and Perinatal Health Population and establishes their operational guidelines, emphasizing the participation of the nursing professional in the preconception consultation and prenatal care. Objective: Recognize the benefits of the care provided by nurses during the pregnancy and labor reported in the literature. Methodolo-gy: Comprehensive review of the literature with a searching period between February-May of 2020 in the EBSCO, Pubmed, LILACS, Cuiden and Google Scholar databases with the following DeCS-MeSH terms: Midwifes, complications, labor, pregnancy, nursing care and postpartum period, logical connectors AND-OR. 44.966 papers in English, Spanish and Por-tuguese were obtained and grouped according to their title, abstract, full text, level of evi-dence and level of recommendation; however, 33 of these papers were chosen for critical reading. It should be made clear that the ethical considerations were met for documentary research. Results: Through the analysis of the content 4 topics were built: benefits of prenatal care and assisted delivery, abilities and interventions of the nurse for the comprehensive care of the expectant mother, risk considerations of the nurse during prenatal care and delivery and nursing care challenges during the pregnancy, labor and postpartum period. Conclusion: The assistance of the nurse during low-risk pregnancies provides multiple benefits for the woman, reduces the pain and period of labor; also enabling the identification of risks in a timely manner.

INTRODUCTION: Aim: This study was conducted to compare the professional commitment of the midwives from the X and Y generations. Method: This research with descriptive design was carried out among midwives in two cities in the Eastern Anatolia in September and November 2019. The study population consisted of the midwives from the X and Y generations, working in the relevant hospitals between the aforementioned dates, and agreed to participate in the study voluntarily. The data of the study were collected by 7-8 interviewers and researchers in each province. The data were collected using the Personal Information Form and the Midwifery Belonging Scale (MBS). Before collecting the study data, an ethics committee approval was obtained and once the midwives were informed, their verbal consent was obtained. Results: Based on comparison of the midwives' descriptive characteristics, it was determined that 42,9% of the midwives from the X generation and 81,2% of the midwives from the Y generation had a bachelor's degree. It was found that 8.4% of the midwives from the X generation and 82.7% of the midwives from the Y generation chose their profession willingly. It was determined that the mean scores of professional developments and opportunities subscale of the midwives from the X and Y generations who were included in the study were 18.61+-3.44 and 19.49+-3.72, respectively and the difference between them was statistically significant (p=0.006). It was determined that the mean scores of professional task and authority limitations subscale of the midwives from the X and Y generations were 10.90+-3.96 and 11.99+-3.31, respectively and the difference between them was statistically significant (p=0.001). It was found that the difference between the total mean score of the MBS was not statistically significant between the groups in the X and Y generations(p>0,05). Conclusion: According to the results of the research, it was observed that the sense of commitment was higher in the generation Y. METHODS: RESULTS: DISCUSSION AND CONCLUSION:

Background: Pregnant women who notice signs of obstetric danger at an early stage contribute to saving lives of both themselves and fetus by applying to health facility more quickly. Objectives: Present study was carried out to determine awareness of pregnant women about danger signs which might occur during pregnancy and related factors. Methods: Data of cross-sectional study were collected by use of a survey between April – September 2018. Sample included 350 pregnant women applying a secondary health institution. Data were analyzed by descriptive statistics and chi-square analysis using SPSS 21.0 statistical program. Results: Average age of participants was 29.57 ± 4.7 and 59.7% of them were multigravida. First 10 symptoms marked as "danger sign" by pregnant women were respectively having contraction or fainting strokes (88.6%), loss of consciousness (88.3%), bleeding from the reproductive organs (86.9%), hypertension (82.3%), fever (81.1%), wound, herpes, wart, pruritus or foul smelling discharge in genitals (78.3%), decrease in frequency of baby movements (78.0%), shortness of breath/ cyanosis (75.7%), ache or irritancy while urinating (71.1%), and changes in vision (69.4%). Sociodemographic and obstetric characteristics and education on obstetric danger symptoms were related with symptoms that pregnant women defined as danger signs. Conclusions: While pregnant women's rates of receiving antenatal care were sufficient, their awareness of in terms of danger signs during pregnancy was not at desired levels and they needed to training in some areas. While presenting these trainings, it is recommended to consider socio-demographic and characteristics of pregnant women.

Aims and Objectives: To evaluate the effectiveness of cold application methods in reducing postpartum episiotomy pain. Background: Many women suffer from pain after giving birth due to an episiotomy. This prolonged pain affects their daily lives as they recover. Various methods can help alleviate this pain; however, the effects of cold application specifically are still under discussion. Design: Systematic review and meta‐analysis were used. Methods: In this review, we investigated studies from the CINAHL, PubMed, Google Scholar and Science Direct databases that met PICOS inclusion criteria. We also assessed the studies' methodological quality with the JADAD and JBI checklists. This study was performed based on the Guidelines of Systematic Reporting of Examination presented in the PRISMA checklist (Appendix S1). The search protocol has been registered at the PROSPERO International Prospective Register of Systematic Reviews. Results: A total of seven published studies including 700 total participants were included in this review. Various cold application methods (cold gel pack/pad, crushed ice gel pad, ice pack) significantly reduced the pain after an episiotomy. Ice packs in particular did not significantly differ from lavender oil and acupressure in reducing pain after an episiotomy. Conclusions: Cold application methods can be an effective, non‐pharmacological midwifery and nursing intervention to reduce pain after an episiotomy. Relevance to clinical practice: The use of cold application methods to reduce pain after episiotomy may reduce the need for pharmacological medication in women due to the reduction in pain in the perineum. [ABSTRACT FROM AUTHOR]