ORCID Profile
0000-0002-9390-787X
Current Organisation
University of Adelaide
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Publisher: Elsevier BV
Date: 03-2020
DOI: 10.1016/J.WOMBI.2019.03.002
Abstract: Every year, 2.6 million babies are stillborn worldwide. Despite these figures, stillbirth remains a relatively ignored public health issue. The wider literature suggests that this is due to the stigma associated with stillbirth. The stigma of stillbirth is seen as possibly one of the greatest barriers in reducing stagnant stillbirth rates and supporting bereaved parents. However, empirical evidence on the extent, type, and experiences of stillbirth stigma remain scarce. This study aimed to explore the stigma experiences of bereaved parents who have endured a stillbirth. An online survey of closed and open-questions with 817 participants (n=796 female n=17 male) was conducted in high-income countries. Based on self-perception, 38% of bereaved parents believed they had been stigmatised due to their stillbirth. Thematic data analysis revealed several themes consistent with Link and Phelan's stigma theory- labelling, stereotyping, status loss and discrimination, separation, and power. One more theme outside of this theory- bereaved parents as agents of change was also discovered. Bereaved parents after stillbirth may experience stigma. Common experiences included feelings of shame, blame, devaluation of motherhood and discrimination. Bereaved parents also reported the silence of stillbirth occurred during their antenatal care with many health care providers not informing them about the possibility of stillbirth. Further research needs to be undertaken to explore further the extent and type of stigma felt by bereaved parents after stillbirth, and how stigma is impacting the health care professional disseminating and distributing resources to pregnant women.
Publisher: Springer Science and Business Media LLC
Date: 15-04-2015
Publisher: Elsevier BV
Date: 03-2021
Publisher: Elsevier BV
Date: 02-2020
DOI: 10.1016/J.WOMBI.2019.02.004
Abstract: Fetal movements are a key indicator of fetal health. Research has established significant correlations between altered fetal activity and stillbirth. However, women are generally unaware of this relationship. Providing pregnant women with information about the importance of fetal movements could improve stillbirth rates. However, there are no consistent fetal movements awareness messages globally for pregnant women. This study aimed to explore the antenatal care experiences of Australian mothers who had recently had a live birth to determine their knowledge of fetal movements, the nature and source of that information. An online survey method was used for 428 women who had a live birth and received antenatal care in Australia. Women's knowledge of fetal movements, stillbirth risk, and the sources of this knowledge was explored. A large proportion of participants (84.6% n=362) stated they had been informed by health care professionals of the importance of fetal movements during pregnancy. Open-ended responses indicate that fetal movements messages are often myth based. Awareness that stillbirth occurs was high (95.2% n=398), although, 65% (n=272) were unable to identify the current incidence of stillbirth in Australia. Women who received antenatal care have high-awareness of fetal movements, but the information they received was inconsistent. Participants knew stillbirth occurred but did not generally indicate they had obtained that knowledge from health care professionals. We recommend a consistent approach to fetal movements messaging throughout pregnancy which focuses on stillbirth prevention.
Publisher: Elsevier BV
Date: 09-2012
DOI: 10.1016/J.NEPR.2012.06.008
Abstract: Online roleplay i.e. role play which occurs using an online asynchronous discussion board, can be effectively utilised to teach a variety of skills to midwifery students. This paper will discuss the design and implementation of an online roleplay for a small (n = 19) class of final year undergraduate Midwifery students. It briefly describes the design of the online roleplay and outlines the expected learning outcomes of the activity. It then outlines evaluative survey results for student evaluation of the online role play. Results focus on student opinion of communication and collaboration skills developed through participation in the roleplay. Students considered that the online roleplay provided them with a means to allow communication skills to be developed and practiced. They also believed that the roleplay enable them to practice collaboration in an authentic real world setting. Finally implications for use of this method of teaching in nurse/midwife education are discussed.
Publisher: Elsevier BV
Date: 06-2019
DOI: 10.1016/J.WOMBI.2018.07.018
Abstract: Undergraduate education for midwives in the area of stillbirth may be lacking. When a baby dies the families are usually cared for, at some stage in their pregnancy or birth journey, by midwives, however, midwives may not be adequately prepared to care for them. The aim of this study was to investigate the current content of stillbirth education in undergraduate midwifery curricula in Australia. Nineteen midwifery program leaders from each of the Australian Universities that deliver undergraduate midwifery education were invited to respond to an online survey regarding content related to stillbirth risk, prevention and/or bereavement care. There were 10 complete surveys. Quantitative survey data were analysed and described using percentages, and data from the free text comments collected verbatim. Responses indicated that there is a erse inclusion of material relating to the topic of stillbirth, with different approaches to teaching the content and the amount of time devoted to the topic is relatively small. This small study in scoping curricula from participating Australian Universities indicated that more could be done to strengthen stillbirth related content. Stillbirth is a complex issue and therefore it is important for midwives to understand not only bereavement care but also the physiological underpinnings of issues that could be an antecedent cause or precursor for stillbirth. There is room to improve and standardise appropriate stillbirth curriculum nationally. It is imperative that midwives are able to provide sensitive and knowledgeable care to all women and their families.
Publisher: Elsevier BV
Date: 05-2011
DOI: 10.1016/J.NEPR.2010.08.007
Abstract: Simulation is becoming widely used in nurse education. However, reports concerning its use focus almost exclusively on describing experiences with high-fidelity manikin simulation used to teach students a range of psychomotor skills and clinical procedures. Simulation has enormous potential as a learning tool and can provide much more than just a basis for safely learning clinical skills. This paper gives a case-study of use of a simulation exercise that is designed to develop nursing students' work organization and people management skills. It also discusses student evaluation of the simulation exercise. Student engagement with this type of simulation and their feedback suggest that skills obtained during the simulation are transferable into and valuable for their clinical placements.
Publisher: Springer Science and Business Media LLC
Date: 14-04-2014
Publisher: Elsevier BV
Date: 10-2013
Publisher: Elsevier BV
Date: 03-2023
DOI: 10.1016/J.WOMBI.2022.11.011
Abstract: Women receiving continuity of midwifery care have increased satisfaction and improved outcomes. Preparation of midwifery students to work in continuity models from the point of graduation may provide an ongoing midwifery workforce that meets rising demand from women for access to such care. The aim of this paper is to describe an innovative midwifery course based on a continuity model, where students acquire more than 50 % of clinical hours through continuity of care experiences. Additional educational strategies incorporated in the course to enhance the CCE experience within the philosophy of midwifery care, include a virtual maternity centre, case-based learning and the Resources Activities Support Evaluation (RASE) pedagogical model of learning. Australian accredited midwifery courses vary in structure, format and philosophy this new course provides students with an alternative option of study for those who have a particular interest in continuity of midwifery care. A midwifery course which provides the majority of clinical hours through continuity of care may prepare graduates for employment within midwifery group practice models by demonstrating the benefits of relationship building, improved outcomes and the reality of an on-call lifestyle.
Publisher: Routledge
Date: 29-08-2019
Publisher: SAGE Publications
Date: 12-07-2013
Abstract: This article presents secondary analysis of data from parents who, 50 to 70 years ago, birthed stillborn babies or babies with lethal anomalies and from adult children born after these losses. The stories reflect a time in history when parents were “protected” from seeing or holding their babies and mothers were unable to attend the funeral. There was no understanding by society or caregivers for parents’ need to process the loss or resources to build memories. They provide a strong argument for health care providers to offer such resources to parents today and offer grief support.
Publisher: Public Library of Science (PLoS)
Date: 23-12-2014
Publisher: Elsevier BV
Date: 02-2018
DOI: 10.1016/J.MEHY.2017.12.024
Abstract: Changes in fetal movement are associated with increased risk of stillbirth after 28 weeks of pregnancy. The majority of studies have focussed on maternal perception of reduced fetal movements, which is associated with stillbirth via placental dysfunction. Recent studies have also described an association between a single episode of excessive fetal movements and late stillbirth. We present a hypothesis that a sudden episode of excessive fetal activity indicates fetal compromise relating to underlying disturbance of the in utero environment, which if it persists can lead to fetal death. The origin of the excessive fetal movements is unknown they may represent fetal seizures induced by asphyxia or infection, an attempt to release cord entanglement or a change in fetal behaviour (inducing signs of distress) in response to a noxious stimulus. It is also possible that an increase in maternal anxiety may lead to increased perception of fetal activity. Current evidence regarding excessive fetal movements is sparse there is no clinical guidance regarding how reporting of this symptom might relate to a fetus at risk and which management might reduce the risk of subsequent stillbirth. This could be addressed by prospective observational studies of mothers presenting with excessive fetal movements which could both explore the underlying pathophysiology and determine which investigations could identify fetal compromise in this population. The presence of fetal seizures or umbilical cord entanglement could be evaluated at the time of presentation by cardiotocography and ultrasonography of the fetus and cord. Exposure to infection or noxious stimuli could be evaluated by maternal history and measurement of maternal blood for inflammatory markers or toxins. Maternal anxiety could be assessed by validated anxiety scores. Fetal outcome following excessive fetal movements can be recorded after birth. In addition, the presence of perinatal asphyxia can be assessed using Apgar scores, assessment of fetal acidaemia or measurement of stress-related factors in umbilical cord blood. The placenta and cord can be systematically examined for signs of hypoxia, infection or umbilical cord compression. Such studies would provide evidence regarding the underlying cause of excessive fetal movement and how this symptom might relate to in utero compromise and stillbirth. Ultimately, this approach will determine whether excessive fetal movements can be used alongside reduced fetal movements as a tool to reduce the perinatal mortality rate.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-2023
Publisher: Elsevier BV
Date: 03-2012
DOI: 10.1016/J.NEPR.2011.07.004
Abstract: Role play in a face-to-face setting is becoming widely accepted as a useful pedagogy in nurse education. However, online e-role play i.e. role play which occurs using an electronic medium, is less well used, particularly with large classes. This paper will discuss the design and implementation of an online e-role play for a large class (n = 414) of undergraduate Nursing and Midwifery students. It describes the rationale for the use of this method and the expected learning outcomes followed by detail about how the e-role play was designed. It also discusses challenges faced in implementing this learning activity with a large group of students and then outlines student and staff evaluation of the e-role play. Finally lessons learned and implications for using this pedagogy in nurse education are considered.
Publisher: SAGE Publications
Date: 08-2011
Abstract: This article presents bereaved parents’ perceptions of their parents’ (the grandparents) reactions at the time of loss and in the pregnancy that follows. Data originated from two phenomenological studies conducted to understand bereaved parents’ experiences during their loss and subsequent pregnancy. However, this article reports a secondary thematic analysis focused on bereaved parents perceptions of the grandparents’ support (or lack of) at the time of loss and during the pregnancy following loss. Our findings illustrate some families found the means to share their grief at the time of loss in a constructive manner, while in others the intergenerational relationship was strained. Most important to parents was intergenerational acknowledgment of the ongoing relationship to the deceased child as an important, though absent family member, especially during the pregnancy that followed. Those supporting bereaved families can play an important role in helping intergenerational communication around perinatal loss and the subsequent pregnancy.
Publisher: Elsevier BV
Date: 05-2023
DOI: 10.1016/J.WOMBI.2022.09.003
Abstract: Presentations for decreased fetal movements comprise a significant proportion of acute antenatal assessments. Decreased fetal movements are associated with increased likelihood of adverse pregnancy outcomes including stillbirth. Consensus-based guidelines recommend pregnant women routinely receive information about fetal movements, but practice is inconsistent, and the information shared is frequently not evidence-based. There are also knowledge gaps about the assessment and management of fetal movement concerns. Women have indicated that they would like more accurate information about what to expect regarding fetal movements. Historically, fetal movement information has focussed on movement counts. This is problematic, as the number of fetal movements perceived varies widely between pregnant women, and no set number of movements has been established as a reliable indicator of fetal wellbeing. Of late, maternity care providers have also advised women to observe their baby's movement pattern, and promptly present if they notice a change. However, normal fetal movement patterns are rarely defined. Recently, a body of research has emerged relating to maternal perception of fetal movement features such as strength, presence of hiccups, and diurnal pattern as indicators of fetal wellbeing in addition to frequency. Sharing comprehensive and gestation-appropriate information about fetal movements may be more satisfying for women, empowering women to identify for themselves when their baby is doing well, and importantly when additional assessment is needed. We propose a conversational approach to fetal movement information sharing, focusing on fetal movement strength, frequency, circadian pattern, and changes with normal fetal development, tailored to the in idual.
Publisher: Springer Science and Business Media LLC
Date: 15-08-2015
Publisher: Elsevier BV
Date: 05-2020
DOI: 10.1016/J.WOMBI.2019.05.004
Abstract: The World Health Organization, and the 2011 and 2016 Lancet Stillbirth series as well as medical and scientific literature, have all called for stillbirth stigma to be reduced. However, few studies have explored or attempted to conceptualise the meaning of stigma in the context of stillbirth. To explore the current knowledge surrounding stillbirth stigma, specifically the extent, type and experiences of bereaved parents. A five-stage scoping review framework was utilised. A search of relevant databases (MedLine, EMBASE, PsychInfo, PsychArticles, and Ovid Emcare) was undertaken with several key words related to 'stillbirth' and 'stigma.' The reference lists of included studies were also searched. A total of 23 resources met the inclusion criteria for this review. A thematic analysis regarding how stigma was conceptualised and/or experienced within results and/or discussion was employed on these studies. Five over-arching themes, with several sub-themes, were discovered: Type of stigma, identity, silence, bereaved mothers' experiences of stigma in low-income countries and transformation. Stillbirth stigma remains an under-researched topic. Few articles conceptualised the experiences of the bereaved parent within a stigma framework. However, ex les of bereaved parents enduring stigma were found within the literature. Common stigmatising experiences included, bereaved parents' identities being challenged and feelings of shame, guilt, and blame after their stillbirth. Stigmatising experiences could be different based on the bereaved parent's cultural background. Further research which attempts to conceptualise stillbirth stigma and explores those experiences from a bereaved parent perspective is needed to help inform stigma reduction strategies.
Publisher: SAGE Publications
Date: 03-2021
Abstract: Mothers who had experienced stillbirth ( n = 436) were asked about their “faith base” and whether it was “helpful to their healing.” Only 178 (24.5%) indicated their faith base was “helpful ” there was also a wide range of other responses including those who indicated their faith was “lost” following their baby’s death. Findings are discussed in terms of what participants found helpful from their pastor and/or church community.
Publisher: Elsevier BV
Date: 11-2023
Publisher: Informa UK Limited
Date: 03-2012
Publisher: Elsevier BV
Date: 02-2016
DOI: 10.1016/J.WOMBI.2016.06.001
Abstract: Information that women receive about the importance of monitoring fetal movements and what to do if there are changes is inconsistent and may not be evidence based. This paper reports a summary of the kind of messages a group of South Australian midwives (n=72) currently give pregnant women. Comment data from two questions in a larger survey asking (1) what information midwives routinely provide to women about fetal movements and (2) their practice regarding advice they give to women reporting reduced fetal movements. Data were analysed using summative content analysis. Four main recurring words and phrases were identified. With respect to information midwives give all women about monitoring fetal movements, recurring words were "10", "normal", "kick charts" and "when to contact" their care-provider. Recurrent words and phrases arising from answers to the second question about advice midwives give to women reporting reduced fetal movement were "ask questions," "suggest fluids," "monitor at home and call back" or "come in for assessment". These findings suggest that a group of South Australian midwives are providing pregnant women with inconsistent information, often in conflict with best practice evidence. As giving correct, evidence based information about what to do in the event of an episode of reduced fetal movement may be a matter of life or death for the unborn baby it is important that midwives use existing guidelines in order to deliver consistent information which is based on current evidence to women in their care.
Publisher: Emerald
Date: 13-04-2015
DOI: 10.1108/JARHE-03-2014-0043
Abstract: – With less time spent on c us, students are increasingly forming peer friendship and study groups either face to face or online. Communities of practice (CoP) with academic support in the wings could benefit students, but little is known in the about their use in the undergraduate space, or how best they may be structured and facilitated (Andrew et al. , 2008). The purpose of this paper is to discuss these issues. – An online CoP was created in partnership with undergraduate bachelor of midwifery students at the University of South Australia using an action research model. This provided an ongoing ability to continuously plan, act, observe and evaluate all aspects of the community created, so that adjustments could be made during the two cycles of the study. – The time paucity of the cohort impacted on their ability to participate fully as partners in the project, and in the community itself. The Facebook community received more visitation than the Weebly community. The student panel reported that despite the online CoP fitting better with their schedules, they would prefer more opportunities to interact face to face with their peers. – Students who spend limited time on c us may prefer more real life social contact and support, despite the convenience of an online community. A larger cohort, drawing from a non-professional degree would have allowed greater membership and community participation for a prospective study such as this. – Remote study is a growing phenomenon, and students need to feel socially connected and supported to remain enroled and engaged. – There has been much discussion around the amount of time in iduals spend online, and whether support groups formed by students on social media support student learning, or encourage unprofessional behaviours without academic support present. – This study reports that online communities are not always a logical solution to time poor students, and they may prefer face to face interactions to build their social and professional relationship.
Publisher: American Academy of Sleep Medicine (AASM)
Date: 15-08-2018
DOI: 10.5664/JCSM.7280
Publisher: Elsevier BV
Date: 09-2015
DOI: 10.1016/J.WOMBI.2015.02.006
Abstract: The purpose of this structured review was to review current evidence of "hands on" and "hands off" techniques as it relates to rates of perineal laceration in order to provide direction for future research in this important area of midwifery practice. A structured literature search using all identified keywords and index terms was undertaken in MEDLINE, EMBASE Joanna Briggs Institute, CINAHL, TRIP, and OVID nursing database. A total of 24 papers were identified from the initial searches as potentially relevant to the review questions. Of these a total of nine papers were considered relevant for this review. These nine included one systematic review with meta-analysis, four randomised controlled trials (RCTs), one quasi-experimental study and three cohort studies. "Hands on" techniques have been traditionally used but not been well defined in the literature, therefore it is currently unclear as to whether or not "hands on" technique can reduce perineal laceration. More studies are required to test the effectiveness of a standardised "hands on" technique and also to determine what part other factors such as maternal position, visualisation and use of water might play in perineal laceration rates.
Publisher: Wiley
Date: 05-12-2022
DOI: 10.1002/HPJA.686
Abstract: To raise expectant fathers' awareness of risk factors for stillbirth. A set of brief text messages was developed addressing recognised risk factors for stillbirth: avoidance of maternal cigarette smoking, maternal going to sleep on side messaging, awareness of the importance of noticing and reporting changes in foetal movement and fathers' involvement in shared decision making for timing of birth. Eight messages were inserted into the SMS4dads pilot program being conducted by NSW Health. Feedback on the messages was requested. Participants rated the quality of the messages on a three‐point Likert scale and provided comments. Overall, 2528 messages were sent to 626 fathers' mobile phones, 45% of fathers replied with 666 ratings and 115 comments evaluating the texts. The quantitative ratings indicated substantial overall approval of the messages. Within the coding category “Evaluation of Message Content,” three themes described fathers' reactions and feelings about the smoking, movement, side sleeping and birth timing messages: “important‐good information,” “not appropriate/anxiety provoking” and “not relevant‐obvious.” Three themes reflecting the attributes of the messages within the “Service Quality” category were “need more information,” “complements public health” and “child voice fit.” Results indicate that the messages are an acceptable way to provide information and suggested actions addressing stillbirth risk factors to fathers‐to‐be. Fathers' awareness of the risk factors for stillbirth can assist mothers to take appropriate actions for a healthy birth. Information on risk factors can be provided to fathers via a father‐focused text messaging service.
Publisher: Elsevier BV
Date: 07-2022
DOI: 10.1016/J.WOMBI.2021.06.008
Abstract: The prevalence of stillbirth in many high income countries like Australia has remained unchanged for over 30 years. The 2018 Australian government Senate Select Committee on Stillbirth Research and Education highlighted the need for a public health c aign to encourage public conversations and increase awareness. However, there is little evidence about the community's knowledge and perceptions towards pregnancy and stillbirth, nor their aspirations for a public health c aign. To assess the general knowledge, perceptions, myths and attitudes towards stillbirth to inform future public health c aigns. Australian participants (n = 344 predominately women n = 294 (85.5%)) were recruited via Facebook.com. They completed a cross-sectional online survey designed to assess their knowledge of pregnancy and stillbirth, with additional questions on socio-demographic characteristics. Stillbirth knowledge and awareness of incidence was low in this s le. Prominent myths, such as baby runs out of room in the uterus (n = 112, 33%) and baby slows down when preparing for labour (n = 24, 27%) were endorsed. Only 25% (n = 85) knew the prevalence of stillbirth in Australia (six per day). Almost two-thirds (n = 205 62%) agreed that there needs to be a public health c aign, however one in five (n = 65 20%) were concerned that talking about stillbirth with pregnant women may cause them to worry. Our findings reinforce the need for a targeted c aign, which educates the general population about the definition and prevalence of stillbirth, stillbirth risks and modifiable health behaviours. Appropriate messaging should target pregnant women during antenatal care as well as their support and care systems (family, friends, and care providers).
Publisher: Elsevier BV
Date: 02-2020
DOI: 10.1016/J.NEDT.2019.104298
Abstract: There is a disconnect between what maternity care providers consider should be done and what they actually do with respect to talking with their pregnant clients about reducing their risk of stillbirth. This suggests that they would benefit from receiving up-to-date knowledge about stillbirth, alongside education that provides them with strategies for talking about stillbirth with pregnant women. To gain an understanding of maternity care provider (obstetricians and midwives) knowledge of stillbirth and determine whether delivering a half day workshop improves knowledge and results in intention to change practice. A pre-post intervention study. Maternity care providers (Obstetricians, Midwives) working in the northern areas of Tasmania, Australia were asked, via questionnaire, about their knowledge of stillbirth both before and after attending a half-day workshop. Maternity care providers (n = 51) attended the workshop and 30 (59%) completed both the pre-workshop and post-workshop surveys. A four hour interactive workshop grounded in understanding the stillbirth experience. Participants were given up-to-date information about stillbirth risks and current prevention research as well as provided with an actionable step wise approach to talking about stillbirth prevention in pregnancy. Stillbirth knowledge scores (total of 8-points) significantly increased following the workshop (pre: mean = 2.9 ± 1.5 post: mean = 4.7 ± 1.4 points, t Attending a stillbirth awareness for prevention education workshop resulted in significant knowledge improvement and self-reported intention to change practice in a group of Australian maternity care providers. While these results are promising, further study is needed to determine the presence and extent of actual practice change following such education.
Publisher: Wiley
Date: 11-05-2009
DOI: 10.1111/J.1365-2702.2008.02779.X
Abstract: The aim of this study was to determine whether there is a relationship between placental position and stillbirth with the objective of establishing if placental position impacted on stillbirth risk. Whilst there has been extensive research on low placental implantation because of the importance of detecting placenta praevia, little research has been undertaken on other aspects of placental position and possible impact on pregnancy outcome. A matched case-control study of stillbirth and placental position was conducted using case-notes from two tertiary obstetric referral centres. Notes were retrospectively examined and Placental position as documented in the case-notes at the routine mid-trimester (20 week) ultrasound was identified. Placental position for a total of 124 pregnancies culminating in stillbirth was compared with placental position in 243 (matched) pregnancies resulting in a live born baby. Women who had a posterior located placenta were statistically more likely to suffer a stillbirth than women who had a placenta in any other position OR 1.64 (95%CI 1.02-2.65 p = 0.04). Posterior located placenta may be a contributory risk factor for stillbirth. Further research is warranted. Implications for practice. Nurses and midwives should be aware of this potential risk factor to monitor foetal well-being closely.
Publisher: Elsevier BV
Date: 10-2017
DOI: 10.1016/J.WOMBI.2017.04.001
Abstract: Accessibility of water immersion for labour and/or birth is often dependent on the care provider and also the policies/guidelines that underpin practice. With little high quality research about the safety and practicality of water immersion, particularly for birth, policies/guidelines informing the practice may lack the evidence necessary to ensure practitioner confidence surrounding the option thereby limiting accessibility and women's autonomy. The aims of the study were to determine how water immersion policies and/or guidelines are informed, who interprets the evidence to inform policies/guidelines and to what extent the policy/guideline facilitates the option for labour and birth. Phase one of a three-phase mixed-methods study critically analysed 25 Australian water immersion policies/guidelines using critical discourse analysis. Policies/guidelines pertaining to the practice of water immersion reflect subjective opinions and views of the current literature base in favour of the risk-focused obstetric and biomedical discursive practices. Written with hegemonic influence, policies and guidelines impact on the autonomy of both women and practitioners. Policies and guidelines pertaining to water immersion, particularly for birth reflect opinion and varied interpretations of the current literature base. A degree of hegemonic influence was noted prompting recommendations for future maternity care policy and guidelines'. The Human Research Ethics Committee of the University of South Australia approved the research.
Publisher: Springer Science and Business Media LLC
Date: 13-11-2017
Publisher: SAGE Publications
Date: 12-2009
Abstract: The large and erse bodies of literature on refugee child and adolescent mental health have not been matched by a commensurate interest in help-seeking. Most help-seeking research has centred on Western and, to a lesser extent, non-refugee ethnic minority adult populations. An emerging child and adolescent help-seeking literature consistently reports widespread underutilization of mental health services by children in the general population. Current research and opinion suggest a similar trend for refugee and other ethnic minority children. While service underutilization appears to be an issue for all children, those from refugee backgrounds may be at increased risk of mental health problems and have greater difficulty accessing mental health care. From a policy and practice perspective, the most important explanation for low uptake of services by refugee families concerns an overall failure of Western mental health systems to accommodate the needs of ethnically erse populations in general and refugees in particular. In order to effectively plan for the mental health needs of refugee children and adolescents, Western host country governments need a clear understanding of help-seeking behaviour.
Publisher: Exeley, Inc.
Date: 2016
Publisher: Elsevier BV
Date: 06-2014
Publisher: Elsevier BV
Date: 10-2011
DOI: 10.1016/J.MIDW.2010.05.007
Abstract: to identify existing literature which addresses the topic of detecting, assessing and intervening when a pregnant woman who has quit smoking relapses. This literature review was conducted in the light of findings of a case-control study which suggest that a quit smoking status is associated with increased risk of late stillbirth (odds ratio 3.03, 95% confidence interval 1.27-7.24, p = 0.01). a structured review was conducted to identify literature related to quitting smoking in early pregnancy, prevalence and likelihood of relapse, possible methods for detecting smoking resumption, potential intervention strategies for the relapsed smoker and the societal burden of continuing to smoke in pregnancy. there is a wide variety of evidence for the effectiveness of intervention strategies aimed at assisting women to quit smoking during pregnancy. However, few studies have specifically aimed to identify strategies to assist those women who report quitting in early pregnancy to maintain that status throughout pregnancy. in light of the results of the case-control study and this literature review, it is important that changes are made to prenatal care in order to enable midwives to better identify women who are struggling with abstinence or who resume smoking during pregnancy. midwives should discuss and monitor smoking status with women at every prenatal visit. If a midwife finds that a woman has relapsed into smoking, they can be offered a range of quit smoking intervention strategies, including referral to a dedicated cessation service, counselling support, alternative therapies and, perhaps, nicotine replacement therapy. Further research aimed at identifying the extent of relapse among these women and the impact this may have on pregnancy outcome is warranted. Research to ascertain the most appropriate interventions to prevent relapse is also needed.
Publisher: Elsevier BV
Date: 11-2014
DOI: 10.1016/J.NEPR.2014.09.006
Abstract: Assertiveness can be defined as an interpersonal behaviour that promotes the fact all people in a relationship are equally important. All health professionals including midwives must work with and care for people. At times this will include facilitating interactions that require skilful negotiation and assertiveness. Yet embedding assertiveness education into undergraduate midwifery curricula has not been widely adopted. This paper explores one method of delivering assertiveness training in an undergraduate midwifery course and provides comment on the effectiveness of this strategy in developing assertiveness skills in a cohort of undergraduate midwifery students. We used an assertiveness survey which was administered immediately before and 3-4 months after an assertiveness training workshop. All students (n = 55) attending the training day were invited to participate. Of these 41 (77% response) chose to participate in the pre intervention survey and 32 participated (9 students lost to follow-up) in the follow up survey. There was an overall improvement in self-perceived assertiveness scores following the assertiveness training workshop. These findings provide encouraging evidence that educational institutions that offer specific and targeted assertiveness education will be rewarded with more assertive graduates.
Publisher: Springer Science and Business Media LLC
Date: 13-05-2015
DOI: 10.1038/NATURE14474
Abstract: The standard model of particle physics describes the fundamental particles and their interactions via the strong, electromagnetic and weak forces. It provides precise predictions for measurable quantities that can be tested experimentally. The probabilities, or branching fractions, of the strange B meson (B(s)(0)) and the B0 meson decaying into two oppositely charged muons (μ+ and μ−) are especially interesting because of their sensitivity to theories that extend the standard model. The standard model predicts that the B(s)(0) →µ+µ− and B(0) →µ+µ− decays are very rare, with about four of the former occurring for every billion mesons produced, and one of the latter occurring for every ten billion B0 mesons. A difference in the observed branching fractions with respect to the predictions of the standard model would provide a direction in which the standard model should be extended. Before the Large Hadron Collider (LHC) at CERN started operating, no evidence for either decay mode had been found. Upper limits on the branching fractions were an order of magnitude above the standard model predictions. The CMS (Compact Muon Solenoid) and LHCb (Large Hadron Collider beauty) collaborations have performed a joint analysis of the data from proton–proton collisions that they collected in 2011 at a centre-of-mass energy of seven teraelectronvolts and in 2012 at eight teraelectronvolts. Here we report the first observation of the B(s)(0) → µ+µ− decay, with a statistical significance exceeding six standard deviations, and the best measurement so far of its branching fraction. Furthermore, we obtained evidence for the B(0) → µ+µ− decay with a statistical significance of three standard deviations. Both measurements are statistically compatible with standard model predictions and allow stringent constraints to be placed on theories beyond the standard model. The LHC experiments will resume taking data in 2015, recording proton–proton collisions at a centre-of-mass energy of 13 teraelectronvolts, which will approximately double the production rates of B(s)(0) and B0 mesons and lead to further improvements in the precision of these crucial tests of the standard model.
Publisher: Elsevier BV
Date: 12-2019
DOI: 10.1016/J.MIDW.2019.102541
Abstract: The objective of this study was to explore the views, experiences, perceptions of and access to water immersion for labor and birth in Australia. A sequential exploratory mixed methods study commenced in 2016. The first phase involved an online survey. The second phase is due to commence in 2019 and will involve focus groups and interviews. This paper presents a subset of results from phase one that asked women to self-rate the benefits and risks associated with water use on Likert-scales and for those who had a previous birth not involving water, how the two experiences compared. A total of 740 Australian women who had used water immersion for labor and/or birth rated the benefits against 7-point Likert scales and 736 responded to 5-point Likert scales relating to commonly cited concerns surrounding the option. Women highly rated water immersion against all benefits. Benefits that were most highly rated (by numbers of 'entirely agree' on 7-point Likert scales) included sense of safety (80.14%), an alert baby (75.00%), a positive birth experience (72.70%), water as soothing (72.03%) and freedom of movement (71.35%). Women were most concerned (by selecting 'somewhat' to 'extremely concerned' on 5-point Likert scales) about being told to get out of the water when they did not want to (n = 120/736, 16.30%), their contractions going away (n = 76/736, 10.33%) and unsupportive staff (n = 65/736, 8.83%). More than 90% (n = 682/740) of women mostly to entirely agreed that they would recommend water immersion to others. Women rated water immersion as more comfortable, more satisfying and more relaxing when compared to previous births that they had that did not involve water. Women value water immersion for labor and birth. They have very little to no concern for the most common adverse events as documented in the literature. The results add to the growing evidence base surrounding water immersion for labor and birth. Whilst there remains ongoing debate about the safety of water immersion, women's experiences should be considered alongside outcome data. The results of this study may assist policy makers and clinicians in their advocacy and support of women who choose water immersion. The Human Research Ethics Committee of the University of South Australia approved the research.
Publisher: Elsevier BV
Date: 02-2019
Publisher: BMJ
Date: 25-09-2012
Publisher: Elsevier BV
Date: 06-2019
DOI: 10.1016/J.WOMBI.2018.08.169
Abstract: Water immersion for labour and birth is consistently challenged as a practice lacking support from high quality evidence. Despite this, the option is available to Australian women. Practitioners are guided by policies and guidelines however, given the research paucity, questions surround the way in which water immersion policies and guidelines are informed. The aims of the study were to determine how water immersion policies and/or guidelines are informed and to what extent the policy/guideline facilitates the option of water immersion for labour and birth with respect to women's choice and autonomy. Phase two of a three phase mixed methods study used critical, post structural interpretive interactionism to examine the process of development and implementation of water immersion policies and guidelines from informant's experience. Semi-structured interviews were conducted with 12 Australian participants. Participants highlighted that the lack of randomised controlled trials had resulted in other forms of evidence being drawn upon to inform water immersion policies and guidelines. This was influenced in part by in idual interpretations of evidence with medical views taking precedence. This sometimes resulted in policy and guideline documents that were restrictive with this impacting on women's ability to access the option. Perceived limitations of research and the subsequent translation of this perceived paucity of evidence into policies and guidelines, has impacted on women's ability to exercise choice and autonomy with respect to water immersion and indeed, on the professional autonomy of practitioners who wish to facilitate it.
Publisher: Elsevier BV
Date: 06-2017
DOI: 10.1016/J.SINY.2017.01.005
Abstract: This article reviews three new and emerging risk factors for stillbirth that may be modifiable or might identify a compromised fetus. We focus on fetal movements, maternal sleep, and maternal diet. Recent studies have suggested than a sudden increase in vigorous fetal activity may be associated with increased risk of stillbirth. We review the papers that have reported this finding and discuss the implications as well as potential future directions for research. There is emerging literature to suggest that maternal sleep position may be a risk for stillbirth, especially if the woman settles to sleep supine. This risk is biologically plausible. How this knowledge may be utilized to assist stillbirth reduction strategies is discussed. Finally, we examine the somewhat limited literature regarding maternal diet and pregnancy outcome. Introducing probiotics into the diet may prove useful, but further work is required. The possible next steps for research are considered, as well as some potential intervention strategies that may ultimately lead to stillbirth reduction.
Publisher: Springer Publishing Company
Date: 2011
DOI: 10.1891/1058-1243.20.4.218
Abstract: In this article, we discuss the intuitive knowledge mothers have of their unborn baby. We propose a shift in focus from caregivers’ merely providing information to first listening to pregnant mothers as they share their intuitive knowledge of their baby. This approach enables mothers and fathers or partners to know they are already parents to their unborn baby and empowers them to get in touch with their baby’s presence and who he or she is during pregnancy. This intuitive knowledge may be a protective behavior that will enable mothers to keep babies safe during pregnancy.
Publisher: Wiley
Date: 20-09-2023
DOI: 10.1111/JAN.15866
Publisher: Elsevier BV
Date: 06-2019
DOI: 10.1016/J.WOMBI.2018.08.165
Abstract: Water immersion for labour and birth is an option that is increasingly favoured by women. Australian water immersion policies and guidelines commonly specify that practitioners, such as midwives, must undertake further education and training to become accredited. A three-phase mixed methods approach was used. Phase one used critical discourse analysis to determine who or what informs policies and guidelines related to water immersion for labour and/or birth. Phase two examined policy and guideline informants' experiences of the development of policies/guidelines, whilst phase three surveyed Australian midwives' views and experiences of water immersion and their use of and/or involvement in the development of policies and guidelines. Practitioner accreditation for the facilitation of water immersion was a common finding across all phases of the study. An examination of policies and guidelines found that practitioners, namely midwives, were required to meet additional training requirements to facilitate water immersion. Participants of phases two and three identified and discussed accreditation as a significant challenge to the option of water immersion, particularly where there were inconsistencies across documents and in the interpretation of their content. The need for practitioners to be accredited to facilitate water immersion was identified as a major barrier to availability and therefore, women's ability to access the option. Given these findings, the need for accreditation should be challenged.
Publisher: Springer Science and Business Media LLC
Date: 08-2012
Publisher: Clute Institute
Date: 13-07-2015
Publisher: Elsevier BV
Date: 10-2011
Publisher: Elsevier BV
Date: 12-2014
DOI: 10.1016/J.WOMBI.2014.08.005
Abstract: To register as a midwife in Australia, students must complete minimum requirements of clinical experiences throughout their programme. This includes following women through their childbirth journey in order to gain continuity of care experience. Research suggests that women and students find the continuity of care experience (COCE) valuable. Nevertheless, students cite difficulty in achieving these experiences. Aim This project sought to explore the challenges and identify supportive strategies for midwifery students undertaking the COCE. This project adopted an action research approach incorporating the four stages of planning, action, observation and reflection. This paper specifically reports the findings from the planning stage in which a focus group with education providers, facilitator and students was conducted and a survey with students (n=69) was undertaken. Key themes were identified through thematic analysis and a number of actions were proposed. Three main themes, 'access', 'boundaries' and 'confidence' were identified as challenges for students undertaking the COCE. Students raised concern regarding lack of access to women for COCE. They identified a need to establish clear professional and personal boundaries in managing the COCE. Students also highlighted the significance of confidence on the success of their experience. Throughout the study students identified strategies that could assist in the COCE. There is a need for clarity and support around the COCE for all stakeholders. Placing the COCE within a Service Learning model is one response that ensures that this experience is understood as being symbiotic for women and students and enables supportive actions to be developed and implemented.
Publisher: Georg Thieme Verlag KG
Date: 04-2008
Abstract: An immense body of literature on the effects of hypertension on perinatal morbidity and mortality exists, but only a handful of studies have reported adverse outcomes associated with low maternal blood pressure during pregnancy. This study aimed to investigate if there is an increased risk of fetal loss associated with hypotension during pregnancy. A matched case-control study of stillbirth and maternal blood pressure was conducted in which maternal blood pressures for a total of 124 pregnancies culminating in stillbirth were compared with maternal blood pressures in 243 (matched) pregnancies resulting in a liveborn infant. Women whose diastolic blood pressures fell in a borderline range (60 to 70 mm Hg) were consistently at greater risk of stillbirth relative to normotensive pregnancies. Women who had three or more mean arterial pressure values or = 130 mmHg) than cases, and the adjusted odds of stillbirth in women who were hypertensive at either their first or last antenatal visit or whose antenatal average SBP was > or = 130 mm Hg were all very close to 0.4 (95% CI 0.37 to 0.43 P = 0.02 to 0.03) relative to normotensives. We concluded that maternal hypotension, particularly borderline hypotension, may be a contributory risk factor for stillbirth. Women with hypertension in pregnancy may now be at a decreased risk of stillbirth as a result of the close care and treatment they receive.
Publisher: Elsevier BV
Date: 07-2018
DOI: 10.1016/J.MIDW.2018.04.009
Abstract: To describe and explore 'gut instinct' that something was wrong in women who identified that they experienced gut instinct during pregnancy. A case-control study utilising an international web-based questionnaire. Stillborn cases (n = 146) and liveborn controls (n = 234) answered the gut instinct question within 30 days of the pregnancy ending. Of those, 84 cases and 27 controls also provided qualitative comment data. Descriptive statistics were used for the question, with a fixed option and summative content analysis was used to analyse the comment data. In all, 110 (75%) of the stillborn cases answered "yes" to the gut instinct question vs only 28 (12%) of the controls who had a livebirth meaning the risk of stillbirth was 22.5 fold higher in those who experience "gut instinct" than in those who do not experience this feeling. Four themes were identified from the comment data namely: When the gut instinct occurred How the gut instinct made the woman feel Dreams and other related phenomena Reassured by someone or something. Women who had a stillborn baby reported a "gut instinct" that something was wrong more frequently than mothers of a live born baby. Our findings may be influenced by recall negativity bias, and a prospective study is needed to confirm or refute our findings. The possibility that "maternal intuition" exists during pregnancy and responds to changes in fetal or placental health merits further exploration. Maternity care providers should be alert to the woman when she expresses intuitive feelings, as well as asking her to report her concerns and act appropriately to assess and manage fetal wellbeing.
Publisher: Wiley
Date: 13-10-2023
DOI: 10.1111/AJO.13759
Publisher: Springer Science and Business Media LLC
Date: 15-04-2015
Publisher: Elsevier BV
Date: 09-2013
DOI: 10.1016/J.MIDW.2012.12.003
Abstract: Traumatic birth is a phenomenon that has been identified in women's birthing experiences, yet there has been no primary research conducted into midwives experiences of witnessing traumatic birth. Traumatic stress from witnessing and working with traumatised clients has been identified in other caring professionals such as nurses, social workers and emergency department personnel. This includes evidence of posttraumatic stress disorder, secondary traumatic stress, vicarious traumatisation and compassion fatigue. A distinct gap in the literature about midwives experiences of witnessing traumatic birth and the effects of working with potentially traumatised women formed the basis for this research. A descriptive qualitative study was used to explore midwives experiences of witnessing traumatic birth. The aim of this research was to enable midwives to describe their experiences and to determine if they are at risk of negative psychological sequalae similar to those in other caring professions. Ten currently or previously Registered Midwives with varying amounts of experience were interviewed, and transcripts of those interviews formed the raw data for the study. The data were independently thematically analysed by the two authors to identify common themes used to describe the experience of witnessing traumatic birth. 'Stuck between two philosophies', 'What could I have done differently', and 'Feeling for the woman', emerged as the main themes from the research. The participants described their emotional distress from feeling 'stuck' between wishing they could practice according to their midwifery philosophy, and the reality of working within a medical model of care. Feelings of responsibility for women and babies' outcomes, and repeatedly questioning what they could have done differently to prevent a traumatic birth was also reported. Feeling for the woman emerged as a major factor in midwives' experiences of witnessing traumatic birth. As far as we can determine this is the first study to explicitly examine the phenomenon of midwives witnessing traumatic birth from the midwives point of view. While it was anticipated that midwives might describe being emotionally distressed by their experiences, the extent of their empathy and feelings of being stuck between two philosophies provide new knowledge into what affects midwives when working with birthing women. Further research into these areas is warranted. Better understanding of how witnessing traumatic birth impacts on midwives and what kind of support after these experiences is required to ensure midwives are equipped to cope when witnessing traumatic birth.
Publisher: Elsevier BV
Date: 10-2015
DOI: 10.1016/J.NEDT.2015.07.031
Abstract: The project aimed to establish the level of knowledge a group of midwives had about risk factors for stillbirth and identify their current willingness to raise and discuss stillbirth with pregnant women during standard antenatal care. Surveys were administered pre and post an education intervention. The intervention consisted of a half day education workshop. A change in knowledge pre and post intervention was measured as a means to determine the effectiveness of the workshop. The workshop first provided participants with up-to-date information about modifiable and preventative risk factors for stillbirth and then provided them with the opportunity to practice a range of strategies to assist them to becoming confident in raising and discussing the topic of stillbirth. Three workshops were offered and a total of 109 qualified midwives attended. In order to explore the level of knowledge increase and retention of knowledge about stillbirth as well as participants willingness to discuss stillbirth with pregnant women, comparisons were made between the pre workshop survey responses and those given to the two follow-up surveys immediately following and 3 months after the workshop. There was a statistically significant improvement in knowledge about stillbirth as well as in participant willingness to engage the pregnant women in their care in a conversation about stillbirth. Providing a workshop on stillbirth for registered midwives is quite effective in raising their awareness about stillbirth. However, before substantial changes can be made in stillbirth awareness, ways and means to sensitively promote public awareness of stillbirth need to be explored and anxieties and taboos addressed. Research could explore whether or not a stillbirth awareness message actually does make women anxious, and if so the nature of this anxiety and how this anxiety might best be ameliorated.
Publisher: Elsevier BV
Date: 10-2013
Publisher: Elsevier BV
Date: 06-2018
DOI: 10.1016/J.WOMBI.2017.09.001
Abstract: There is little published research that has examined practitioners' views and experiences of pain relieving measures commonly used during labour and birth, particularly for non-pharmacological measures such as water immersion. Furthermore, there is minimal published research examining the process of policy and guideline development, that is, the translation of published research to usable practice guidance. The aims of phase three of a larger study were to explore midwives knowledge, experiences and support for the option of water immersion for labour and birth in practice and their involvement, if any, in development of policy and guidelines pertaining to the option. Phase three of a three phased mixed methods study included a web based survey of 234 Australian midwives who had facilitated and/or been involved in the development of policies and/or guidelines relating to the practice of water immersion. Midwives who participated in this study were supportive of both water immersion for labour and birth reiterating documented benefits of reduced pain, maternal relaxation and a positive birth experience. The most significant concerns were maternal collapse, the difficulty of estimating blood loss and postpartum haemorrhage whilst barriers included lack of accredited staff, lifting equipment and negative attitudes. Midwives indicated that policy/guideline documents limited their ability to facilitate water immersion and did not always to support women's informed choice. Midwives who participated in this study supported the practice of water immersion reiterating the benefits documented in the literature and minimal risk to the woman and baby. The Human Research Ethics Committee of the University of South Australia approved the research.
Publisher: Elsevier BV
Date: 11-2020
Publisher: Elsevier BV
Date: 12-2011
DOI: 10.1016/J.WOMBI.2010.10.003
Abstract: To gain a better understanding of women's baseline level of knowledge of induction of labour (IOL) and determine whether giving written information at the time IOL is decided, results in significant differences in knowledge and understanding of the process. Fifty pregnant women undergoing antenatal care at a small maternity hospital were recruited. A quasi experimental trial was conducted with non random selection of participants, 25 selected to act as the control group and 25 selected as the intervention group. The study was conducted to determine women's knowledge of IOL both before (non-intervention) and after (intervention) the introduction of a written information brochure. Statistically significant increases in knowledge were evident in the intervention group for knowledge about action (p=0.002) and timing of prostaglandins (p=0.03), the number of side effects known (p<0.0001) as well as time to birth (p=0.001) indicating an increased understanding of the process as a result of reading an information brochure. These results suggest that those in the non-intervention group lacked knowledge pertinent to IOL, even though they have consented to and actually arrived at the hospital prepared to undergo the IOL procedure. The most significant disparity noted between the intervention and non-intervention groups was women's knowledge of side effects of prostaglandin. Further to this, many women in the non-intervention group had unrealistic expectations of both the time for drug action and likely time from prostaglandin administration to birth. In contrast women in the intervention group knew about the common side effects of prostaglandin and possessed a more realistic understanding of the likely time to birth following this procedure. The results indicate that a specifically designed information brochure explaining the process of IOL in plain language has the effect of enhancing women's knowledge. This area of study warrants further investigation, especially research into the role of written information to improve women's understanding across other areas of maternity care education provision.
Publisher: Elsevier BV
Date: 05-2015
DOI: 10.1016/J.NEPR.2015.01.014
Abstract: This paper describes the process of creating and applying a Visually Authentic Learning Tool (VALT™) in an undergraduate midwifery program. The VALT was developed to facilitate learning in the topic "bleeding in pregnancy". The VALTs objective is to open the mind of the student to facilitate learning via the visual representation of authentic real life simulations designed to enhance and bring to life the written scenario. Students were asked for their feedback of the VALTs. A descriptive analysis was performed on the collated results to determine how the students rated the VALTS in terms of satisfaction and meeting their learning needs. Overall the students seemed to value the VALTs as they present an engaging and unique opportunity to promote learning whilst acknowledging and valuing different learning style within the student group.
Publisher: Public Library of Science (PLoS)
Date: 24-09-2020
Publisher: Wiley
Date: 15-02-2017
DOI: 10.1113/JP273705
Publisher: Elsevier BV
Date: 02-2013
DOI: 10.1016/J.MIDW.2011.11.008
Abstract: to gain a better understanding of women's baseline level of knowledge of stillbirth and determine whether giving written information during pregnancy results in improvement in knowledge about stillbirth. a pre-post intervention study. women undergoing antenatal care at a small maternity hospital were asked, via questionnaire, about their knowledge of stillbirth both before and after reading an information brochure on the subject. 22 pregnant women who were in the last trimester of pregnancy. a statistically significant increase in knowledge was evident in awareness of the incidence in stillbirth (p<0.001). Women also were more aware of some of the proactive things they could do to prevent this tragedy from occurring to them. This improvement in understanding may be attributed to reading the brochure. prior to reading the brochure all women understood the term 'stillbirth' but most lacked knowledge pertinent to understanding how often it occurs. The most significant difference noted between the pre- and post-intervention analysis was the improvement in women's knowledge of the incidence of stillbirth. Further to this, prior to reading the brochure most women were unaware of action they themselves could take to reduce risk such as awareness of fetal movements, whereas after reading the brochure this was more likely to be cited. the results from this pilot study may indicate that a specifically designed information brochure explaining the incidence of stillbirth in plain language could enhance pregnant women's knowledge. This area of study warrants further investigation, especially as to whether such knowledge is of an enduring nature or whether awareness results in reduced incidence.
Publisher: Elsevier BV
Date: 10-2011
DOI: 10.1016/J.MIDW.2010.06.019
Abstract: to gain an in-depth understanding of subsequent children's experiences of being born into and raised in a family following an infant death. an exploratory qualitative study. semi-structured interview in the participants' homes. Data were collected over a five-month period in 2009 and analysed using thematic analysis. a purposive s le of 10 subsequent children (five boys and five girls) was used. Children whose parents had accessed the support services offered by two bereavement support agencies were recruited. Participants were asked to describe their experiences of being a subsequent child. Interviews were conducted when the subsequent child was at least 13 years of age. all participants spent time describing how they felt about being a subsequent child. They described how they had experienced life as a subsequent child, how they considered others felt about them (especially their mother), and finally how they felt about their deceased sibling. all participants in this study provided a picture of emotional well-being. They were aware of their family history, and all appreciated the grief and loss which their parents had suffered. However, they did not believe that this had impacted negatively on them rather, most talked about positive effects including feeling loved and special because of the circumstances resulting in their birth. Even those who recognised that they may not have been born had their sibling lived accepted this and appeared to be emotionally secure and well adjusted. These findings suggest that intervention with bereaved parents at the time of the perinatal/infant death and soon after is beneficial to the experiences of the subsequent child. Further research to determine the nature and extent of this benefit is warranted.
Publisher: Elsevier BV
Date: 10-2011
DOI: 10.1016/J.MIDW.2010.02.004
Abstract: to gain an in-depth understanding of the parenting experiences of bereaved parents in the years following an infant death. an exploratory qualitative study. semi-structured interview in the participants' homes. Data were collected over a five-month period in 2008 and analysed using thematic analysis. a purposive s le of 13 bereaved parents (10 mothers and three fathers) was used. Parents who had accessed the support services offered by two bereavement support agencies were recruited. Participants were asked to describe their experiences of raising their subsequent child. Interviews were conducted when the next born child was at least three years of age. the parents described a 'paradoxical' parenting style where they were trying to parent using two diametrically opposed unsustainable options. For ex le, they described trying to hold their subsequent child emotionally close but aloof at the same time. the results from this study indicate that the impact of a loss of an infant has far-reaching consequences on subsequent parenting. Support and early intervention at the time of the stillbirth and subsequent pregnancy are likely to be useful. However, further research is required to determine the extent to which early intervention can alter the tendency towards bereaved parents adopting a paradoxical parenting style. The impact of this style on mental health and the emotional health and well-being of the next born child/ren after perinatal loss should also be further examined.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-05-2021
Publisher: Elsevier BV
Date: 06-2019
DOI: 10.1016/J.SRHC.2019.02.002
Abstract: We investigated how women, seeking care due to decreased movements, had paid attention to fetal movements and if the method of monitoring was associated with pregnancy outcome. A questionnaire was distributed to women from gestational week 28, who had sought care due to decreased fetal movements in Stockholm between January 1st and December 31st There were 29166 births in Stockholm in 2014, we have information from 2683 women who sought care for decreased fetal movements. The majority (96.6%) of the women stated that they paid attention to fetal movements. Some women observed fetal movements weekly (17.2%) and 69.5% concentrated on fetal movements daily (non-structured group). One in ten (9.9%) used counting methods daily for observing fetal movements (structured group). Women in the structured group more often had caesarean section before onset of labor (RR 1.6, 95% CI 1.2-2.2) and a lower risk of their baby being transferred to neonatal nursery (RR 0.25, 95% CI 0.03-0.94) compared to women in the non-structured group. Women, who had a daily and structured approach to awareness of fetal movements, were more likely to have a caesarean section but their babies were less likely to be transferred to a neonatal nursery as compared with women who used a non-structured method daily.
Publisher: Elsevier BV
Date: 05-2020
Publisher: SLACK, Inc.
Date: 03-2012
DOI: 10.3928/01484834-20120127-03
Abstract: Online role-play has the potential to actively engage students in authentic learning experiences and help develop their clinical reasoning skills. However, evaluation of student learning for this kind of simulation focuses mainly on the content and outcome of learning, rather than on the process of learning through student engagement. This article reports on the use of a student engagement framework to evaluate an online role-play offered as part of a course in Bachelor of Nursing and Bachelor of Midwifery programs. Instruments that measure student engagement to date have targeted large numbers of students at program and institutional levels, rather than at the level of a specific learning activity. Although the framework produced some useful findings for evaluation purposes, further refinement of the questions is required to be certain that deep learning results from the engagement that occurs with course-level learning initiatives.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2018
DOI: 10.1097/ANC.0000000000000533
Abstract: Nurses working in the neonatal intensive care unit (NICU) who care for dying infants and their families say they do not necessarily have the expertise or the specific training to provide quality end-of-life-care (EOLC). The purpose of this review was to critically appraise the existing qualitative literature regarding nurses' experiences when caring for infants during end of life in the NICU and to identify barriers and enablers to provide quality EOLC. A literature search was conducted using CINAHL and OVID databases. Studies that explored nurses' experiences when caring for infants who were dying or when lifesaving care was withdrawn were retrieved and 15 studies were thematically analyzed. Five major themes emerged: advocating for the dying infant, building close relationships with the family, providing an appropriate care environment, nurses' emotional responses to dying or death, and professional inadequacy in EOLC. Nurses face multiple challenges when providing EOLC including moral dilemmas and feelings of professional inadequacy. Avoidance was a common strategy used by nurses to cope with the stress associated with EOLC. Managers can foster quality EOLC by implementing education sessions about infant mortality, EOLC, advocacy, team communication, and self-care practices. Research could evaluate the effectiveness of EOLC education sessions to build nurses' competence and confidence in advocacy and EOLC clinical skills.
Publisher: E.U. European Publishing
Date: 04-08-2022
DOI: 10.18332/EJM/150355
Publisher: Wiley
Date: 20-03-2022
DOI: 10.1111/AJO.13507
Abstract: There is now robust evidence that when women settle to sleep on their back in late pregnancy ( weeks) they are at increased risk of stillbirth. Therefore, there are several stillbirth prevention programs worldwide that have begun advising pregnant women to adopt a side position when settling to sleep in late pregnancy. However, some hold concerns that giving women information about sleep position and stillbirth risk may make them anxious. This study aimed to determine what influences how ‘safe sleep’ messages are perceived by pregnant women and if there is anxiety associated with receiving this message. An online survey of 537 Australian women ( n = 97 were ‘currently pregnant’). The survey examined participant’s views regarding sleep position messages, type of information source as well as participant characteristics such as general anxiety and their fetal health locus of control (FHLC). Our findings suggest that the FHLC may influence how health messaging regarding sleep in pregnancy is perceived and acted upon. We have also shown a subset of pregnant women may feel anxiety associated with the sleep position in pregnancy message. This may not be related to history of anxiety, but rather to their higher ‘internal’ FHLC, ie those who reflect a greater sense of personal agency over fetal health. Our findings suggest most women will perceive information about settling into sleep position as informative rather than anxiety provoking. Therefore, maternity care providers should not be overly concerned about provoking anxiety when providing this information.
Publisher: Wiley
Date: 18-01-2019
DOI: 10.1111/BIRT.12416
Publisher: Elsevier BV
Date: 02-2021
Publisher: Elsevier BV
Date: 06-2022
DOI: 10.1016/J.MIDW.2022.103298
Abstract: Some research attention has been paid to women's experiences of water immersion for labour and/or birth. Development of a psychometric scale specific to water immersion may provide further insight into women's experiences. The objective of this paper is to share the development, and preliminary psychometric evaluation, of the Water immersion Agency plus Expectations and Relief (WA+ER) scale for assessing women's experiences of using water for labour and/or birth. Items for the WA+ER scale were informed by a thorough literature review, and review by midwifery experts. An online survey was conducted, and 17 items were rated on a 7-point Likert scale (from entirely disagree to entirely agree) by 740 women who had used water immersion for labour and/or birth. An initial exploratory factor analysis was conducted to determine the initial structure of the scale. A confirmatory factor analysis showed that the initial 17-items were not a 'good fit' but with further statistical exploration, a good fit was achieved with 11-items. Results identified three factors with good reliability: Sense of Agency (4 items α = 0.87 ), Expectations (3 items α = 0.83) and Relief (4 items α = 0.82). A confirmatory factor analysis confirmed good model fit (CFI=0.93 GFI=0.91 AGFI=0.85 TLI=0.90). The WA+ER scale is a statistically and theoretically sound tool for measuring women's experiences of labouring and/or birthing in water. Additional testing is required to further assess the validity and reliability of the scale and to determine the appropriateness of its use in other populations.
Publisher: Elsevier BV
Date: 10-2018
DOI: 10.1016/J.SMRV.2018.03.004
Abstract: There is a wealth of evidence to say that sleep impacts maternal health during pregnancy, however, little has been published on fetal health and maternal sleep. This scoping review summarises current literature on maternal sleep including sleep disordered breathing, sleep quality, sleep duration and supine sleep position, as these relate to fetal outcomes specifically birth weight, growth, preterm birth and stillbirth. An overall interpretation of the studies evaluated shows that events occurring during maternal sleep such as obstructive sleep apnea, sleep disruption and sleep position may have a negative effect on the fetus resulting in altered growth, gestational length and even death. These effects are biologically and physically plausible. In conclusion, there is limited and often conflicting information on maternal sleep and fetal outcomes. However, existing evidence suggests that this is an important area for future research. This area is ripe for investigation if there is to be reduction in the physical, emotional, and financial burden of poor fetal outcomes related to maternal sleep.
Publisher: Elsevier BV
Date: 03-2013
DOI: 10.1016/J.MIDW.2012.01.007
Abstract: to determine if the way caregivers offer opportunities to see and hold a stillborn baby impacts a mother's feelings about the experience of seeing and holding her newborn. a web questionnaire hosted by the Swedish National Infant Foundation from March 2008 to April 2010. 840 eligible participants who had experienced a stillbirth after the 22nd gestational week from 1955 to 2010 and completed an online questionnaire about their experiences. descriptive and inferential statistics. when mothers were presented the baby as a normal part of birth without being asked if they wanted to see, they more often reported that the experience was comfortable compared to mothers who were asked if they wanted to see the baby 86% vs. 76% (p=<0.01). The incitation of fear in mothers was 70% vs. 80% (p=0.02) in favour of mothers who were not asked. Furthermore the mothers who were not asked more often stated that it felt natural and good when compared to those who said staff asked if the mother wanted to see, 73% vs. 61% (p=0.07) and (78%) vs. (69%) p=0.19, respectively. A trend was seen toward more mothers feeling natural, good, comfortable, and less frightened if the provider engaged in 'assumptive bonding', that is the baby is simply and naturally presented to the mother without asking her to choose. mothers of stillborn babies felt more natural, good, comfortable and less frightened if the staff supported assumptive bonding by simply offering the baby to the mother. care providers should approach caring for grieving mothers with tenderness and humility, assuming that they will wish to see and hold their stillborn baby.
Publisher: Informa UK Limited
Date: 03-03-2020
No related grants have been discovered for Jane Warland.