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1 – 10 of 193Satar Rezaei, Yahya Salimi, Telma Zahirian Moghadam, Tiba Mirzarahimi, Mohammad Mehrtak and Hamed Zandian
There are so many studies which evaluated the maternal quality of life based on their delivery type with different results. The purpose of this paper is to evaluate the effect of…
Abstract
Purpose
There are so many studies which evaluated the maternal quality of life based on their delivery type with different results. The purpose of this paper is to evaluate the effect of type of delivery on the maternal QOL systematically.
Design/methodology/approach
In this systematic review, which was conducted for 15 years (2000-2016), the international databases including PubMed, Scopes and ISI and the Persian databases were searched using the following words: quality of life or health-related quality of life, vaginal delivery, cesarean delivery or cesarean section. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was adopted for this study. The quality of articles was assessed by a checklist that has been used in previous studies. All of the data analysis was performed using STATA ver.12.
Findings
In total, 13 articles were included in the present systematic review and meta-analysis. The overall sample included 8,136 women (3,990 cesareans vs 4,146 vaginal). The results of the random effect model for eight QOL dimensions based on SF-36 questionnaire showed that there was no significant difference between two groups in terms of QOL. But this model for four QOL dimensions of WHOQOL showed that the maternal in two groups had a significant difference in two dimensions of QOL (mental health and total health) and insignificant difference in other dimensions.
Research limitations/implications
The results of the study may have been affected by the selection of few databases. Therefore, researchers are encouraged to test the proposed propositions in further databases.
Practical implications
The study results could be helpful to design appropriate policies for maternal based on their type of delivery.
Originality/value
This systematic review showed that despite the insignificant difference between women with vaginal delivery vs women with cesarean delivery in some aspects of QOL, it can be concluded that health status of women with vaginal delivery is better than women with cesarean delivery, so it should be considered in the setting of appropriate policies and implementation framework to encourage women for choosing the appropriate delivery type.
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Katherine M. Johnson, Richard M. Simon, Jessica L. Liddell and Sarah Kington
There has been substantial interest in US cesarean rates, which increased from 5% of deliveries in the 1970s to nearly one-third of births by the mid-2000s. Explanations typically…
Abstract
There has been substantial interest in US cesarean rates, which increased from 5% of deliveries in the 1970s to nearly one-third of births by the mid-2000s. Explanations typically emphasize individual risk factors (e.g., advanced maternal age, increased BMI, and greater desire for control over delivery) of women giving birth, or address institutional factors, such as the medicalization of childbirth and the culture of liability leading physicians to practice defensive medicine. We focus here on another non-medical explanation – childbirth education (CBE). CBE is an important, underexplored mechanism that can shape women’s expectations about labor and birth and potentially lead them to expect, or desire, a cesarean delivery as a normalized outcome. We analyze data from three waves (2002, 2006, 2013) of the Listening to Mothers national survey on US women’s childbearing experiences (n = 3,985). Using logistic regression analysis, we examined both mode of delivery (vaginal versus cesarean), and attitudes about future request for elective cesarean among both primiparous and multiparous women. Despite previous research suggesting that CBE increased the likelihood of vaginal delivery, we find that CBE attendance was not associated with likelihood of vaginal delivery among either primiparous or multiparous women. However, both primiparous and multiparous women who attended CBE classes were significantly more likely to say they would request a future, elective cesarean. Furthermore, these effects were in the opposite direction of effects for natural birth attitudes. Our findings suggest that contemporary CBE classes may be a form of “anticipatory socialization”, potentially priming women’s acceptance of medicalized childbirth.
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Yousaf Ali, Muhammad Waseem Khan, UbaidUllah Mumtaz, Aneel Salman, Noor Muhammad and Muhammad Sabir
The rate of cesarean sections has been rapidly increased in the last few decades in all the developing as well as developed countries. The rate of cesarean sections determined by…
Abstract
Purpose
The rate of cesarean sections has been rapidly increased in the last few decades in all the developing as well as developed countries. The rate of cesarean sections determined by the World Health Organization has been crossed by many countries, like Brazil, India, China, USA, Australia, etc. Similarly, this rate has also increased in Pakistan. The purpose of this paper is to explore and identify the factors that are responsible for the rising rate of cesarean sections in Pakistan.
Design/methodology/approach
These factors are categorized under medical and non-medical factors. The medical factors include the obesity of mother, age of mother, weight of the baby, umbilical cord prolapse, fetal distress, abnormal presentation, dystocia and failure to progress. The non-medical factors include financial incentives of doctors, time convenience for doctors, high tolerance to surgery, patient’s preference toward cesarean section, private hospitals, public hospitals, income status of patients, rural areas, urban areas and the education of patients. To identify the critical factors, data have been collected and a multi-criteria decision-making technique, called Decision Making Trial and Evaluation Laboratory, is used.
Findings
The result shows that the medical factors that are responsible for the rise in the rate of cesarean sections are umbilical cord prolapse, age of mother and obesity of mother. On the other hand, the non-medical factors that are the reasons for the increase in cesarean sections are the large number of private hospitals and the unethical acts of the doctors in these hospitals, preference of patients, and either the unavailability of doctors or poor conditions of hospitals in rural areas.
Originality/value
Cesarean section is an important surgical intervention and is considered to be very essential in the cases of existing as well as potential medical problems to the mother or the baby. Cesarean section is also performed for non-medical reasons. In Pakistan, the number of private hospitals has increased and these hospitals provide good health care. However, these hospitals do not work under the rules and regulations set by the government. The doctors in private hospitals perform unnecessary cesarean sections in order to fulfill the demands of private hospital’s owners. In addition to this, it is also found that, nowadays, most women prefer to give birth through cesarean section in order to eliminate the pain of normal vaginal delivery.
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Jessica Liddell and Katherine M. Johnson
There is extensive research documenting the physical outcomes of childbirth, but significantly less on socio-psychological outcomes. Investigating women’s perception of dignified…
Abstract
Purpose
There is extensive research documenting the physical outcomes of childbirth, but significantly less on socio-psychological outcomes. Investigating women’s perception of dignified treatment during birth contributes to a salient, under-examined aspect of women’s childbirth experiences.
Methodology/approach
We use a two-part conceptualization of dignity, respect and autonomy, to understand how birth experiences and interactions either facilitate or undermine women’s perceived dignity. Data came from the Listening-to-Mothers I survey, the first nationally representative study of postpartum women in the United States (n = 1,406). Through linear regression analysis, we separately modeled women’s perception of respectful treatment and women’s perception of medical autonomy during birth.
Findings
Overall women reported high scores for both autonomy and respect. Differences between the models emerged related primarily to the role of interventions and provider support. While women’s perceived dignity is related to elements that she brings in to the delivery room (e.g., birth knowledge, health status), much variation was explained by the medical encounter itself (e.g., type of medical interventions, pain management, nurse support, and number of staff present).
Research limitations/implications
This study is cross-sectional, and required either a telephone or internet access, thus limiting the full generalizability of findings. Two findings have direct practical relevance for promoting women’s dignity in childbirth. First, the number of staff persons present during labor and birth was negatively associated with both respect and autonomy. Second, that women with high levels of knowledge about their legal rights during childbirth were more likely to report high scores on the dignity scale. Limiting staff in the delivery room and including knowledge of legal rights in childbirth education or during prenatal visits may be two mechanisms to promote dignity in birth.
Originality/value
These findings address an important, under-examined aspect of women’s childbirth experiences. This study investigates how different birth experiences and interactions either promote or violate childbearing women’s perception of dignity, and has significant implications for the provision of maternal healthcare. The results reinforce the importance of focusing on the socio-psychological dimensions of childbirth.
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Kathryn Connors, Dean V. Coonrod, Patricia Habak, Stephanie Ayers and Flavio Marsiglia
This chapter examines birth outcomes of patients enrolled in Familias Sanas (Healthy Families), an educational intervention designed to reduce health disadvantages of low-income…
Abstract
Purpose
This chapter examines birth outcomes of patients enrolled in Familias Sanas (Healthy Families), an educational intervention designed to reduce health disadvantages of low-income, immigrant Latina mothers by providing social support during and after pregnancy.
Methodology/approach
Using a randomized control-group design, the project recruited 440 pregnant Latina women, 88% of whom were first generation. Birth outcomes were collected through medical charts and analyzed using regression analysis to evaluate if there were any differences between patients enrolled in Familias Sanas compared to those patients who followed a typical prenatal course.
Findings
Control and intervention groups were found to be similar with regard to demographic characteristics. In addition, we did not observe a decrease in rate of a number of common pregnancy-related complications. Likewise, rates of operative delivery were similar between the two groups as were fetal weight at delivery and use of regional anesthesia at delivery.
Research limitations/implications
The lack of improvements in birth outcomes for this study was perhaps because this social support intervention was not significant enough to override long-standing stressors such as socioeconomic status, poor nutrition, genetics, and other environmental stressors.
Originality/value of chapter
This study was set in an inner-city, urban hospital with a large percentage of patients being of Hispanic descent. The study itself is a randomized controlled clinical trial, and data were collected directly from electronic medical records by physicians.
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Miriam Naiman-Sessions, Megan M. Henley and Louise Marie Roth
This research examines effects on emotional burnout among “maternity support workers” (MSWs) that support women in labor (labor and delivery (L&D) nurses and doulas). The…
Abstract
This research examines effects on emotional burnout among “maternity support workers” (MSWs) that support women in labor (labor and delivery (L&D) nurses and doulas). The emotional intensity of maternity support work is likely to contribute to emotional distress, compassion fatigue, and burnout.
This study uses data from the Maternity Support Survey (MSS) to analyze emotional burnout among 807 L&D nurses and 1,226 doulas in the United States and Canada. Multivariate OLS regression models examine the effects of work–family conflict, overwork, emotional intelligence, witnessing unethical mistreatment of women in labor, and practice characteristics on emotional burnout among these MSWs. We measure emotional burnout using the Professional Quality of Life (PROQOL) Emotional Burnout subscale.
Work–family conflict, feelings of overwork, witnessing a higher frequency of unethical mistreatment, and working in a hospital with a larger percentage of cesarean deliveries are associated with higher levels of burnout among MSWs. Higher emotional intelligence is associated with lower levels of burnout, and the availability of hospital wellness programs is associated with less burnout among L&D nurses.
While the MSS obtained a large number of responses, its recruitment methods produced a nonrandom sample and made it impossible to calculate a response rate. As a result, responses may not be generalizable to all L&D nurses and doulas in the United States and Canada.
This research reveals that MSWs attitudes about medical procedures such as cesarean sections and induction are tied to their experiences of emotional burnout. It also demonstrates a link between witnessing mistreatment of laboring women and burnout, so that traumatic incidents have negative emotional consequences for MSWs. The findings have implications for secondary trauma and compassion fatigue, and for the quality of maternity care.
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Alessa Leila Andrade, Zenewton André da Silva Gama, Marise Reis de Freitas, Wilton Rodrigues Medeiros, Kelienny de Meneses Sousa, Edna Marta Mendes da Silva and Tatyana Souza Rosendo
Obstetric adverse outcomes (AOs) are an important topic and the use of composite measures may favor the understanding of their impact on patient safety. The aim of the present…
Abstract
Purpose
Obstetric adverse outcomes (AOs) are an important topic and the use of composite measures may favor the understanding of their impact on patient safety. The aim of the present study was to estimate AO frequency and obstetric care quality in low and high-risk maternity hospitals.
Design/methodology/approach
A one-year longitudinal follow-up study in two public Brazilian maternity hospitals. The frequency of AOs was measured in 2,880 randomly selected subjects, 1,440 in each institution, consisting of women and their newborn babies. The frequency of 14 AOs was estimated every two weeks for one year, as well as three obstetric care quality indices based on their frequency and severity as follows: the Adverse Outcome Index (AOI), the Weighted Adverse Outcome Score and the Severity Index.
Findings
A significant number of mothers and newborns exhibited AOs. The most prevalent maternal AOs were admission to the ICU and postpartum hysterectomy. Regarding newborns, hospitalization for > seven days and neonatal infection were the most common complications. Adverse outcomes were more frequent at the high-risk maternity, however, they were more severe at the low-risk facility. The AOI was stable at the high-risk center but declined after interventions during the follow-up year.
Originality/value
High AO frequency was identified in both mothers and newborns. The results demonstrate the need for public patient safety policies for low-risk maternity hospitals, where AOs were less frequent but more severe.
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Figen Alp Yilmaz and Yeter Durgun Ozan
The impact of birth beliefs on pregnancy and delivery are universally recognized, but the factors that affect birth beliefs vary across regions depending on individual and…
Abstract
Purpose
The impact of birth beliefs on pregnancy and delivery are universally recognized, but the factors that affect birth beliefs vary across regions depending on individual and cultural characteristics. This study aimed to determine women's birth beliefs and examine their associated factors.
Design/methodology/approach
This cross-sectional study was conducted with 548 primiparas in the obstetrics clinic of a university hospital located in the Southeastern Anatolian Region of Turkey from February to June 2019. Descriptive characteristics, form and the Birth Beliefs Scale were used in data collection. To analyze the data, descriptive statistics, T-tests and ANOVA analyses were used.
Findings
It was determined that factors such as age group, income level, any problems during pregnancy and preferred delivery mode statistically affected women's birth beliefs.
Originality/value
Based on the findings from this study, healthcare personnel should provide training and consultation services to pregnant women starting from the prenatal period to help ensure a positive labor experience.
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Surrogacy is a practice that requires the participation of multiple social actors: sperm and/or egg donors, intended parents (IPs) and gestational carriers (GCs). The data were…
Abstract
Surrogacy is a practice that requires the participation of multiple social actors: sperm and/or egg donors, intended parents (IPs) and gestational carriers (GCs). The data were collected during a research on US surrogacy conducted in Southern California between September 2017 and January 2020. The study involved IPs, GCs and the clinical and hospital staffs of a fertility clinic and six hospitals. In this contribution, I will read surrogacy as a sophisticated interweaving of relationships (Berend, 2016a) that is activated thanks to the support of artificial reproductive technologies (ARTs). I will analyze the surrogacy pregnancy not exclusively as an organic process, but, following Elly Teman (2009) and Zsuzsa Berend (2016a) insights, I will read it as a choral project shaped by all the actors directly or indirectly involved in it. I will show which rituals are practiced during the surrogacy pathway, and in particular, I will pay attention to some specific aspects that are invested by particular meaning such as ultrasounds, rooming-in, breastfeeding and the ‘skin-to-skin’ practice.
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A. Agrawal, S. Ghosh and C.E. Lennox
Instrumental vaginal delivery is an area often responsible for indefensible claims. One of the important reasons for this is poor medical record keeping. The standard of record…
Abstract
Instrumental vaginal delivery is an area often responsible for indefensible claims. One of the important reasons for this is poor medical record keeping. The standard of record keeping for instrumental vaginal deliveries within our unit was audited with a view to improving deficiencies. A retrospective analysis of 100 case records of women having an instrumental vaginal delivery was made over a period of one year. After identifying deficiencies in the quality of record keeping a pre‐printed standard record form was introduced and a further 50 cases audited. Deficiencies were identified in the documentation of clinical obstetric findings, type of anaesthesia, estimated blood loss, type and size of ventouse cup used. Analysis of cases using the standard record form has demonstrated 100 percent compliance with adequate record keeping.
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