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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]

Menstruation is a key function of the reproductive system and is central to sexual and reproductive health and rights. Menstrual health and hygiene is critical to the well-being and ability of women and adolescent girls to take care of themselves in a healthy way during menstruation. Therefore, they should be explained and considered as an educational and health process. Topic relevance: respondents' attitudes to receiving information about the menstrual cycle from a midwife. Purpose: to provide health information about the nature of menstruation. Materials and methods: A survey was conducted in the month of April 2024 from schools in the city of Burgas, the city of Karnobat, the city of Sungurlare, the village of Ruen. There are 108 mothers of adolescent students who showed interest and desire to participate in the anonymous study. For the purpose of the study, the students, together with a teacher, prepared a multimedia presentation containing health information about the menstrual cycle, menstruation, hygiene care related to it, ways to achieve menstrual health; Results: Students aged 10 to 18 took part in the study. More than half of the girls studied had menarche between the ages of 12-14 (50.80%). The mother is the source of information (87.50%), and at the same time, children want to receive guidance on menstrual health from a doctor (52.50%), a school nurse (37.70%), even a familiar midwife ( 9.80%). A large proportion of mothers recognize the midwife as the appropriate health professional for menstrual health education.Conclusion: The study confirms the need for a premenstrual conversation, which mostly calms and prepares the girl for the upcoming menstruation. Adolescence is the most appropriate period during which an adolescent girl can develop healthy habits, including habits to maintain menstrual health. [ABSTRACT FROM AUTHOR]

Aim Design Methods Results Conclusions Implications for the Profession and/or Patient Care What Problem Did the Study Address? What Were the Main Findings? Where and on Whom Will the Research have an Impact? Reporting Method Patient or Public Contribution To explore the perceptions and experiences of midwives caring for couples who experience a stillbirth.Qualitative study based on Gadamer's hermeneutic phenomenology.This study was conducted with midwives (n = 18) at the birth unit of a third‐level public hospital in Jaén (Spain) in 2023. Personal semi‐structured interviews were recorded in audio for later transcription by two researchers following steps described by Fleming.Two themes were identified as important aspects of the practise of midwives in a situation of the birth of a stillborn child: (1) the importance of each action of the midwife, and (2) the availability of resources determines the care provided.Having a stillbirth is a very complex experience, in which the psychological support and human and material resources involved are the basic tool for the care of these families. Acknowledging limitations of the available resources, the assistance and care provided by midwives are in line with the clinical practice guidelines, which can have an emotional impact on them.The care to be provided in stillbirth requires appropriate human and material resources for these families. Midwifery and nursing professionals are in a unique position for acting in cases of families with a stillbirth, updated protocols and, in general, the coordination of the different agents involved within the healthcare system.The midwives´ experiences in cases which end with the delivery of a stillborn.Each action of the midwife is as important as the availability of resources to offer the most appropriate care.In each woman who receives the care of a midwife who attends the birth of a stillborn.COREQ checklist.No patient or public contribution occurred for this study as this research focused on exploring staffs' perspectives from the specific viewpoint of their personal experience. [ABSTRACT FROM AUTHOR]

This article on the case of R v Noor (2024) discusses the second successful UK prosecution under the Female Genital Mutilation Act 2003, marking a significant legal precedent in addressing female genital mutilation. It underscores the critical role of midwives in detecting, reporting and caring for victims, highlighting the intersection of healthcare, law and ethics in combating this practice. By examining the case of Amina Noor, who took a child abroad for female genital mutilation, the article elucidates the legal ramifications of such acts. It stresses the importance of midwifery awareness, education and collaboration with legal entities to protect women and girls. The article advocates for continuous professional development, the use of legal tools such as female genital mutilation protection orders and a Commissioner to prevent female genital mutilation, emphasising the collective responsibility of healthcare professionals in eradicating this harmful practice and safeguarding vulnerable individuals. [ABSTRACT FROM AUTHOR]

Aim: To understand and interpret the lived experience of newly qualified midwives (NQMs) as they acquire skills to work in free‐standing birth centres (FSBCs), as well as the lived experience of experienced midwives in FSBCs in Germany who work with NQMs. Background: In many high‐, middle‐ and low‐income countries, the scope of practice of midwives includes autonomous care of labouring women in all settings, including hospitals, home and FSBCs. There has been to date no research detailing the skills acquired when midwives who have trained in hospitals offer care in out‐of‐hospital settings. Methods: This study was underpinned by hermeneutic phenomenology. Fifteen NQMs in their orientation period in a FSBC were interviewed three times in their first year. In addition to this, focus groups were conducted in 13 FSBCs. Data were collected between 2021 and 2023. Findings: Using Heidegger's theory of technology as the philosophical underpinning, the results illustrate that the NQMs were facilitated to bring forth competencies to interpret women's unique variations of physiological labour, comprehending when they could enact intervention‐free care, when the women necessitated a gentle intervention, and when acceleration of labour or transfer to hospital was necessary. Conclusion: NQMs learned to effectively integrate medical knowledge with midwifery skills and knowledge, creating a bridge between the medical and midwifery approaches to care. Implications: This paper showed the positive effects that an orientation and familiarization period with an experienced team of midwives have on the skill development of novice practitioners in FSBCs. Impact: The findings of this study will have an impact on training and orientation for nurse‐midwives and direct‐entry midwives when they begin to practice in out‐of‐hospital settings after training and working in hospital labour wards. Patient and Public Contribution: This research study has four cooperating partners: MotherHood, Network of Birth Centres, the Association for Quality at Out‐of‐Hospital Birth and the German Association of Midwifery Science. The cooperating partners met six times in a period of 2 ½ years to hear reports on the preliminary research findings and discuss these from the point of view of each organization. In addition, at each meeting, three midwives from various FSBCs were present to discuss the results and implications. The cooperating partners also helped disseminate study information that facilitated recruitment. [ABSTRACT FROM AUTHOR]

Aims: To synthesize literature examining (1) rural hospital or obstetric unit closures as a social determinant of maternal/infant health outcomes and (2) closures as a social determinant of racial/ethnic disparities in maternal/infant health outcomes. Design: Scoping review. Data Sources: MEDLINE, OVID/Embase and CINAHL were searched systematically to identify sources from 31 July 2003 to 31 July 2023. The Arksey and O'Malley methodology for scoping reviews was used. Results: Four studies from the United States and Australia documented the impact of rural hospital or obstetric unit closures on maternal/infant health outcomes, such as increased births in hospitals without obstetric units, out‐of‐hospital births or babies born before arrival, preterm birth, infant mortality and sociocultural risks that contribute to clinical risk. No eligible studies investigated hospital or obstetric unit closure as a social determinant of racial disparities in rural maternal/infant health outcomes. Conclusion: Despite significant racial and ethnic rural maternal health disparities, associations between rural closures and maternal health outcomes for racial and ethnic minorities are understudied. More research is needed to understand the extent to which rural closures, a social determinant of health, could disproportionately, negatively affect the health of racially and ethnically minoritized women. Implications for the Profession and Patient Care: Rural women have a greater risk of maternal and infant mortality and morbidity compared with urban women, and the impact of rural closures on racial and ethnic maternal health disparities is not well documented. Research about the impact of rural closures on maternal health disparities could inform policy to assure essential obstetric care is available for rural populations globally. Impact: Findings provide a call to action for research to understand relationships between rural closures and racial and ethnic maternal health disparities, which is especially important for serving rural Non‐Hispanic Black and American Indian/Alaska Native women. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Introduction: Midwives in an Australian birth unit undertook a project to develop a resource for women and their support person. The aim of this study was to explore how the women, support persons and midwives viewed the introduction of this resource designed to guide and support women in their choice of support person. Methods: A quantitative survey study was used to explore how three participant groups viewed the introduction of a support person information resource. A hospital designed survey was developed for women, support people and midwives. Data were analyzed using SPSS, version 26 and Braun and Clarke's guide for thematic analysis. Results: More than half (55%) of the midwives believed that the information resource presented influenced women's choice of support people during labor. Almost threequarters (72%) of the women did not change their choice of number of support people that they wanted during their labor. The majority (83%) of women would recommend the support person brochure to other women. The majority (83%) of support people stayed the entire duration of labor. Four themes were generated from open-ended questions: value of the information sheet, knowing how to be a support person, connecting midwives with being woman-centered, and choosing the support person. Conclusions: The availability of an information resource was of benefit for women, support people and midwives, contributing to women feeling more informed in choosing their support person. Midwives felt they had evidence to support conversations with women, contributing to the feeling of being woman-centered. Support people had increased confidence. [ABSTRACT FROM AUTHOR]

Polycystic Ovary Syndrome (PCOS), affecting 1–11% of reproductive-age women, is characterised by many symptoms that cause important concerns especially in young adults. This study aimed to evaluate the concerns about fertility, social appearance, and relationships in young adults with PCOS. This descriptive study included 140 young female adults aged 18–26, who were diagnosed with PCOS, agreed to participate in the onlineresearch through social media between July and December 2022 in Turkey. Data were collected using the 'Participant Interview Form' and the "Social Appearance Anxiety Scale (SAAS). The mean age of the participants was 22.1 ± 2.1. As the most common symptoms, 78.6% experienced menstrual irregularities, 16.4% were overweight, 7.1% were obese, 67.1% had hirsutism and 65.7% had acne. Most of the participants expressed concerns about future infertility (72.9%), and worried about being unable to conceive due to PCOS in the future (sometimes = 61.4%). Over eighty percent of the participants expressed some level of dissatisfaction with their physical appearance. They commonly believe that their self-esteem, emotionalstate, social relationships and partner relationships could be negatively affected by PCOS. SAAS scores were significantly increased by low income, high BMI, hirsutism, dissatisfaction with physicalappearance, low self-esteem, emotional problems and concerns related to social and partner relationships (p < 0.05). Young adults have common concerns about the potential negative impacts of PCOS on fertility, social appearance, and relationships. Health professionals should be aware of their counselling needs about the possible physical and psycho-social effects of PCOS and provide continuous care and support. [ABSTRACT FROM AUTHOR]

Background: Nursing and midwifery students' perceptions and attitudes toward older adults affect their behaviours, career choices and/or the quality of care provided to older adults after graduation. This study aimed to evaluate the perceptions of second year nursing and midwifery students toward elderly people staying in nursing homes through metaphor analysis. Methods: This qualitative study has used the phenomenological approach. The sample of the study consisted of 128 nursing and midwifery students by purposive sampling method. Students were prompted to complete a sentence to express their perceptions about the elderly living in nursing homes: 'The elderly in the nursing home is similar to ... because ...' Participants were required to fill in their responses in two stages, providing metaphors in the first blank and reasons for their metaphors in the second blank. Results: The results indicated that five main themes and 12 sub‐themes were obtained from student metaphors: (i) needing help in meeting their needs (need for care and need for love); (ii) the emotional burden of a life away from loved ones (loneliness, abandonment, and helplessness); (iii) exhaustion at the end of the road (end, loss, and unproductive); (iv) holding on to life again (friendship and beginning); and (v) post‐traumatic growth (strong and experienced). Conclusion: Students should question how to create opportunities and increase interaction for the elderly in the age of changing and developing technology before graduation and should be trained as professional individuals who are willing for this purpose. [ABSTRACT FROM AUTHOR]

Background/Aims: Increased rates of caesarean sections globally have potential short- and long-term impacts for mothers and babies. Research on models of care and mode of birth has reported varied results. The aim of this study was to analyse the relationship between the midwife-led model of care and mode of birth. Methods: This systematic review and meta-analysis searched PubMed, Scopus and Web of Science. Quantitative full-text open access research articles published between 2010 and 2023 in Indonesian or English were included. Research that assessed the relationship between the model and birth planning were excluded. Results: A total of 16 articles were included. Two were experimental, and the remaining 14 were observational, with a total sample of 125 201 people. The midwife-led model supported spontaneous vaginal birth (odds ratio: 1.64, P=0.01) when compared to other models. Conclusions: Implementing the midwife-led model of care may increase the likelihood of physiological birth and reduce the incidence of caesarean section, especially in low-risk pregnancies. [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]

High-risk pregnancies not only heighten concerns about the baby's health but also have the potential to impact the mother–infant relationship by shifting the mother's focus towards her own health needs. This study aims to delve into the intricacies of motherhood roles among women experiencing high-risk pregnancies compared to those with uncomplicated pregnancies, aiming to shed light on the disparities between the two groups. The participants of this descriptive, comparative, and correlational study consisted of literate mothers admitted to a hospital in Eastern Turkey, diagnosed with high-risk pregnancies, and with no prior history of psychological support. Due to an inability to reach the entire population, an unknown sampling method was employed for sampling calculation. The sample comprised 133 mothers with high-risk pregnancies and an equal number of healthy mothers, totaling 266 participants. Data were collected using the "Maternal Introduction Form" and the "Maternal Role Gaining Scale", and analyses were conducted using the SPSS Statistical Programme. Given the non-normal distribution of the variables, nonparametric tests were applied post reliability analysis. There is a statistically significant difference (p < 0.05) in the scores of maternal attitude and anxiety, as well as maternal role and the Maternal Role Gaining Scale, based on various demographic factors such as marriage duration, spouse's education, family economic status, pre-pregnancy health issues, medication use, hospitalization status and reason, assigned sex of the baby and desired gender, total pregnancies, mode of delivery, postpartum difficulties, support for baby care, feeding method, high-risk pregnancy diagnosis, and week of diagnosis. A Bonferroni corrected analysis also revealed significant differences between mothers with and without high-risk pregnancies. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the present study was to evaluate the level of knowledge of prenatal health professionals concerning the relationship between periodontal diseases and pregnancy complications, as well as their professional implications in the oral health field. Materials and Methods: A questionnaire was distributed to obstetricians/gynecologists, interns specialised in obstetrics/ gynecology, midwives, and student midwives at Loire Atlantique and Vendée hospitals (France). The questionnaire included 5 sociodemographic questions and 14 questions regarding the level of knowledge about the relationship between periodontal diseases and pregnancy complications as well as the professionals' level of involvement in oral health care. Results: Twenty-three obstetricians/gynecologists and 55 midwives responded to the questionnaire. Preterm delivery and chorioamnionitis were the most frequently mentioned complications of pregnancy, whereas the risk of pre-eclampsia was rarely mentioned. Half of the professionals said they were aware of the oral manifestations of pregnancy. Gingivitis and an increased risk of caries were the most frequently mentioned items, whereas epulis was the least frequently mentioned item. The level of involvement of prenatal care practitioners in oral health care was limited due to a lack of competence and time. Nevertheless, 64% of the participants discussed the risks of poor oral hygiene with their patients. Conclusion: There is good knowledge among French gynecologists/obstetricians and midwives regarding the oral manifestations of pregnancy. However, there is still a lack of knowledge concerning the links between periodontal diseases and pregnancy complications. The involvement and behaviour of pregnancy professionals in the oral health field is inadequate. The present survey highlights the need to improve the initial and continuing education of obstetricians and midwives on this topic. [ABSTRACT FROM AUTHOR]

Amaç: Araştırmada kadınlarda fertilite farkındalığının ve fertiliteyi etkileyen yaşam biçimi davranışlarının belirlenmesi amaçlanmıştır. Yöntem: Araştırma kesitsel tanımlayıcı tiptedir. Örneklemi, Ağustos-Ekim 2022 tarihleri arasında Sivas Akıncılar İlçe Aile Sağlığı Merkezine başvuran, 20-49 yaş aralığında ve araştırmaya katılmayı kabul eden 305 kadın oluşturmuştur. Veriler Kişisel Bilgi Formu, Fertilite Farkındalık Ölçeği (FFÖ) ve Sağlıklı Yaşam Biçimi Davranışları Ölçeği-II (SYBDÖ-II) ile toplanmıştır. Verilerin değerlendirilmesinde; tanımlayıcı istatistik analizi, tek yönlü varyans analizi, bağımsız gruplarda t testi, ki-kare testi ve pearson kolerasyon analizi kullanılmıştır. Bulgular: Kadınların yaş ortalaması 36,41±7,85 dir. FFÖ puan ortalaması 64,17±11,63; bedensel farkındalık ortalaması 36,46±6,82; bilişsel farkındalık ortalaması 27,71±6,30’dur. Kadınların %59,6’sı orta, %36,1’i yüksek, %4,3’ü düşük düzeyde fertilite farkındalığına sahiptir. SYBDÖ-II toplam puan ortalaması 132,84±21,16, manevi gelişim 27,17±4,32, sağlık sorumluluğu 21,55±5,02, fiziksel aktivite 15,68±4,98, beslenme 21,90±3,96, stres yönetimi 20,49±3,82, kişiler arası ilişkiler 26,06±4,61’dir. FFÖ ve SYBDÖ-II toplam ve alt boyut puan ortalamaları orta düzeyde bulunmuştur. FFÖ ile SYBDÖ-II toplam ve alt boyut (manevi gelişim, sağlık sorumluluğu, beslenme, kişiler arası ilişkiler, stres yönetimi) puanları arasında orta düzeyde, pozitif yönlü, anlamlı; fiziksel aktivite arasında ise çok düşük düzeyde, pozitif yönlü, anlamlı ilişki saptanmıştır (p < ,05). Sonuç: Kadınların fertilite farkındalık düzeyi ve sağlıklı yaşam biçim davranışları orta düzeydedir. Kadınlar en yüksek manevi gelişim en düşük fiziksel aktivite davranışına sahiptir. Fertilite farkındalık düzeyi arttıkça sağlıklı yaşam biçimi davranışları artmaktadır. Bu sonuçlar doğrultusunda kadınlara fertilite farkındalığı ve fertiliteyi etkileyen yaşam biçimi davranışları hakkında eğitim ve danışmanlık yapılması önerilmektedir.

The performance of midwives needs to be measured to provide guaranteed health services to mothers and children. Therefore, the aim of this study is to measure the performance of midwives using several variables, including internal branding, meaningfulness of work, work engagement, and innovative behavior, both directly and indirectly. The analysis was conducted in 29 districts and nine cities in East Java, Indonesia, with a sample of 330 midwives. Primary data were obtained by distributing questionnaires and analyzed using PLS-SEM. The research results show that all the variables tested have a positive and significant influence on midwifes’ performance. Innovative behavior has the strongest direct influence (73%), and meaningfulness of work has the weakest direct influence on midwifes’ performance (6%). Meanwhile, indirect relationships through work engagement provide a positive and significant influence, but are not as strong as the direct influence. These results offer practical insight for midwives to maintain and improve their individual performance, considering that more and more new midwives are ready to compete in providing health services for mothers and children.

Wanqi Gong,1 Jiamei Tang,1 Yang Chen,2 Jing Ma3 1School of Journalism and Communication, Guangdong University of Foreign Studies, Guangzhou, People’s Republic of China; 2Health Science Center, Jinan University, Guangzhou, People’s Republic of China; 3The First Affiliated Hospital of Guangzhou Medical University, Department of Gynecology and Obstetrics, Guangzhou, People’s Republic of ChinaCorrespondence: Jiamei Tang, School of Journalism and Communication, Guangdong University of Foreign Studies, No. 1689 Bai Yun Avenue, Guangzhou, 510420, People’s Republic of China, Tel +86 20 39328095, Email tangjiamei@gdufs.edu.cnPurpose: Clinical nursing in obstetrics and gynecology is a technically demanding job. Doctors and nurses have different professional backgrounds and work priorities, and there are differences in communication modes, which can easily lead to poor communication between medical staff and their patients. Therefore this study aims to examine the different communication roles and emphases of obstetrician and gynecologists, nurses and midwives in different sections of SEGUE framework, and further navigate the effectiveness and differences of offline and online provider-patient communication.Participants and Methods: This study employs in-depth interviews to address the research questions. A total of 24 health care providers, including 8 doctors, 5 midwives and 11 nurses, were interviewed face-to-face or by telephone.Results: Doctors pay more attention to the “giving information” stage, while nurses pay more attention to “set the stage” and “elicit information” steps. Midwives and nurses spend more time with patients before and after labor. In addition to information giving, they also accommodate the “understand the patient’s perspective” and “end the encounter” steps. Nurses and midwives would attach greater importance to “understanding of patients’ perspective”. Online medical consultation is more convenient for patients, which can be used as a follow-up complement to offline medical consultation.Conclusion: The health care providers of different types in obstetrics and gynecology communicate collaboratively with patients, highlighting the equally important role of midwives and nurses when communicating with patients. Nurses focus on “set the stage” and “elicit information” stage. Midwife is another important information source and medical care provider, especially for pregnant women in stable conditions. Nutrition clinic of midwife could be recommended for hospitals in second- and third-tier cities, which could help to alleviate obstetricians’ workload. The provision of an online collaborative consultation could be beneficial supplement after face-to-face doctor-patient communication.Keywords: SEGUE framework, physician-patient communication, obstetrician and gynecologist, online health consultation, midwife

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.

(1) Background: The transition to twin parenthood is a demanding challenge with a higher risk of maternal and fetal complications during pregnancy and a postpartum period that involves caring for more than one newborn at the same time with similar and simultaneous needs. (2) Aim: To find out about parents' needs when experiencing the transition to twin parenthood and to describe the intervention of their specialized nursing support network. (3) Methodology: A descriptive exploratory study, based on a proper non-probabilistic sample of 15 nurses and 55 couples who are parents of twins, using two online questionnaires publicized on social networks. (4) Results: The couple's needs were identified through knowledge of their experiences and difficulties during pregnancy and after the twin birth. Couples' and nurses' perceptions differed on the identified needs. The specialized nursing support network focuses its intervention on providing informative guidance on twin pregnancy and postpartum period, health education, group sharing experiences, home visits, planning, and including a family support network in the management of twin care and the creation of a daily routine. (5) Conclusions: There is a need to implement a program focused on the needs of parents of twins, promoting realistic expectations for the birth and parenting of twins, preparing parents, improving their well-being, and creating a specialized nursing support network available to this population. [ABSTRACT FROM AUTHOR]

Objective: To reach consensus between care providers and childbearing women about the midwife's relevant and appropriate domains and elements to support transition to motherhood. Methods: A modified web‐based Delphi study was conducted in Flanders (Belgium). After performing a systematic literature review, searching the grey literature and an online poll, a set of 79 items was generated. In two rounds, the items were presented to an expert panel of (1) care providers from various disciplines providing services to childbearing women and (2) to pregnant women and postpartum women up to 1‐year postpartum. Consensus was defined when 70% or more of the experts scored ≥6, 5% or less scored ≤3, and a standard deviation of ≤1.1. Findings: In the first Delphi round, 91 experts reached consensus on 24 items. Seventeen round one items that met one or two consensus objectives were included in round two and were scored by 64 panel experts, reaching consensus on three additional items. The final 27 items covered seven domains: attributes, liaison, management of care from a woman‐centred perspective, management of care from the midwife's focus, informational support, relational support, and the midwife's competencies. Conclusion: The shared understanding between childbearing women and care providers shows that the midwife's transitional support is multifaceted. Our findings offer midwives a standard of care, criteria, guidance, and advice on how they can support childbearing women during transition to motherhood, beyond the existing recommendations and current provision of transitional care. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Midwifery & Health Sciences is the property of Ataturk University Coordinatorship of Scientific Journals and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Midwifery & Health Sciences is the property of Ataturk University Coordinatorship of Scientific Journals and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Advances in Women's Studies is the property of Ataturk University Coordinatorship of Scientific Journals and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This quasi-experimental study aimed to assess the impact of a midwife-led psycho-education intervention on reducing fear of childbirth (FOC) and perceived stress (PS) in pregnant women. The present study involved 96 pregnant women. The intervention group received three 30–45 min telephone sessions using 'BELIEF' (Birth Emotion-Looking to Improve Expectant Fear) psycho-education approach. The outcomes were assessed using questionnaires on childbirth attitudes and PS. Data analysis was performed using Stata version 17. In the intervention group, the mean score for FOC decreased from 39.41 ± 7.02 to 29.91 ± 5.60 (9.5; 24.1%). The mean difference (MD) of 28.22% was statistically significant (adjusted MD: −10.51, 95% CI: −11.60, −9.41, P  < 0.001). In the intervention group, mean scores for PS decreased from 22.77 ± 6.94 to 18.23 ± 5.69 (4.54; 19.93%). In the control group, scores increased from 22.68 ± 6.76 to 24.82 ± 6.58 (2.14; 9.43%). The 29.36% MD was statistically significant (aMD: −6.95, 95% CI: −8.73, −5.18, P  < 0.001). The findings of this study indicate that the midwife-led psycho-education intervention, utilizing the 'BELIEF' protocol over the telephone, has a significant effect on reducing FOC and PS, as well as increasing the preference for vaginal birth. [ABSTRACT FROM AUTHOR]

Midwives' self-efficacy can significantly affect the provided care and, therefore, maternal and neonatal outcomes. The aim of the present study was to investigate associations of perceived self-efficacy with emotional intelligence, personality, resilience, and attitudes towards death among midwives in Greece. From 2020 to 2022, a total of 348 midwives were recruited in this descriptive cross-sectional study. The participants were employed as independent professionals, in public hospitals or regional health authorities. Data collection involved five research instruments: the General Self-Efficacy Scale (GSES), the Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF), the Eysenck Personality Questionnaire (EPQ), the Connor-Davidson Resilience scale (CD-RISC), and the Death Attitude Profile-Revised (DAP-R) scale. The mean score for the GSES was 29.1 (SD = 4.2), suggesting a moderately elevated level of self-efficacy among midwives. The results revealed that higher scores on the GSES were significantly associated with higher scores on the Extraversion subscale (p < 0.001) and lower scores on the Neuroticism (p < 0.001) and Lie (p = 0.002) subscales of the EPQ. Additionally, high self-efficacy was significantly correlated with high emotional intelligence (p < 0.001), high neutral acceptance of death (p = 0.009), and high resilience (p < 0.001). These findings highlight the relationship between the self-efficacy of Greek midwives and various psychological factors, as well as the multifaceted nature of self-efficacy and its importance for midwives' psychological well-being and professional functioning. [ABSTRACT FROM AUTHOR]

BACKGROUND: The Australian Health Practitioners Registration Agency (AHPRA) records 98.7% of the 32,000 registered midwives as female. In 2021, Australia recorded 309,996 births, and one in three women experienced birth trauma. While the exact proportion of midwives who have given birth is unknown, it is likely the majority. As a consequence, 5,000–11,000 midwives may have experienced primary birth trauma (PBT). Little is known about midwives' personal experience of birth trauma and its relationship to factors that affect their experience of the maternity workplace setting. AIMS: This study aimed to explore mental health morbidity and factors associated with the severity of PBT in Australian midwives and the relationships between these factors and professional quality of life. METHODS: Australian registered midwives 12 months post birth trauma experience and having returned to the maternity workplace without restrictions to their AHPRA registration were included. Data were collected via an online survey with four validated tools and general demographic information. FINDINGS: Midwives who have experienced PBT have symptomology for posttraumatic stress disorder, depression, anxiety, and burnout. Midwives with these symptomologies work within maternity settings with little known about the implications of accumulative symptoms, their impact on care provision or clinical decision-making, and overall long-term personal and professional well-being and health. CONCLUSION: This study found that midwives experience psychological, professional, and personal issues and trauma symptomology associated with their own primary birth trauma. Further research exploring simplified symptomatology identification and appropriate interventions both inside and outside the work environment is required to improve midwives' mental health, rates of retention in the workplace, and job satisfaction. [ABSTRACT FROM AUTHOR]

Aim: To identify what is currently known about how women experience online antenatal education. Design: Integrative literature review. Review Methods: This integrative review applied the five‐stage methodological framework outlined by Whittemore and Knafl (2005), supporting rigour in problem identification, selection and critical appraisal of quality literature, data analysis and synthesis of findings. Data Sources: A literature search was conducted in May/June 2022, utilizing databases including OVID Embase, CINAHL, Joanna Briggs Institute EBP database, Nursing and Allied Health database, Wiley Online Library, Google scholar search engine and related reference lists. The search was limited to English language and primary research articles published in the last 10‐year period (2012–2022). Results: 12 articles met inclusion criteria. Three primary themes were identified: Comprehensibility: Looking back – understanding women's needs and preferences; Manageability: In the moment – flexibility versus social connection; and Meaningfulness & sustainability: Looking forward – the future of digital maternity education. Conclusion: Findings identified a marked digital divide for women accessing online antenatal education, placing vulnerable women at risk of continuing inequity. E‐health literacy frameworks need to be implemented to create genuine accessibility, comprehensibility and cultural responsiveness to best meet the needs of users. Implications for the Profession and/or Health Care Consumer: As digital health is an emerging field, there is strong evidence that online antenatal education requires further evaluation to better meet the needs of pregnant women and their support people. Enhancing digital health literacy for health professionals will also promote a greater understanding for how to uphold and support the socio‐technical dimensions of online service delivery. Patient or Public Contribution: There were no patient or public contributions as part of this integrative review of the literature. [ABSTRACT FROM AUTHOR]

Aim: To explore support strategies for older nurses and midwives in Australian healthcare workplaces. Design: A qualitative descriptive study. Method: Participants were 50 older nurses and midwives and 20 healthcare managers recruited from a broad range of Australian healthcare settings. Data were collected using semi‐structured interviews from November 2018 to April 2021. The interviews were recorded, transcribed and thematically analysed. Results: The limited number of identified sedentary roles and inequitable distribution of workload responsibilities were identified as constraints that impact the provision of workplace support for older nurses and midwives in healthcare settings. Three major themes were identified: Workplace support, Personal support and Doing more. A small number of participants reported support was available at work, but most said there was not. Of the reported strategies some were offered exclusively to a cohort that met an age criterion, while others were open to all staff regardless of age. Personal support strategies were employed outside of the workplace while others used strategies during working hours. Doing more related to suggestions about how organizations could do more to support older nurses and midwives at work. Conclusion: Support mechanisms like adjustments in workload, employment fraction, practice location, upskilling and wellness programs in workplaces are limited. To facilitate retention and support older nurses and midwives in the workforce, health workplaces should consider implementing support mechanisms that can be tailored to the individual needs of the nurse or midwife over the life course of their career. Impact: The findings of this study highlight the lack of support for many older nurses and midwives in Australian healthcare workplaces, emphasizing the need for further research into innovative practices on how to better support healthcare staff as they age. Reporting Method: This study adhered to the COREQ reporting method. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Copyright of Fenerbahce University Journal of Health Sciences (FBU-JOSH) / Fenerbahçe Üniversitesi Sağlık Bilimleri Dergisi is the property of Fenerbahce University Journal of Health Sciences (FBU-JOSH) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background Determining how women make sense of their birth preferences with metaphor analysis will be an important step in determining perceptions about birth options. Objective The aim of this study is to examine the perceptions of women who had cesarean section regarding the concept of "cesarean birth" and "Vaginal birth after cesarean section" with metaphor analysis. Materials and Methods: This study is a qualitative research based on the philosophy of Husserl's phenomenology, which was carried out between June and November 2022. Within the scope of the research, 50 women who had a cesarean section were interviewed face to face. The metaphor form prepared in line with the international literature was used to determine women's perceptions of the concept of "Cesarean section" and "Vaginal birth after cesarean section". Results 25 metaphors for cesarean birth and 28 metaphors for vaginal birth after caesarean section were identified. Considering the common features and analogy aspects of the metaphors obtained, three themes were determined within the scope of cesarean section and vaginal birth after caesarean section. Conclusions This study took a unique approach to revealing women's birth experiences and perceptions. Vaginal birth after caesarean section is a very valuable birth method for women who have had a cesarean section and are curious about the feeling of vaginal birth. [ABSTRACT FROM AUTHOR]

Aim Design Data Sources Review Methods Results Conclusion Impact Reporting Method Patient or Public Contribution To describe the current state of the literature on nurses' and midwives' knowledge, perceptions and experiences of managing parental postnatal depression (PPND).The Joanna Briggs Institute scoping review method and the PRISMA extension for Scoping Reviews guided the work.A systematic search of PubMed, CINAHL, Embase, MEDLINE, PsycINFO and Scopus databases was conducted in January and February 2023.Peer‐reviewed primary research articles published in English between 2012 and 2023 that involved nurses or midwives managing PPND were included. Rayyan was used to screen titles, abstracts and full‐text articles. A spreadsheet was used to organize extracted data and synthesize results.Twenty‐nine articles met the inclusion criteria. Most study samples were of mothers, and few were from middle‐ and lower‐income countries. Nurses and midwives lacked knowledge about PPND, yet they felt responsible for its management. Nurses and midwives faced significant organizational and systems‐level challenges in managing PPND. However, nurses and midwives facilitated PPND care in collaboration with other healthcare providers.The review highlights significant gaps in the nurses' and midwives' care of PPND. Educational programmes are necessary to increase nurse and midwife knowledge of PPND and strategies for its management, including facilitating collaboration across the healthcare system and eliminating organizational and systemic‐related barriers. Additional focused research is needed on nurses' and midwives' knowledge, perception of and experience with PPND beyond mothers, such as with fathers, sexually and gender‐minoritized parents and surrogate mothers. Finally, additional research is needed in middle‐ and lower‐income countries where nurses and midwives may face a higher burden of and unique cultural considerations in managing PPND.PPND can affect the parent's mental and physical health and relationship with their child. If left untreated, PPND can lead to long‐term consequences, including child developmental delays, behavioural problems and difficulties with parental–child attachment.This scoping review adheres to PRISMA Extension for Scoping Review guidelines and the Joanna Briggs Institute scoping review method.This research is a scoping review of published peer‐reviewed studies. [ABSTRACT FROM AUTHOR]

Purpose To identify midwifery practices during childbirth that help prevent perineal lacerations in hospitals, and how these differ according to the level of experience in newborn delivery assistance. Methods A self-administered, unmarked questionnaire was distributed to 202 midwives working in hospital obstetric wards in the Tokyo metropolitan area and having experience assisting in deliveries. The main questions asked were about the frequency of information collection and support offered during birth that help prevent perineal laceration. Descriptive statistics were calculated, and the midwives were divided into groups with less than 200 cases of delivery assistance and more than 200 cases of delivery assistance based on the median. Comparisons were made based on the number of experiences of delivery assistance using the Mann-Whitney's U test. This study was conducted with the approval of the Research Ethics Committee at Yokohama City University (Approval No.: F221000005). Results A total of 100 valid completed questionnaires were analyzed (50.5% response rate, 98.0% valid response rate). The types of information gathered most frequently ("always" or "sometimes" by more than 90% of midwives) were "whether the baby is a first birth or a multiparous birth" and "estimated weight of the baby." In terms of support, the most frequent ("always") practices were "perineal protection" (88.0%), while the less frequent ones were applying a "perineal warm pack" and "bathing in the first stage of labor." Furthermore, midwives who had assisted in more than 200 deliveries were significantly more likely than midwives who had assisted in fewer than 200 deliveries to collect information on obstacles to perineal extension, such as previous episiotomy or perineal laceration, and to provide support that did not interfere with natural perineal extension, such as "a voice that does not require excessive effort" and "not touching the perineum too much." Conclusion Midwives with more experience in assisting deliveries provided support based on what they learned experientially. The study suggested the need to facilitate the transfer of assessments and supports from experienced midwives to novices, to raise the standard of midwifery practices. [ABSTRACT FROM AUTHOR]

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 (<10%). Odds ratios (OR) and adjusted odds ratios (aOR) with 95% confidence intervals were estimated. Results: Intrapartum perineal massage was not normally used by 253 (83%) of midwives, and 186 (61%) applied compresses soaked in warm water to the perineum. Regarding episiotomy, there was a great deal of variability, noting that 129 (42.3%) adopted a restrictive use of this procedure, 125 (41%) performed it between 10% and 20%, while 51 midwives (16.7%) performed it in more than 20% of cases. In addition, 165 (54.1%) midwives followed an incision angle of 60º. Concerning tears, 155 (50.8%) usually sutured first‐degree tears and 273 (89.5%) always sutured second‐degree tears. Midwives attending home births (aOR = 6.5; 95% CI: 2.69–15.69), working at a teaching hospital (aOR = 3.69; 95% CI: 1.39–9.84), and the ones who recently completed their professional training (aOR = 3.58; 95% CI: 1.46–8.79) were significantly more likely to adopt a restrictive use of episiotomy. Conclusions: There is a significant variability in Spanish midwives' practices for preventing and repairing perineal tears. Moreover, the restrictive use of episiotomy is associated with midwives attending home births, working in teaching hospitals and having recent professional training. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Copyright of University of Health Sciences Journal of Nursing is the property of Saglik Bilimleri Universitesi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Matronas Hoy is the property of Asociacion Espanola de Matronas (AEM) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Matronas Hoy is the property of Asociacion Espanola de Matronas (AEM) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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<0.001). However, the educational intervention did not lead to a behavior change. Conclusion: Based on the findings, it is imperative for health planners to focus on providing organizational support and fostering a positive attitude among obstetricians and midwives to prioritize the implementation of VBAC. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Academic Research in Nursing (JAREN) is the property of Hemsirelikte Egitim ve Arastirma Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction The professional identity of midwives develops and consolidates through various personal and professional experiences in the practice of care. However, the autonomous practice of midwifery, within a multidisciplinary approach, remains a significant obstacle to this construction. Purpose This study aims to understand how midwives construct their professional identity and autonomy in their practice. Method This is a qualitative study using grounded theory. Data were collected from seven midwives at the N'Djili General Reference Hospital through semi-structured interviews. The questions addressed professional identity. The analysis was conducted using open, axial, and selective coding, allowing the discovery of themes, categories, and concepts using an analysis grid. Results The construction of professional identity is associated with initial training, the specific care practices of midwives (roles), the support from health structures, and the support of the midwifery association. This process occurs through the practices of identity care, the precision of the midwife's field of activities, the publication of professional guidelines, and the dissemination of regulations specifying the scope of action of midwives. Conclusion The midwifery profession has experienced significant evolution in its skills in recent years, an evolution perfectly integrated from academic training. It is, therefore, necessary to inform learners in training about ways to achieve professional autonomy in a clinical environment. Practicing midwives should strive to create autonomy within a professional group, practice and demand to perform autonomous acts, and provide independent care in maternity wards, birthing centers, medically assisted procreation centers, family planning centers, or in private practice when they are independent.

We study the myths that consistently present Prometheus acting as midwife in contexts where a social birth is in question. We start from the myth of Pandora to show how Prometheus tries to abort her birth. Then, we will analyse in more detail this quality of the Titan by examining the birth of humankind narrated by Plato in the myth attributed to Protagoras. Finally, we will analyse the story of the birth of the Athenians, in which we do not find Prometheus, but other gods protagonists in previous stories: Gaia, Athena and Hephaestus. This will allow us to explore the role of the τέχναι in these social births as well as the determining role of Zeus.

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.

Abstract Context Working with women to best meet their needs has always been central to midwifery in Quebec, Canada. The creation of birthing centres at the end of the 1990s consolidated this desire to prioritize women’s involvement in perinatal care and was intended to encourage the establishment of a care and services partnership between care providers and users. The aim of this pilot study is to evaluate the perceptions of clients, midwives and birth assistants of the way in which women are involved in partnership working in Quebec birthing centres. Methods A single qualitative case and pilot study was conducted with midwives (n = 5), birth assistants (n = 4), a manager (n = 1), clients (n = 5) and members of the users’ committee (n = 2) at a birthing centre in Quebec, Canada in July and August 2023. The partnership was evaluated using the dimensions of a validated CADICEE questionnaire. Results The women and professionals stressed that the relationship was established in a climate of trust. The caregivers also attached importance to autonomy, information sharing and decision-making, adaptation to context, empathy and recognition of the couple’s expertise. The women confirmed that they establish a relationship of trust with the professionals when the latter show empathy and that they adapt the follow-up to their knowledge and life context. Key factors in establishing this kind of care relationship are the time given, a de-medicalized environment, the comprehensive care received, and professionals who are well-informed about the partnership. In addition, the birthing centre has a users’ committee that can put forward ideas but has no decision-making powers. Conclusions Both the women and the professionals at the birthing centre appear to be working in partnership. However, at the organizational level, the women are not involved in decision-making. A study of all birthing centres in Quebec would provide a more comprehensive picture of the situation.