Factors Related to Women's Childbirth Satisfaction in Physiologic and Routine Childbirth Groups

PubMed Central

Jafari, Elham; Mohebbi, Parvin; Mazloomzadeh, Saeideh

2017-01-01

Background: Women's satisfaction with childbirth is an important measure of the quality of maternity care services. This study aims to address factors related to women's childbirth satisfaction in physiological and routine childbirth groups. Materials and Methods: This descriptive-analytical study was conducted among 340 women in physiological and routine childbirth groups in 2012. Women were selected through convenience sampling method in the routine group and by census in the physiological group. Data were collected using a 5-part questionnaire composed of demographic and obstetrics details, Mackey's Childbirth Satisfaction Rating Scale (CSRS), satisfied with birth setting, Labor Agentry Scale (LAS), and Visual Analogue Scale (VAS), which was completed by interview 24 hours after childbirth. Data were analyzed using the Statistical Package for the Social Sciences version 18 software using Pearson correlation test, independent t-test, analysis of variance, and linear, multivariate regression model at the significant level of P < 0.05. Results: In both the physiological and routine childbirth groups, satisfaction was found related to the severity of pain (P < 0.05), self-control (P < 0.0001), and birth setting satisfaction (P < 0.0001). In the physiological group, satisfaction was significantly related to previous knowledge of childbirth (P = 0.024), attitude toward the recent pregnancy (P = 0.007), and perceived severity of pain (P = 0.016). However, in the routine group, satisfaction was related only to intentional pregnancy (P = 0.002). In neither group, satisfaction was related to demographic characteristics, maternal parity, and participation in pregnancy and childbirth classes or maternal feelings toward the onset of childbirth (P > 0.05). Conclusions: Improved physical structure and setting of birth room, nonmedical pain relief, mothers' involvement in the process of labor, and sense of being in control are associated with mothers' satisfaction. PMID

Factors Related to Women's Childbirth Satisfaction in Physiologic and Routine Childbirth Groups.

PubMed

Jafari, Elham; Mohebbi, Parvin; Mazloomzadeh, Saeideh

2017-01-01

Women's satisfaction with childbirth is an important measure of the quality of maternity care services. This study aims to address factors related to women's childbirth satisfaction in physiological and routine childbirth groups. This descriptive-analytical study was conducted among 340 women in physiological and routine childbirth groups in 2012. Women were selected through convenience sampling method in the routine group and by census in the physiological group. Data were collected using a 5-part questionnaire composed of demographic and obstetrics details, Mackey's Childbirth Satisfaction Rating Scale (CSRS), satisfied with birth setting, Labor Agentry Scale (LAS), and Visual Analogue Scale (VAS), which was completed by interview 24 hours after childbirth. Data were analyzed using the Statistical Package for the Social Sciences version 18 software using Pearson correlation test, independent t -test, analysis of variance, and linear, multivariate regression model at the significant level of P < 0.05. In both the physiological and routine childbirth groups, satisfaction was found related to the severity of pain ( P < 0.05), self-control ( P < 0.0001), and birth setting satisfaction ( P < 0.0001). In the physiological group, satisfaction was significantly related to previous knowledge of childbirth ( P = 0.024), attitude toward the recent pregnancy ( P = 0.007), and perceived severity of pain ( P = 0.016). However, in the routine group, satisfaction was related only to intentional pregnancy ( P = 0.002). In neither group, satisfaction was related to demographic characteristics, maternal parity, and participation in pregnancy and childbirth classes or maternal feelings toward the onset of childbirth ( P > 0.05). Improved physical structure and setting of birth room, nonmedical pain relief, mothers' involvement in the process of labor, and sense of being in control are associated with mothers' satisfaction.

What are children's trusts? Early findings from a national survey.

PubMed

Bachmann, M O; Reading, R; Husbands, C; O'Brien, M; Thoburn, J; Shemilt, I; Watson, J; Jones, N; Haynes, R; Mugford, M

2006-03-01

The Children Act 2004 and National Service Framework for Children, Young People and Maternity Services require fuller integration of health, education and social services for children and young people in England and Wales. The UK government supported the establishment of 35 experimental children's trust pathfinders (henceforth called children's trusts) in England. A questionnaire was completed by managers in all 35 children's trusts a year after their start. Children's trust documents were examined. Census and performance indicators were compared between children's trust areas and the rest of England. Children's trust areas had demographic and social characteristics typical of England. All children's trusts aimed to improve health, education and social services by greater managerial and service integration. All had boards representing the three sectors; other agencies' representation varied. Two-thirds of children's trusts had moved towards pooling budgets in at least some service areas. At this stage in their development, some had prioritized joint procurement or provision of services, with formal managerial structures, while others favoured an informal strategic planning, co-ordination and information sharing approach. The commonest priorities for services development were for disabled children (16 children's trusts), followed by early intervention (11) and mental health services (8). The diverse strategies adopted by these 35 children's trusts during their first year is due to their own characteristics and to the way government strategy developed during this period. Whilst some prioritized organizational development, joint financing and commissioning, and information sharing, others laid more emphasis on mechanisms for bringing front-line professionals closer together. Their experiences are of value to others deciding how best to integrate children's services.

The gender gap in relation to happiness and preferences in married couples after childbirth: evidence from a field experiment in rural Ghana.

PubMed

Kamiya, Yusuke; Akpalu, Bright; Mahama, Emmanuel; Ayipah, Emmanuel Kwesi; Owusu-Agyei, Seth; Hodgson, Abraham; Shibanuma, Akira; Kikuchi, Kimiyo; Jimba, Masamine

2017-03-15

How does the gap in preferences between married couples affect their happiness after childbirth? Are couples that share similar preferences happier? In recent years, gender, marriage, and happiness have been considered to be key issues in public health research. Although much research has examined the happiness status of married couples, practically no study has explored the gender gap in relation to happiness and the preferences of married couples after childbirth. Therefore, our study was conducted to assess the association between the preference gap and the happiness status among married couples in the afterbirth period. We conducted a field experiment in rural communities in the Brong-Ahafo region of Ghana. Participants were 80 married couples who had experienced childbirth within 2 years prior to the survey. As preference indicators, we measured trust, reciprocity, altruism, and risk lovingness through an economic experiment. Then, we assessed how, for a couple, the gap between these preferences affected their happiness. Wives' happiness was positively associated with the absolute value of the gap in risk lovingness between a couple (OR = 4.83, p = 0.08), while husbands' happiness was negatively associated with the gap in trust (OR = -3.58, p = 0.04) or altruism (OR = -3.33, p = 0.02). Within a couple, wives felt greater happiness than their husbands if there was a wider gap in trust (OR = 6.22, p = 0.01), reciprocity (OR = 2.80, p = 0.01), or risk lovingness (OR = 3.81, p = 0.07). The gender gaps in the preference indicators were found to be closely associated with the happiness levels between married couples after childbirth. For the further improvement of maternal and child health, we must consider the gender gaps between couples in relation to happiness and preferences.

76 FR 50719 - Models for a Governance Structure for the National Strategy for Trusted Identities in Cyberspace...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-16

... DEPARTMENT OF COMMERCE National Institute of Standards and Technology [Docket No. 110524296-1455-02] Models for a Governance Structure for the National Strategy for Trusted Identities in Cyberspace... comments regarding the governance structure for the National Strategy for Trusted Identities in Cyberspace...

75 FR 51333 - Surety Companies Acceptable on Federal Bonds; Change in State of Incorporation; National Trust...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-19

... DEPARTMENT OF THE TREASURY Fiscal Service Surety Companies Acceptable on Federal Bonds; Change in State of Incorporation; National Trust Insurance Company AGENCY: Financial Management Service, Fiscal... NATIONAL TRUST INSURANCE COMPANY (NAIC 20141) has redomesticated from the state of Tennessee to the state...

76 FR 29195 - National Strategy for Trusted Identities in Cyberspace (NSTIC) Governance Workshop

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-20

... Trusted Identities in Cyberspace (NSTIC) Governance Workshop AGENCY: National Institute of Standards... for Trusted Identities in Cyberspace (NSTIC) Governance Workshop to be held on Thursday, June 9, 2011... Cyberspace (NSTIC) Governance Workshop will be held Thursday, June 9, 2011, 9 a.m. until 5 p.m. and Friday...

Capturing Young American Trust in National Databases

ERIC Educational Resources Information Center

Menard, Lauren A.

2011-01-01

A pattern of decreasing trusting proportions in each consecutive decade and increasing trusting proportions with age was revealed in data. Although trust levels were lower in younger adults and the 2000s, findings did not support hypotheses of more rapidly falling trust levels or a college degree procuring less trust in the 2000s. A hypothesis of…

Economics of childbirth.

PubMed

Fahy, Michael; Doyle, Orla; Denny, Kevin; McAuliffe, Fionnuala M; Robson, Michael

2013-05-01

Increasing birth rates have raised questions for policy makers and hospital management about the economic costs of childbirth. The purpose of this article is to identify and review all existing scientific studies in relation to the economic costs of alternative modes of childbirth delivery and to highlight deficiencies in the existing scientific research. We searched Cochrane, Centre for Reviews and Dissemination, EconLit, the Excerpta Medica Database, the Health Economic Evaluations Database, MEDLINE and PubMed. Thirty articles are included in this review. The main findings suggest that there is no internationally acceptable childbirth cost and clinical outcome classification system that allows for comparisons across different delivery modes. This review demonstrates that a better understanding and classification of the costs and associated clinical outcomes of childbirth is required to allow for valid comparisons between maternity units, and to inform policy makers and hospital management. © 2013 The Authors Acta Obstetricia et Gynecologica Scandinavica © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

Fine tuning fear of childbirth: the relationship between Childbirth Fear Questionnaire subscales and demographic and reproductive variables.

PubMed

Fairbrother, Nichole; Thordarson, Dana S; Stoll, Kathrin

2018-02-01

The objective of the current study was to investigate the relationship between the newly developed Childbirth Fear Questionnaire (CFQ) and demographic and reproductive variables. The CFQ was developed in an effort to improve measurement and understanding of women's childbirth fears. To our knowledge the CFQ is the only multidimensional measure of childbirth fears in which (a) multiple domains of childbirth fear are assessed and (b) individual subscales have been psychometrically developed. Participants were 643 pregnant women residing in English-speaking countries, recruited via online forums. Participants completed a set of questionnaires, including the multidimensional CFQ, via an online survey. Given the differences in childbirth fear between nulliparous and multiparous women, findings are stratified by parity. Gestational age was largely unrelated to fear of childbirth. Age, income and education were negatively related to fear of childbirth. Assisted vaginal delivery and episiotomy in a previous pregnancy were positively associated with a fear of pain. Self-reported history of traumatic vaginal birth was associated with higher scores on all aspects of fear of childbirth. History of caesarean birth was not generally associated with increased childbirth fears, but women with a prior, self-reported traumatic caesarean birth reported more fear of future caesarean births. Findings are consistent with previous reports of fear of childbirth. However, the CFQ provides increased specificity with respect to women's childbirth fears. This information is relevant to both education and treatment planning for pregnant women and women wishing to reproduce.

Childbirth Education at the Crossroads

PubMed Central

Lothian, Judith A.

2008-01-01

In this column, a reader expresses concern that attendance at childbirth classes is declining at the same time the cesarean rate is rising. The history of childbirth education is discussed in the context of both access to information and changes in maternity care since the introduction of formal childbirth education. Changing goals and contemporary challenges facing childbirth education are discussed. The need for a new model of educating and empowering women is identified, and ideas for changes are explored. PMID:19252688

Validation of the Childbirth Attitudes Questionnaire in Greek and psychosocial characteristics of pregnant women with fear of childbirth.

PubMed

Gourounti, Kleanthi; Kouklaki, Eleni; Lykeridou, Katerina

2015-09-01

Fear of childbirth has been found to be a factor that influences women's decision about their choice of delivery. The investigation of psychological factors that relate to fear of childbirth as well as the validation of the Childbirth Attitudes Questionnaire (CAQ) can help identify pregnant women with high fear of childbirth. This study aimed to (a) translate and validate the Childbirth Attitude Questionnaire in Greek and (b) explore how fear of childbirth was related to childbirth self-efficacy, state anxiety, depression, neuroticism, self-esteem and optimism. 145 nulliparous pregnant women, in late pregnancy, attending routine antenatal visit in a private maternity clinic participated. All participants completed the CAQ (fear of childbirth) and other self-report questionnaires that measured childbirth self-efficacy, self-esteem, optimism, neuroticism, state anxiety and depressive symptomatology. Factor structure was investigated using principal axis factoring. Cronbach's α was used to measure internal consistency reliability. Pearson's correlation coefficients were calculated between all study variables, followed by multiple linear regression. The factor analysis suggested the existence of one-factor structure. Construct validity was confirmed by computing correlations between the CAQ and childbirth self-efficacy, self-esteem and optimism. Multivariate analysis showed that childbirth self-efficacy, self-esteem and optimism were negatively and significantly associated with fear of childbirth. The Greek version of the CAQ is a reliable and valid measure. The clinical use of CAQ may enable midwives and other health care professionals to identify pregnant women with low childbirth confidence and to provide information and support. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

The effect of exercise and childbirth classes on fear of childbirth and locus of labor pain control.

PubMed

Guszkowska, Monika

2014-01-01

This study sought to track changes in intensity of fear of childbirth and locus of labor pain control in women attending an exercise program for pregnant women or traditional childbirth classes and to identify the predictors of these changes. The study was longitudinal/non-experimental in nature and run on 109 healthy primigravidae aged from 22 to 37, including 62 women participating in an exercise program for pregnant women and 47 women attending traditional childbirth classes. The following assessment tools were used: two scales developed by the present authors - the Fear of Childbirth Scale and the Control of Birth Pain Scale, three standardized psychological inventories for the big five personality traits (NEO Five Factors Inventory), trait anxiety (State-Trait Anxiety Inventory) and dispositional optimism (Life Oriented Test-Revised) and a questionnaire concerning socioeconomic status, health status, activities during pregnancy, relations with partners and expectations about childbirth. Fear of childbirth significantly decreased in women participating in the exercise program for pregnant women but not in women attending traditional childbirth classes. Several significant predictors of post-intervention fear of childbirth emerged: dispositional optimism and self-rated health (negative) and strength of the belief that childbirth pain depends on chance (positive).

Effects of Age at First Childbirth and Other Factors on Central Obesity in Postmenopausal Women: The 2013–2015 Korean National Health and Nutrition Examination Survey

PubMed Central

Lee, Wang Jin; Lee, Joo Ha; Kwag, Byoung Gyu; Chang, Shin Hae; Choi, Yu Jin

2018-01-01

Background Waist circumference is one of the key components of metabolic syndrome. Recent studies demonstrated that the reproductive profile was associated with metabolic syndrome in postmenopausal women. This study focused on the association between central obesity and age at first childbirth. It also considered other factors associated with central obesity in postmenopausal women. Methods This study was based on the 2013–2015 Korean National Health and Nutrition Examination Survey and involved 3,143 naturally postmenopausal women. These women were divided into three groups according to their age at first childbirth: 19 years or younger (n=252), 20–29 years (n=2,695), and 30 years or older (n=196). Multivariate analysis using logistic regression was performed to evaluate the effects of various reproductive factors, including other confounding factors. Results During adjustment for confounding factors, in the early age at first childbirth group, odds ratios (95% confidence intervals) for central obesity decreased. In the final model, younger age at first childbirth was not significantly related to central obesity (waist circumference more than 85 cm) in naturally postmenopausal women after adjusting for other confounding factors. Conclusion Younger age at first childbirth was not significantly associated with central obesity after adjustment for confounding factors. PMID:29788703

An integrative review of fathers' experiences during pregnancy and childbirth.

PubMed

Poh, H L; Koh, S S L; He, H-G

2014-12-01

While fathers are increasingly expected to participate during their partners' pregnancies and childbirth and many studies have reported their experiences during these periods, no review studies have examined fathers' experiences and needs during pregnancy and childbirth together. To provide an overview of evidence on fathers' experiences and needs during their partners' pregnancies and childbirth to identify any gaps in the existing literature and practice. An integrative literature review was performed to analyse and synthesize fathers' experiences and/or needs during pregnancy and/or childbirth based on articles published in CINAHL, PubMed, Scopus, PsycINFO and Web of Science databases between the years 2002 and 2012. Only articles found in the National University of Singapore's online library collection were retrieved. Altogether, 25 studies (six quantitative and 19 qualitative studies) that reported fathers' experiences during pregnancy (n = 8), childbirth (n = 13) or during both periods (n = 4) were reviewed. Fathers experienced mixed feelings both during pregnancy and childbirth. They required support from their partners and healthcare professionals and wanted to be informed, involved and respected. However, more studies are needed to explore this phenomenon in different cultural contexts or care models. This review provides evidence for healthcare professionals to pay more attention to fathers when delivering perinatal care. Sociocultural-sensitive interventions should be developed to facilitate a smoother transition to fatherhood. Father-specific information should be given to prepare fathers for pregnancy and childbirth. Healthcare professionals and policymakers should take fathers' feelings and concerns into consideration and provide family-centred care to the couple during the antenatal and intrapartum periods. © 2014 International Council of Nurses.

Male involvement during pregnancy and childbirth: men’s perceptions, practices and experiences during the care for women who developed childbirth complications in Mulago Hospital, Uganda

PubMed Central

2014-01-01

Background Development of appropriate interventions to increase male involvement in pregnancy and childbirth is vital to strategies for improving health outcomes of women with obstetric complications. The objective was to gain a deeper understanding of their experiences of male involvement in their partners’ healthcare during pregnancy and childbirth. The findings might inform interventions for increasing men’s involvement in reproductive health issues. Methods We conducted 16 in-depth interviews with men who came to the hospital to attend to their spouses/partners admitted to Mulago National Referral Hospital. All the spouses/partners had developed severe obstetric complications and were admitted in the high dependency unit. We sought to obtain detailed descriptions of men’s experiences, their perception of an ideal “father” and the challenges in achieving this ideal status. We also assessed perceived strategies for increasing male participation in their partners’ healthcare during pregnancy and childbirth. Data was analyzed by content analysis. Results The identified themes were: Men have different descriptions of their relationships; responsibility was an obligation; ideal fathers provide support to mothers during childbirth; the health system limits male involvement in childbirth; men have no clear roles during childbirth, and exclusion and alienation in the hospital environment. The men described qualities of the ideal father as one who was available, easily reached, accessible and considerate. Most men were willing to learn about their expected roles during childbirth and were eager to support their partners/wives/spouses during this time. However, they identified personal, relationship, family and community factors as barriers to their involvement. They found the health system unwelcoming, intimidating and unsupportive. Suggestions to improve men’s involvement include creating more awareness for fathers, male-targeted antenatal education and

[Home childbirth: progress or retrocession?].

PubMed

de Sanfelice, Clara Fróes Oliveira; Shimo, Antonieta Keiko Kakuda

2014-03-01

Giving birth at home represents a rising modality of delivery care in the Brazilian society, although in unrepresentative proportion when compared to the number of hospital childbirths. In Brazil, the topic has been broadly discussed by different professional categories, highlighting the safety issue involved in the process. The aim of this theoretical and reflective study was to present a brief overview of the overall care related to home childbirth, also questioning the reality of the contemporary Brazilian obstetric scenario. The scientific literature presents both obstetric and neonatal outcomes as favorable to home childbirth; similar risks when compared to hospital childbirth and higher rates of maternal satisfaction, and these both factors justify its practice. Therefore, a movement of women who are deeply unhappy with the current model of obstetric care is currently observed and they have been opting for home childbirth as a response to institutional violence,fragmentation and depersonalization of hospital care.

Husband Gatekeeping in Childbirth.

ERIC Educational Resources Information Center

Block, Carolyn R.; And Others

1981-01-01

Interviews with new mothers document the husband's role as gatekeeper in his wife's preparing for and coping with childbirth. Social class, race, family stage, and the husband-wife relationship explain about 40 percent of the variance in whether husbands choose to prepare for childbirth. (Author)

The Development of a Conceptual Framework and Preliminary Item Bank for Childbirth-Specific Patient-Reported Outcome Measures.

PubMed

Korst, Lisa M; Fridman, Moshe; Saeb, Samia; Greene, Naomi; Fink, Arlene; Gregory, Kimberly D

2018-05-24

To develop a conceptual framework and preliminary item bank for childbirth-specific patient-reported outcome (PRO) domains. Women, who were U.S. residents, ≥18 years old, and ≥20 weeks pregnant, were surveyed regarding their childbirth values and preferences (V&P) using online panels. Using community-based research techniques and Patient-Reported Outcomes Management Information System (PROMIS ® ) methodology, we conducted a comprehensive literature review to identify self-reported survey items regarding patient-reported V&P and childbirth experiences and outcomes (PROs). The V&P/PRO domains were validated by focus groups. We conducted a cross-sectional observational study and fitted a multivariable logistic regression model to each V&P item to describe "who" wanted each item. We identified 5,880 V&P/PRO items that mapped to 19 domains and 58 subdomains. We present results for the 2,250 survey respondents who anticipated a vaginal delivery in a hospital. Wide variation existed regarding each V&P item, and personal characteristics, such as maternal confidence and ability to cope well with pain, were frequent predictors in the models. The resulting preliminary item bank consisted of 60 key personal characteristics and 63 V&P/PROs. The conceptual framework and preliminary (PROMIS ® ) item bank presented here provide a foundation for the development of childbirth-specific V&P/PROs. © Health Research and Educational Trust.

Tackling Work Related Stress in a National Health Service Trust

ERIC Educational Resources Information Center

Vick, Donna; Whyatt, Hilary

2004-01-01

The challenge of tackling the problem of coping with work related stress in a National Health Service (NHS) Trust was undertaken. Ideas were developed within the context of two different action learning sets and led to actions resulting in a large therapy Taster Session event and the establishment of a centre offering alternative therapies and…

Pregnant women's expectations about pain intensity during childbirth and their attitudes towards pain management: Findings from an Icelandic national study.

PubMed

Karlsdottir, Sigfridur Inga; Sveinsdottir, Herdis; Olafsdottir, Olof Asta; Kristjansdottir, Hildur

2015-12-01

Pregnant women expect childbirth to be painful. However, little is known about their expectations of the intensity of pain in childbirth (EIPC) and their attitudes to pain management. The design was a cross-sectional survey, with self-reported questionnaires used to collect data from low-risk pregnant women (N = 1111) early in pregnancy at 26 of the largest primary health care centres in Iceland. This consecutive national sample was stratified by residency. The mean score for the EIPC was 5.58 (SD = 1.38) measured on a 7 point scale. The strongest predictors of a high EIPC score were: negative attitude to the impending childbirth (OR = 2.39), low manifestation of a sense of security (OR = 1.80), and a positive attitude to pain management with medication (OR = 1.63). Women living outside the capital area were less likely to have a high EIPC (OR = 0.68). Most women (77%) had a positive attitude towards pain management without medication and 35% had a positive attitude to pain management with medication. The study detected multiple predictors of women's EIPC and attitude to pain management. Early and throughout pregnancy, midwives and health care professionals need to address these predictors in order to assist women to prepare themselves for the pain of labour. Copyright © 2015 Elsevier B.V. All rights reserved.

Can consumer choice replace trust in the National Health Service in England? Towards developing an affective psychosocial conception of trust in health care.

PubMed

Fotaki, Marianna

2014-11-01

Trust has long been regarded as a vitally important aspect of the relationship between health service providers and patients. Recently, consumer choice has been increasingly advocated as a means of improving the quality and effectiveness of health service provision. However, it is uncertain how the increase of information necessary to allow users of health services to exercise choice, and the simultaneous introduction of markets in public health systems, will affect various dimensions of trust, and how changing relations of trust will impact upon patients and services. This article employs a theory-driven approach to investigate conceptual and material links between choice, trust and markets in health care in the context of the National Health Service in England. It also examines the implications of patient choice on systemic, organisational and interpersonal trust. The article is divided into two parts. The first argues that the shift to marketisation in public health services might lead to an over-reliance on rational-calculative aspects of trust at the expense of embodied, relational and social attributes. The second develops an alternative psychosocial conception of trust: it focuses on the central role of affect and accounts for the material and symbolic links between choice, trust and markets in health care. © 2014 The Author. Sociology of Health & Illness © 2014 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

National Literacy Trust Survey in Partnership with Nursery World: Investigating Communication, Language and Literacy Development in the Early Years Sector

ERIC Educational Resources Information Center

Halden, Amanda; Clark, Christina; Lewis, Fiona

2011-01-01

In May 2011 "Nursery World" and the National Literacy Trust launched its language development survey to celebrate Hello; the national year of communication. The National Literacy Trust teamed up with "Nursery World" to carry out research into the sector's support for children's language and literacy development. Two hundred…

Institutional trust in the national social security and municipal healthcare systems for the elderly in Japan.

PubMed

Murayama, Hiroshi; Taguchi, Atsuko; Ryu, Shuhei; Nagata, Satoko; Murashima, Sachiyo

2012-09-01

Japanese social security systems and institutions for the elderly, as well as the general attitude toward elderly care services among the Japanese population, have been undergoing a dramatic change. By examining the association between institutional trust, which is a representative element of social capital, and anxiety regarding receiving elderly care, we can uncover clues toward building a more robust social security system for the elderly. This study examines the relationship between institutional trust, in the national social security and municipal healthcare systems for the elderly, and anxiety with respect to receiving elderly care among the general Japanese population. A cross-sectional survey was conducted using a self-administered questionnaire that was returned by mail in January and February 2005. The target population was 4735 community residents aged 20-75 years, who lived in the city of Koka, Shiga, Japan. A total of 2264 questionnaires were included in the analysis. A binominal logistic regression analysis showed that responses of 'trust' [odds ratio (OR): 2.09, 95% confidence interval (95% CI): 1.01-4.30] and 'strongly trust' (OR: 3.80, 95% CI: 1.55-9.31) for the national system were associated with not having anxiety regarding elderly care, compared with the reference category of feeling strongly distrust. However, trust in the municipal system showed no association with this anxiety. These results indicate the importance of developing strategies to increase a common trust in the national care services for the elderly to reduce the anxiety people feel regarding whether they will be able to receive elderly care when required.

Revisiting the Classics in Childbirth Education

PubMed Central

Shilling, Teri; Bingham, Stacie

2010-01-01

In celebration of Lamaze International's 50th anniversary, reviewers share their thoughts on some classic Lamaze resource materials and how their content relates to today's viewpoints on birth and childbirth education. Although some of the material may be outdated, all of the resources offer timeless insights as well as a unique view on the history of childbirth education. The following topics are addressed: past cultural views of birth; advocacy for change in birth practices; Lamaze method; pioneers in childbirth; importance of childbirth education; and birth advocacy. PMID:21629386

The social nature of natural childbirth.

PubMed

Mansfield, Becky

2008-03-01

This paper aims to develop a better understanding of what proponents of natural childbirth mean by "natural." Using a biosocial approach to birth that posits that all birth is both social and natural, the paper investigates how proponents represent the relationship between nature and society. The study asks about what kinds of nature-society relationships are expressed in proponents' representations of natural childbirth. The study examines how natural childbirth is represented by proponents in popular non-fictional English language books written for pregnant women. Claims in these books are not taken as reality, but are analyzed as ideas about nature-society relations. The central finding is that these authors simultaneously emphasize the naturalness of birth and showcase three types of social practices that they describe as being integral to natural childbirth: (1) activity during birth, (2) preparation before birth, and (3) social support, both in an individual and in a broader socio-cultural sense. At least for these authors, it is these social practices that allow natural childbirth to be natural. These findings on the social nature of natural childbirth challenge current social science scholarship, in which natural childbirth is characterized as an essentializing and nostalgic attempt to return to nature.

Fear of childbirth in expectant fathers, subsequent childbirth experience and impact of antenatal education: subanalysis of results from a randomized controlled trial.

PubMed

Bergström, Malin; Rudman, Ann; Waldenström, Ulla; Kieler, Helle

2013-08-01

To explore if antenatal fear of childbirth in men affects their experience of the birth event and if this experience is associated with type of childbirth preparation. Data from a randomized controlled multicenter trial on antenatal education. 15 antenatal clinics in Sweden between January 2006 and May 2007. 762 men, of whom 83 (10.9%) suffered from fear of childbirth. Of these 83 men, 39 were randomized to psychoprophylaxis childbirth preparation where men were trained to coach their partners during labor and 44 to standard care antenatal preparation for childbirth and parenthood without such training. Experience of childbirth was compared between men with and without fear of childbirth regardless of randomization, and between fearful men in the randomized groups. Analyses by logistic regression adjusted for sociodemographic variables. Self-reported data on experience of childbirth including an adapted version of the Wijma Delivery Experience Questionnaire (W-DEQ B). Men with antenatal fear of childbirth more often experienced childbirth as frightening than men without fear: adjusted odds ratio 4.68, 95% confidence interval 2.67-8.20. Men with antenatal fear in the psychoprophylaxis group rated childbirth as frightening less often than those in standard care: adjusted odds ratio 0.30, 95% confidence interval 0.10-0.95. Men who suffer from antenatal fear of childbirth are at higher risk of experiencing childbirth as frightening. Childbirth preparation including training as a coach may help fearful men to a more positive childbirth experience. Additional studies are needed to support this conclusion. © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

Risky business: framing childbirth in hospital settings.

PubMed

Hausman, Bernice L

2005-01-01

"Risky Business" considers hospital childbirth and the production of the concept of risk in obstetrics. Risk is a defining concept of medicalized childbirth. Approaching obstetrical risk with a goal of challenging its hold on practices demonstrates how risk itself is produced and maintained in particular institutional contexts. The goal here is to imagine new ways of understanding and assessing obstetrical risk, as part of an overall strategy of challenging technocratic approaches to childbirth and mothering. Surveying feminist approaches to childbirth, the essay discusses how the mother's health profile affects both medical education and the construction of childbirth as "risky business."

Effects of extended childbirth education by midwives on the childbirth fear of first-time mothers: an RCT.

PubMed

Haapio, Sari; Kaunonen, Marja; Arffman, Martti; Åstedt-Kurki, Päivi

2017-06-01

This study evaluates how extended childbirth education intervention affects first-time mothers' fear of childbirth and its manifestation during pregnancy. A randomised controlled trial was conducted. A total of 659 first-time mothers were recruited before week 14 of gestation during the first ultrasound screening at the hospital's maternity outpatient clinic. The mothers were randomly assigned into an intervention group (n = 338) or a control group (n = 321). The control group received all available regular childbirth education. In addition, the intervention group received an enhanced 2-hour childbirth education at the maternity hospital. The objects of childbirth fears (childbirth-related fear, fear for the mother's and the child's well-being, fear related to Caesarean section) were the primary outcomes. The manifestations of childbirth fears (everyday life, stress symptoms and the wish to have a Caesarean section) were the secondary outcomes. These outcomes were measured over 34 weeks of gestation using two parts of the instrument 'Feelings of Fear and Security Associated with Pregnancy and Childbirth'. Logistic and ordinal linear regression models were used to model the effect of the intervention on the outcomes. The mothers in the intervention group had less childbirth-related fear than those in the control group [odds ratio (OR) 0.58, 95% confidence level (CL) 0.38-0.88]. Also, fear influenced the mothers in the intervention group less in everyday life than it did the mothers in the control group [OR 0.64, 95% CL 0.44-0.94]. The effectiveness of the intervention can be considered moderate: one of three objects and one of three manifestations of fears were reduced. The intervention proved most efficient in alleviating relatively limited objects of fears. © 2016 Nordic College of Caring Science.

Effectiveness of a Mindfulness-Based Childbirth Education pilot study on maternal self-efficacy and fear of childbirth.

PubMed

Byrne, Jean; Hauck, Yvonne; Fisher, Colleen; Bayes, Sara; Schutze, Robert

2014-01-01

This pilot study tested the feasibility and effectiveness of using Mindfulness-Based Childbirth Education (MBCE), a novel integration of mindfulness meditation and skills-based childbirth education, for mental health promotion with pregnant women. The MBCE protocol aimed to reduce fear of birth, anxiety, and stress and improve maternal self-efficacy. This pilot study also aimed to determine the acceptability and feasibility of the MBCE protocol. A single-arm pilot study of the MBCE intervention using a repeated-measures design was used to analyze data before and after the MBCE intervention to determine change trends with key outcome variables: mindfulness; depression, anxiety, and stress; childbirth self-efficacy; and fear of childbirth. Pregnant women (18-28 weeks' gestation) and their support companions attended weekly MBCE group sessions over 8 weeks in an Australian community setting. Of the 18 women who began and completed the intervention, missing data allowed for complete data from 12 participants to be analyzed. Statistically significant improvements and large effect sizes were observed for childbirth self-efficacy and fear of childbirth. Improvements in depression, mindfulness, and birth outcome expectations were underpowered. At postnatal follow-up significant improvements were found in anxiety, whereas improvements in mindfulness, stress, and fear of birth were significant at a less conservative alpha level. This pilot study demonstrated that a blended mindfulness and skills-based childbirth education intervention was acceptable to women and was associated with improvements in women's sense of control and confidence in giving birth. Previous findings that low self-efficacy and high childbirth fear are linked to greater labor pain, stress reactivity, and trauma suggest the observed improvements in these variables have important implications for improving maternal mental health and associated child health outcomes. Ways in which these outcomes can be

A hermeneutic phenomenological analysis of midwives' ways of knowing during childbirth.

PubMed

Hunter, Lauren P

2008-12-01

to explore the ways of knowing used by the midwife while attending women during childbirth through textual analysis of poems written by American midwives. a hermeneutic phenomenology and human science research method inspired by van Manen was used. Midwifery ways of knowing during childbirth were thematically derived from 10 poems written by midwives about attending childbirth or the experience of being a midwife. Textual analysis included examination of the poems as a whole, via verse and metaphor, and via individual lines of prose. 10 American midwives wrote the poems used in this study. The poems were discovered through online searches of many databases using the key words 'poetry, poems, midwifery and childbirth' and through a national call for poetry by the researcher over a period of 4 years (1996-2000), undertaken in order to publish an anthology of poetry written by midwives. three authoritative ways of knowing that guided the care given by the midwife to women during childbirth were discovered. They were self-knowledge from the belief system of the individual midwife, grounded knowledge from the midwife's personal lived experience with childbirth, and informed knowledge from objective and scholarly sources. midwives must continue to develop their own body of knowledge in order to move the profession forward. Multiple ways of knowing including the use of experiential/contextual and intuitive knowledge is legitimate and humane, if provision of care is holistic. Care of women during childbirth can be enhanced with the use of multiple knowers and multiple ways of knowing. This study captured a unique and fresh interpretation of the lived experience of midwifery knowledge. Midwifery educational programmes should offer opportunities for students to explore the artistry as well as the science of midwifery practice.

Cashless childbirth, but at a cost: A grounded theory study on quality of intrapartum care in public health facilities in India.

PubMed

Jha, Paridhi; Christensson, Kyllike; Svanberg, Agneta Skoog; Larsson, Margareta; Sharma, Bharati; Johansson, Eva

2016-08-01

this study aimed to explore and understand the perceptions and experiences of women regarding quality of care received during childbirth in public health facilities. qualitative in-depth interviews were conducted and analysed using the Grounded Theory approach. thirteen women who had given vaginal birth to a healthy newborn infant. participants were interviewed in their homes in one district of Chhattisgarh, India. the interview followed a pre-tested guide comprising one key question: How did the women experience and perceive the care provided during labour and childbirth? 'cashless childbirth but at a cost: subordination during childbirth' was identified as the core category. Women chose a public health facility due to their socio-economic limitations, and to have a cashless and safe childbirth. Participants expressed a sense of trust in public health facilities, and verbalised that free food and ambulance services provided by the government were appreciated. Care during normal birth was medicalised, and women lacked control over the process of their labour. Often, the women experienced verbal and physical abuse, which led to passive acceptance of all the services provided to avoid confrontation with the providers. increasingly higher numbers of women give birth in public health facilities in Chhattisgarh, India, and women who have no alternative place to have a safe and normal birth are the main beneficiaries. The labour rooms are functional, but there is a need for improvement of interpersonal processes, information-sharing, and sensitive treatment of women seeking childbirth services in public health facilities. Copyright © 2016 Elsevier Ltd. All rights reserved.

Public Trust in Health Information Sharing: A Measure of System Trust.

PubMed

Platt, Jodyn E; Jacobson, Peter D; Kardia, Sharon L R

2018-04-01

To measure public trust in a health information sharing in a broadly defined health system (system trust), inclusive of health care, public health, and research; to identify individual characteristics that predict system trust; and to consider these findings in the context of national health initiatives (e.g., learning health systems and precision medicine) that will expand the scope of data sharing. Survey data (n = 1,011) were collected in February 2014. We constructed a composite index of four dimensions of system trust-competency, fidelity, integrity, and trustworthiness. The index was used in linear regression evaluating demographic and psychosocial predictors of system trust. Data were collected by GfK Custom using a nationally representative sample and analyzed in Stata 13.0. Our findings suggest the public's trust may not meet the needs of health systems as they enter an era of expanded data sharing. We found that a majority of the U.S. public does not trust the organizations that have health information and share it (i.e., the health system) in one or more dimensions. Together, demographic and psychosocial factors accounted for ~18 percent of the observed variability in system trust. Future research should consider additional predictors of system trust such as knowledge, attitudes, and beliefs to inform policies and practices for health data sharing. © Health Research and Educational Trust.

Mode of childbirth and neonatal outcome after external cephalic version: A prospective cohort study.

PubMed

Rosman, A N; Vlemmix, F; Ensing, S; Opmeer, B C; Te Hoven, S; Velzel, J; de Hundt, M; van den Berg, S; Rota, H; van der Post, J A M; Mol, B W J; Kok, M

2016-08-01

to assess the mode of childbirth and adverse neonatal outcomes in women with a breech presentation with or without an external cephalic version attempt, and to compare the mode of childbirth among women with successful ECV to women with a spontaneous cephalic presentation. prospective matched cohort study. 25 clusters (hospitals and its referring midwifery practices) in the Netherlands. Data of the Netherlands perinatal registry for the matched cohort. singleton pregnancies from January 2011 to August 2012 with a fetus in breech presentation and a childbirth from 36 weeks gestation onwards. Spontaneous cephalic presentations (selected from national registry 2009 and 2010) were matched in a 2:1 ratio to cephalic presentations after a successful version attempt. Matching criteria were maternal age, parity, gestational age at childbirth and fetal gender. Main outcomes were mode of childbirth and neonatal outcomes. of 1613 women eligible for external cephalic version, 1169 (72.5%) received an ECV attempt. The overall caesarean childbirth rate was significantly lower compared to women who did not receive a version attempt (57% versus 87%; RR 0.66 (0.62-0.70)). Women with a cephalic presentation after ECV compared to women with a spontaneous cephalic presentation had a decreased risk for instrumental vaginal childbirth (RR 0.52 (95% CI 0.29-0.94)) and an increased risk of overall caesarean childbirth (RR 1.7 (95%CI 1.2-2.5)). women who had a successful ECV are at increased risk for a caesarean childbirth but overall, ECV is an important tool to reduce the caesarean rate. ECV is an important tool to reduce the caesarean section rates. Copyright © 2016. Published by Elsevier Ltd.

A comparative study of expectant parents ' childbirth expectations.

PubMed

Kao, Bi-Chin; Gau, Meei-Ling; Wu, Shian-Feng; Kuo, Bih-Jaw; Lee, Tsorng-Yeh

2004-09-01

The purpose of this study was to understand childbirth expectations and differences in childbirth expectations among expectant parents. For convenience sampling, 200 couples willing to participate in this study were chosen from two hospitals in central Taiwan. Inclusion criteria were at least 36 weeks of gestation, aged 18 and above, no prenatal complications, and willing to consent to participate in this study. Instruments used to collect data included basic demographic data and the Childbirth Expectations Questionnaire. Findings of the study revealed that (1) five factors were identified by expectant parents regarding childbirth expectations including the caregiving environment, expectation of labor pain, spousal support, control and participation, and medical and nursing support; (2) no general differences were identified in the childbirth expectations between expectant fathers and expectant mothers; and (3) expectant fathers with a higher socioeconomic status and who had received prenatal (childbirth) education had higher childbirth expectations, whereas mothers displayed no differences in demographic characteristics. The study results may help clinical healthcare providers better understand differences in expectations during labor and birth and childbirth expectations by expectant parents in order to improve the medical and nursing system and promote positive childbirth experiences and satisfaction for expectant parents.

Does a referral from home to hospital affect satisfaction with childbirth? A cross-national comparison.

PubMed

Christiaens, Wendy; Gouwy, Anneleen; Bracke, Piet

2007-07-12

The Belgian and Dutch societies present many similarities but differ with regard to the organisation of maternity care. The Dutch way of giving birth is well known for its high percentage of home births and its low medical intervention rate. In contrast, home births in Belgium are uncommon and the medical model is taken for granted. Dutch and Belgian maternity care systems are compared with regard to the influence of being referred to specialist care during pregnancy or intrapartum while planning for a home birth. We expect that a referral will result in lower satisfaction with childbirth, especially in Belgium. Two questionnaires were filled out by 605 women, one at 30 weeks of pregnancy and one within the first two weeks after childbirth, either at home or in a hospital. Of these, 563 questionnaires were usable for analysis. Women were invited to participate in the study by independent midwives and obstetricians during antenatal visits in 2004-2005. Satisfaction with childbirth was measured by the Mackey Satisfaction with Childbirth Rating Scale, which takes into account the multidimensional nature of the concept. Belgian women are more satisfied than Dutch women and home births are more satisfying than hospital births. Women who are referred to the hospital while planning for a home birth are less satisfied than women who planned to give birth in hospital and did. A referral has a greater negative impact on satisfaction for Dutch women. There is no reason to believe Dutch women receive hospital care of lesser quality than Belgian women in case of a referral. Belgian and Dutch attach different meaning to being referred, resulting in a different evaluation of childbirth. In the Dutch maternity care system home births lead to higher satisfaction, but once a referral to the hospital is necessary satisfaction drops and ends up lower than satisfaction with hospital births that were planned in advance. We need to understand more about referral processes and how women

Childbirth and Diagnosis Related Groups (DRGs): patient classification and hospital reimbursement in 11 European countries.

PubMed

Bellanger, Martine M; Quentin, Wilm; Tan, Siok Swan

2013-05-01

The study compares how Diagnosis-Related Group (DRG) based hospital payment systems in eleven European countries (Austria, England, Estonia, Finland, France, Germany, Ireland, Netherlands, Poland, Spain, and Sweden) deal with women giving birth in hospitals. It aims to assist gynaecologists and national authorities in optimizing their DRG systems. National or regional databases were used to identify childbirth cases. DRG grouping algorithms and indicators of resource consumption were compared for those DRGs which account for at least 1% of all childbirth cases in the respective database. Five standardized case vignettes were defined and quasi prices (i.e. administrative prices or tariffs) of hospital deliveries according to national DRG-based hospital payment systems were ascertained. European DRG systems classify childbirth cases according to different sets of variables (between one and eight variables) into diverging numbers of DRGs (between three and eight DRGs). The most complex DRG is valued 3.5 times more resource intensive than an index case in Ireland but only 1.1 times more resource intensive than an index case in The Netherlands. Comparisons of quasi prices for the vignettes show that hypothetical payments for the most complex case amount to only € 479 in Poland but to € 5532 in Ireland. Differences in the classification of hospital childbirth cases into DRGs raise concerns whether European systems rely on the most appropriate classification variables. Physicians, hospitals and national DRG authorities should consider how other countries' DRG systems classify cases to optimize their system and to ensure fair and appropriate reimbursement. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

[Post-traumatic stress disorder after childbirth].

PubMed

Korábová, I; Masopustová, Z

2016-01-01

The aim of this paper is to introduce the issue of post-traumatic stress disorder after childbirth to health care professionals. The text focuses on the diagnostic definition of post-traumatic stress disorder after childbirth, symptoms, physiological background, prevalence, course, risk factors and consequences of post-traumatic stress disorder after childbirth for a woman, her child and her partner. Options for interventions and therapy are outlined as well.

An analysis of National Health Service Trust websites on the occupational backgrounds of 'Non-Executive Directors' on England's Acute Trusts.

PubMed

Pritchard, Colin; Harding, Andrew Je

2014-05-01

To explore the occupational backgrounds of English Non-Executive Directors (NED) on Acute National Health Service (NHS) Trusts. Data extrapolated from Trust websites of NED' occupational backgrounds by gender and occupations, and inter-rater reliability test undertaken. Data were available on all but 24 of the 166 Acute Trusts' from all regions. Trust Chairs and NED were categorised by their dominant occupation. Differentiating NED with and without health or social care leadership experience. The ratings of NED' occupations positively correlated (p < 0.001). Occupational categories were Commerce and Finance from private and public sectors or with Medical or Community leadership experience. Only 4% of Chairs were Medical, 2% from Community - the majority (61%) from Commerce and Finance. Of the 1001 NED, 8% and 6% respectively had Medical or Community leadership experience; most (86%) were Commerce, Finance and non-clinical Managerial backgrounds. Females made up 27% of NED. With a predominance of Chairs and NED without health or social care leadership experience, are current Boards equipped to avoid inadvertently 'doing the system's business' (Francis, 2013) rather than developing a more patient-centred, clinically led and integrated NHS? It is suggested that Boards need more NED with health and social care leadership experience and methods to identify the 'patient's agenda' to create 'a common culture' that places 'patients at the centre of everything we do' (Hunt, 2012). A key context for Trust Boards operations is funding, which Francis' terms of reference excluded, an issue that is briefly discussed.

Institutional trust and alcohol consumption in Sweden: the Swedish National Public Health Survey 2006.

PubMed

Ahnquist, Johanna; Lindström, Martin; Wamala, Sarah P

2008-08-13

Trust as a measure of social capital has been documented to be associated with health. Mediating factors for this association are not well investigated. Harmful alcohol consumption is believed to be one of the mediating factors. We hypothesized that low social capital defined as low institutional trust is associated with harmful alcohol consumption. Data from the 2006 Swedish National Survey of Public Health were used for analyses. The total study population comprised a randomly selected representative sample of 26.305 men and 30.584 women aged 16-84 years. Harmful alcohol consumption was measured using a short version the Alcohol Use Disorders Identification Test (AUDIT), developed and recommended by the World Health Organisation. Low institutional trust was defined based on trust in ten main welfare institutions in Sweden. Independent of age, country of birth and socioeconomic circumstances, low institutional trust was associated with increased likelihood of harmful alcohol consumption (OR (men) = 1.52, 95% CI 1.34-1.70) and (OR (women) = 1.50, 95% CI 1.35-1.66). This association was marginally altered after adjustment for interpersonal trust. Findings of the present study show that lack of trust in institutions is associated with increased likelihood of harmful alcohol consumption. We hope that findings in the present study will inspire similar studies in other contexts and contribute to more knowledge on the association between institutional trust and lifestyle patterns. This evidence may contribute to policies and strategies related to alcohol consumption.

Dirty and 40 days in the wilderness: Eliciting childbirth and postnatal cultural practices and beliefs in Nepal.

PubMed

Sharma, Sheetal; van Teijlingen, Edwin; Hundley, Vanora; Angell, Catherine; Simkhada, Padam

2016-07-05

Pregnancy and childbirth are socio-cultural events that carry varying meanings across different societies and cultures. These are often translated into social expectations of what a particular society expects women to do (or not to do) during pregnancy, birth and/or the postnatal period. This paper reports a study exploring beliefs around childbirth in Nepal, a low-income country with a largely Hindu population. The paper then sets these findings in the context of the wider global literature around issues such as periods where women are viewed as polluted (or dirty even) after childbirth. A qualitative study comprising five in-depth face-to-face interviews and 14 focus group discussions with mainly women, but also men and health service providers. The qualitative findings in Nepal were compared and contrasted with the literature on practices and cultural beliefs related to the pregnancy and childbirth period across the globe and at different times in history. The themes that emerged from the analysis included: (a) cord cutting & placenta rituals; (b) rest & seclusion; (c) purification, naming & weaning ceremonies and (d) nutrition and breastfeeding. Physiological changes in mother and baby may underpin the various beliefs, ritual and practices in the postnatal period. These practices often mean women do not access postnatal health services. The cultural practices, taboos and beliefs during pregnancy and around childbirth found in Nepal largely resonate with those reported across the globe. This paper stresses that local people's beliefs and practices offer both opportunities and barriers to health service providers. Maternity care providers need to be aware of local values, beliefs and traditions to anticipate and meet the needs of women, gain their trust and work with them.

Factors associated with health facility childbirth in districts of Kenya, Tanzania and Zambia: a population based survey

PubMed Central

2014-01-01

Background Maternal mortality continues to be a heavy burden in low and middle income countries where half of all deliveries take place in homes without skilled attendance. The study aimed to investigate the underlying and proximate determinants of health facility childbirth in rural and urban areas of three districts in Kenya, Tanzania and Zambia. Methods A population-based survey was conducted in 2007 as part of the ‘REsponse to ACcountable priority setting for Trust in health systems’ (REACT) project. Stratified random cluster sampling was used and the data included information on place of delivery and factors that might influence health care seeking behaviour. A total of 1800 women who had childbirth in the previous five years were analysed. The distal and proximate conceptual framework for analysing determinants of maternal mortality was modified for studying factors associated with place of delivery. Socioeconomic position was measured by employing a construct of educational attainment and wealth index. All analyses were stratified by district and urban–rural residence. Results There were substantial inter-district differences in proportion of health facility childbirth. Facility childbirth was 15, 70 and 37% in the rural areas of Malindi, Mbarali and Kapiri Mposhi respectively, and 57, 75 and 77% in the urban areas of the districts respectively. However, striking socio-economic inequities were revealed regardless of district. Furthermore, there were indications that repeated exposure to ANC services and HIV related counselling and testing were positively associated with health facility deliveries. Perceived distance was negatively associated with facility childbirth in rural areas of Malindi and urban areas of Kapiri Mposhi. Conclusion Strong socio-economic inequities in the likelihood of facility childbirths were revealed in all the districts added to geographic inequities in two of the three districts. This strongly suggests an urgent need to

Childbirth in ancient Egypt.

PubMed

Chamberlain, Geoffrey

2004-11-01

Medicine in ancient Egypt was much more advanced than the rest of the Biblical world, especially in trauma surgery. Care at the time of childbirth was however virtually non-existent. There were no trained obstetricians or midwives but a galaxy of gods were at hand. This article traces what we can piece together about pregnancy of childbirth from the evidence we have in tombs and papyri of Egypt.

77 FR 66606 - Allegheny Electric Cooperative, Inc. and the Connecticut Bank and Trust Company, National...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-06

... Electric Cooperative, Inc. and the Connecticut Bank and Trust Company, National Association; Notice of..., Allegheny Electric Cooperative, Inc. (AECI) and The U.S. Bank National Association, (as successor in..., Allegheny Electric Cooperative, Inc., 212 Locust Street, Harrisburg, PA 17101, phone (717) 233-5704. Mr...

Childbirth and criteria for traumatic events.

PubMed

Boorman, Rhonda J; Devilly, Grant J; Gamble, Jenny; Creedy, Debra K; Fenwick, Jennifer

2014-02-01

for some women childbirth is physically and psychologically traumatic and meets Criterion A1 (threat) and A2 (intense emotional response) for Posttraumatic Stress Disorder of the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV).This study differentiates Criterion A1 and A2 to explore their individual relationship to prevalence rates for posttraumatic stress, each other, and associated factors for childbirth trauma. women were recruited at three hospitals from October 2008 to October 2009. Questionnaires were completed at recruitment and at 14 days post partum. women in the third trimester of pregnancy (n=890) were recruited by a research midwife while waiting for their antenatal clinic appointment. Participants were over 17 years of age, expected to give birth to a live infant, not undergoing psychological treatment, and able to complete questionnaires in English. this study found 14.3% of women met criteria for a traumatic childbirth. When the condition of A2 was removed, the prevalence rate doubled to 29.4%. Approximately half the women who perceived threat in childbirth did not have an intense negative emotional response. Predictors of finding childbirth traumatic were pre-existing psychiatric morbidity, being a first time mother and experiencing an emergency caesarean section. the fear response is an important diagnostic criterion for assessing psychologically traumatic childbirth. The identification of risk factors may inform maternity service delivery to prevent traumatic birth and postpartum approaches to care to address long-term negative consequences. prevention and treatment of traumatic childbirth are improved through knowledge of potential risk factors and understanding the woman's subjective experience. Copyright © 2013 Elsevier Ltd. All rights reserved.

The effects of antenatal education on fear of childbirth, maternal self-efficacy and post-traumatic stress disorder (PTSD) symptoms following childbirth: an experimental study.

PubMed

Gökçe İsbir, Gözde; İnci, Figen; Önal, Hatice; Yıldız, Pelin Dıkmen

2016-11-01

Fear of birth and low childbirth self-efficacy is predictive of post-traumatic stress disorder symptoms following childbirth. The efficacy of antenatal education classes on fear of birth and childbirth self-efficacy has been supported; however, the effectiveness of antenatal classes on post-traumatic stress disorder symptoms after childbirth has received relatively little research attention. This study examined the effects of antenatal education on fear of childbirth, maternal self-efficacy and post-traumatic stress disorder symptoms following childbirth. Quasi-experimental study. The study was conducted in a city located in the Middle Anatolia region of Turkey and data were collected between December 2013 and May 2015. Two groups of women were compared-an antenatal education intervention group (n=44), and a routine prenatal care control group (n=46). The Wijma Delivery Expectancy/Experience Questionnaire, Version A and B, Childbirth Self-efficacy Inventory and Impact of Event Scale-Revised was used to assess fear of childbirth, maternal self-efficacy and PTSD symptoms following childbirth. Compared to the control group, women who attended antenatal education had greater childbirth self-efficacy, greater perceived support and control in birth, and less fear of birth and post-traumatic stress disorder symptoms following childbirth (all comparisons, p<0.05). Antenatal education appears to alleviate post-traumatic stress disorder symptoms after childbirth. Copyright © 2016 Elsevier Inc. All rights reserved.

Men, masculine identities and childbirth.

PubMed

Dolan, Alan; Coe, Christine

2011-11-01

In recent years, fathers' experiences during childbirth have attracted much research and policy interest. However, little of this work has been grounded in the first-hand accounts of men and there is a lack of theory-based research to help understand men's thoughts and practices around childbirth. This paper is based on qualitative research undertaken with first-time fathers and healthcare professionals. It draws on Connell's (1995) conceptualisation of hegemonic masculinity to explore how men construct masculine identities within the context of pregnancy and childbirth and also how healthcare professionals construct masculinity. The paper demonstrates the ways in which men can find themselves marginalised within the context of pregnancy and childbirth, but are still able to draw on identifiable markers of masculine practice which enable them to enact a masculine form congruent with dominant masculinity. It also illustrates how healthcare professionals' constructions of masculinity enable them to predict how men will behave and allow them to position men in ways that involve minimum disruption to their own practice. The paper also highlights how men's marginal status is embedded in the dynamics of the social structure, which produce and reproduce dominant masculine identities within the context of childbirth. © 2011 The Authors. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

Women's views on partnership working with midwives during pregnancy and childbirth.

PubMed

Boyle, Sally; Thomas, Hilary; Brooks, Fiona

2016-01-01

to explore whether the UK Government agenda for partnership working and choice was realised or desired for women during pregnancy and childbirth. a qualitative study was used to explore women's experience of partnership working with midwives. Data was generated using a diary interview method throughout pregnancy and birth. 16 women were recruited from two district general hospitals in the South East of England. three themes emerged from the data: organisation of care, relationships and choice. Women described their antenatal care as 'ticking the box', with midwives focusing on the bio-medical aspects of care but not meeting their psycho-social and emotional needs. Time poverty was a significant factor in this finding. Women rarely described developing a partnership relationship with midwives due to a lack of continuity of care and time in which to formulate such relationships. In contrast women attending birth centres for their antenatal care were able to form relationships with a group of midwives who shared a philosophy of care and had sufficient time in which to meet women's holistic needs. Most of the women in this study did not feel they were offered the choices as outlined in the national choice agenda (DoH, 2007). NHS Trusts should review the models of care available to women to ensure that these are not only safe but support women's psycho-social and emotional needs as well. Partnership case loading models enable midwives and women to form trusting relationships that empowers women to feel involved in decision making and to exercise choice. Group antenatal and postnatal care models also effectively utilise midwifery time whilst increasing maternal satisfaction and social engagement. Technology should also be used more effectively to facilitate inter-professional communication and to provide a more flexible service to women. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

The lamaze certified childbirth educator: standards of practice.

PubMed

Lothian, Judith A

2007-01-01

A student in a Lamaze Childbirth Educator Program expresses concern that some Lamaze Certified Childbirth Educators (LCCE educators) do not teach classes that reflect Lamaze standards. In this column, the ethical and professional standards of the LCCE educator and the challenges the childbirth educator experiences while practicing in the current maternity-care environment are presented and discussed. Lamaze International's Code of Ethics for Lamaze Certified Childbirth Educators provides guidance when dealing with these challenges.

Back Labor: Childbirth Myth or Reality?

MedlinePlus

... and Gynecologists. Month 6. In: Your Pregnancy and Childbirth Month to Month. 6th ed. Washington, D.C.: ... Martensson LB, et al. Sterile water injections for childbirth pain: An evidence based guide to practice. Women ...

The Lamaze Certified Childbirth Educator: Standards of Practice

PubMed Central

Lothian, Judith A.

2007-01-01

A student in a Lamaze Childbirth Educator Program expresses concern that some Lamaze Certified Childbirth Educators (LCCE educators) do not teach classes that reflect Lamaze standards. In this column, the ethical and professional standards of the LCCE educator and the challenges the childbirth educator experiences while practicing in the current maternity-care environment are presented and discussed. Lamaze International's Code of Ethics for Lamaze Certified Childbirth Educators provides guidance when dealing with these challenges. PMID:18408808

Childbirth in aristocratic households of Heian Japan.

PubMed

Andreeva, Anna

2014-01-01

This paper focuses on childbirth in Japan's aristocratic households during the Heian period (794-1185). Drawing on various sources, including court diaries, visual sources, literary records, and Japan's first medical collection, with its assortment of gynaecological and obstetric prescriptions, as well as Buddhist and other ritual texts, this short excursion into the cultural history of childbirth offers an insight into how childbirth was experienced and managed in Heian Japan. In particular, it addresses the variety of ideas, knowledge systems and professionals involved in framing and supporting the process of childbirth in elite households. In so doing, it casts light on the complex background of early Japanese medicine and healthcare for women.

Nurse attitudes toward childbirth: a concept clarification.

PubMed

Levine, Martha S; Lowe, Nancy K

2014-01-01

To clarify the concept of "nurse attitudes toward childbirth." It has been suggested that the international trend of escalating cesarean birth rates can be attributed to attitudes that perceive childbirth as an illness. Nurses' attitudes about childbirth direct their nursing care and may influence patient outcomes like cesarean birth. However, the concept "nurse attitudes toward childbirth" must be clarified to inform future research. An English-language literature review, from 1990 to present, was performed using CINAHL, PubMed, and Ovid. Norris's model of concept clarification was used. Although the nursing literature poorly defined "nurse attitudes" and rarely used a conceptual framework, the discipline of psychology has been refining this concept for over 40 years. Psychologists have established that attitude can predict behavior as demonstrated through testing of the theory of planned behavior. Various types of "nurse attitudes toward childbirth" were identified through our literature review, and five central beliefs were noted. This resulted in the development of a preliminary model using theory of planned behavior as a foundation. Finally, potential research hypotheses were generated. This paper clarifies "nurse attitudes toward childbirth" and supports its use for research. Nurse scholars have demonstrated that labor and delivery nurses do have individual attitudes toward childbirth, and the measurement of these attitudes may predict nursing care intentions and behavior. This concept is appropriate, important, and may be used as a means of exploring relationships between nursing care and the rising primary cesarean birth rate. © 2013 Wiley Periodicals, Inc.

Fear of Childbirth and Preference for Cesarean Delivery Among Young American Women Before Childbirth: A Survey Study.

PubMed

Stoll, Kathrin; Edmonds, Joyce Katherine; Hall, Wendy A

2015-09-01

Fear of birth and mode of delivery preferences are similar among pregnant and nonpregnant women, suggesting that attitudes toward birth are formed in young adulthood or earlier. Understanding why some young women fear birth and prefer obstetric interventions can inform public health initiatives aimed at reducing fear and promoting birth as a normal life event. We conducted an online survey with 752 American nulliparous young women to assess their preferences and attitudes toward childbirth. We identified explanatory variables associated with reported fear of childbirth and cesarean delivery (CD) preferences. A preference for CD was reported by 14 percent of young women and 27 percent had scores indicating elevated fear of birth. Fear of birth increased the likelihood of cesarean preference (adjusted relative risk (ARR) 3.84 [95% CI 2.49-5.95]) as did a family history of CD (ARR 1.65 [95% CI 1.13-2.42]). The likelihood of reporting elevated childbirth fear was increased among young women who reported concerns about the physical changes pregnancy and birth have on women's bodies (ARR 2.04 [95% CI 1.50-2.78]). Young women who reported a high degree of confidence in their knowledge about childbirth were significantly less likely to report childbirth fear (ARR 0.61 [95% CI 0.42-0.87]). Access to childbirth information was also associated with a decreased likelihood of fear of birth (ARR 0.75 [95% CI 0.59-0.95]). Young women reporting high levels of childbirth fear are nearly four times more likely to prefer a CD. Specific fears, such as worries over the influence of pregnancy and birth on the female body, need to be addressed before pregnancy. © 2015 Wiley Periodicals, Inc.

[Physical activity and childbirth classes during a pregnancy and the level of perceived stress and depressive symptoms in women after childbirth].

PubMed

Kowalska, Joanna; Olszowa, Daria; Markowska, Dominika; Teplik, Marzena; Rymaszewska, Joanna

2014-01-01

The aim of this study was to answer the question of whether physical activity during pregnancy and participation in childbirth classes prepare women for childbirth; further, does it influence the levels of perceived stress and the occurrence of depressed mood. 100 women participated in the study. Half of the women had taken part in the childbirth classes before giving birth. A questionnaires of own authorship, Edinburgh Postnatal Depressioni Scale (EPDS) and Perceived Stress Scale (PSS-10) were used. There was no significant relationship observed between participation in childbirth classes and the results of EPDS and PSS-10. The mood of women after childbirth correlated significantly with the level of stress in the whole study group (p<0.0001). Best mean well-being and lowest mean perceived stress were observed in women who stayed in a relationship (p =0.0029, p = 0.0008). Women physically active during pregnancy were also characterized by better mood and lower levels of perceived stress (6.7 and 14.4 vs. 8.4 and 16.0). Among women exercising during pregnancy the participants in childbirth classes was far more numerous (p<0.0001). Declared physical activity during pregnancy was linked to lower levels of stress experienced by women and less severe depressive symptoms after childbirth,; espe- cially in the group of childbirth classes participants.

Literacy: A Route to Addressing Child Poverty? National Literacy Trust Research Review

ERIC Educational Resources Information Center

National Literacy Trust, 2011

2011-01-01

This short document reviews research into the role of low literacy in poverty and disadvantage. It sets out evidence for the impact of parental engagement in home learning and the significance of attitudes, aspirations and literacy development. The National Literacy Trust hopes that this is a useful resource for those with responsibility for, and…

First-time fathers' experiences of normal childbirth.

PubMed

Ledenfors, Anna; Berterö, Carina

2016-09-01

To identify and describe first-time fathers' experiences of normal childbirth. A qualitative interview study using a thematic analysis for analysing the transcripts. purposeful sampling was used. Eight men were interviewed two to six months after experiencing childbirth. Participants were men who had become fathers for the first time. A county located in the middle of Sweden covering both urban and rural areas. The analysis resulted in one major theme - a transformative experience - with four sub-themes: preparing for childbirth, feeling vulnerable in a new situation, being confirmed as part of a unit, and meeting their child for the first time. The findings indicate that the needs of prospective fathers should be given more recognition during childbirth. The findings also show that the midwife is an important person for prospective fathers, both before and during the birth. The findings of the study show what affects first-time fathers' experiences of childbirth. By listening to fathers and recognising them as part of a unit with the woman giving birth, midwifes can support them and increase their participation. Thereby, they can find their role in an unfamiliar situation and thus have a positive experience of childbirth. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Journey of an Early Lamaze Childbirth Educator

PubMed Central

Kushner, Lorraine

2005-01-01

The author, who accomplished the majority of her work as a childbirth educator while based in Tampa, Florida, journals the experience of being an early pioneer in promoting Lamaze childbirth in the United States, beginning in the 1960s. Many aspects of her story are common to the stories of other childbirth educators who also pioneered the childbirth movement in the United States during the same time frame. This history is presented for its potential usefulness to those who continue to work to advance the Lamaze International goal of promoting normal birth. PMID:17273418

The matron's role in acute National Health Service trusts.

PubMed

Gould, Dinah

2008-10-01

The aim of this study was to describe how matrons in an acute National Health Service trust perceive and undertake their role since its reconfiguration in 2005 and to investigate their needs for continuing professional development. Matrons returned to acute National Health Service trusts in 2002 to provide a senior, authoritative nursing presence throughout clinical areas. Their function is to promote high standards of clinical care and leadership; ensure that administrative and support services are in place to deliver high standards of care; and provide a visible, accessible and authoritative presence in ward settings. Data were obtained by interview. A qualitative approach using a semi-structured interview schedule was used to obtain data from 22 matrons and the data were subjected to thematic analysis. There were differences in the way that matrons performed their role. They promoted clinical leadership effectively and maintained a high clinical profile. Attempts to promote high standards of cleanliness and infection control were less effective because of the shortcomings of the domestic service. Overall the matron role is proving effective. However, matrons' ability to promote adequate levels of environmental cleanliness and control infection is a cause for concern. IMPLICATIONS FOR NURSING MANAGERS: The study findings suggest that where an existing service is performing poorly, expecting another occupational group to oversee it will not contribute to improvement unless resources can be improved. WHAT THIS PAPER ADDS TO CURRENT KNOWLEDGE: This study has provided an in-depth evaluation of the matron role at a local level. It is to date the most comprehensive study of its kind.

The Effect of Childbirth Self-Efficacy on Perinatal Outcomes

PubMed Central

Tilden, Ellen L.; Caughey, Aaron B.; Lee, Christopher S.; Emeis, Cathy

2016-01-01

Objective To synthesize and critique the quantitative literature on measuring childbirth self-efficacy and the effect of childbirth self-efficacy on perinatal outcomes. Data Sources Eligible studies were identified through searching MEDLINE, CINAHL, Scopus, and Google Scholar databases. Study Selection Published research using a tool explicitly intended to measure childbirth self-efficacy and also examining outcomes within the perinatal period were included. All manuscripts were in English and published in peer-reviewed journals. Data Extraction First author, country, year of publication, reference and definition of childbirth self-efficacy, measurement of childbirth self-efficacy, sample recruitment and retention, sample characteristics, study design, interventions (with experimental and quasi-experimental studies), and perinatal outcomes were extracted and summarized. Data Synthesis Of 619 publications, 23 studies published between 1983 and 2015 met inclusion criteria and were critiqued and synthesized in this review. Conclusions There is overall consistency in how childbirth self-efficacy is defined and measured among studies, facilitating comparison and synthesis. Our findings suggest that increased childbirth self-efficacy is associated with a wide variety of improved perinatal outcomes. Moreover, there is evidence that childbirth self-efficacy is a psychosocial factor that can be modified through various efficacy-enhancing interventions. Future researchers will be able to build knowledge in this area through: (a) utilization of experimental and quasi-experimental design; (b) recruitment and retention of more diverse samples; (c) explicit reporting of definitions of terms (e.g. ‘high risk’); (d) investigation of interventions that increase childbirth self-efficacy during pregnancy; and, (e) investigation regarding how childbirth self-efficacy enhancing interventions might lead to decreased active labor pain and suffering. Exploratory research should

The Effect of Childbirth Self-Efficacy on Perinatal Outcomes.

PubMed

Tilden, Ellen L; Caughey, Aaron B; Lee, Christopher S; Emeis, Cathy

2016-01-01

To synthesize and critique the quantitative literature on measuring childbirth self-efficacy and the effect of childbirth self-efficacy on perinatal outcomes. Eligible studies were identified through searches of MEDLINE, CINAHL, Scopus, and Google Scholar databases. Published research articles that used a tool explicitly intended to measure childbirth self-efficacy and that examined outcomes within the perinatal period were included. All articles were in English and were published in peer-reviewed journals. First author, country, year of publication, reference and definition of childbirth self-efficacy, measurement of childbirth self-efficacy, sample recruitment and retention, sample characteristics, study design, interventions (with experimental and quasiexperimental studies), and perinatal outcomes were extracted and summarized. Of 619 publications, 23 studies published between 1983 and 2015 met inclusion criteria and were critiqued and synthesized in this review. There is overall consistency in how childbirth self-efficacy is defined and measured among studies, which facilitates comparison and synthesis. Our findings suggest that increased childbirth self-efficacy is associated with a wide variety of improved perinatal outcomes. Moreover, there is evidence that childbirth self-efficacy is a psychosocial factor that can be modified through various efficacy-enhancing interventions. Future researchers will be able to build knowledge in this area through (a) use of experimental and quasiexperimental design, (b) recruitment and retention of more diverse samples, (c) explicit reporting of definitions of terms (e.g., high risk), (d) investigation of interventions that increase childbirth self-efficacy during pregnancy, and (e) investigation about how childbirth self-efficacy-enhancing interventions might lead to decreased active labor pain and suffering. Exploratory research should continue to examine the potential association between higher prenatal childbirth self

Patient satisfaction with childbirth after external cephalic version.

PubMed

Bogner, Gerhard; Hammer, Barbara Eva; Schausberger, Christiane; Fischer, Thorsten; Reisenberger, Klaus; Jacobs, Volker

2014-03-01

To assess acceptance and impact of external cephalic version (ECV) for breech presentation at term on maternal satisfaction with childbirth. Retrospective study on n = 131 women with breech presentation comparing maternal satisfaction after ECV and consecutive childbirth (n = 66; 50.4% of these successful attempts in n = 33; 50%) against the group without ECV and primary caesarean section (CS) (n = 65; 49.6%) instead using a questionnaire. Women with successful ECV tolerated side effects of the intervention better than after unsuccessful ECV (pain, tocolytics, mental and physical state, for all p < 0.001). They were not more satisfied with childbirth than women who experienced an unsuccessful ECV (p = 0.37). However, they would undergo the procedure again (p = 0.003) and would recommend it to other women (p < 0.001). Only women with spontaneous vaginal deliveries after successful version were more satisfied with childbirth than women with planned CS (p = 0.05). Women with version attempts tend to perceive childbirth as being less problematic with fewer complications (9.5 vs. 19%, p = 0.12). Unsuccessful ECVs had no negative impact on satisfaction with childbirth (p = 0.072). Attempting ECV seems to be an option for increasing the rate of vaginal births with breech presentation without negative impact on maternal satisfaction regarding consecutive childbirth.

Associations between perceptions of care and women's childbirth experience: a population-based cross-sectional study in Rwanda.

PubMed

Mukamurigo, Judith U; Berg, Marie; Ntaganira, Joseph; Nyirazinyoye, Laetitia; Dencker, Anna

2017-06-09

In recent years Rwanda has achieved remarkable improvement in quality of maternity care services but there is evidence of deficiencies in care quality in terms of disrespectful care. Women's overall childbirth experience is an important outcome of childbirth and a factor in assessing quality of care. The aim of this study was to investigate how women's overall childbirth experience in Rwanda was related to their perceptions of childbirth care. A cross-sectional household study of women who had given birth 1-13 months earlier (n = 921) was performed in the Northern Province and in the capital city. Data was collected via structured interviews following a questionnaire. Significant variables measuring perceptions of care were included in a stepwise forward selection logistic regression model with overall childbirth experience as a dichotomised target variable to find independent predictors of a good childbirth experience. The majority of women (77.5%) reported a good overall childbirth experience. In a logistic regression model five factors of perceived care were significant independent predictors of a good experience: confidence in staff (Adjusted OR 1.73, 95% CI 1.20-2.49), receiving enough information (AOR 1.44, 95% CI 1.03-2.00), being treated with respect (AOR 1.69, 95% CI 1.18-2.43), getting support from staff (AOR 1.75, 95% CI 1.20-2.56), and having the baby skin-to-skin after birth (AOR 2.21, 95% CI 1.52-3.19). To further improve childbirth care in Rwanda and care for women according to their preferences, it is important to make sure that the childbirth care includes the following quality aspects in national and clinical guidelines: build confidence, provide good information, treat women and families with respect, provide good professional support during childbirth and put the newborn baby skin-to-skin with its mother early after birth.

Psychological perspectives on fear of childbirth.

PubMed

Rondung, Elisabet; Thomtén, Johanna; Sundin, Örjan

2016-12-01

The objective of this narrative review was to examine the literature on fear of childbirth from a psychological perspective, addressing the specificity of childbirth fear, the pathways of fear acquisition, and the physiological, cognitive and behavioral aspects of fear. Systematic procedures for literature search, inclusion and exclusion left 86 original research papers for analysis. Findings summarize the body of knowledge for each area of interest, as well as the number of studies addressing each theme. Overall, few studies adopt a clear-cut psychological perspective, leaving the psychological mechanisms of childbirth fear largely unexplored. Although methodological limitations make conclusions difficult, results give a hint of etiological diversity and possible psychological mechanisms commonly described as transdiagnostic features in anxiety. Systematic investigations of psychological mechanisms, longitudinal studies exploring possible vicious circles of fear, and studies comparing psychological characteristics within the group of women fearing childbirth are identified as research areas of high priority. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Spirituality and spiritual care in and around childbirth.

PubMed

Crowther, Susan; Hall, Jennifer

2015-06-01

Emerging evidence points to childbirth as a spiritually felt meaningful occasion. Although growing literature and development of guidelines charge the midwife to provide spiritual care felt spiritual experiences are not addressed. There is need to revisit contemporary approaches to spiritual care in midwifery lest something of significance becomes lost in policy rhetoric. The aim of this discussion paper is to bring to the surface what is meant by spiritual care and spiritual experiences, to increase awareness about spirituality in childbirth and midwifery and move beyond the constraints of structured defined protocols. The authors' own studies and other's research that focuses on the complex contextual experiences of childbirth related to spirituality are discussed in relation to the growing interest in spiritual care assessments and guidelines. There is a growing presence in the literature about how spirituality is a concern to the wellbeing of human beings. Although spirituality remains on the peripheral of current discourse about childbirth. Spiritual care guidelines are now being developed. However spiritual care guidelines do not appear to acknowledge the lived-experience of childbirth as spiritually meaningful. Introduction of spiritual care guidelines into midwifery practice do not address the spiritual meaningful significance of childbirth. If childbirth spirituality is relegated to a spiritual care tick box culture this would be a travesty. The depth of spirituality that inheres uniquely in the experience of childbirth would remain silenced and hidden. Spiritual experiences are felt and beckon sensitive and tactful practice beyond words and formulaic questions. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Correlates of consumer trust in online health information: findings from the health information national trends survey.

PubMed

Ye, Yinjiao

2011-01-01

The past few decades have witnessed a dramatic increase in consumers seeking health information online. However, the quality of such information remains questionable, and the trustworthiness of online health information has become a hot topic, whereas little attention has been paid to how consumers evaluate online health information credibility. This study builds on theoretical perspectives of trust such as personal-capital-based, social-capital-based, and transfer-based, and it examines various correlates of consumer trust in online health information. The author analyzed the 2007 Health Information National Trends Survey data (N = 7,674). Results showed that consumer trust in online health information did not correlate with personal capital such as income, education, and health status. Social capital indicated by visiting social networking Web sites was not associated with trust in online health information either. Nevertheless, trust in online health information transferred from traditional mass media and government health agencies to the Internet, and it varied by such information features as easiness to locate and to understand. Age appeared to be a key factor in understanding the correlates of trust in online health information. Theoretical and empirical implications of the results are discussed.

Activating the Consumer about Pregnancy and Childbirth.

ERIC Educational Resources Information Center

James, Gordon B.

1980-01-01

A variety of consumer issues involved in education about pregnancy and childbirth are outlined for inclusion in health education programs. They include consumer concern prior to and during pregnancy, and surrounding childbirth. (JMF)

Evaluation of the supportive needs of adolescents during childbirth intrapartum nursing intervention on adolescents' childbirth satisfaction and breastfeeding rates.

PubMed

Grassley, Jane S; Sauls, Donna J

2012-01-01

To evaluate the effect of the Supportive Needs of Adolescents during Childbirth (SNAC) intrapartum nursing intervention on adolescents' childbirth satisfaction and breastfeeding rates. Separate sample posttest quasi-experimental. A tertiary hospital intrapartum unit. A convenience sample of 106 parturient adolescents. During Phase 1 the control group received current standard of intrapartum care. During Phase 2, the interventionist nurses provided the SNAC intervention and standard of care to the intervention group. The t test indicated higher childbirth satisfaction in the intervention group. Chi-square analysis indicated that the intervention group was more likely to breastfeed within the first hour after birth. There was no significant relationship between childbirth satisfaction and breastfeeding at three months and no differences between the groups in breastfeeding rates at hospital discharge and three months. These results suggest that learning the SNAC intervention may help nurses positively influence adolescents' childbirth experience and timing of breastfeeding initiation. Replication of the study is needed to further explore whether the intervention can significantly influence breastfeeding duration. © 2011 AWHONN, the Association of Women's Health, Obsteric and Neonatal Nurses.

12 CFR 7.2022 - Voting trusts.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Voting trusts. 7.2022 Section 7.2022 Banks and... Practices § 7.2022 Voting trusts. The shareholders of a national bank may establish a voting trust under the applicable law of a state selected by the participants and designated in the trust agreement, provided the...

Trust versus Manipulation

ERIC Educational Resources Information Center

Lewis, Anne C.

2005-01-01

This article discusses the issue of trust in the education system. What is different about the issue of trust in the education system is the assault upon it, sometimes overt but most often subtle. There is a difference between strong criticism and willful manipulation. The nation's schools are responding to the former--perhaps too slowly for…

Group psychoeducation with relaxation for severe fear of childbirth improves maternal adjustment and childbirth experience--a randomised controlled trial.

PubMed

Rouhe, Hanna; Salmela-Aro, Katariina; Toivanen, Riikka; Tokola, Maiju; Halmesmäki, Erja; Ryding, Elsa-Lena; Saisto, Terhi

2015-01-01

Previous studies on the treatment of women with fear of childbirth have focused on the delivery mode. Women with fear of childbirth often suffer from anxiety and/or depression, and treatment therefore also needs to target postnatal psychological well-being and the early mother-infant relationship. Three hundred and seventy-one nulliparous women out of 4575 scored ≥100 in prospective screening (Wijma Delivery Expectancy Questionnaire, W-DEQ-A), indicating severe fear of childbirth. These women were randomised to psychoeducative group intervention with relaxation (n = 131; six sessions during pregnancy, one postnatal) or to conventional care (n = 240) by community nurses (referral if necessary). Psycho-emotional and psychosocial evaluations [Edinburgh Postnatal Depression Scale (EPDS), social support, Maternal Adjustment and Attitudes (MAMA), Traumatic Events Scale (TES) and the Wijma Delivery Experience Questionnaire (W-DEQ-B)] were completed twice during pregnancy and/or 3 months postpartum. Postnatal maternal adjustment (MAMA mean score 38.1 ± 4.3 versus 35.7 ± 5.0, p = 0.001) and childbirth experience (mean W-DEQ-B sum score 63.0 ± 29 versus 73.7 ± 32, p = 0.008) were better in the intervention group compared with controls. In hierarchical regression, social support, participating in intervention, and less fearful childbirth experience predicted better maternal adjustment. The level of postnatal depressive symptoms was significantly lower in the intervention group (mean sum score 6.4 ± 5.4 versus 8.0 ± 5.9 p = 0.04). There were no differences in the frequency of post-traumatic stress symptoms between the groups. In nulliparous women with severe fear of childbirth, participation in a targeted psychoeducative group resulted in better maternal adjustment, a less fearful childbirth experience and fewer postnatal depressive symptoms, compared with conventional care.

Introducing Emergency Preparedness in Childbirth Education Classes

PubMed Central

DeWald, Lauren; Fountain, Lily

2006-01-01

In the wake of recent natural and man-made disasters and emergency situations, pregnant women are especially vulnerable. The authors of this column encourage childbirth educators to include disaster preparedness instruction and emergency childbirth techniques in their class content. PMID:17322945

[The primiparae couple's experience of childbirth: quantitative study].

PubMed

Moreau, A; Kopff-Landas, A; Séjourné, N; Chabrol, H

2009-03-01

The aim of this research was to study childbirth experience for the primiparae couple and their emotional state in early post-partum. Thirty-three couples were interviewed 2 days after the birth. A questionnaire on childbirth experience and the EPDS were carried out. According to the results, mothers feel less satisfied, less calm, more useful and suffer more than fathers. Moreover, they consider father's participation more active and more supportive than themselves assess it. Experience of childbirth is linked with parent's emotional state in early postpartum. These results stress the importance to take into account the woman, the men and the couple as three separate and singular units and to create space for dialogue before and after childbirth.

Top-selling childbirth advice books: a discourse analysis.

PubMed

Kennedy, Holly Powell; Nardini, Katrina; McLeod-Waldo, Rebecca; Ennis, Linda

2009-12-01

Recent evidence suggests that one-third of women receive information about pregnancy and childbirth through books. Messages about what characteristics are normal (or expected) in childbirth are disseminated in a variety of ways, including popular childbirth education books, but little study of them has been conducted. The purpose of this investigation is to address that gap by examining the discussions about childbirth in the 10 top-selling books in the United States. Discourse analysis (relating to the public, personal, and political discussions about a specific phenomenon) was used to study 10 best-selling United States childbirth advice books marketed to childbearing women during the first week of November 2007. Book styles ranged from clinical descriptions of pregnancy and birth primarily offering reassurance, self-help information, and danger signs to more folksy and humorous commentaries. Presentation of scientific evidence to support recommendations was uneven and at times inaccurate. Five focal areas of discourse included body image, labor and birth, pain, power and control, and life preparation for motherhood. Top-selling books shine an interesting light on the current state of United States maternity practices. Women and health professionals should assess them carefully and engage with each other about their recommendations and implications for childbirth.

Psychosocial health and well-being among obstetricians and midwives involved in traumatic childbirth.

PubMed

Schrøder, Katja; Larsen, Pia Veldt; Jørgensen, Jan Stener; Hjelmborg, Jacob V B; Lamont, Ronald F; Hvidt, Niels Christian

2016-10-01

this study investigates the self-reported psychosocial health and well-being of obstetricians and midwives in Denmark during the most recent four weeks as well as their recall of their health and well-being immediately following their exposure to a traumatic childbirth. a 2012 national survey of all Danish obstetricians and midwives (n=2098). The response rate was 59% of which 85% (n=1027) stated that they had been involved in a traumatic childbirth. The psychosocial health and well-being of the participants was investigated using six scales from the Copenhagen Psychosocial Questionnaire (COPSOQII). Responses were assessed on six scales: burnout, sleep disorders, general stress, depressive symptoms, somatic stress and cognitive stress. Associations between COPSOQII scales and participant characteristics were analysed using linear regression. midwives reported significantly higher scores than obstetricians, to a minor extent during the most recent four weeks and to a greater extent immediately following a traumatic childbirth scale, indicating higher levels of self-reported psychosocial health problems. Sub-group analyses showed that this difference might be gender related. Respondents who had left the labour ward partly or primarily because they felt that the responsibility was too great a burden to carry reported significantly higher scores on all scales in the aftermath of the traumatic birth than did the group who still worked on the labour ward. None of the scales were associated with age or seniority in the time after the traumatic birth indicating that both junior and senior staff may experience similar levels of psychosocial health and well-being in the aftermath. KEY CONCLUSIONS AND IMPLICATIONS: this study shows an association between profession (midwife or obstetrician) and self-reported psychosocial health and well-being both within the most recent four weeks and immediately following a traumatic childbirth. The association may partly be explained by

Building and Understanding Trust Relationships

DTIC Science & Technology

2012-03-17

Building and Understanding Trust Relationships by Lieutenant Colonel Frederick W. Olison United States Air National Guard...To) 4. TITLE AND SUBTITLE Building and Understanding Trust Relationships 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT...foundation of trust . Without it, the military loses the ability to serve its client, the American people. This threatens the military’s ability to develop

Variation in childbirth services in California: a cross-sectional survey of childbirth hospitals.

PubMed

Korst, Lisa M; Feldman, Daniele S; Bollman, D Lisa; Fridman, Moshe; El Haj Ibrahim, Samia; Fink, Arlene; Wyatt, Lacey; Gregory, Kimberly D

2015-10-01

The objective of the study was to describe the resources and activities associated with childbirth services. We adapted models for assessing the quality of healthcare to generate a conceptual framework hypothesizing that childbirth hospital resources and activities contributed to maternal and neonatal outcomes. We used this framework to guide development of a survey, which we administered by telephone to hospital labor and delivery nurse managers in California. We describe the findings by hospital type (ie, integrated delivery system [IDS], teaching, and other [community] hospitals). Of 248 nonmilitary childbirth hospitals in California, 239 (96%)responded; 187 community, 27 teaching, and 25 IDS hospitals reported. The context of services varied across hospital types, with community hospitals more likely to have for-profit ownership, be in a rural or isolated location, and have fewer annual deliveries per hospital. Results included the findings of the following: (1) 24 hour anesthesia availability in 50% of community vs 100% of IDS and teaching hospitals (P < .001); (2) 24 hour in-house labor and delivery physician coverage in 5% of community vs 100% of IDS and 48% of teaching hospitals (P < .001); (3) 24 hour blood bank availability in 88% of community vs 96% of IDS and 100% of teaching hospitals (P = .092); (4) adult subspecialty intensive care unit availability in 33% of community vs 36% of IDS and 82% of teaching hospitals (P < .001); (5) ability to perform emergency cesarean delivery in 30 minutes 100% of the time in 56% of community vs 100% of IDS and 85% of teaching hospitals (P < .001); (6) pediatric care available both day and night in 54% of community vs 63% of IDS vs 76% of teaching hospitals (P = .087); and (7) no neonatal intensive care unit in 44% of community vs 12% of IDS and 4% of teaching hospitals (P < .001). Childbirth services varied widely across California hospitals. Cognizance of this variation and linkage of these data to childbirth

76 FR 34650 - Models for a Governance Structure for the National Strategy for Trusted Identities in Cyberspace

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-14

... Identities in Cyberspace AGENCY: U.S. Department of Commerce, Office of the Secretary, and National Institute... National Strategy for Trusted Identities in Cyberspace (NSTIC or ``Strategy''). The Strategy refers to this... cyberspace to U.S. innovation, prosperity, education and political and cultural life, and the need for a...

Childbirth experience according to a group of Brazilian primiparas.

PubMed

Nakano, Ana Márcia Spanó; Homsi Jorge Ferreira, Cristine; de Almeida, Ana Maria; Gomes, Flávia Azevedo

2012-12-01

to understand the meaning of the childbirth experience for Brazilian primiparas in the postpartum period. a qualitative approach using semi-structured interviews. Content analysis was used to derive the two themes that emerged from the discourses. participants were recruited at four primary-level health-care units in Ribeirão Preto, Brazil. After providing written informed consent, an appointment was made for an interview at the participants' homes. 20 primiparas in the postpartum period, aged 15-26 years old, who attended the health-care units to vaccinate their infants and test for phenylketonuria. two thematic categories emerged from the interviews: the meaning attributed to childbirth (with four subcategories) and perceptions of care. Among the participants, the childbirth experience was marked by the 'fear of death' and 'losing the child'. The pain of giving birth was expected, and the moment of childbirth was associated with pain of high intensity. childbirth is considered synonymous with physical and emotional suffering, pain, fear and risk of death. this research indicates the need to break the current mechanistic model of care on which health professionals' actions are based. Care during childbirth must be guided by the foundation that women are the subjects of childbirth actions, in an attempt to emphasise actions that grant them with the autonomy and empowerment needed to experience the situation. Copyright © 2011 Elsevier Ltd. All rights reserved.

The transition of childbirth practices among tribal women in Gujarat, India - a grounded theory approach.

PubMed

Sharma, Bharati; Giri, Gayatri; Christensson, Kyllike; K V, Ramani; Johansson, Eva

2013-10-03

Under the National Rural Health Mission, the current emphasis is on achieving universal institutional births through incentive schemes as part of reforms related to childbirth in India. There has been rapid progress in achieving this goal. To understand the choices made as well as practices and perceptions related to childbirth amongst tribal women in Gujarat and how these have been influenced by modernity in general and modernity brought in through maternal health policies. A model depicting the transition in childbirth practices amongst tribal women was constructed using the grounded theory approach with; 8 focus groups of women, 5 in depth interviews with traditional birth attendants, women, and service providers and field notes on informal discussions and observations. A transition in childbirth practices across generations was noted, i.e. a shift from home births attended by Traditional Birth Attendants (TBAs) to hospital births. The women and their families both adapted to and shaped this transition through a constant 'trade-off between desirable and essential'- the desirable being a traditional homebirth in secure surroundings and the essential being the survival of mother and baby by going to hospital. This transition was shaped by complex multiple factors: 1) Overall economic growth and access to modern medical care influencing women's choices, 2) External context in terms of the international maternal health discourses and national policies, especially incentive schemes for promoting institutional deliveries, 3) Socialisation into medical childbirth practices, through exposure to many years of free outreach services for maternal and child health, 4) Loss of self reliance in the community as a consequence of role redefinition and deskilling of the TBAs and 5) Cultural belief that intervention is necessary during childbirth aiding easy acceptance of medical interventions. In resource poor settings where choices are limited and mortality is high, hospital

The transition of childbirth practices among tribal women in Gujarat, India - a grounded theory approach

PubMed Central

2013-01-01

Background Under the National Rural Health Mission, the current emphasis is on achieving universal institutional births through incentive schemes as part of reforms related to childbirth in India. There has been rapid progress in achieving this goal. To understand the choices made as well as practices and perceptions related to childbirth amongst tribal women in Gujarat and how these have been influenced by modernity in general and modernity brought in through maternal health policies. Method A model depicting the transition in childbirth practices amongst tribal women was constructed using the grounded theory approach with; 8 focus groups of women, 5 in depth interviews with traditional birth attendants, women, and service providers and field notes on informal discussions and observations. Results A transition in childbirth practices across generations was noted, i.e. a shift from home births attended by Traditional Birth Attendants (TBAs) to hospital births. The women and their families both adapted to and shaped this transition through a constant ’trade-off between desirable and essential’- the desirable being a traditional homebirth in secure surroundings and the essential being the survival of mother and baby by going to hospital. This transition was shaped by complex multiple factors: 1) Overall economic growth and access to modern medical care influencing women’s choices, 2) External context in terms of the international maternal health discourses and national policies, especially incentive schemes for promoting institutional deliveries, 3) Socialisation into medical childbirth practices, through exposure to many years of free outreach services for maternal and child health, 4) Loss of self reliance in the community as a consequence of role redefinition and deskilling of the TBAs and 5) Cultural belief that intervention is necessary during childbirth aiding easy acceptance of medical interventions. Conclusion In resource poor settings where choices are

Does antenatal education reduce fear of childbirth?

PubMed

Karabulut, Ö; Coşkuner Potur, D; Doğan Merih, Y; Cebeci Mutlu, S; Demirci, N

2016-03-01

The aim of this study was to determine the effect of antenatal education on fear of childbirth, acceptance of pregnancy and identification with motherhood role. There is insufficient evidence pertaining to the effect of antenatal education on fear of childbirth, acceptance of pregnancy and identification with motherhood role. The purpose of antenatal education is to help couples make the right decisions during delivery. Through antenatal education, couples prepare themselves for delivery. This is a quasi-experimental and prospective study that employs a pre- and post-education model. In total, 192 pregnant women (education group, n = 69 and control group, n = 123) participated in the study. Data were collected using the pregnancy identification form: the Prenatal Self-Evaluation Questionnaire and a version of the Wijma Delivery Expectancy/Experience Questionnaire. Prior to participating in the study, the education group and control group had similar levels of acceptance of pregnancy and identification with motherhood role, whereas a significant difference was found in their fear of childbirth levels. When surveyed again after receiving education, the two groups' levels of acceptance of pregnancy and fear of childbirth were found to be significantly different. However, they had similar levels of identification with the motherhood role. Antenatal education appears to increase the acceptance of pregnancy, does not affect the identification with motherhood role and reduces the fear of childbirth. A systematic antenatal education programme, as part of routine antenatal care services, would help reduce the rate of interventional labour and facilitate pregnant women's conscious participation in the act of labour by reducing their fear of childbirth. © 2015 International Council of Nurses.

Trustful societies, trustful individuals, and health: An analysis of self-rated health and social trust using the World Value Survey.

PubMed

Jen, Min Hua; Sund, Erik R; Johnston, Ron; Jones, Kelvyn

2010-09-01

This study analyses the relationships between self-rated health and both individual and mean national social trust, focusing on a variant of Wilkinson's hypothesis that individuals will be less healthy the greater the lack of social cohesion in a country. It employs multilevel modelling on World Values Survey data across 69 countries with a total sample of 160,436 individuals. The results show that self-rated health are positively linked to social trust at both country and individual levels after controlling for individual socio-demographic and income variables plus individual social trust; increased trust is associated with better health. Moreover, this analysis of social trust gives some insight into distinctive results for the former Soviet Bloc countries, which have high reported levels of poor health, alongside the Scandinavian countries which have high levels of trust and better health situations. Our results support and extend the Wilkinson hypothesis that the level of trust, an indicator of social cohesion, is predictive of individuals' health. Copyright 2010 Elsevier Ltd. All rights reserved.

Antenatal hypnosis training and childbirth experience: a randomized controlled trial.

PubMed

Werner, Anette; Uldbjerg, Niels; Zachariae, Robert; Wu, Chun Sen; Nohr, Ellen A

2013-12-01

Childbirth is a demanding event in a woman's life. The aim of this study was to explore whether a brief intervention in the form of an antenatal course in self-hypnosis to ease childbirth could improve the childbirth experience. In a randomized, controlled, single-blinded trial, 1,222 healthy nulliparous women were allocated to one of three groups during pregnancy: A hypnosis group participating in three 1-hour sessions teaching self-hypnosis to ease childbirth, a relaxation group receiving three 1-hour lessons in various relaxation methods and Mindfulness, and a usual care group receiving ordinary antenatal care only. Wijmas Delivery Expectancy/Experience Questionnaire (W-DEQ) was used to measure the childbirth experience 6 weeks postpartum. The intention-to-treat analysis indicated that women in the hypnosis group experienced their childbirth as better compared with the other two groups (mean W-DEQ score of 42.9 in the Hypnosis group, 47.2 in the Relaxation group, and 47.5 in the Care as usual group (p = 0.01)). The tendency toward a better childbirth experience in the hypnosis group was also seen in subgroup analyses for mode of delivery and for levels of fear. In this large randomized controlled trial, a brief course in self-hypnosis improved the women's childbirth experience. © 2013, Copyright the Authors Journal compilation © 2013, Wiley Periodicals, Inc.

Effect of Maternal Age at Childbirth on Obesity in Postmenopausal Women: A Nationwide Population-Based Study in Korea.

PubMed

We, Ji-Sun; Han, Kyungdo; Kwon, Hyuk-Sang; Kil, Kicheol

2016-05-01

The object of this study was to assess the obesity in postmenopausal women, according to age at childbirth.We analyzed the association between age at first childbirth, age at last childbirth, parity, and subject obesity status (general obesity; BMI >25 kg/m, nongeneral obesity; BMI ≤25 kg/m, abdominal obesity; waist circumference >85 cm, nonabdominal obesity; waist circumference ≤85 cm), using data from a nationwide population-based survey, the 2010 to 2012 Korean National Health and Nutrition Examination Survey. Data from a total of 4382 postmenopausal women were analyzed using multivariate regression analysis with complex survey design sampling. And, the subjects were subdivided into groups according to obesity or not. Age, smoking, alcohol consumption, exercise, education, income level, number of pregnancies, oral contraceptive uses, breast feeding experience were adjusted as the confounders.The prevalence of general obesity among Korean postmenopausal women was 37.08%. Women with general obesity and abdominal obesity were significantly younger at first childbirth compared with women with nongeneral obesity and no abdominal obesity (23.89 ± 0.1 vs. 23.22 ± 0.1, P <0.001). Age at first childbirth was inversely associated with obesity, while age at last childbirth was not associated with obesity or abdominal obesity. Women with a higher number of pregnancies were also more likely to have obesity and abdominal obesity. Age at first childbirth remained significantly associated with obesity, after adjusting for confounding factors.Obesity in postmenopausal women is associated with first childbirth at a young age, and higher parity. Further research is needed to clarify the association between obesity and reproductive characteristics.

Prevalence of childbirth fear in an Australian sample of pregnant women.

PubMed

Toohill, Jocelyn; Fenwick, Jennifer; Gamble, Jenny; Creedy, Debra K

2014-08-14

Childbirth fear is reported to affect around 20% of women. However reporting on levels of symptom severity vary. Unlike Scandinavian countries, there has been limited focus on childbirth fear in Australia. The aim of this paper is to determine the prevalence of low, moderate, high and severe levels of childbirth fear in a large representative sample of pregnant women drawn from a large randomised controlled trial and identify demographic and obstetric characteristics associated with childbirth fear. Using a descriptive cross-sectional design, 1,410 women in their second trimester were recruited from one of three public hospitals in south-east Queensland. Participants were screened for childbirth fear using the Wijma Delivery Expectancy/Experience Questionnaire Version A (WDEQ-A). Associations of demographic and obstetric factors and levels of childbirth fear between nulliparous and multiparous women were investigated. Prevalence of childbirth fear was 24% overall, with 31.5% of nulliparous women reporting high levels of fear (score ≥ 66 on the WDEQ-A) compared to 18% of multiparous women. Childbirth fear was associated with paid employment, parity, and mode of last birth, with higher levels of fear in first time mothers (p < 0.001) and in women who had previously had an operative birth (p < 0.001). Prevalence of childbirth fear in Australian women was comparable to international rates. Significant factors associated with childbirth fear were being in paid employment, and obstetric characteristics such as parity and birth mode in the previous pregnancy. First time mothers had higher levels of fear than women who had birthed before. A previous operative birth was fear provoking. Experiencing a previous normal birth was protective of childbirth fear.

Childbirth after surgery for familial adenomatous polyposis in Japan.

PubMed

Kobayashi, Hirotoshi; Ishida, Hideyuki; Ueno, Hideki; Hinoi, Takao; Inoue, Yasuhiro; Ishida, Fumio; Kanemitsu, Yukihide; Konishi, Tsuyoshi; Yamaguchi, Tatsuro; Tomita, Naohiro; Matsubara, Nagahide; Watanabe, Toshiaki; Sugihara, Kenichi

2017-02-01

Familial adenomatous polyposis (FAP) is a genetic disorder. Some female patients with FAP can become pregnant. However, the current state of childbirth after surgery for FAP is unclear in Japan. The study investigated 303 patients (147 female) who had undergone surgery for FAP at the 23 institutions between 2000 and 2012. Eighty female patients had information available on childbirth after surgery for FAP. Eight patients (10 %) gave birth after surgery. The mean age at surgery for FAP was 27 (range 20-41) years and 37 years in patients with and without childbirth after surgery, respectively (P = 0.044). The rate of childbirth after surgery was 17 % in women ≤30 years of age and 13 % in those ≤40 years of age. Although only one patient with invasive cancer (2.9 %) gave childbirth after surgery, seven patients without cancer (15.6 %) gave birth (P = 0.045). This study clarified the current state of childbirth after surgery for FAP in Japan. It is important to use these data to determine the best therapeutic approach for female FAP patients.

Beyond the United States and Japan: Testing Yamagishi's Emancipation Theory of Trust across 31 Nations

ERIC Educational Resources Information Center

Gheorghiu, Mirona A.; Vignoles, Vivian L.; Smith, Peter B.

2009-01-01

We examined the relationship between Individualism/Collectivism and generalized social trust across 31 European nations participating in the European Social Survey. Using multilevel regression analyses, the current study provides the first empirical investigation of the effects of cultural norms of Individualism/Collectivism on generalized social…

Awareness and trust of the FDA and CDC: Results from a national sample of US adults and adolescents

PubMed Central

2017-01-01

Trust in government agencies plays a key role in advancing these organizations' agendas, influencing behaviors, and effectively implementing policies. However, few studies have examined the extent to which individuals are aware of and trust the leading United States agencies devoted to protecting the public’s health. Using two national samples of adolescents (N = 1,125) and adults (N = 5,014), we examined demographic factors, with a focus on vulnerable groups, as correlates of awareness of and trust in the Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA), and the federal government. From nine different weighted and adjusted logistic regression models, we found high levels of awareness of the existence of the FDA and CDC (ranging from 55.7% for adolescents’ awareness of the CDC to 94.3% for adults’ awareness of the FDA) and moderate levels of trust (ranging from a low of 41.8% for adults’ trust in the federal government and a high of 78.8% for adolescents’ trust of the FDA). In the adolescent and adult samples, awareness was higher among non-Hispanic Blacks and respondents with low numeracy. With respect to trust, few consistent demographic differences emerged. Our findings provide novel insights regarding awareness and trust in the federal government and specific United States public health agencies. Our findings suggest groups to whom these agencies may want to selectively communicate to enhance trust and thus facilitate their communication and regulatory agendas. PMID:28520750

Awareness and trust of the FDA and CDC: Results from a national sample of US adults and adolescents.

PubMed

Kowitt, Sarah D; Schmidt, Allison M; Hannan, Anika; Goldstein, Adam O

2017-01-01

Trust in government agencies plays a key role in advancing these organizations' agendas, influencing behaviors, and effectively implementing policies. However, few studies have examined the extent to which individuals are aware of and trust the leading United States agencies devoted to protecting the public's health. Using two national samples of adolescents (N = 1,125) and adults (N = 5,014), we examined demographic factors, with a focus on vulnerable groups, as correlates of awareness of and trust in the Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA), and the federal government. From nine different weighted and adjusted logistic regression models, we found high levels of awareness of the existence of the FDA and CDC (ranging from 55.7% for adolescents' awareness of the CDC to 94.3% for adults' awareness of the FDA) and moderate levels of trust (ranging from a low of 41.8% for adults' trust in the federal government and a high of 78.8% for adolescents' trust of the FDA). In the adolescent and adult samples, awareness was higher among non-Hispanic Blacks and respondents with low numeracy. With respect to trust, few consistent demographic differences emerged. Our findings provide novel insights regarding awareness and trust in the federal government and specific United States public health agencies. Our findings suggest groups to whom these agencies may want to selectively communicate to enhance trust and thus facilitate their communication and regulatory agendas.

Midwives' supervisory styles and leadership role as experienced by Norwegian mothers in the context of a fear of childbirth.

PubMed

Lyberg, Anne; Severinsson, Elisabeth

2010-05-01

The aim of the present study was to describe the midwives' supervisory style and leadership role as experienced by pregnant women and new mothers in the context of a fear of childbirth. A service led by midwives can influence the quality of care. The sample consisted of 13 mothers. Data were interpreted by means of qualitative content analysis. The findings revealed that the midwives' supervisory styles were related to their ability to create a trusting and caring relationship, demonstrate problem-solving capacity, and showing willingness, preparedness and courage to support the women. The midwives' leadership role was described as involving a crucial set of professional management skills and techniques. The findings have strengthened the argument for the provision of continuity of care to women who are afraid of childbirth. Further studies should focus more specifically on the implementation of research in practice. It is necessary for midwives to demonstrate leadership in order to develop practice, predict challenges and changes, provide different care delivery models and acquire an evidence base for care. This also demands systematic supervision to improve care outcomes.

Psychological growth after childbirth: an exploratory prospective study.

PubMed

Nishi, Daisuke; Usuda, Kentaro

2017-06-01

It is important to elucidate the psychologically positive aspects of childbirth for mothers, and not only the negative aspects such as perinatal depression. This study aimed to examine psychological growth after childbirth and its related variables by focussing on five factors of posttraumatic growth: relating to others, new possibilities, personal strength, spiritual change and appreciation of life. Pregnant women during mid-pregnancy were consecutively recruited at a women's hospital in Japan and followed up 1 month after childbirth. Psychological growth was assessed by the Posttraumatic Growth Inventory. Among 177 participants, 117 (66.1%) completed follow-up assessments 1 month after childbirth. Multivariable regression analysis revealed that primipara, higher resilience and less fear at childbirth were associated with posttraumatic growth factors of relating to others and new possibilities. High resilience and less fear at childbirth were also associated with personal strength. On the other hand, being primiparous and high depressive symptoms were associated with greater appreciation of life. No variables were associated with spiritual change. These findings suggest that giving birth for the first time could be a highly challenging life event as well as an opportunity which leads to PTG, and that giving birth with low fear might lead to mothers' psychological growth. On the other hand, appreciation of life might need attention as it might signify some sorts of coping response. These findings contribute to our understanding of the psychological changes experienced by mothers.

Evolution of childbirth expectations in Spanish pregnant women.

PubMed

Peñacoba-Puente, Cecilia; Carmona-Monge, Francisco Javier; Marín-Morales, Dolores; Écija Gallardo, Carmen

2016-02-01

To analyze the change of childbirth expectations over the course of pregnancy as well as their relation to socio-demographic and clinical variables. The study of expectations in pregnant women is gaining more interest from a biopsychosocial approach because of its consequences on pregnant women's wellbeing. To our knowledge there are no previous studies analyzing the evolution of childbirth expectations over the course of pregnancy. Longitudinal study (first trimester and third trimester). Women were evaluated for childbirth expectations in their first trimester (n=285) and third trimester (n=122) of pregnancy. They also completed questionnaires collecting socio-demographic information. Childbirth expectations appear to remain more or less stable over the course of pregnancy, although they tend to become slightly negative at the end of gestation, specifically referring to personal control and delivery circumstances. Multiparity and planned pregnancy are associated with higher positive expectations. It seems essential to explore and to try to adjust childbirth expectations to more realistic ones, in order for them to be fulfilled. Midwives and other maternity healthcare providers play a key role in this regard. Copyright © 2015 Elsevier Inc. All rights reserved.

32 CFR 32.37 - Property trust relationship.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 1 2011-07-01 2011-07-01 false Property trust relationship. 32.37 Section 32.37 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE DoD GRANT AND AGREEMENT... trust relationship. Real property, equipment, intangible property and debt instruments that are acquired...

Birth Stories: A Way of Knowing in Childbirth Education

PubMed Central

Savage, Jane Staton

2001-01-01

Birth stories have a lasting impact on expectant mothers. The purpose of this paper is to recognize the influence of birth stories as a key component of informal communication of knowledge about childbirth for expectant mothers. The review of literature and research is related to childbirth education, anthropological thinking, and applied learning theory with foundational concepts from Vygotsky, Bruner, and Bandura. Implications for childbirth educators are included. PMID:17273247

New Resources for Childbirth Educators and Parents

PubMed Central

Shilling, Teri

2009-01-01

In this column, reviewers offer perspectives and comments on a variety of new media resources for childbirth educators and expectant and new parents. The books, CDs, DVDs, and kits reviewed in this issue's column include the following topics: the birth experiences of mothers who survived childhood sexual abuse; lively teaching techniques and ideas to help energize and enhance childbirth education classes; breastfeeding in the workplace; expectant fathers; perspectives on motherhood; unique, helpful tools for childbirth educators to use in designing their class content, addressing the stages of labor, and discussing planned cesarean birth; exercises for pregnant women on bedrest; and a compilation of presentations featured at Birthing the Future's international symposiums. PMID:20190851

Particularized trust, generalized trust, and immigrant self-rated health: cross-national analysis of World Values Survey.

PubMed

Kim, H H-S

2018-05-01

This research examined the associations between two types of trust, generalized and particularized, and self-rated health among immigrants. Data were drawn from the World Values Survey (WVS6), the latest wave of cross-sectional surveys based on face-to-face interviews. The immigrant subsample analyzed herein contains 3108 foreign-born individuals clustered from 51 countries. Given the hierarchically nested data, two-level logistic regressions models were estimated using HLM (Hierarchical Linear Modeling) 7.1. At the individual level, net of socio-economic and demographic factors (age, gender, marital status, education, income, neighborhood security, and subjective well-being), particularized trust was positively related to physical health (odds ratio [OR] = 1.11, P < .001). Generalized trust, however, was not a significant predictor. At the country level, based on alternative models, the aggregate measure of particularized trust was negatively associated with subjective health. The odds of being healthy were on average about 30% lower. The interdisciplinary literature on social determinants of health has largely focused on the salubrious impact of trust and other forms of social capital on physical well-being. Many previous studies based on general, not immigrant, populations also did not differentiate between generalized and particularized types of trust. Results from this study suggest that this conceptual distinction is critical in understanding how and to what extent the two are differentially related to immigrant well-being across multiple levels of analysis. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Intent and Choice Regarding Maternal Employment Following Childbirth.

ERIC Educational Resources Information Center

Werbel, James

1998-01-01

A study of 70 pregnant working mothers before and six months after childbirth found that traditional gender-role values and perceived spousal preference influenced their employment intention before giving birth. Employment intention and spouse's income influenced return to employment after childbirth. (SK)

Prevention of childbirth injuries to the pelvic floor.

PubMed

Heit, M; Mudd, K; Culligan, P

2001-08-01

The majority of childbirth injuries to the pelvic floor occur after the first vaginal delivery. Cesarean sections performed after the onset of labor may not protect the pelvic floor. Elective cesarean section is the only true primary prevention strategy for childbirth injuries to the pelvic floor. Alternative primary prevention strategies include elective cesarean section for women with nonmodifiable risks for childbirth injuries to the pelvic floor, antepartum pelvic floor exercises, or intrapartum pudendal nerve monitoring. Secondary prevention strategies must focus on modifying obstetric practices that predispose women to pelvic floor injury. These factors are best delineated for anal incontinence and include restrictive use of episiotomy, mediolateral episiotomy when necessary, spontaneous over forceps-assisted vaginal delivery, vacuum extraction over forceps delivery, and antepartum perineal massage. Finally, tertiary prevention strategies should address the mode of delivery made for women with childbirth injuries to the pelvic floor who desire future fertility.

The effects of counseling on fear of childbirth.

PubMed

Larsson, Birgitta; Karlström, Annika; Rubertsson, Christine; Hildingsson, Ingegerd

2015-06-01

To investigate women's experiences of attending existing counseling programs for childbirth-related fear and the effect of this counseling over time. A longitudinal survey. Three hospitals in the central north of Sweden. A selected sample of 936 women. Of these, 70 received counseling due to fear of childbirth (study-group). Data were collected with questionnaires 2 months and 1 year after giving birth with background data collected during midpregnancy. Comparisons were made between women with or without counseling. Crude and adjusted odds ratios (OR) were calculated. Self-reported childbirth fear, experience of counseling, birth experience and preferred mode of birth. Women in the counseling group reported higher childbirth fear 1 year after giving birth (OR 5.0, 95% confidence interval (95% CI) 2.6-9.3), they had a more negative birth experience that did not change over time (OR 2.1, 95% CI 1.2-3.9) and they preferred cesarean section to a greater extent (OR 12.0, 95% CI 5.1-28.1) in the case of another birth. Also, they were more often delivered by planned cesarean section (OR 4.7, 95% CI 2.4-9.1). However, 80% were satisfied with the given support. Although women were satisfied with the treatment, this study shows that counseling had a minor effect on fear of childbirth, birth experiences or cesarean section rates. To help women with their fear of childbirth, more effective methods of treatment are needed. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

New Resources for Childbirth Educators and Parents

PubMed Central

Shilling, Teri

2008-01-01

In this column, reviewers offer perspectives and comments on a variety of new media resources for childbirth educators and for expectant and new parents. From audio CDs on building one's birthing business endeavor to books for expectant parents focusing on breastfeeding, calming babies, cosleeping, and supplementing what is learned in a childbirth class, the marketplace always has new resources to offer.

32 CFR 32.37 - Property trust relationship.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false Property trust relationship. 32.37 Section 32.37... trust relationship. Real property, equipment, intangible property and debt instruments that are acquired or improved with Federal funds shall be held in trust by the recipient as trustee for the...

Trusting patients, trusting nurses.

PubMed

Sellman, Derek

2007-01-01

The general expectation that patients should be willing to trust nurses is rarely explored or challenged despite claims of diminishing public trust in social and professional institutions. Everyday meanings of trust take account of circumstance and suggest that our understanding of what it means to trust is contextually bound. However, in the context of health care, to trust implies a particular understanding which becomes apparent when abuses of this trust are reported and acknowledged as scandals. The predominant assumption in the literature that trust is something that occurs between equally competent adults cannot explain trust in nursing precisely because of the unequal power relationships between patients on the one hand and healthcare professionals on the other. Moreover, the tendency to conflate terms such as trust, reliance, confidence and so on suggests that confusion permeates discussions of trust in nursing. In this paper, I argue in support of Annette Baier's requirement of good will (or lack of ill will) as the essential feature of trust, and outline how this account (i) enables us to make the necessary distinctions between trust on the one hand and 'trust pretenders' on the other; and (ii) lays the foundations for understanding trust in relationships, such as those between patients and nurses, where power differentials exist.

Predictors of childbirth fear among pregnant Chinese women: A cross-sectional questionnaire survey.

PubMed

Gao, Ling-Ling; Liu, Xiao Jun; Fu, Bai Ling; Xie, Wen

2015-09-01

to examine childbirth fear and identify its predictors among pregnant Chinese women. a cross-sectional descriptive questionnaire survey was conducted in a regional teaching hospital in Guangzhou, China, between October and November 2013. 353 pregnant Chinese women who were at least 18 years old, with a singleton fetus, in the third trimester of pregnancy, not at high risk for complications of pregnancy, and not having had a previous caesarean section. a social-demographic data sheet; the Chinese version of the Childbirth Attitude Questionnaire and the Spielberger׳s State-Trait Anxiety Inventory; and the short form of 32-item Chinese Childbirth Self-Efficacy Inventory. the pregnant Chinese women reported moderate levels of childbirth fear. The pregnant Chinese women who were younger, with lower educational level, not satisfied with their husbands׳ support, and with previous experience of miscarriage reported higher level of childbirth fear. Pregnant women׳s childbirth self-efficacy, state anxiety and trait anxiety were correlated with childbirth fear. The best-fit regression analysis revealed four variables that explained 28% of variance in childbirth fear: trait anxiety, state anxiety, age and previous experience of miscarriage. this study highlighted the connection between childbirth fear, state and trait anxiety, childbirth self-efficacy, age, education and previous miscarriage among pregnant Chinese women. the CAQ was an appropriate method to measure childbirth fear in pregnant Chinese women. The health-care professionals should be sensitive toward issues that could affect levels of childbirth fear in pregnant Chinese women, including age, education and previous miscarriage. Copyright © 2015 Elsevier Ltd. All rights reserved.

Plot and irony in childbirth narratives of middle-class Brazilian women.

PubMed

O'Dougherty, Maureen

2013-03-01

Brazil's rate of cesarean deliveries is among the highest in the world and constitutes the majority of childbirths in private hospitals. This study examines ways middle-class Brazilian women are exercising agency in this context. It draws from sociolinguistics to examine narrative structure and dramatic properties of 120 childbirth narratives of 68 low- to high-income women. Surgical delivery constituted 62% of the total. I focus on 20 young middle-class women, of whom 17 had C-sections. Doctors determined mode of childbirth pre-emptively or appeared to accommodate women's wishes, while framing the scenario as necessitating surgical delivery. The women strove to imbue C-section deliveries with value and meaning through staging, filming, familial presence, attempting induced labor, or humanized childbirth. Their stories indicate that class privilege does not lead to choice over childbirth mode. The women nonetheless struggle over the significance of their agency in childbirth. © 2013 by the American Anthropological Association.

Social Support, Trust in Health Information, and Health Information-Seeking Behaviors (HISBs): A Study Using the 2012 Annenberg National Health Communication Survey (ANHCS).

PubMed

Yang, Qinghua; Chen, Yixin; Wendorf Muhamad, Jessica

2017-09-01

We proposed a conceptual model to predict health information-seeking behaviors (HISBs) from three different sources (family, the Internet, doctors). To test the model, a structural equation modeling (SEM) analysis was conducted using data from the 2012 Annenberg National Health Communication Survey (ANHCS) (N = 3,285). Findings suggest higher social support from family predicts higher trust in health information from family members (abbreviated as trust in this article). Trust is positively related to HISBs from all three sources, with the path linking trust to HISB from family being the strongest. The effect of social support on HISB from family is partially mediated by trust, while effect of social support on HISBs from the Internet/doctors is fully mediated by trust. Implications of the study are discussed.

An analysis of National Health Service Trust websites on the occupational backgrounds of ‘Non-Executive Directors’ on England’s Acute Trusts

PubMed Central

Harding, Andrew JE

2014-01-01

Summary Objectives To explore the occupational backgrounds of English Non-Executive Directors (NED) on Acute National Health Service (NHS) Trusts. Design Data extrapolated from Trust websites of NED’ occupational backgrounds by gender and occupations, and inter-rater reliability test undertaken. Setting Data were available on all but 24 of the 166 Acute Trusts’ from all regions. Participants Trust Chairs and NED were categorised by their dominant occupation. Main outcome measure Differentiating NED with and without health or social care leadership experience. Results The ratings of NED’ occupations positively correlated (p < 0.001). Occupational categories were Commerce and Finance from private and public sectors or with Medical or Community leadership experience. Only 4% of Chairs were Medical, 2% from Community – the majority (61%) from Commerce and Finance. Of the 1001 NED, 8% and 6% respectively had Medical or Community leadership experience; most (86%) were Commerce, Finance and non-clinical Managerial backgrounds. Females made up 27% of NED. Conclusions With a predominance of Chairs and NED without health or social care leadership experience, are current Boards equipped to avoid inadvertently ‘doing the system's business’ (Francis, 2013) rather than developing a more patient-centred, clinically led and integrated NHS? It is suggested that Boards need more NED with health and social care leadership experience and methods to identify the ‘patient’s agenda’ to create ‘a common culture’ that places ‘patients at the centre of everything we do’ (Hunt, 2012). A key context for Trust Boards operations is funding, which Francis’ terms of reference excluded, an issue that is briefly discussed. PMID:25057396

Social trust, interpersonal trust and self-rated health in China: a multi-level study.

PubMed

Feng, Zhixin; Vlachantoni, Athina; Liu, Xiaoting; Jones, Kelvyn

2016-11-08

Trust is important for health at both the individual and societal level. Previous research using Western concepts of trust has shown that a high level of trust in society can positively affect individuals' health; however, it has been found that the concepts and culture of trust in China are different from those in Western countries and research on the relationship between trust and health in China is scarce. The analyses use data from the national scale China General Social Survey (CGSS) on adults aged above 18 in 2005 and 2010. Two concepts of trust ("out-group" and "in-group" trust) are used to examine the relationship between trust and self-rated health in China. Multilevel logistical models are applied, examining the trust at the individual and societal level on individuals' self-rated health. In terms of interpersonal trust, both "out-group" and "in-group" trust are positively associated with good health in 2005 and 2010. At the societal level, the relationships between the two concepts of trust and health are different. In 2005, higher "out-group" social trust (derived from trust in strangers) is positively associated with better health; however, higher "in-group" social trust (derived from trust in most people) is negatively associated with good health in 2010. The cross-level interactions show that lower educated individuals (no education or only primary level), rural residents and those on lower incomes are the most affected groups in societies with higher "out-group" social trust; whereas people with lower levels of educational attainment, a lower income, and those who think that most people can be trusted are the most affected groups in societies with higher "in-group" social trust. High levels of interpersonal trust are of benefit to health. Higher "out-group" social trust is positively associated with better health; while higher "in-group" social trust is negatively associated with good health. Individuals with different levels of educational

Variations in childbirth interventions in high-income countries: protocol for a multinational cross-sectional study

PubMed Central

van den Akker, Thomas; Beeckman, Katrien; Bogaerts, Annick; Barros, Monalisa; Janssen, Patricia; Binfa, Lorena; Rydahl, Eva; Frith, Lucy; Gross, Mechthild; Hálfdánsdóttir, Berglind; Daly, Deirdre; Calleja-Agius, Jean; Gillen, Patricia; Vika Nilsen, Anne Britt; Declercq, Eugene

2018-01-01

Introduction There are growing concerns about the increase in rates of commonly used childbirth interventions. When indicated, childbirth interventions are crucial for preventing maternal and perinatal morbidity and mortality, but their routine use in healthy women and children leads to avoidable maternal and neonatal harm. Establishing ideal rates of interventions can be challenging. This study aims to describe the range of variations in the use of commonly used childbirth interventions in high-income countries around the world, and in outcomes in nulliparous and multiparous women. Methods and analysis This multinational cross-sectional study will use data from births in 2013 with national population data or representative samples of the population of pregnant women in high-income countries. Data from women who gave birth to a single child from 37 weeks gestation onwards will be included and the results will be presented for nulliparous and multiparous women separately. Anonymised individual level data will be analysed. Primary outcomes are rates of commonly used childbirth interventions, including induction and/or augmentation of labour, intrapartum antibiotics, epidural and pharmacological pain relief, episiotomy in vaginal births, instrument-assisted birth (vacuum or forceps), caesarean section and use of oxytocin postpartum. Secondary outcomes are maternal and perinatal mortality, Apgar score below 7 at 5 min, postpartum haemorrhage and obstetric anal sphincter injury. Univariable and multivariable logistic regression analyses will be conducted to investigate variations among countries, adjusted for maternal age, body mass index, gestational weight gain, ethnic background, socioeconomic status and infant birth weight. The overall mean rates will be considered as a reference category, weighted for the size of the study population per country. Ethics and dissemination The Medical Ethics Review Committee of VU University Medical Center Amsterdam confirmed that

Childbirth Fear: Relation to Birth and Care Provider Preferences.

PubMed

Stoll, Kathrin; Fairbrother, Nichole; Thordarson, Dana S

2018-01-01

The purpose of this study was to assess how preferences for place of birth and mode of birth relate to different dimensions of childbirth fear and whether there is an association between Canadian women's prenatal fear of childbirth and the type and quality of prenatal care they received. A link to an online survey was posted on Canadian pregnancy and birth websites; 409 women completed the survey that included sociodemographic questions, questions about the current pregnancy and previous pregnancy experiences (if applicable), and the Childbirth Fear Questionnaire, a validated 40-item scale that measures 9 dimensions of childbirth fear. Women under physician care and those with a preference for cesarean birth were generally more fearful of pain associated with vaginal birth, fear of loss of sexual pleasure and attractiveness, and fear of harm to themselves or their infant. Conversely, women under the care of midwives and women who preferred to give birth vaginally were more fearful of interventions. Women who preferred a cesarean birth were significantly more likely to report that fear of childbirth interfered with daily functioning, compared to women who preferred a vaginal birth. Satisfaction with care was associated with lower scores on the Childbirth Fear Questionnaire full and subscales, especially among midwifery clients. At present there are no guidelines in Canada or the United States for the treatment and/or referral of pregnant women who suffer from childbirth fear. Until such guidelines are developed, findings from the current study can help maternity care providers identify and address specific fears among women in their care and understand how different fear domains relate to care provider choice, satisfaction with care, and women's preferences for place and mode of birth. © 2018 by the American College of Nurse-Midwives.

Pain relief in childbirth: changing historical and feminist perspectives.

PubMed

Skowronski, G A

2015-07-01

Pain during human childbirth is ubiquitous and severe. Opium and its derivatives constitute the oldest effective method of pain relief and have been used in childbirth for several thousand years, along with numerous folk medicines and remedies. Interference with childbirth pain has always been criticised by doctors and clergy. The 19th century saw the introduction of three much more effective approaches to childbirth pain; diethyl ether, chloroform and nitrous oxide. Access to pain relief was demanded by the first wave of feminist activists as a woman's right. They popularised the use of 'twilight sleep', a combination of morphine and scopolamine, which fell into disrepute as its adverse effects became known. From the 1960s, as epidural analgesia became more popular, a second wave of feminists took the opposite position, calling for a return to non-medicalised, female-controlled, 'natural' childbirth and, in some cases, valorising the importance of the pain experience as empowering for women. However, from the 1990s, a third wave of feminist thought has begun to emerge, revalidating a woman's right to choose a 'technological', pain-free birth, rather than a 'natural' one, and regarding this as a legitimate feminist position.

Ethics and childbirth educators: do your values cause you ethical distress?

PubMed

Ondeck, Michele

2009-01-01

The Code of Ethics for Lamaze Certified Childbirth Educators outlines the ethical principles and standards that are derived from childbirth education's core values to assure quality and ethical practice. This article presents a summary of the history of ethics and medical ethics that informs a value-oriented decision-making process in childbirth education. The role of evidence in ethics is explored from the childbirth educator's viewpoint, and scenarios are used to reflect on situations that are examples of ethical distress. The conclusion is that the practice of ethics and ethical decision making includes regular reflection.

Using video in childbirth research.

PubMed

Harte, J Davis; Homer, Caroline Se; Sheehan, Athena; Leap, Nicky; Foureur, Maralyn

2017-03-01

Conducting video-research in birth settings raises challenges for ethics review boards to view birthing women and research-midwives as capable, autonomous decision-makers. This study aimed to gain an understanding of how the ethical approval process was experienced and to chronicle the perceived risks and benefits. The Birth Unit Design project was a 2012 Australian ethnographic study that used video recording to investigate the physical design features in the hospital birthing space that might influence both verbal and non-verbal communication and the experiences of childbearing women, midwives and supporters. Participants and research context: Six women, 11 midwives and 11 childbirth supporters were filmed during the women's labours in hospital birth units and interviewed 6 weeks later. Ethical considerations: The study was approved by an Australian Health Research Ethics Committee after a protracted process of negotiation. The ethics committee was influenced by a traditional view of research as based on scientific experiments resulting in a poor understanding of video-ethnographic research, a paradigmatic view of the politics and practicalities of modern childbirth processes, a desire to protect institutions from litigation, and what we perceived as a paternalistic approach towards protecting participants, one that was at odds with our aim to facilitate situations in which women could make flexible, autonomous decisions about how they might engage with the research process. The perceived need for protection was overly burdensome and against the wishes of the participants themselves; ultimately, this limited the capacity of the study to improve care for women and babies. Recommendations are offered for those involved in ethical approval processes for qualitative research in childbirth settings. The complexity of issues within childbirth settings, as in most modern healthcare settings, should be analysed using a variety of research approaches, beyond efficacy

Mental health after first childbirth in women requesting a caesarean section; a retrospective register-based study.

PubMed

Möller, Louise; Josefsson, Ann; Bladh, Marie; Lilliecreutz, Caroline; Andolf, Ellika; Sydsjö, G

2017-09-29

Psychiatric illness before delivery increases the risk of giving birth by caesarean section on maternal request (CSMR) but little is known about these women's mental health after childbirth. In this study we aimed to compare the prevalence of psychiatric disorders five years before and after delivery in primiparae giving birth by CS on maternal request to all other primiparae giving birth, indifferent on their mode of delivery. The study population comprised all women born in Sweden 1973-1983 giving birth for the first time in 2002-2004. Psychiatric diagnoses, in- and outpatient care were retrieved from the National Patient Register in Sweden. The risk of psychiatric care after childbirth was estimated using CSMR, previous mental health and sociodemographic variables as covariates. Psychiatric disorders after childbirth were more common in women giving birth by CSMR compared to the other women (11.2% vs 5.5%, p < 0.001). CSMR increased the risk of psychiatric disorders after childbirth (aOR 1.5, 95% CI 1.2-1.9). The prevalence of psychiatric disorders had increased after compared to before childbirth (mean difference 0.02 ± 0.25, 95% CI 0.018-0.022, p < 0.001). Women giving birth by CSMR tended to be diagnosed in the inpatient care more often (54.9% vs. 45.8%, p = 0.056) and were more likely to have been diagnosed before childbirth as well (39.8% vs. 24.2%, p < 0.001). Women giving birth by CSMR more often suffer from psychiatric disorders both before and after delivery. This indicates that these women are a vulnerable group requiring special attention from obstetric- and general health-care providers. This vulnerability should be taken into account when deciding on mode of delivery.

Trust and Fertility Dynamics

PubMed Central

Billari, Francesco C.; Pessin, Léa

2016-01-01

We argue that the divergence in fertility trends in advanced societies is influenced by the interaction of long-standing differences in generalized trust with the increase in women’s educational attainment. Our argument builds on the idea that trust enhances individuals’ and couples’ willingness to outsource childcare to outside their extended family. This becomes critically important as women’s increased education enhances the demand for combining work and family life. We test our hypothesis using data from the World Values Survey and European Values Study on 36 industrialized countries between the years 1981 and 2009. Multilevel statistical analyses reveal that the interaction between national-level generalized trust and cohort-level women’s education is positively associated with completed fertility. As education among women expands, high levels of generalized trust moderate fertility decline. PMID:28003707

Can Any Childbirth Educator Use the Lamaze Trademark?

PubMed Central

Philipsen, Nayna Campbell

2001-01-01

A Lamaze Certified Childbirth Educator asks about the use of the name Lamaze, which is a licensed (trademark) name. A trademark is a mark of authenticity. It protects both the users and the consumers. Penalty for unauthorized use (e.g., by a childbirth educator who is not an LCCE) can be substantial. PMID:17273241

Skills-based childbirth preparation reduces stress for midwives.

PubMed

Howarth, Anne M; Scott, Kate M; Swain, Nicola R

2017-07-01

to explore the potential benefits of skills-based childbirth preparation on the work related stress levels of midwives. a questionnaire was sent out to midwives who had clients participating in an RCT of an education package for childbirth preparation (The Pink Kit (PK) Method for Birthing Better®) delivered to parents. midwives were in private practice and acted as lead maternity carers to New Zealand first time mothers. one hundred and four independent midwives participated. a brief questionnaire using a Visual Analogue Scale to portray perceptions of work-related stress and a yes/no question about expected and/or unexpected physical complications. midwives working with clients in the intervention group experienced less work-related stress after correction for medical complications compared to the two control groups. working with mothers who have used a programme that increased their childbirth self-efficacy decreased the work-related stress experienced by midwives. encouraging pregnant women to develop childbirth skills merits further investigation in an effort to reduce the work-related stress experienced by midwives. Copyright © 2017 Elsevier Ltd. All rights reserved.

Childbirth Education: A Consumer's Viewpoint

PubMed Central

Mackie, J. William; Mackie, Susan J.; Livingstone, Verity

1986-01-01

This article describes a series of classes for expectant parents and siblings and outlines how differences of opinion by health-care providers in the perinatal period can adversely affect a mother's undertsanding of, and satisfaction with, the birth process. It comments on concepts that family physicians should consider before suggesting prenatal classes to their patients. Family physicians must know what is being taught in prenatal classes, either directly through dialogue with the instructors or indirectly through conversation with their patients. There should be open dialogue between family physicians, expectant couples and childbirth educators in order to ensure supportive co-operation among all parties. Such co-operation will lead to maximum satisfaction with the experience of childbirth. PMID:21267322

Ethics and Childbirth Educators: Do Your Values Cause You Ethical Distress?

PubMed Central

Ondeck, Michele

2009-01-01

The Code of Ethics for Lamaze Certified Childbirth Educators outlines the ethical principles and standards that are derived from childbirth education's core values to assure quality and ethical practice. This article presents a summary of the history of ethics and medical ethics that informs a value-oriented decision-making process in childbirth education. The role of evidence in ethics is explored from the childbirth educator's viewpoint, and scenarios are used to reflect on situations that are examples of ethical distress. The conclusion is that the practice of ethics and ethical decision making includes regular reflection. PMID:19436591

Pregnancy and childbirth: is the doctor necessary?

PubMed

Llewellyn-Jones, D

1979-05-01

The changing fashions in childbirth over the past 200 years are related to the present demand by women and their partners for "participatory" childbirth, including homebirth. The argument is advanced that doctors must be responsive to these changes. The opinion is made that home birth is currently inappropriate, but that hospitals should provide "birth centres"; and that obstetrics should be conducted by a "team", in which nurse-midwives and family doctors play as important a role as specialist obstetricians.

Development of a questionnaire for assessing the childbirth experience (QACE).

PubMed

Carquillat, Pierre; Vendittelli, Françoise; Perneger, Thomas; Guittier, Marie-Julia

2017-08-30

Due to its potential impact on women's psychological health, assessing perceptions of their childbirth experience is important. The aim of this study was to develop a multidimensional self-reporting questionnaire to evaluate the childbirth experience. Factors influencing the childbirth experience were identified from a literature review and the results of a previous qualitative study. A total of 25 items were combined from existing instruments or were created de novo. A draft version was pilot tested for face validity with 30 women and submitted for evaluation of its construct validity to 477 primiparous women at one-month post-partum. The recruitment took place in two obstetric clinics from Swiss and French university hospitals. To evaluate the content validity, we compared item responses to general childbirth experience assessments on a numeric, 0 to 10 rating scale. We dichotomized two group assessment scores: "0 to 7" and "8 to 10". We performed an exploratory factor analysis to identify underlying dimensions. In total, 291 women completed the questionnaire (response rate = 61%). The responses to 22 items were statistically significant between the 0 to 7 and 8 to 10 groups for the general childbirth experience assessments. An exploratory factor analysis yielded four sub-scales, which were labelled "relationship with staff" (4 items), "emotional status" (3 items), "first moments with the new born," (3 items) and "feelings at one month postpartum" (3 items). All 4 scales had satisfactory internal consistency levels (alpha coefficients from 0.70 to 0.85). The full 25-item version can be used to analyse each item by itself, and the short 4-dimension version can be scored to summarize the general assessment of the childbirth experience. The Questionnaire for Assessing the Childbirth Experience (QACE) could be useful as a screening instrument to identify women with negative childbirth experiences. It can be used as both a research instrument in its short version

The Lived Experience of Knowing in Childbirth

PubMed Central

Savage, Jane Staton

2006-01-01

Research on knowing in childbirth has largely been a quantitative process. The purpose of this study was to understand the ways first-time mothers learn about birth. A phenomenological approach, using a feminist view, was used to analyze two in-depth interviews and journals to understand nine first-time expectant mothers' experiences of knowing in childbirth. The findings demonstrated a range of knowledge that contributed to issues of control and conflict. The participants also described an increased dependency on their mothers and a lack of their own intuition contiguous to the birth process. These findings contribute understanding to how expectant mothers know birth, suggesting that their knowing does not diminish conflict surrounding the event and may even exacerbate it when not combined with learning skills to manage conflict. Childbirth educators may want to include instruction on negotiating power differential in relationships encountered during childbirth in order to strengthen a first-time mother's ability to receive the care she wants. Educators may also want to assess the expectant mother's view of birth and her expectations for birth. Schools of nursing should consider the inclusion of women-centered care curricula at both the undergraduate and graduate levels. The mothers' responses in this study clearly reveal that the politics surrounding birthing remain in place and must be removed in order to provide a supportive environment for normal birth. PMID:17541456

Hypnosis antenatal training for childbirth: a randomised controlled trial.

PubMed

Cyna, A M; Crowther, C A; Robinson, J S; Andrew, M I; Antoniou, G; Baghurst, P

2013-09-01

To determine the use of pharmacologic analgesia during childbirth when antenatal hypnosis is added to standard care. Randomised controlled clinical trial, conducted from December 2005 to December 2010. The largest tertiary referral centre for maternity care in South Australia. A cohort of 448 women at >34 weeks of gestation, with a singleton pregnancy and cephalic presentation, planning a vaginal birth. Exclusions were: the need for an interpreter; pre-existing pain; psychiatric illness; younger than 18 years; and previous experience of hypnosis for childbirth. All participants received usual care. The group of women termed Hypnosis + CD (hypnotherapist guided) were offered three antenatal live hypnosis sessions plus each session's corresponding audio CD for further practise, as well as a final fourth CD to listen to during labour. The group of women termed CD only (nurse administered) were played the same antenatal hypnosis CDs as group 1, but did not receive live hypnosis training. The control group participants were given no additional intervention or CDs. Use of pharmacological analgesia during labour and childbirth. No difference in the use of pharmacological analgesia during labour and childbirth was found comparing hypnosis + CD with control (81.2 versus 76.2%; relative risk, RR 1.07; 95% confidence interval, 95% CI 0.95-1.20), or comparing CD only with control (76.9 versus 76.2%, RR 1.01, 95% CI 0.89-1.15). Antenatal group hypnosis using the Hypnosis Antenatal Training for Childbirth (HATCh) intervention in late pregnancy does not reduce the use of pharmacological analgesia during labour and childbirth. © 2013 RCOG.

Paternal engagement during childbirth depending on the manner of their preparation.

PubMed

Sioma-Markowska, Urszula; Poręba, Ryszard; Machura, Mariola; Skrzypulec-Plinta, Violetta

2016-01-01

The analysis of the forms of paternal activity depending on the manner of their preparation, including stages of labor. A prospective survey-based study involved 250 fathers who participated in their child's birth. The fathers included in the study were present during all stages of family-assisted natural labor. The study was conducted one day after childbirth with the use of a survey prepared by the authors. Statistical calculations were conducted using the Statistica PL software. The frequency of individual qualitative features (non-measurable) was assessed by means of a non-parametric χ² (chi-squared) test. The statistical significance level was p < 0.05. A half of the fathers included in the study (52.4%) participated in childbirth with no prior preparation. The dominant form of preparation involved self-education from books, magazines and the Internet (24%). 23.6% of fathers participated in ante-natal classes. The study demonstrated that fathers prepared for childbirth in ante-natal classes more often engaged in the supportive role, provided nursing care and carried out instrumental monitoring during each stage of childbirth. The fathers prepared for childbirth in ante-natal classes more often engage in the supportive role, provide nursing care and carry out instrumental control during each stage of childbirth. Ante-natal classes should be promoted as an optimal form of preparation for active participation in childbirth. Moreover, other forms of paternal ante-natal education as well as continued education in a delivery room should be developed.

Weather and childbirth: A further search for relationships

NASA Astrophysics Data System (ADS)

Driscoll, Dennis M.

1995-09-01

Previous attempts to find relationships between weather and parturition (childbirth) and its onset (the beginning of labor pains) have revealed, firstly, limited but statistically significant relationships between weather conditions much colder than the day before, with high winds and low pressure, and increased onsets; and secondly, increased numbers of childbirths during periods of atmospheric pressure rise (highly statistically significant). To test these findings, this study examined weather data coincident childbirth data from a hospital at Bryan-College Station, Texas (for a period of 30 cool months from 1987 to 1992). Tests for (1) days of cold fronts, (2) a day before and a day after the cold front, (3) days with large temperature increases, and (4) decreases from the day before revealed no relationship with mean daily rate of onset. Cold days with high winds and low pressure had significantly fewer onsets, a result that is the opposite of previous findings. The postulated relationship between periods of pressure rise and increased birth frequency was negative, i.e., significantly fewer births occurred at those times — again, the opposite of the apparent occurrence in an earlier study. The coincidence of diurnal variations in both atmospheric pressure and frequency of childbirths, was shown to account for fairly strong negative associations between the two variables. This same reasoning might explain the positive association found in an earlier study. A comparison has been made between childbirth and onset as the response variable, and the advantage is emphasized of using data from women whose labor is not induced.

Post-Traumatic Stress Disorder (PTSD) Following Childbirth: Prevalence and Contributing Factors.

PubMed

Shaban, Zainab; Dolatian, Mahrokh; Shams, Jamal; Alavi-Majd, Hamid; Mahmoodi, Zohreh; Sajjadi, Homeira

2013-03-01

Childbirth might be a traumatic event for some women. This study was conducted with the objective of investigating the prevalence of Post-Traumatic Stress Disorder (PTSD) following childbirth. The study was designed using a descriptive correlation scheme. The participants were selected from the women referred to the healthcare centers affiliated with Zahedan University of Medical Sciences, Zahedan, Iran. Personal interviews were conducted with 600 women who were 6-8 weeks postpartum and had been undergone to this center for postpartum and child care. One hundred and three (17. 2%) women had symptoms of PTSD following childbirth based on the PTSD Symptom Scale (PSS). The results of logistic regression analysis revealed a significant correlation between maternal occupation (P = 0.01), depression level (P < 0.001) and anxiety level (P < 0.001) with PTSD following childbirth. PTSD from childbirth occurs in some women. Early identification of risk factors should lead to early therapeutic intervention in the mothers at risk of PTSD.

Attitudes and beliefs about childbirth among college students: results of an educational intervention.

PubMed

Cleeton, E R

2001-09-01

Research on knowledge of childbirth has focused primarily on expectant mothers. The purpose of this study was to investigate college student beliefs, knowledge of, and interest in learning more about childbirth. Qualitative research methods were used to analyze college students' written responses to a childbirth video as the first stage in a research project aimed at understanding nulliparous and prepaternity knowledge of childbirth among adolescents and young adults. Participants were 65 students at a liberal arts college in upstate New York. The findings demonstrated a range of levels of awareness, interest, and knowledge. In their responses, students described childbirth as a miraculous event associated with fear of pain; students primarily knew that childbirth takes place in the hospital, where "safe and effective" pain medication is administered; students liked seeing the experiential aspect of birth; and students wanted to know about the risks and benefits of various hospital procedures, and the "spiritual" emotional aspects of giving birth. The findings contribute insights into how college students think about pain in childbirth, suggesting that their fear is associated with a lack of knowledge. Teaching high school students specifics about pregnancy and childbirth practices and procedures holds promise for reducing anxiety, increasing maternal control, and supporting positive birth experiences.

The Risks of Childbirth:

PubMed Central

De Renzi, Silvia

2010-01-01

Summary In seventeenth-century Rome a popular financial scheme made it crucial to establish if pregnancy or childbirth had caused a woman's death. Courts sought medical advice, and this prompted physicians to reconsider the issues. Their disagreements provide historians with evidence from which to reassess received views of early modern doctors' involvement with birthing bodies. Among others, Paolo Zacchia intervened, revealing discord between physicians and jurists on how to establish the causes of death. One of his testimonies in a case shows more broadly how legal, medical, and lay views on pregnancy and childbirth intersected in courts of law. In Roman tribunals the very distinction between healthy and preternatural births was contentious, and the parties had an interest in having births either proved healthy in medical terms or construed as pathological. The controversies, the author argues, challenge historical expectations about early modern perceptions, including the boundaries between female and male, private and public, healthy and pathological. PMID:21196603

14 CFR 1260.137 - Property trust relationship.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Property trust relationship. 1260.137 Section 1260.137 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION GRANTS AND... Property trust relationship. Real property, equipment, intangible property and debt instruments that are...

Study protocol for reducing childbirth fear: a midwife-led psycho-education intervention.

PubMed

Fenwick, Jennifer; Gamble, Jenny; Creedy, Debra K; Buist, Anne; Turkstra, Erika; Sneddon, Anne; Scuffham, Paul A; Ryding, Elsa L; Jarrett, Vivian; Toohill, Jocelyn

2013-10-20

Childbirth fear has received considerable attention in Scandinavian countries, and the United Kingdom, but not in Australia. For first-time mothers, fear is often linked to a perceived lack of control and disbelief in the body's ability to give birth safely, whereas multiparous women may be fearful as a result of previous negative and/or traumatic birth experiences. There have been few well-designed intervention studies that test interventions to address women's childbirth fear, support normal birth, and diminish the possibility of a negative birth experience. Pregnant women in their second trimester of pregnancy will be recruited and screened from antenatal clinics in Queensland, Australia. Women reporting high childbirth fear will be randomly allocated to the intervention or control group. The psycho-educational intervention is offered by midwives over the telephone at 24 and 34 weeks of pregnancy. The intervention aims to review birth expectations, work through distressing elements of childbirth, discuss strategies to develop support networks, affirm that negative childbirth events can be managed and develop a birth plan. Women in the control group will receive standard care offered by the public funded maternity services in Australia. All women will receive an information booklet on childbirth choices. Data will be collected at recruitment during the second trimester, 36 weeks of pregnancy, and 4-6 weeks after birth. This study aims to test the efficacy of a brief, midwife-led psycho-education counselling (known as BELIEF: Birth Emotions - Looking to Improve Expectant Fear) to reduce women's childbirth fear. 1) Relative to controls, women receiving BELIEF will report lower levels of childbirth fear at term; 2) less decisional conflict; 3) less depressive symptoms; 4) better childbirth self-efficacy; and 5) improved health and obstetric outcomes. Australian New Zealand Controlled Trials Registry ACTRN12612000526875.

Study protocol for reducing childbirth fear: a midwife-led psycho-education intervention

PubMed Central

2013-01-01

Background Childbirth fear has received considerable attention in Scandinavian countries, and the United Kingdom, but not in Australia. For first-time mothers, fear is often linked to a perceived lack of control and disbelief in the body’s ability to give birth safely, whereas multiparous women may be fearful as a result of previous negative and/or traumatic birth experiences. There have been few well-designed intervention studies that test interventions to address women’s childbirth fear, support normal birth, and diminish the possibility of a negative birth experience. Methods/design Pregnant women in their second trimester of pregnancy will be recruited and screened from antenatal clinics in Queensland, Australia. Women reporting high childbirth fear will be randomly allocated to the intervention or control group. The psycho-educational intervention is offered by midwives over the telephone at 24 and 34 weeks of pregnancy. The intervention aims to review birth expectations, work through distressing elements of childbirth, discuss strategies to develop support networks, affirm that negative childbirth events can be managed and develop a birth plan. Women in the control group will receive standard care offered by the public funded maternity services in Australia. All women will receive an information booklet on childbirth choices. Data will be collected at recruitment during the second trimester, 36 weeks of pregnancy, and 4–6 weeks after birth. Discussion This study aims to test the efficacy of a brief, midwife-led psycho-education counselling (known as BELIEF: Birth Emotions - Looking to Improve Expectant Fear) to reduce women’s childbirth fear. 1) Relative to controls, women receiving BELIEF will report lower levels of childbirth fear at term; 2) less decisional conflict; 3) less depressive symptoms; 4) better childbirth self-efficacy; and 5) improved health and obstetric outcomes. Trial registration Australian New Zealand Controlled Trials Registry

Environmental Hazards Education for Childbirth Educators

PubMed Central

Ondeck, Michele; Focareta, Judith

2009-01-01

The purpose of this article is to educate childbirth educators about environmental hazards and provide resources. Hazardous chemicals have been found in cord blood, placenta, meconium, and breastmilk samples. These chemicals include commonly known hazards such as lead, mercury, and environmental tobacco smoke, as well as some pesticides, solvents, products containing chlorine, and other chemicals referred to as “persistent organic pollutants.” The fetus is particularly vulnerable to environmental chemicals that can disrupt the developmental process at critical times during gestation. Childbirth educators are encouraged to inform themselves in order to inform childbearing families to take preventive action and explore alternative behaviors to reduce exposure to environmental hazards. PMID:20808430

Preparedness of pregnant women for childbirth and the postpartum period: their knowledge and fear.

PubMed

Tugut, N; Tirkes, D; Demirel, G

2015-05-01

The aim of the study was to identify knowledge and fear related to childbirth and the postpartum period in pregnant women. The sample consisted of 114 pregnant women. It was determined that pregnant women had insufficient levels of knowledge related to childbirth and the postpartum period. The Fear of Childbirth and Postpartum Anxiety Scale score for childbirth and the postpartum period related to 'fear regarding the action of childbirth', was found to be the highest. The highest causes for concern were determined to be 'infant-related anxiety' and 'fear regarding infant and puerperal health'. No statistically significant correlation was observed between the perceived sufficiency of the knowledge of pregnant women in terms of maintaining their own health and care, and their mean childbirth and postpartum period concern score. These findings indicate that the level of concern among pregnant women with relation to the postpartum period and childbirth is rather high.

Effects of Pregnancy, Childbirth, and Motherhood on High School Dropout. Discussion Paper No. 1027-93.

ERIC Educational Resources Information Center

Anderson, Douglas K.

This paper uses data from the National Longitudinal Survey of Youth to explore the effect of fertility on high school dropout, and differences in that effect by age at first birth. Fertility is conceptualized as a series of states: pregnancy, childbirth, postpartum, and motherhood. Pregnant students and mothers are much more likely to drop out…

Subsequent childbirth after a previous traumatic birth.

PubMed

Beck, Cheryl Tatano; Watson, Sue

2010-01-01

Nine percent of new mothers in the United States who participated in the Listening to Mothers II Postpartum Survey screened positive for meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for posttraumatic stress disorder after childbirth. Women who have had a traumatic birth experience report fewer subsequent children and a longer length of time before their second baby. Childbirth-related posttraumatic stress disorder impacts couples' physical relationship, communication, conflict, emotions, and bonding with their children. The purpose of this study was to describe the meaning of women's experiences of a subsequent childbirth after a previous traumatic birth. Phenomenology was the research design used. An international sample of 35 women participated in this Internet study. Women were asked, "Please describe in as much detail as you can remember your subsequent pregnancy, labor, and delivery following your previous traumatic birth." Colaizzi's phenomenological data analysis approach was used to analyze the stories of the 35 women. Data analysis yielded four themes: (a) riding the turbulent wave of panic during pregnancy; (b) strategizing: attempts to reclaim their body and complete the journey to motherhood; (c) bringing reverence to the birthing process and empowering women; and (d) still elusive: the longed-for healing birth experience. Subsequent childbirth after a previous birth trauma has the potential to either heal or retraumatize women. During pregnancy, women need permission and encouragement to grieve their prior traumatic births to help remove the burden of their invisible pain.

36 CFR 1210.37 - Property trust relationship.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 3 2011-07-01 2011-07-01 false Property trust relationship. 1210.37 Section 1210.37 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS... Standards § 1210.37 Property trust relationship. Real property, equipment, intangible property and debt...

45 CFR 2543.37 - Property trust relationship.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 4 2011-10-01 2011-10-01 false Property trust relationship. 2543.37 Section 2543.37 Public Welfare Regulations Relating to Public Welfare (Continued) CORPORATION FOR NATIONAL AND...-PROFIT ORGANIZATIONS Post-Award Requirements Property Standards § 2543.37 Property trust relationship...

Variations in childbirth interventions in high-income countries: protocol for a multinational cross-sectional study.

PubMed

Seijmonsbergen-Schermers, Anna; van den Akker, Thomas; Beeckman, Katrien; Bogaerts, Annick; Barros, Monalisa; Janssen, Patricia; Binfa, Lorena; Rydahl, Eva; Frith, Lucy; Gross, Mechthild M; Hálfdánsdóttir, Berglind; Daly, Deirdre; Calleja-Agius, Jean; Gillen, Patricia; Vika Nilsen, Anne Britt; Declercq, Eugene; de Jonge, Ank

2018-01-10

There are growing concerns about the increase in rates of commonly used childbirth interventions. When indicated, childbirth interventions are crucial for preventing maternal and perinatal morbidity and mortality, but their routine use in healthy women and children leads to avoidable maternal and neonatal harm. Establishing ideal rates of interventions can be challenging. This study aims to describe the range of variations in the use of commonly used childbirth interventions in high-income countries around the world, and in outcomes in nulliparous and multiparous women. This multinational cross-sectional study will use data from births in 2013 with national population data or representative samples of the population of pregnant women in high-income countries. Data from women who gave birth to a single child from 37 weeks gestation onwards will be included and the results will be presented for nulliparous and multiparous women separately. Anonymised individual level data will be analysed. Primary outcomes are rates of commonly used childbirth interventions, including induction and/or augmentation of labour, intrapartum antibiotics, epidural and pharmacological pain relief, episiotomy in vaginal births, instrument-assisted birth (vacuum or forceps), caesarean section and use of oxytocin postpartum. Secondary outcomes are maternal and perinatal mortality, Apgar score below 7 at 5 min, postpartum haemorrhage and obstetric anal sphincter injury. Univariable and multivariable logistic regression analyses will be conducted to investigate variations among countries, adjusted for maternal age, body mass index, gestational weight gain, ethnic background, socioeconomic status and infant birth weight. The overall mean rates will be considered as a reference category, weighted for the size of the study population per country. The Medical Ethics Review Committee of VU University Medical Center Amsterdam confirmed that an official approval of this study was not required

Open, trusting relationships underpin safety in rural maternity a hermeneutic phenomenology study.

PubMed

Crowther, Susan; Smythe, Elizabeth

2016-11-24

There are interwoven personal, professional and organisational relationships to be navigated in maternity in all regions. In rural regions relationships are integral to safe maternity care. Yet there is a paucity of research on how relationships influence safety and nurture satisfying experiences for rural maternity care providers and mothers and families in these regions. This paper draws attention to how these relationships matter. This research is informed by hermeneutic phenomenology drawing on Heidegger and Gadamer. Thirteen participants were recruited via purposeful sampling and asked to share their experiences of rural maternity care in recorded unstructured in-depth interviews. Participants were women and health care providers living and working in rural regions. Recordings were transcribed and data interpretively analysed until a plausible and trustworthy thematic pattern emerged. Throughout the data the relational nature of rural living surfaced as an interweaving tapestry of connectivity. Relationships in rural maternity are revealed in myriad ways: for some optimal relationships, for others feeling isolated, living with discord and professional disharmony. Professional misunderstandings undermine relationships. Rural maternity can become unsustainable and unsettling when relationships break down leading to unsafeness. This study reveals how relationships are an important and vital aspect to the lived-experience of rural maternity care. Relationships are founded on mutual understanding and attuned to trust matter. These relationships are forged over time and keep childbirth safe and enable maternity care providers to work sustainably. Yet hidden unspoken pre-understandings of individuals and groups build tension in relationships leading to discord. Trust builds healthy rural communities of practice within which everyone can flourish, feel accepted, supported and safe. This is facilitated by collaborative learning activities and open respectful

Socioeconomic and Marital Outcomes of Adolescent Marriage, Adolescent Childbirth, and Their Co-Occurrence.

ERIC Educational Resources Information Center

Teti, Douglas M.; Lamb, Michael E.

1989-01-01

Examined adolescent marriage, adolescent childbirth, and their co-occurrence in adult women. Poorest socioeconomic outcomes were associated with adolescent childbirth regardless of presence or timing of first marriage. Marital instability was associated with both adolescent marriage and adolescent childbirth. Findings suggest that risk associated…

Effects of natural childbirth preparation versus standard antenatal education on epidural rates, experience of childbirth and parental stress in mothers and fathers: a randomised controlled multicentre trial.

PubMed

Bergström, M; Kieler, H; Waldenström, U

2009-08-01

To examine the effects of antenatal education focussing on natural childbirth preparation with psychoprophylactic training versus standard antenatal education on the use of epidural analgesia, experience of childbirth and parental stress in first-time mothers and fathers. Randomised controlled multicentre trial. Fifteen antenatal clinics in Sweden between January 2006 and May 2007. A total of 1087 nulliparous women and 1064 of their partners. Natural group: Antenatal education focussing on natural childbirth preparation with training in breathing and relaxation techniques (psychoprophylaxis). Standard care group: Standard antenatal education focussing on both childbirth and parenthood, without psychoprophylactic training. Both groups: Four 2-hour sessions in groups of 12 participants during third trimester of pregnancy and one follow-up after delivery. Epidural analgesia during labour, experience of childbirth as measured by the Wijma Delivery Experience Questionnaire (B), and parental stress measured by the Swedish Parenthood Stress Questionnaire. The epidural rate was 52% in both groups. There were no statistically significant differences in the experience of childbirth or parental stress between the randomised groups, either in women or men. Seventy percent of the women in the Natural group reported having used psychoprophylaxis during labour. A minority in the Standard care group (37%) had also used this method, but subgroup analysis where these women were excluded did not change the principal findings. Natural childbirth preparation including training in breathing and relaxation did not decrease the use of epidural analgesia during labour, nor did it improve the birth experience or affect parental stress in early parenthood in nulliparous women and men, compared with a standard form of antenatal education.

Prevalence and associated factors of fear of childbirth in six European countries.

PubMed

Lukasse, Mirjam; Schei, Berit; Ryding, Elsa Lena

2014-10-01

This study set out to compare the prevalence, content and associated factors of fear of childbirth in six European countries. A cross-sectional study of 6870 pregnant women attending routine antenatal care in Belgium, Iceland, Denmark, Estonia, Norway and Sweden (Bidens). Severe fear of childbirth, defined as a Wijma Delivery Expectancy Questionnaire score of ≥85. Eleven percent of all women reported severe fear of childbirth, 11.4% among primiparous and 11.0% among multiparous women. There were significant differences between the countries for prevalence of severe fear of childbirth, varying from 4.5% in Belgium to 15.6% in Estonia for primiparous women and from 7.6% in Iceland to 15.2% in Sweden for multiparous women. After adjusting for age, education and gestational age, only primiparous women from Belgium had significantly less fear of childbirth, AOR 0.35 (0.19-0.52) compared to Norway (largest participating group). Exploratory factor analyses revealed significant differences between the countries for the six factors extracted. FOC appears to be an international phenomenon, existing with similar proportions in the participating European countries, except for primiparous women in Belgium who in our study reported significantly less severe fear of childbirth. Our study suggests that the content of fear of childbirth may differ between countries. Copyright © 2014 Elsevier B.V. All rights reserved.

Effects of continuous midwifery labour support for women with severe fear of childbirth.

PubMed

Sydsjö, Gunilla; Blomberg, Marie; Palmquist, Sofie; Angerbjörn, Louise; Bladh, Marie; Josefsson, Ann

2015-05-15

Continuous support by a midwife during childbirth has shown positive effects on the duration of active labour, use of pain relief and frequency of caesarean section (CS) in women without fear of childbirth (FOC). We have evaluated how continuous support by a specially assigned midwife during childbirth affects birth outcome and the subjective experience of women with severe FOC. A case-control pilot study with an index group of 14 women with severe FOC and a reference group of 28 women without FOC giving birth. In this study the index group received continuous support during childbirth. The women with severe FOC more often had an induction of labour. The parous women with severe FOC had a shorter duration of active labour compared to the parous reference women (p = 0.047). There was no difference in caesarean section frequency between the two groups. Women with severe FOC experienced a very high anxiety level during childbirth (OR = 20.000, 95% CI: 3.036-131.731). Women with severe FOC might benefit from continuous support by a midwife during childbirth. Midwives should acknowledge the importance of continuous support in order to enhance the experience of childbirth in women with severe FOC.

The relationship between place bonding and social trust, as explored in a study in the Big Thicket National Preserve, Texas

Treesearch

Christopher J. Wynveen; Gerard T. Kyle; Gene L. Theodori

2009-01-01

The management of feral hogs surrounding the Big Thicket National Preserve (BTNP) in southeastern Texas requires that National Park Service (NPS) staff and stakeholders manage resource issues collaboratively. Past research has indicated that place bonding can be the common ground upon which managers and stakeholders develop social trust with one another to form a basis...

Iranian Kurdish women's experiences of childbirth: A qualitative study.

PubMed

Shahoei, Roonak; Khosravy, Farangis; Zaheri, Farzaneh; Hasheminasab, Lila; Ranaei, Fariba; Hesame, Kajal; Shahoei, Faranak

2014-02-01

The experience of labor and birth, referred to as childbirth, is complex, multidimensional, and subjective, relating to both the outcome and the process that is experienced by an individual woman. The aim of this study was to describe the experience of childbirth among Kurdish women giving birth at Besat Hospital in Sanandaj, Iran. A qualitative study was conducted using phenomenological approach. Women eligible for the study were recruited from the postpartum ward. Inclusion criteria were being an Iranian Kurdish woman, being nulliparous, and having vaginal childbirth. Data collection was performed between 2010 and 2011. Women were interviewed by the first researcher 6-12 weeks after they had given birth to their first child. All participants had spontaneous vaginal births without their husbands present. None of them received any analgesia or anesthesia during labor and birth. The findings are described under the following four themes: Feeling empowered, changing life, importance of being supported during labor, and the spiritual dimensions of giving birth. Women communicate through telling stories and create meaning as they articulate their feelings about pivotal life events such as childbirth. The findings of this study provide a useful first step toward the identification of aspects of Kurdish women's experience of giving birth. The women in this study identified that the presence or absence of effective support had a significant effect on their experience of labor and birth. It is important for midwives and other professionals to understand the benefits of support given for women during childbirth.

We trust in government, just not in yours: race, partisanship, and political trust, 1958-2012.

PubMed

Wilkes, Rima

2015-01-01

Although it is generally accepted that political trust is reflective of satisfaction with the performance of the incumbent administration, this is only considered true for White Americans. Because their trust reflects a larger discontent with the political system, Black Americans, it is held, do not respond in the same way in the short term. This argument has yet to be tested with over-time data. Time matters. Not only does the race gap in trust change over time but the impact of partisanship and political winning is, by definition, time-dependent. The results of an analysis of the 1958-2012 American National Election Studies data show that Black Americans and White Americans are equally likely to tie short-term performance to trust in government. However, the relationship between partisanship and political trust and, therefore, system discontent, clearly differs for the two groups. Aggregate models that do not take race-partisan sub-group differences into account will therefore be misleading. Copyright © 2014 Elsevier Inc. All rights reserved.

Management of post traumatic stress disorder after childbirth: a review.

PubMed

Lapp, Leann K; Agbokou, Catherine; Peretti, Charles-Siegfried; Ferreri, Florian

2010-09-01

Prevalence and risk factors for the development of post traumatic stress disorder (PTSD) after childbirth is well described in the literature. However, its management and treatment has only begun to be investigated. The aim of this article is to describe the studies that examine the effects of interventions on PTSD after childbirth. MedLine, PILOTS, CINAHL and ISI Web of Science databases were systematically searched for randomised controlled trials, pilot studies and case studies using key words related to PTSD, childbirth, treatment and intervention. The reference lists of the retrieved articles were also used to supplement the search. A total of nine studies were retrieved. Seven studies that examined debriefing or counselling were identified; six randomised controlled trials and one pilot study. Also found were one case report describing the effects of cognitive behavioural therapy (CBT) on two women, and one pilot study of eye movement desensitisation and reprocessing (EMDR). Overall, there is limited evidence concerning the management of women with PTSD after childbirth. The results agree with the findings from the non-childbirth related literature: debriefing and counselling are inconclusively effective while CBT and EMDR may improve PTSD status but require investigation in controlled trials before conclusions could be drawn.

Childbirth fear in expectant fathers: findings from a regional Swedish cohort study.

PubMed

Hildingsson, Ingegerd; Johansson, Margareta; Fenwick, Jennifer; Haines, Helen; Rubertsson, Christine

2014-02-01

to investigate the prevalence of childbirth related fear in Swedish fathers and associated factors. a regional cohort study. Data was collected by a questionnaire. three hospitals in the middle-north part of Sweden 1047 expectant fathers recruited in mid-pregnancy during one year (2007) who completed the Fear of Birth Scale (FOBS). prevalence of childbirth fear and associated factors. Crude and adjusted odds ratios were calculated between men who scored 50 and above (childbirth fear) and those that did not (no fear). Logistic regression analysis was used to assess which factors contributed most to childbirth fear in fathers. the prevalence of childbirth fear in men was 13.6%. Factors associated with childbirth related fear were as follows: Less positive feelings about the approaching birth (OR 3.4; 2.2-5.2), country of birth other than Sweden (OR 2.8; 1.3-6.1), a preference for a caesarean birth (OR 2.1; 1.7-4.1), childbirth thoughts in mid-pregnancy (OR 1.9; 1.1-2.0) and expecting the first baby (OR 1.8; 1.2-2.6). high levels of fear were associated with first time fathers and being a non-native to Sweden. Men with fear were more likely to experience pregnancy and the coming birth as a negative event. These men were also more likely to identify caesarean section as their preferred mode of birth. engaging expectant fathers in antenatal conversations about their experiences of pregnancy and feelings about birth provides health-care professionals with an opportunity to address childbirth fear, share relevant information and promote birth as a normal but significant life event. Copyright © 2013. Published by Elsevier Ltd.

Yemeni women's perceptions of own authority during childbirth: what does it have to do with achieving the Millennium Development Goals?

PubMed

Kempe, Annica; Theorell, Töres; Noor-Aldin Alwazer, Fatoom; Christensson, Kyllike; Johansson, Annika

2013-10-01

women's underutilisation of professional care during childbirth in many low-income countries is a serious concern in terms of achievement of maternal Millennium Development Goal 5. to explore women's perceived own authority within the modern and traditional spheres of childbirth in a high maternal mortality setting on the Arab peninsula. Yemen is a signatory to the Millennium Development Goals and one of 10 countries chosen for the United Nations Millennium Project. In Yemen, home birth has remained the norm for several decades in spite of high maternal mortality and morbidity rates. a multistage (stratified-purposive-random) sampling process was used. Two hundred and twenty women with childbirth experience in urban/rural Yemen were selected at random for interview. Answers to the question 'Did you feel that you were the authority during childbirth?' were analysed using qualitative content analysis. the governorates of Aden, Lahej, Hadramout, Taiz and Hodeidah. three main themes emerged from the analysis: (i) 'Being at the centre', including two categories 'being able to follow through on own wants' and its opposite 'to be under the authority of others'; (ii) 'A sense of belonging' with the categories 'belonging and support among women in the community' and 'the denial of support, the experience of separation' and (iii) 'Husband's role in childbirth' including one category 'opportunity to show authority over the husband'. Authority was experienced primarily among women within the traditional childbirth sector although a general complaint among women delivered by trained medical staff was the loss of own authority. these findings show that women's authority during childbirth is decreasing in the context of Safe Motherhood and the expansion of modern delivery care. This is likely to be an important reason why women underutilise professional care. Acquisition of knowledge from the traditional childbirth sector regarding how women exercise authority to facilitate

"Is it realistic?" the portrayal of pregnancy and childbirth in the media.

PubMed

Luce, Ann; Cash, Marilyn; Hundley, Vanora; Cheyne, Helen; van Teijlingen, Edwin; Angell, Catherine

2016-02-29

Considerable debate surrounds the influence media have on first-time pregnant women. Much of the academic literature discusses the influence of (reality) television, which often portrays birth as risky, dramatic and painful and there is evidence that this has a negative effect on childbirth in society, through the increasing anticipation of negative outcomes. It is suggested that women seek out such programmes to help understand what could happen during the birth because there is a cultural void. However the impact that has on normal birth has not been explored. A scoping review relating to the representation of childbirth in the mass media, particularly on television. Three key themes emerged: (a) medicalisation of childbirth; (b) women using media to learn about childbirth; and (c) birth as a missing everyday life event. Media appear to influence how women engage with childbirth. The dramatic television portrayal of birth may perpetuate the medicalisation of childbirth, and last, but not least, portrayals of normal birth are often missing in the popular media. Hence midwives need to engage with television producers to improve the representation of midwifery and maternity in the media.

An audit of the use of isolation facilities in a UK National Health Service trust.

PubMed

Damji, S; Barlow, G D; Patterson, L; Nathwani, D

2005-07-01

To aid the ongoing battle against hospital-acquired infection in the UK, all acute National Health Service (NHS) trusts should have audit data about how dedicated isolation beds within the trust are being used. In a previously published audit, we demonstrated that one-third of patients admitted to a dedicated isolation room in Tayside were not thought to be an infection risk by experienced healthcare staff. Since this audit, Tayside's isolation facilities have moved from a small peripheral 'fever' hospital to a large central teaching hospital site. At the time of this move, and using the above audit data, we designed and implemented a guideline for general practitioners and hospital doctors regarding the admission of patients to an isolation bed. The aim of this study was to compare the use of isolation beds before and after the move to the new facilities, which we anticipated would increase the demand for isolation. The results show that by all three criteria used, the utilization of isolation beds has deteriorated following the move, mainly due to the increased admission of general medical 'boarders' and low-risk infection patients. At a time when hospital-acquired infections are increasing, NHS trusts should ensure that dedicated isolation beds are used appropriately.

32 CFR 644.542 - Application of anti-trust laws.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Application of anti-trust laws. 644.542 Section... PROPERTY REAL ESTATE HANDBOOK Disposal Sale Procedure § 644.542 Application of anti-trust laws. The Federal... tend to create or maintain a situation inconsistent with the anti-trust laws. Prior to obligating the...

Barriers to Institutional Childbirth in Rumbek North County, South Sudan: A Qualitative Study

PubMed Central

Wilunda, Calistus; Scanagatta, Chiara; Putoto, Giovanni; Takahashi, Risa; Montalbetti, Francesca; Segafredo, Giulia; Betrán, Ana Pilar

2016-01-01

Background South Sudan has one of the world’s poorest health indicators due to a fragile health system and a combination of socio-cultural, economic and political factors. This study was conducted to identify barriers to utilisation of institutional childbirth services in Rumbek North County. Methods Data were collected through 14 focus group discussions with 169 women and 45 men, and 18 key informant interviews with community leaders, staff working in health facilities, traditional birth attendants, and the staff of the County Health Department. Data were analysed using inductive content analysis. Results The barriers to institutional childbirth were categorised under four main themes: 1) Issues related to access and lack of resources: long distance to health facilities, lack of transportation means, referral problems, flooding and poor roads, and payments in health facilities; 2) Issues related to the socio-cultural context and conflict: insecurity, influence of the husband, lack of birth preparedness, domestic chores of women, influence of culture; 3) Perceptions about pregnancy and childbirth: perceived benefit of institutional childbirth, low childbirth risk perception, and medicalisation of childbirth including birth being perceived to be natural, undesirable birth practices, privacy concerns, and fear of caesarean section; and 4) Perceptions about the quality of care: inadequate health facility infrastructure and perceived neglect during admission. Conclusions Multiple factors hinder institutional childbirth in Rumbek North. Some of the factors such as insecurity and poor roads are outside the scope of the health sector and will require a multi-sectoral approach if childbirth services are to be made accessible to women. Detailed recommendations to increase utilisation of childbirth services in the county have been suggested. PMID:27977745

Barriers to Institutional Childbirth in Rumbek North County, South Sudan: A Qualitative Study.

PubMed

Wilunda, Calistus; Scanagatta, Chiara; Putoto, Giovanni; Takahashi, Risa; Montalbetti, Francesca; Segafredo, Giulia; Betrán, Ana Pilar

2016-01-01

South Sudan has one of the world's poorest health indicators due to a fragile health system and a combination of socio-cultural, economic and political factors. This study was conducted to identify barriers to utilisation of institutional childbirth services in Rumbek North County. Data were collected through 14 focus group discussions with 169 women and 45 men, and 18 key informant interviews with community leaders, staff working in health facilities, traditional birth attendants, and the staff of the County Health Department. Data were analysed using inductive content analysis. The barriers to institutional childbirth were categorised under four main themes: 1) Issues related to access and lack of resources: long distance to health facilities, lack of transportation means, referral problems, flooding and poor roads, and payments in health facilities; 2) Issues related to the socio-cultural context and conflict: insecurity, influence of the husband, lack of birth preparedness, domestic chores of women, influence of culture; 3) Perceptions about pregnancy and childbirth: perceived benefit of institutional childbirth, low childbirth risk perception, and medicalisation of childbirth including birth being perceived to be natural, undesirable birth practices, privacy concerns, and fear of caesarean section; and 4) Perceptions about the quality of care: inadequate health facility infrastructure and perceived neglect during admission. Multiple factors hinder institutional childbirth in Rumbek North. Some of the factors such as insecurity and poor roads are outside the scope of the health sector and will require a multi-sectoral approach if childbirth services are to be made accessible to women. Detailed recommendations to increase utilisation of childbirth services in the county have been suggested.

An evaluation of staff engagement programmes in four National Health Service Acute Trusts.

PubMed

Hewison, Alistair; Gale, Nicola; Yeats, Rowena; Shapiro, Jonathan

2013-01-01

The purpose of this paper is to report the findings from an evaluation project conducted to investigate the impact of two staff engagement programmes introduced to four National Health Service (NHS) hospital Trusts in England. It seeks to examine this development in the context of current policy initiatives aimed at increasing the level of staff involvement in decision-making, and the related literature. A mixed-methods approach incorporating document analysis, interviews, a survey and appreciative inquiry, informed by the principles of impact evaluation design, was used. The main finding to emerge was that leadership was crucial if widespread staff engagement was to be achieved. Indeed, in some of the trusts the staff engagement programmes were seen as mechanisms for developing leadership capability. The programmes had greater impact when they were "championed" by the Chief Executive. Effective communication throughout the organisations was reported to be a prerequisite for staff engagement. Problems were identified at the level of middle management where the lack of confidence in engaging with staff was a barrier to implementation. The nature of the particular organisational context is crucial to the success of efforts to increase levels of staff engagement. The measures that were found to work in the trusts would need to be adapted and applied to best meet the needs of other organisations. Many health care organisations in England will need to harness the efforts of their workforce if they are to meet the significant challenges of dealing with financial restraint and increasing patient demand. This paper provides some insights on how this can be done.

Effects of natural childbirth preparation versus standard antenatal education on epidural rates, experience of childbirth and parental stress in mothers and fathers: a randomised controlled multicentre trial

PubMed Central

Bergström, M; Kieler, H; Waldenström, U

2009-01-01

Objective To examine the effects of antenatal education focussing on natural childbirth preparation with psychoprophylactic training versus standard antenatal education on the use of epidural analgesia, experience of childbirth and parental stress in first-time mothers and fathers. Design Randomised controlled multicentre trial. Setting Fifteen antenatal clinics in Sweden between January 2006 and May 2007. Sample A total of 1087 nulliparous women and 1064 of their partners. Methods Natural group: Antenatal education focussing on natural childbirth preparation with training in breathing and relaxation techniques (psychoprophylaxis). Standard care group: Standard antenatal education focussing on both childbirth and parenthood, without psychoprophylactic training. Both groups: Four 2-hour sessions in groups of 12 participants during third trimester of pregnancy and one follow-up after delivery. Main outcome measures Epidural analgesia during labour, experience of childbirth as measured by the Wijma Delivery Experience Questionnaire (B), and parental stress measured by the Swedish Parenthood Stress Questionnaire. Results The epidural rate was 52% in both groups. There were no statistically significant differences in the experience of childbirth or parental stress between the randomised groups, either in women or men. Seventy percent of the women in the Natural group reported having used psychoprophylaxis during labour. A minority in the Standard care group (37%) had also used this method, but subgroup analysis where these women were excluded did not change the principal findings. Conclusion Natural childbirth preparation including training in breathing and relaxation did not decrease the use of epidural analgesia during labour, nor did it improve the birth experience or affect parental stress in early parenthood in nulliparous women and men, compared with a standard form of antenatal education. PMID:19538406

Paternal mental health following perceived traumatic childbirth.

PubMed

Inglis, Christian; Sharman, Rachael; Reed, Rachel

2016-10-01

the objective behind the current study was to explore the experiences and perceptions of fathers after childbirth trauma, an area of minimal research. This is part two of a two-part series conducted in 2014 researching the mental health of fathers after experiencing a perceived traumatic childbirth. qualitative methodology using semi-structured interviews and reporting of qualitative questions administered in part one's online survey (Inglis, 2014). interviews conducted face-to-face at an Australian University or on Skype. sixty-nine responded to the online qualitative questions and of these seven were interviewed. thematic analysis of verbal and written qualitative responses. thematic analysis of qualitative survey data and interviews found a global theme 'standing on the sideline' which encompassed two major themes of witnessing trauma: unknown territory, and the aftermath: dealing with it, and respective subthemes. according to the perceptions and experiences of the fathers, there was a significant lack of communication between birthing teams and fathers, and fathers experienced a sense of marginalisation before, during, and after the traumatic childbirth. The findings of this study suggest that these factors contributed to the perception of trauma in the current sample. Whilst many fathers reported the negative impact of the traumatic birth on themselves and their relationships, some reported post-traumatic growth from the experience and others identified friends and family as a valuable source of support. improved communication between midwifery staff and fathers before, during and after childbirth may reduce the rates of paternal postpartum mental health difficulties and experiences of trauma. Copyright © 2016 Elsevier Ltd. All rights reserved.

A blessing and a curse? Political institutions in the growth and decay of generalized trust: a cross-national panel analysis, 1980-2009.

PubMed

Robbins, Blaine G

2012-01-01

Despite decades of research on social capital, studies that explore the relationship between political institutions and generalized trust-a key element of social capital-across time are sparse. To address this issue, we use various cross-national public-opinion data sets including the World Values Survey and employ pooled time-series OLS regression and fixed- and random-effects estimation techniques on an unbalanced panel of 74 countries and 248 observations spread over a 29-year time period. With these data and methods, we investigate the impact of five political-institutional factors-legal property rights, market regulations, labor market regulations, universality of socioeconomic provisions, and power-sharing capacity-on generalized trust. We find that generalized trust increases monotonically with the quality of property rights institutions, that labor market regulations increase generalized trust, and that power-sharing capacity of the state decreases generalized trust. While generalized trust increases as the government regulation of credit, business, and economic markets decreases and as the universality of socioeconomic provisions increases, both effects appear to be more sensitive to the countries included and the modeling techniques employed than the other political-institutional factors. In short, we find that political institutions simultaneously promote and undermine generalized trust.

New Resources for Childbirth Educators and Parents

PubMed Central

Shilling, Teri

2009-01-01

In this column, reviewers offer perspectives and comments on a variety of new media resources for childbirth educators and for expectant and new parents. The books and DVDs reviewed in this issue's column address the following topics: new directions for childbirth education classes; pregnancy tips for expectant mothers; empowering women to give birth naturally; midwifery care; breastfeeding; labyrinths and “laborinths” (an alternative approach to preparing for birth); preterm labor; understanding newborns' language cues; and exercise programs during pregnancy and the postnatal period, as well as exercises that strengthen the pelvic floor and help new mothers deal with incontinence. PMID:20514118

Weather and childbirth: a further search for relationships.

PubMed

Driscoll, D M

1995-03-01

Previous attempts to find relationships between weather and parturition (childbirth) and its onset (the beginning of labor pains) have revealed, firstly, limited but statistically significant relationships between weather conditions much colder than the day before, with high winds and low pressure, and increased onsets; and secondly, increased numbers of childbirths during periods of atmospheric pressure rise (highly statistically significant). To test these findings, this study examined weather data coincident childbirth data from a hospital at Bryan-College Station, Texas (for a period of 30 cool months from 1987 to 1992). Tests for (1) days of cold fronts, (2) a day before and a day after the cold front, (3) days with large temperature increases, and (4) decreases from the day before revealed no relationship with mean daily rate of onset. Cold days with high winds and low pressure had significantly fewer onsets, a result that is the opposite of previous findings. The postulated relationship between periods of pressure rise and increased birth frequency was negative, i.e., significantly fewer births occurred at those times--again, the opposite of the apparent occurrence in an earlier study. The coincidence of diurnal variations in both atmospheric pressure and frequency of childbirths, was shown to account for fairly strong negative associations between the two variables.(ABSTRACT TRUNCATED AT 250 WORDS)

Iranian Kurdish women's experiences of childbirth: A qualitative study

PubMed Central

Shahoei, Roonak; Khosravy, Farangis; Zaheri, Farzaneh; Hasheminasab, Lila; Ranaei, Fariba; Hesame, Kajal; Shahoei, Faranak

2014-01-01

Background: The experience of labor and birth, referred to as childbirth, is complex, multidimensional, and subjective, relating to both the outcome and the process that is experienced by an individual woman. The aim of this study was to describe the experience of childbirth among Kurdish women giving birth at Besat Hospital in Sanandaj, Iran. Materials and Methods: A qualitative study was conducted using phenomenological approach. Women eligible for the study were recruited from the postpartum ward. Inclusion criteria were being an Iranian Kurdish woman, being nulliparous, and having vaginal childbirth. Data collection was performed between 2010 and 2011. Women were interviewed by the first researcher 6–12 weeks after they had given birth to their first child. Results: All participants had spontaneous vaginal births without their husbands present. None of them received any analgesia or anesthesia during labor and birth. The findings are described under the following four themes: Feeling empowered, changing life, importance of being supported during labor, and the spiritual dimensions of giving birth. Conclusions: Women communicate through telling stories and create meaning as they articulate their feelings about pivotal life events such as childbirth. The findings of this study provide a useful first step toward the identification of aspects of Kurdish women's experience of giving birth. The women in this study identified that the presence or absence of effective support had a significant effect on their experience of labor and birth. It is important for midwives and other professionals to understand the benefits of support given for women during childbirth. PMID:25949245

Fear of childbirth and elective caesarean section: a population-based study.

PubMed

Størksen, Hege Therese; Garthus-Niegel, Susan; Adams, Samantha S; Vangen, Siri; Eberhard-Gran, Malin

2015-09-17

This population-based cohort study aimed to investigate the demographic and psychosocial characteristics associated with fear of childbirth and the relative importance of such fear as a predictor of elective caesarean section. A sample of 1789 women from the Akershus Birth Cohort in Norway provided data collected by three self-administered questionnaires at 17 and 32 weeks of pregnancy and 8 weeks postpartum. Information about the participants' childbirths was obtained from the hospital records. Eight percent of the women reported fear of delivery, defined as a score of ≥85 on the Wijma Delivery Expectancy Questionnaire. Using multivariable logistic regression models, a previous negative overall birth experience exerted the strongest impact on fear of childbirth, followed by impaired mental health and poor social support. Fear of childbirth was strongly associated with a preference for elective caesarean section (aOR 4.6, 95% CI 2.9-7.3) whereas the association of fear with performance of caesarean delivery was weaker (aOR 2.4, 95% CI 1.2-4.9). The vast majority (87%) of women with fear of childbirth did not, however, receive a caesarean section. By contrast, a previous negative overall birth experience was highly predictive of elective caesarean section (aOR 8.1, 95% CI 3.9-16.7) and few women without such experiences did request caesarean section. Results suggest that women with fear of childbirth may have identifiable vulnerability characteristics, such as poor mental health and poor social support. Results also emphasize the need to focus on the subjective experience of the birth to prevent fear of childbirth and elective caesarean sections on maternal request. Regarding the relationship with social support, causality has to be interpreted cautiously, as social support was measured at 8 weeks postpartum only.

Negative impressions of childbirth in a North-West England student population.

PubMed

Thomson, Gill; Stoll, Kathrin; Downe, Soo; Hall, Wendy A

2017-03-01

Sociocultural childbirth representations can influence the perceptions of childbirth negatively. In this paper we report on a survey study to explore the factors associated with negative impressions of childbirth in a North-West England University student sample. We also explored whether different sources and perceptions of childbirth information were linked to fear of childbirth. All students received a survey link via an online messaging board and/or direct e-mail. Female students who were 18-40 years of age and childless (but planned to have children in the future) were invited to participate. Demographics, birth preferences, a fear of birth and general anxiety measures were included as well as questions about what sources of information shaped students' attitudes toward pregnancy and birth (i.e. visual/written media, experiences of friends/family members, school-based education and other) and impressions of birth from these sources (i.e. positive, negative, both positive and negative and not applicable). Eligible students (n = 276) completed the online questionnaire. The majority were Caucasian (87%) with a mean age of 22.6 years. Ninety-two students (33.3%) reported negative childbirth impressions through direct or vicarious sources. Students with negative birth impressions were significantly more likely to report higher fear of birth scores. Negatively perceived birth stories of friends/family members, and mixed perceptions of visual media representations of birth were associated with higher fear of birth scores. Having witnessed a birth first-hand and describing the experience as amazing was linked to lower fear scores. First-hand observations of birth, especially positive experiences, had implications for salutary outcomes. Negative or conflicting perceptions of vicarious experiences were associated with increased levels of childbirth fear. While further research is needed, these insights suggest a need for positive birth stories and messages to be

Breech presentation and choice of mode of childbirth: a qualitative study of women's experiences.

PubMed

Guittier, Marie-Julia; Bonnet, Jocelyne; Jarabo, Graziella; Boulvain, Michel; Irion, Olivier; Hudelson, Patricia

2011-12-01

To explore women's perceptions of their experience of the diagnosis of breech presentation and decision-making processes regarding the choice of mode of childbirth. A qualitative study was conducted using semi-structured interviews. Data were analysed thematically. Department of Gynaecology and Obstetrics, University Hospitals of Geneva, Switzerland. seven primiparous and five multiparous women experiencing a singleton breech presentation for childbirth were interviewed. Two concomitant and interdependent processes were identified. First, an emotional response ranging from the hope that the fetus would return to a normal vertex position to the acceptance of breech presentation and its consequences. Second, a decision-making process related to childbirth mode for breech presentation with the complex management of intra- and extra-personal factor influences. Women perceive information about the risks of vaginal childbirth of paramount importance compared with those associated with caesarean childbirth. When women choose vaginal childbirth, influences related to their personality and life history appear to predominate. Women often have the feeling of being alone to assume the choice of childbirth mode and possible complications. The diagnosis of breech presentation should not be treated as a commonplace event. The role of caregivers needs to go beyond information on the risks and benefits of both modes of childbirth. Emphasis should be placed on listening to the expectations of pregnant women for childbirth, creating spaces for dialogue, and allowing additional time for reflection. Useful information material should be provided to give the women a feeling of shared decision-making. Copyright © 2010 Elsevier Ltd. All rights reserved.

Resolution of pain after childbirth.

PubMed

Eisenach, James C; Pan, Peter; Smiley, Richard M; Lavand'homme, Patricia; Landau, Ruth; Houle, Timothy T

2013-01-01

Chronic pain after surgery occurs in 10-40% of individuals, including 5-20% of women after cesarean delivery in previous reports. Pain and depression 2 months after childbirth are independently associated with more severe acute post-delivery pain. Here we examine other predictors of pain at 2 months and determine the incidence of pain at 6 and 12 months after childbirth. Following Institutional Review Board approval, 1228 women were interviewed within 36 h of delivery. Of these, 937 (76%) were successfully contacted by telephone at 2 months, and, if they had pain, at 6 and 12 months after delivery. The primary outcome measure was presence of pain which began at the time of delivery. We also generated a model of severity of acute post-delivery pain and 2 month pain and depression. Pain which began at the time of delivery was remarkably rare 6 and 12 months later (1.8% and 0.3% [upper 95% confidence limit, 1.2%], respectively). Past history of pain and degree of tissue damage at delivery accounted for 7.0% and 16.7%, respectively, of one aspect in the variability in acute post-delivery pain. Neither of these factors was associated with incidence of pain 2 months later. Using a definition of new onset pain from delivery, we show a remarkably low incidence of pain 1 yr after childbirth, including those with surgical delivery. Additionally, degree of tissue trauma and history of chronic pain, risk factors for pain 2 months after other surgery, were unimportant to pain 2 months after cesarean or vaginal delivery.

Public trust in the healthcare system in a developing country.

PubMed

Peters, Dexnell; Youssef, Farid F

2016-04-01

Broadly defined, trust in the healthcare system is concerned with how the public perceives the system and the actors therein as it pertains to their ability to both deliver services and seek the best interests of their clientele. Trust is important because it impacts upon a range of health behaviors including compliance and ultimately affects the ability of the healthcare system to meet its goals. While several studies exist on public trust within the developed world, few studies have explored this issue in developing countries. This paper therefore assesses public trust in the healthcare system of a developing small island nation, Trinidad and Tobago. A cross-sectional survey of adults was conducted using a questionnaire that has been successfully used across Europe. We report that trust levels in the healthcare system in Trinidad and Tobago are relatively low with less than 50% of persons indicating fair trust in the healthcare system. In addition, individual health professionals also did not score highly with lowest scores found for nurses and complementary therapists. Results on four out of five dimensions of trust also demonstrated scores significantly lower than those reported in more developed nations. Open-ended comments supported these findings with the majority of persons indicating a lack of confidence in the healthcare system. These results may reflect the reality in the wider developing world, and we suggest that bolstering trust is a needed area of focus in the delivery of healthcare services throughout the nation. Copyright © 2014 John Wiley & Sons, Ltd. Copyright © 2014 John Wiley & Sons, Ltd.

Inter-relationships between sexual abuse, female sexual function and childbirth.

PubMed

Gottfried, Ruth; Lev-Wiesel, Rachel; Hallak, Mordechai; Lang-Franco, Nessia

2015-11-01

the present quantitative longitudinal study focuses on the inter-relationships between sexual abuse, distressed female sexual function and childbirth. Additional variables studied include depression, mode of delivery, subjective birth experience and traumatic life events other than sexual abuse. data collection for the study was extended across three time periods: during the third trimester of pregnancy and approximately one and six months postpartum. Self-reported questionnaire responses of 300 women from two medical centres in Israel, as well as hospital records regarding their mode of childbirth, were included in the data analysis. Measures incorporated in the study included the Female Sexual Distress Scale-Revised, the Beck Depression Inventory and modified versions of the Traumatic Events Questionnaire, the Sexual Experiences Survey, and the Subjective Birth Experience Questionnaire. findings demonstrated that women with a lifetime history of sexual abuse compared to women without such history, are at an increased risk for distressed antenatal and postpartum female sexual function (Odds Ratio OR=2.66 and OR=2.26, respectively); and postpartum depression (OR=2.36). Antenatal depression was likewise shown to be significantly associated with antenatal and postpartum distressed female sexual function (OR=4.32 and OR=10.4, respectively), as well as with a more negatively experienced childbirth (T-Ratio, T=1.98, p<0.05). Moreover, distressed antenatal female sexual function was found to increase the risk for a more negatively experienced childbirth (T=2.04, p<0.05), and caesarean childbirth (OR=3.34). the current study enriches the understanding of the inter-relationships between the antenatal, childbirth and postpartum variables studied herein; and has implications for evidence based practice in both preventative and intervention efforts. Recommendations for future research are presented and discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

Women's experiences of continuous support during childbirth: a meta-synthesis.

PubMed

Lunda, Petronellah; Minnie, Catharina Susanna; Benadé, Petronella

2018-05-15

Despite the known benefits of continuous support during childbirth, the practice is still not routinely implemented in all maternity settings and women's views and experiences might not be considered. The purpose of the study was to integrate individual studies' findings related to women's experiences of continuous support during childbirth in order to expand the understanding of the phenomenon. The review question was: What were the views and experiences of women regarding continuous support during childbirth as reported in studies that adopted qualitative or mixed research methods (with a qualitative component) using semi-structured, in-depth or focus group interviews or case studies? A detailed search was executed on electronic data bases: EBSCOhost: Medline, CINAHL, PsychINFO, SocINDEX, OAlster, Scopus, SciELO, Science Direct, PubMED and Google Scholar, using a predetermined search strategy. Reference lists of included studies were analysed to identify possible studies that were missing from electronic data bases. Pre-determined inclusion and exclusion criteria were applied during the selection of eligible sources. After critical appraisal, a total of 12 studies were included for data-extraction and meta-synthesis. Two themes were identified, namely the roles and attributes of the support persons and the type of support provided. Women's perceptions about continuous support during childbirth were influenced by the characteristics and attributes of the support person as well as the types of supportive care rendered. Women preferred someone with whom they were familiar and comfortable. Continuous support during childbirth was valued by most women. Their perceptions were influenced by the type of support person: a health professional or a lay support person. Health care institutions should include continuous support during childbirth in their policies and guidelines.

Childbirth Education for Parents Experiencing Pregnancy after Perinatal Loss

PubMed Central

Wright, Patricia Moyle

2005-01-01

Expectant parents who have experienced previous perinatal loss have special concerns, which can be partially addressed by modifying prepared childbirth education courses. This article presents a review of current literature, highlighting the unique needs of expectant parents who have experienced previous pregnancy loss. Modifications to traditional childbirth education courses are suggested, which include addressing parents' grief, managing anxiety, and facilitating communication with health-care providers and others. PMID:17273448

Predictors of posttraumatic stress symptoms following childbirth

PubMed Central

2014-01-01

Background Posttraumatic stress disorder (PTSD) following childbirth has gained growing attention in the recent years. Although a number of predictors for PTSD following childbirth have been identified (e.g., history of sexual trauma, emergency caesarean section, low social support), only very few studies have tested predictors derived from current theoretical models of the disorder. This study first aimed to replicate the association of PTSD symptoms after childbirth with predictors identified in earlier research. Second, cognitive predictors derived from Ehlers and Clark’s (2000) model of PTSD were examined. Methods N = 224 women who had recently given birth completed an online survey. In addition to computing single correlations between PTSD symptom severities and variables of interest, in a hierarchical multiple regression analyses posttraumatic stress symptoms were predicted by (1) prenatal variables, (2) birth-related variables, (3) postnatal social support, and (4) cognitive variables. Results Wellbeing during pregnancy and age were the only prenatal variables contributing significantly to the explanation of PTSD symptoms in the first step of the regression analysis. In the second step, the birth-related variables peritraumatic emotions and wellbeing during childbed significantly increased the explanation of variance. Despite showing significant bivariate correlations, social support entered in the third step did not predict PTSD symptom severities over and above the variables included in the first two steps. However, with the exception of peritraumatic dissociation all cognitive variables emerged as powerful predictors and increased the amount of variance explained from 43% to a total amount of 68%. Conclusions The findings suggest that the prediction of PTSD following childbirth can be improved by focusing on variables derived from a current theoretical model of the disorder. PMID:25026966

Benefits of preparing for childbirth with mindfulness training: a randomized controlled trial with active comparison.

PubMed

Duncan, Larissa G; Cohn, Michael A; Chao, Maria T; Cook, Joseph G; Riccobono, Jane; Bardacke, Nancy

2017-05-12

Childbirth fear is linked with lower labor pain tolerance and worse postpartum adjustment. Empirically validated childbirth preparation options are lacking for pregnant women facing this problem. Mindfulness approaches, now widely disseminated, can alleviate symptoms of both chronic and acute pain and improve psychological adjustment, suggesting potential benefit when applied to childbirth education. This study, the Prenatal Education About Reducing Labor Stress (PEARLS) study, is a randomized controlled trial (RCT; n = 30) of a short, time-intensive, 2.5-day mindfulness-based childbirth preparation course offered as a weekend workshop, the Mind in Labor (MIL): Working with Pain in Childbirth, based on Mindfulness-Based Childbirth and Parenting (MBCP) education. First-time mothers in the late 3rd trimester of pregnancy were randomized to attend either the MIL course or a standard childbirth preparation course with no mind-body focus. Participants completed self-report assessments pre-intervention, post-intervention, and post-birth, and medical record data were collected. In a demographically diverse sample, this small RCT demonstrated mindfulness-based childbirth education improved women's childbirth-related appraisals and psychological functioning in comparison to standard childbirth education. MIL program participants showed greater childbirth self-efficacy and mindful body awareness (but no changes in dispositional mindfulness), lower post-course depression symptoms that were maintained through postpartum follow-up, and a trend toward a lower rate of opioid analgesia use in labor. They did not, however, retrospectively report lower perceived labor pain or use epidural less frequently than controls. This study suggests mindfulness training carefully tailored to address fear and pain of childbirth may lead to important maternal mental health benefits, including improvements in childbirth-related appraisals and the prevention of postpartum

Childbirth customs in Orthodox Jewish traditions.

PubMed Central

Bodo, K.; Gibson, N.

1999-01-01

OBJECTIVE: To describe cultural beliefs of Orthodox Jewish families regarding childbirth in order to help family physicians enhance the quality and sensitivity of their care. QUALITY OF EVIDENCE: These findings were based on a review of the literature searched in MEDLINE (1966 to present), HEALTHSTAR (1975 to present), EMBASE (1988 to present), and Social Science Abstracts (1984 to present). Interviews with several members of the Orthodox Jewish community in Edmonton, Alta, and Vancouver, BC, were conducted to determine the accuracy of the information presented and the relevance of the paper to the current state of health care delivery from the recipients' point of view. MAIN MESSAGE: Customs and practices surrounding childbirth in the Orthodox Jewish tradition differ in several practical respects from expectations and practices within the Canadian health care system. The information presented was deemed relevant and accurate by those interviewed, and the subject matter was considered to be important for improving communication between patients and physicians. Improved communication and recognition of these differences can improve the quality of health care provided to these patients. CONCLUSIONS: Misunderstandings rooted in different cultural views of childbirth and the events surrounding it can adversely affect health care provided to women in the Orthodox Jewish community in Canada. A basic understanding of the cultural foundations of potential misunderstandings will help Canadian physicians provide effective health care to Orthodox Jewish women. PMID:10099807

Integrating Preparation for Parenting Into Childbirth Education: Part II—A Study

PubMed Central

Corwin, Ann

1999-01-01

This study was designed to test the effectiveness of using a broad conceptualization of childbirth education that includes parenting preparation in pregnancy. The goal is to assist in breaking cycles of dysfunction in families. At the core of this expanded model of childbirth education is the concept of prevention. The intervention described in Part I in the Journal of Perinatal Education 7(4), 26–33 provided parents with information and coping mechanisms by drawing parallels to traditionally learned coping skills for childbirth with techniques needed to cope in post-partum. This approach also encouraged prenatal parents to learn techniques for promoting attachment to their children before birth. The curriculum was tested by randomizing 48 couples to the expanded or traditional model of childbirth education. A pre- and post-Prenatal Parenting Scale was administered to both groups. Only the experimental group demonstrated improvement at the post-class administration. PMID:22945974

Integrating Preparation for Parenting Into Childbirth Education: Part II-A Study.

PubMed

Corwin, A

1999-01-01

This study was designed to test the effectiveness of using a broad conceptualization of childbirth education that includes parenting preparation in pregnancy. The goal is to assist in breaking cycles of dysfunction in families. At the core of this expanded model of childbirth education is the concept of prevention. The intervention described in Part I in the Journal of Perinatal Education 7(4), 26-33 provided parents with information and coping mechanisms by drawing parallels to traditionally learned coping skills for childbirth with techniques needed to cope in post-partum. This approach also encouraged prenatal parents to learn techniques for promoting attachment to their children before birth. The curriculum was tested by randomizing 48 couples to the expanded or traditional model of childbirth education. A pre- and post-Prenatal Parenting Scale was administered to both groups. Only the experimental group demonstrated improvement at the post-class administration.

Perspectives on Learning for Childbirth Educators

PubMed Central

Wilkerson, Norma N.

2000-01-01

This continuing education module reviews the uses of ways of knowing and ways of learning to assist the childbirth educator become a master teacher who facilitates the growth of the learner. PMID:17273213

Korean immigrant women's lived experience of childbirth in the United States.

PubMed

Seo, Jin Young; Kim, Wooksoo; Dickerson, Suzanne S

2014-01-01

To understand Korean immigrant women's common experiences and practices of utilizing health care services in the United States during childbirth. A qualitative interpretive phenomenological research design. Recruitment was conducted through advertisement on the MissyUSA.com website, which is the largest online community for married Korean women who live in North America. A purposive sample of 15 Korean immigrant women who experienced childbirth in the United States within the past 5 years was recruited. Data were collected using semistructured telephone interviews and were analyzed using the Heideggerian hermeneutical methodology. During childbirth in the United States, participants faced multifaceted barriers in unfamiliar sociocultural contexts yet maintained their own cultural heritages. They navigated the unfamiliar health care system and developed their own strategies to overcome barriers to health care access. Korean immigrant women actively sought health information on the Internet and through social networking during childbirth. Korean immigrant women selectively accepted new cultural beliefs with some modifications from their own cultural contexts and developed their own distinct birth cultures. Understanding a particular culture and respecting women's traditions, beliefs, and practices about their childbirth could help nurses to provide culturally sensitive care. © 2014 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

[Characterization of access to normal childbirth care in Bahia State, Brazil, based on graph theory].

PubMed

Sousa, Ludmilla Monfort Oliveira; Araújo, Edna Maria de; Miranda, José Garcia Vivas

2017-12-18

Origin-destination flow is a phenomenon that can be modeled as a network. Graph theory is a mathematical tool to characterize a network and thus allows studying the topological properties and temporal and spatial development of a set of related elements. The article aims to estimate the topological evolution of an inter-municipal network of normal deliveries. We selected the admissions for normal deliveries in the Hospital Information System of the Brazilian Unified National Health System, from 2008 to 2014, for women residing in Bahia State, Brazil. The following indices were applied: entry degree (from how many municipalities the women came for childbirth), exit degree (to how many municipalities they left), entry flow (how many women came), exit flow (how many women left), and the mean size of the exit edge (distance traveled). Analyses between macro-regions used the following indicators: proportion of normal deliveries performed outside the municipality of residence and mean size of the exit edge. The results indicate an increase in deliveries performed outside the municipality of residence, in addition to the persistence of concentration of deliveries in the hub municipalities in the Health Regions, and an increase in the distance between the municipality of residence and the municipality where the delivery took place. The organization of networks for normal childbirth poses an on-going challenge. It is important to analyze the flow of women for childbirth care in order to support the establishment of inter-municipal references to guarantee safe labor and childbirth. In conclusion, it is necessary to develop a regionalized network to meet the demand by pregnant women in the territory with universal and equitable coverage.

'Birthgasm': A Literary Review of Orgasm as an Alternative Mode of Pain Relief in Childbirth.

PubMed

Mayberry, Lorel; Daniel, Jacqueline

2016-12-01

Childbirth is a fundamental component of a woman's sexual cycle. The sexuality of childbirth is not well recognized in Western society despite research showing that some women experience orgasm(s) during labor and childbirth. Current thinking supports the view that labor and childbirth are perceived to be physically painful events, and more women are relying on medical interventions for pain relief in labor. This review explores the potential of orgasm as a mode of pain relief in childbirth and outlines the physiological explanations for its occurrence. Potential barriers to sexual expression during childbirth and labor, including the influence of deeply held cultural beliefs about sexuality, the importance of privacy and intimacy in facilitating orgasmic birth experiences, and the value of including prospective fathers in the birthing experience, are discussed. The role of midwives and their perceptions of the use of complementary and alternative therapies for pain relief in labor are examined. While there are indications of widespread use of complementary and alternative therapies such as hydrotherapy, herbal remedies, and breathing techniques for pain relief in childbirth, orgasm was not among those mentioned. Lack of recognition of the sexuality of childbirth, despite findings that orgasm can attenuate the effects of labor pain, suggests the need for greater awareness among expectant parents, educators, and health professionals of the potential of orgasm as a means of pain relief in childbirth. © The Author(s) 2015.

The Role of Demand Factors in Utilization of Professional Care during Childbirth: Perspectives from Yemen

PubMed Central

Kempe, Annica; Noor-Aldin Alwazer, Fatoom; Theorell, Töres

2011-01-01

Background. Utilization of professional care during childbirth by women in low-income countries is important for the progress towards MDG 5. In Yemen, home births have decreased minimally during the past decades. Objective. The study investigates the influence of socio-demographic, birth outcome and demand factors on women's future preference of a home or institutional childbirth. Method. We interviewed 220 women with childbirth experience in urban/rural Yemen. We performed bivariate chi-square tests and multiple logistic regression analysis. A multistage sampling process was used. Results. The issues of own choice, birth support and birth complications were the most important for women's preference of future location of childbirth. Women who had previously been able to follow their own individual choice regarding birth attendance and/or location of childbirth were six times more likely to plan a future childbirth in the same location and women who received birth support four times more likely. Birth complications were associated with a 2.5-fold decrease in likelihood. Conclusions. To offer women with institutional childbirth access to birth support is crucial in attracting women to professional care during childbirth. Yemeni women's low utilization of modern delivery care should be seen in the context of women's low autonomy and status. PMID:21941663

A time for psycho-spiritual transcendence: The experiences of Iranian women of pain during childbirth.

PubMed

Taghizdeh, Z; Ebadi, A; Dehghani, M; Gharacheh, M; Yadollahi, P

2017-12-01

The description of women's experiences of childbirth improves our understandings of the nature of childbirth, women's suffering and pain during childbirth. This study aimed to explore women's experiences of pain during childbirth. A qualitative study was conducted using a conventional content analysis method proposed by Graneheim and Lundman (2004). In-depth face to face semi-structured interviews were held with 17 women who met inclusion criteria for participation in this study. The women's experiences of pain during childbirth was described as 'a time for psycho-spiritual transcendence'. Categories developed during the data analysis were 'conflicting emotions towards pain', 'new insight towards labor pain', 'self-actualization' and 'spiritual development'. Most participants had positive experiences and attitudes towards pain during childbirth influenced by cultural, context and religious factors. According to this study, 'transcendental progression' was an eminent feeling that created positive inner feelings along with self-actualization in women. This provides a new insight on labor pain and helps healthcare providers understand the effect of pain during childbirth on women's spiritual, mental and psychological needs. Copyright © 2017. Published by Elsevier Ltd.

Is it feasible to pool funds for local children's services in England? Evidence from the national evaluation of children's trust pathfinders.

PubMed

Lorgelly, Paula; Bachmann, Max; Shreeve, Ann; Reading, Richard; Thorburn, June; Mugford, Miranda; O'Brien, Margaret; Husbands, Chris

2009-01-01

To describe how funds were pooled or otherwise jointly managed by National Health Service (NHS) primary care trusts and local authorities in England. To compare expenditure on local children's services by health, education and social services. We conducted a questionnaire survey of all 35 children's trust pathfinders, six months after they were launched, with a follow-up at 2.5 years. We also undertook an in-depth analysis of local authorities and primary care trusts, within eight pathfinder areas and three non-pathfinder areas, whereby we compared expenditure on children's services, interviewed managers and professionals and examined financial documents. Local authorities and NHS trusts coordinated expenditure in various ways, most commonly through informal agreements and aligning budgets but also by formally pooling budgets. The latter were usually for selected services such as child and adolescent mental health services, though four children's trusts pathfinders pooled (or aligned) their budgets for all children's services. Total expenditure per child was greatest for education, lowest for social services and intermediate for health. However, it was difficult to quantify education expenditure on children with health and social care needs, and health care expenditure on children. Sharing money for local children's services requires shared objectives, trust, and legal and accounting expertise. Several different mechanisms are permitted and many are feasible but programme budgeting for children's services could make them more effective.

26 CFR 301.7507-1 - Banks and trust companies covered.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 18 2011-04-01 2011-04-01 false Banks and trust companies covered. 301.7507-1... States § 301.7507-1 Banks and trust companies covered. (a) Section 7507 applies to any national bank, or bank or trust company organized under State law, a substantial portion of the business of which...

26 CFR 301.7507-1 - Banks and trust companies covered.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 18 2010-04-01 2010-04-01 false Banks and trust companies covered. 301.7507-1... States § 301.7507-1 Banks and trust companies covered. (a) Section 7507 applies to any national bank, or bank or trust company organized under State law, a substantial portion of the business of which...

29 CFR 1604.10 - Employment policies relating to pregnancy and childbirth.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 4 2011-07-01 2011-07-01 false Employment policies relating to pregnancy and childbirth... COMMISSION GUIDELINES ON DISCRIMINATION BECAUSE OF SEX § 1604.10 Employment policies relating to pregnancy... employment applicants or employees because of pregnancy, childbirth or related medical conditions is in prima...

29 CFR 1604.10 - Employment policies relating to pregnancy and childbirth.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 4 2010-07-01 2010-07-01 false Employment policies relating to pregnancy and childbirth... COMMISSION GUIDELINES ON DISCRIMINATION BECAUSE OF SEX § 1604.10 Employment policies relating to pregnancy... employment applicants or employees because of pregnancy, childbirth or related medical conditions is in prima...

29 CFR 1604.10 - Employment policies relating to pregnancy and childbirth.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 4 2012-07-01 2012-07-01 false Employment policies relating to pregnancy and childbirth... COMMISSION GUIDELINES ON DISCRIMINATION BECAUSE OF SEX § 1604.10 Employment policies relating to pregnancy... employment applicants or employees because of pregnancy, childbirth or related medical conditions is in prima...

29 CFR 1604.10 - Employment policies relating to pregnancy and childbirth.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 4 2013-07-01 2013-07-01 false Employment policies relating to pregnancy and childbirth... COMMISSION GUIDELINES ON DISCRIMINATION BECAUSE OF SEX § 1604.10 Employment policies relating to pregnancy... employment applicants or employees because of pregnancy, childbirth or related medical conditions is in prima...

Trust Management - Building Trust for International Cross Disciplinary Collaboration on Climate Change

NASA Astrophysics Data System (ADS)

Oakley, K. V.; Gurney, R. J.

2014-12-01

Successful communication and collaboration entails mutual understanding, and transfer, of information. The risk of misunderstanding and/or miscommunication between collaborating groups is tackled in different ways around the globe; some are well documented whereas others may be unknown outside particular groups, whether defined geographically or by specialism. For example; in some countries legally binding contracts define the terms of collaboration. Some regions place greater emphasis on developing trust relationships, and sometimes an official agreement is implied, such as many electronic data transfers on the web. International collaboration on climate change increasingly involves electronic data exchange (e.g. open access publications, shared documents, data repositories etc.) and with this increased reliance on electronic data a need has arisen for scientists to collaborate both internationally and cross-disciplinarily particularly with information technology and data management specialists. Trust of data and metadata on the internet (e.g. privacy, legitimacy etc.) varies, possibly due to a lack of internationally agreed standards for data governance and management, leaving many national, regional and institutional practices tailored to the needs of that group only. It is proposed that building trust relationships between cross-disciplinary and international groups could help facilitate further communication, understanding and benefits from the relationship, while still maintaining independence as separate groups. Complex international cross-disciplinary group relationship dynamics are not easily mapped and producing a set of trust building rules that can be applied to any current and future collaboration with equal validity may be unfeasible. An alternative to such a set of rules may be found in a Trust Manager, whose role is to improve mutually beneficial knowledge exchange between groups, build trust and increase future collaborative potential. This

Patterns of trust in sources of health information.

PubMed

Lawson, Rob; Forbes, Sarah; Williams, John

2011-01-21

To understand the different patterns of trust that exist regarding different sources of information about health issues. Data from a large national health lifestyles survey of New Zealanders was examined using a factor analysis of trust toward 24 health information sources (HIS). Differences in trust are compared across a range of demographic variables. Factor analysis identified six different groupings of health information. Variations in trust in sources for health information are identified by age, employment status, level of education, income, sex and ethnic group. Systematic variations exist in the trust that people report with respect to different sources of health information. Understanding these variations may assist policymakers and other agencies which are responsible for planning the dissemination of health information.

Childbirth in ancient Rome: from traditional folklore to obstetrics.

PubMed

Todman, Donald

2007-04-01

In ancient Rome, childbirth was a hazardous event for both mother and child with high rates of infant and maternal mortality. Traditional Roman medicine centred on folklore and religious practices, but with the development of Hippocratic medicine came significant advances in the care of women during pregnancy and confinement. Midwives or obstetrices played an important role and applied rational scientific practices to improve outcomes. This evolution from folklore to obstetrics was a pivotal point in the history of childbirth.

25 CFR 15.3 - Who can make a will disposing of trust or restricted land or trust personalty?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Who can make a will disposing of trust or restricted land or trust personalty? 15.3 Section 15.3 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR PROBATE PROBATE OF INDIAN ESTATES, EXCEPT FOR MEMBERS OF THE OSAGE NATION AND THE FIVE CIVILIZED TRIBES Introduction § 15.3 Who can make a will...

Inspirational Resources for Childbirth Educators

PubMed Central

Shilling, Teri

2005-01-01

In this column, reviewers offer perspectives and comments on The REAL DEAL on Breastfeeding™, a delightful and instructional video; The Story of the Weeping Camel, an Academy Award-nominated film from Mongolia's Gobi Desert; and Normal Childbirth: Evidence and Debate, a new book that examines critical issues on today's maternity care.

The impact of negative childbirth experience on future reproductive decisions: A quantitative systematic review.

PubMed

Shorey, Shefaly; Yang, Yen Yen; Ang, Emily

2018-06-01

The aim of this study was to systematically retrieve, critique and synthesize available evidence regarding the association between negative childbirth experiences and future reproductive decisions. A child's birth is often a joyous event; however, there is a proportion of women who undergo negative childbirth experiences that have long-term implications on their reproductive decisions. A systematic review of quantitative studies was undertaken using Joanna Briggs Institute's methods. A search was carried out in CINAHL Plus with Full Text, Embase, PsycINFO, PubMed, Scopus and Web of Science from January 1996 - July 2016. Studies that fulfilled the inclusion criteria were assessed by two independent reviewers using the Joanna Briggs Institute's Critical Appraisal Tools. Data were extracted under subheadings adapted from the institute's data extraction forms. Twelve studies, which examined either one or more influences of negative childbirth experiences, were identified. The included studies were either cohort or cross-sectional designs. Five studies observed positive associations between prior negative childbirth experiences and decisions to not have another child, three studies found positive associations between negative childbirth experiences and decisions to delay a subsequent birth and six studies concluded positive associations between negative childbirth experiences and maternal requests for caesarean section in subsequent pregnancies. To receive a holistic understanding on negative childbirth experiences, a suitable definition and validated measuring tools should be used to understand this phenomenon. Future studies or reviews should include a qualitative component and/or the exploration of specific factors such as cultural and regional differences that influence childbirth experiences. © 2018 John Wiley & Sons Ltd.

Classification of deaths in women with human immunodeficiency virus/acquired immunodeficiency syndrome in pregnancy and childbirth.

PubMed

Brayner, Manuella Coutinho; Alves, Sandra Valongueiro

2017-01-01

To reclassify deaths of women infected with the human immunodeficiency virus/acquired immunodeficiency syndrome in pregnancy and childbirth in the State of Pernambuco, Brazil, from 2000 to 2010. A descriptive exploratory study, developed from the following steps: translation to Portuguese of the item "HIV and aids" of the United Nations document "The WHO application of ICD-10 to deaths during pregnancy, childbirth and the puerperium: DCI MM 2012"; development of a classification algorithm of deaths of women living with the human immunodeficiency virus/acquired immunodeficiency syndrome in pregnancy and childbirth; and reclassification of deaths by a group of experts. Among the 25 reclassified deaths, 12 were due to human immunodeficiency virus/acquired immunodeficiency syndrome, and pregnancy condition was coexisting; 9 were reclassified as indirect maternal death, with O98.7 code, proposed by the World Health Organization; 2 as direct/indirect maternal death; and 2 were considered indeterminate. The reclassification showed a possible pattern of change in maternal mortality, since most of the deaths were attributed to the virus and may lead to a reduction in deaths from maternal causes. The algorithm will subsidize the use of the new classification of maternal death and human immunodeficiency virus/acquired immunodeficiency syndrome.

Generalized Trust and Intelligence in the United States

PubMed Central

Carl, Noah; Billari, Francesco C.

2014-01-01

Generalized trust refers to trust in other members of society; it may be distinguished from particularized trust, which corresponds to trust in the family and close friends. An extensive empirical literature has established that generalized trust is an important aspect of civic culture. It has been linked to a variety of positive outcomes at the individual level, such as entrepreneurship, volunteering, self-rated health, and happiness. However, two recent studies have found that it is highly correlated with intelligence, which raises the possibility that the other relationships in which it has been implicated may be spurious. Here we replicate the association between intelligence and generalized trust in a large, nationally representative sample of U.S. adults. We also show that, after adjusting for intelligence, generalized trust continues to be strongly associated with both self-rated health and happiness. In the context of substantial variation across countries, these results bolster the view that generalized trust is a valuable social resource, not only for the individual but for the wider society as well. PMID:24619035

Generalized trust and intelligence in the United States.

PubMed

Carl, Noah; Billari, Francesco C

2014-01-01

Generalized trust refers to trust in other members of society; it may be distinguished from particularized trust, which corresponds to trust in the family and close friends. An extensive empirical literature has established that generalized trust is an important aspect of civic culture. It has been linked to a variety of positive outcomes at the individual level, such as entrepreneurship, volunteering, self-rated health, and happiness. However, two recent studies have found that it is highly correlated with intelligence, which raises the possibility that the other relationships in which it has been implicated may be spurious. Here we replicate the association between intelligence and generalized trust in a large, nationally representative sample of U.S. adults. We also show that, after adjusting for intelligence, generalized trust continues to be strongly associated with both self-rated health and happiness. In the context of substantial variation across countries, these results bolster the view that generalized trust is a valuable social resource, not only for the individual but for the wider society as well.

Indications for Emergency Intervention, Mode of Delivery, and the Childbirth Experience.

PubMed

Handelzalts, Jonathan E; Waldman Peyser, Avigail; Krissi, Haim; Levy, Sigal; Wiznitzer, Arnon; Peled, Yoav

2017-01-01

Although the impact of emergency procedures on the childbirth experience has been studied extensively, a possible association of childbirth experience with indications for emergency interventions has not been reported. To compare the impacts on childbirth experience of 'planned' delivery (elective cesarean section and vaginal delivery) versus 'unplanned' delivery (vacuum extraction or emergency cesarean section); the intervention itself (vacuum extraction versus emergency cesarean section); and indications for intervention (arrest of labor versus risk to the mother or fetus). A total of 469 women, up to 72 hours post-partum, in the maternity ward of one tertiary health care institute completed the Subjective Childbirth Experience Questionnaire (score: 0-4, a higher score indicated a more negative experience) and a Personal Information Questionnaire. Intra-partum information was retrieved from the medical records. One-way analysis of variance and two-way analysis of variance, followed by analysis of covariance, to test the unique contribution of variables, were used to examine differences between groups in outcome. Tukey's Post-Hoc analysis was used when appropriate. Planned delivery, either vaginal or elective cesarean section, was associated with a more positive experience than unplanned delivery, either vacuum or emergency cesarean section (mean respective Subjective Childbirth Experience scores: 1.58 and 1.49 vs. 2.02 and 2.07, P <0.01). The difference in mean Subjective Childbirth Experience scores following elective cesarean section and vaginal delivery was not significant; nor was the difference following vacuum extraction and emergency cesarean section. Interventions due to immediate risk to mother or fetus resulted in a more positive birth experience than interventions due to arrest of labor (Subjective Childbirth Experience: 1.9 vs. 2.2, P <0.01). Compared to planned interventions, unplanned interventions were shown to be associated with a more negative

The relationship between childbirth self-efficacy and aspects of well-being, birth interventions and birth outcomes.

PubMed

Carlsson, Ing-Marie; Ziegert, Kristina; Nissen, Eva

2015-10-01

this study aimed to examine how women׳s childbirth self-efficacy beliefs relate to aspects of well-being during the third trimester of pregnancy and whether there was any association between childbirth self-efficacy and obstetric factors. a cross-sectional design was used. The data was obtained through the distribution of a composite questionnaire and antenatal and birth records. data were recruited from antenatal health-care clinics in Halland, Sweden. a consecutive sample of 406 pregnant women was recruited at the end of pregnancy at gestational weeks of 35-42. five different measures were used; the Swedish version of Childbirth Self-Efficacy Inventory, the Wijma Delivery Expectancy/Experience Questionnaire, the Sense of Coherence Questionnaire, the Maternity Social Support Scale and finally the Profile of Mood States. results showed that childbirth self-efficacy was correlated with positive dimensions as vigour, sense of coherence and maternal support and negatively correlated with previous mental illness, negative mood states and fear of childbirth. Women who reported high childbirth self-efficacy had less epidural analgesia during childbirth, compared to women with low self-efficacy. this study highlights that childbirth self-efficacy is a positive dimension that interplays with other aspects and contributes to well-being during pregnancy and thereby, acts as an asset in the context of childbirth. Copyright © 2015 Elsevier Ltd. All rights reserved.

Antenatal education for childbirth-epidural analgesia.

PubMed

Cutajar, Lisa; Cyna, Allan M

2018-05-07

The language structures used by antenatal educators have not been previously researched in the context of antenatal childbirth classes. Epidural analgesia for labour is a common, and a frequently asked about, component of antenatal education for parents in hospitals providing maternity care. We aimed to identify the way information is described and presented by childbirth educators to assess content and determine which language structures such as metaphor, suggestion, information and storytelling are utilized. This observational study of antenatal education was conducted at a single tertiary referral center for maternity care in Western Sydney, Australia. All three childbirth educators agreed to be video recorded whilst providing information to parents during antenatal classes. Audio data was subsequently transcribed and then analysed by two researchers, independently categorising the various language structures and types of information provided. For the purposes of the current study, data concerning a single topic was used for the analysis-'epidural analgesia for labour'. Language structures used were highly variable between educators, as was the content and time taken for the information being provided. Our findings represent a first attempt to identify baseline information used in the clinical setting of antenatal education in order to categories communication structures used. This study has identified areas for further improvements and consistency in the way educators provide information to parents and has important implications for future midwifery practice, education and research. Copyright © 2018 Elsevier Ltd. All rights reserved.

Implementation of the presence of companions during hospital admission for childbirth: data from the Birth in Brazil national survey.

PubMed

Diniz, Carmen Simone Grilo; d'Orsi, Eleonora; Domingues, Rosa Maria Soares Madeira; Torres, Jacqueline Alves; Dias, Marcos Augusto Bastos; Schneck, Camilla A; Lansky, Sônia; Teixeira, Neuma Zamariano Fanaia; Rance, Susanna; Sandall, Jane

2014-08-01

Robust evidence of the benefits of continuous support during childbirth led to the recommendation that it should be offered for all women. In Brazil, it has been guaranteed by law since 2005, but scarce data on implementation is available. We aimed to estimate the frequency and associated socio-demographic, obstetric and institutional predictors of women having companionship during childbirth in the Birth in Brazil survey. Descriptive statistical analysis was done for the characterization of companions (at different moments of hospital stay), maternal and institutional factors; associations were investigated in bivariate and multivariate models. We found that 24.5% of women had no companion at all, 18.8% had continuous companionship and 56.7% had partial companionship. Independent predictors of having no or partial companionship at birth were: lower income and education, brown color of skin, using the public sector, multiparity, and vaginal delivery. Implementation of companionship was associated with having an appropriate environment, and clear institution al rules about women's rights to companionship.

Cochrane pregnancy and childbirth database: resource for evidence-based practice.

PubMed

Callister, L C; Hobbins-Garbett, D

2000-01-01

The Cochrane Pregnancy and Childbirth database is an ongoing meta-analysis of evidence documenting effective health care practices for childbearing women and their neonates. It is proving invaluable to nurse educators, researchers, clinicians, and administrators working in a variety of health care delivery settings. Evidence-based nursing practice that is safe and effective can enhance rather than overpower pivotal and celebratory life events such as childbirth.

Organisational effectiveness within National Health Service (NHS) Trusts.

PubMed

Jackson, S

1998-01-01

In view of the dearth of information relating to organisational effectiveness of NHS Trusts in comparison with clinical effectiveness, a complex study was undertaken to determine whether overall effectiveness was a result of management processes, people, or a combination of both. The study incorporated two phases involving the distribution of a comprehensive questionnaire to identify the "whats" of organisational effectiveness, and a bench-marking exercise aimed at identifying the "hows". In the main, the better performing trusts were found to be subscribing to the concepts of "keeping it simple", innovation and attainment of highly efficient processes. A number of examples of better/best practices were observed which included visible leadership, a commitment towards stakeholder involvement and the practice of teamworking. Given the complexity of the study area, the findings were deemed valuable to managers practising within all areas of healthcare. However, a need for further research was identified in order to substantiate the results.

Gems: Nutrition Education in Childbirth Classes.

ERIC Educational Resources Information Center

Easches, Janet G.; And Others

1983-01-01

Describes a nutrition education packet for natural childbirth (Lamaze) classes. The packet consists of four 15- to 20-minute lessons, each containing goal, objectives, questions (with answers), activities, and pamphlets. List of goals and sample activities are included. (JN)

Women's experiences of coping with pain during childbirth: a critical review of qualitative research.

PubMed

Van der Gucht, Natalie; Lewis, Kiara

2015-03-01

to identify and analyse qualitative literature exploring women's experiences of coping with pain during childbirth. critical review of qualitative research. ten studies were included, conducted in Australia, England, Finland, Iceland, Indonesia, Iran and Sweden. Eight of the studies employed a phenomenological perspective with the remaining two without a specific qualitative methodological perspective. Thematic analysis was used as the approach for synthesising the data in this review. Two main themes emerged as the most significant influences upon a woman's ability to cope with pain: (i) the importance of individualised, continuous support and (ii) an acceptance of pain during childbirth. This review found that women felt vulnerable during childbirth and valued the relationships they had with health professionals. Many of the women perceived childbirth pain as challenging, however, they described the inherent paradox for the need for pain to birth their child. This allowed them to embrace the pain subsequently enhancing their coping ability. women's experience of coping with pain during childbirth is complex and multifaceted. Many women felt the need for effective support throughout childbirth and described the potential implications where this support failed to be provided. Feeling safe through the concept of continuous support was a key element of care to enhance the coping ability and avoid feelings of loneliness and fear. A positive outlook and acceptance of pain was acknowledged by many of the women, demonstrating the beneficial implications for coping ability. These findings were consistent despite the socio-economic, cultural and contextual differences observed within the studies suggesting that experiences of coping with pain during childbirth are universal. the findings suggest there is a dissonance between what women want in order to enhance their ability to cope with pain and the reality of clinical practice. This review found women would like health

Long-Term Effect of Exposure to a Friend's Adolescent Childbirth on Fertility, Education, and Earnings.

PubMed

Kapinos, Kandice A; Yakusheva, Olga

2016-09-01

To examine the long-term effect of a female adolescent's exposure to a peer's childbirth on fertility, schooling, and earnings. Estimating causal peer effects in fertility is challenging because the exposure variable (peer pregnancy and childbirth) is nonrandomly assigned. Miscarriages in early pregnancy occur spontaneously in a significant proportion of pregnancies and, therefore, create a natural experiment within which the causal effect of childbirth can be examined. This exploratory study compared adjusted fertility, educational, and labor market outcomes of female adolescents whose adolescent pregnant friend gave birth to female adolescents whose pregnant friend miscarried. Longitudinal data from the National Longitudinal Study of Adolescent Health were analyzed using logistic, ordinal logistic, linear, and log-linear regressions. Females whose adolescent pregnant friends gave birth (instead of miscarried) had decreased adolescent sexual activity, pregnancy, and teen childbearing and increased educational attainment, but there were no significant long-term effects on total fertility or differences in labor market outcomes, relative to females whose pregnant adolescent friend miscarried. Adolescent females appear to learn vicariously from teen childbearing experiences of their friends, resulting in delayed childbearing and higher educational attainment. Interventions that expose adolescents to the reality of teen motherhood may be an effective way of reducing the rates of teen childbearing and improving schooling. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Fear of childbirth and risk of cesarean delivery: a cohort study in six European countries.

PubMed

Ryding, Elsa Lena; Lukasse, Mirjam; Parys, An-Sophie Van; Wangel, Anne-Marie; Karro, Helle; Kristjansdottir, Hildur; Schroll, Anne-Mette; Schei, Berit

2015-03-01

Few studies have examined the mode of birth among women with fear of childbirth, and the results are conflicting. The objective of this study was to assess the association between fear of childbirth and cesarean delivery in North European women. A longitudinal cohort study was conducted among 6,422 pregnant women from Belgium, Iceland, Denmark, Estonia, Norway, and Sweden. Fear of childbirth was measured by the Wijma Delivery Expectancy Questionnaire during pregnancy and linked to obstetric information from hospital records. Among 3,189 primiparous women, those reporting severe fear of childbirth were more likely to give birth by elective cesarean, (OR, 1.66 [95% CI 1.05-2.61]). Among 3,233 multiparous women, severe fear of childbirth increased the risk of elective cesarean (OR 1.87 [95% CI 1.30-2.69]). Reporting lack of positive anticipation, one of six dimensions of fear of childbirth, was most strongly associated with elective cesarean (OR 2.02 [95% CI 1.52-2.68]). A dose-effect pattern was observed between level of fear and risk of emergency cesarean in both primiparous and multiparous women. Indications for cesarean were more likely to be reported as "nonmedical" among those with severe fear of childbirth; 16.7 versus 4.6 percent in primiparous women, and 31.7 versus 17.5 percent in multiparous women. Having severe fear of childbirth increases the risk of elective cesarean, especially among multiparous women. Lack of positive anticipation of the upcoming childbirth seems to be an important dimension of fear associated with cesarean delivery. Counseling for women who do not look forward to vaginal birth should be further evaluated. © 2015 Wiley Periodicals, Inc.

Misplaced Trust: Racial Differences in Use of Tobacco Products and Trust in Sources of Tobacco Health Information.

PubMed

Alcalá, Héctor E; Sharif, Mienah Z; Morey, Brittany N

2017-10-01

Recently, the rates of utilization of alternative tobacco products have increased. Providing health information about tobacco products from trustworthy sources may help decrease the popularity of these products. Using a nationally representative study of adults, we fill the current gap in research on racial and ethnic disparities in utilization of alternative tobacco products as well as in trust of sources of health information about tobacco products. Data came from the Health Information National Trends Survey (N = 3738), which was collected in 2015. Logistic regression models were used to calculate odds of use of seven different tobacco product (eg, hookah, e-cigarettes, etc.), trust in seven different sources of e-cigarette health information (eg, family or friends, health care providers, etc.), and trust in six different sources of tobacco health information, adjusting for control variables. There were disparities in utilization of alternative tobacco products and in trust, in tobacco companies across racial and ethnic groups. Blacks and Asians were far more likely than whites to trust tobacco (adjusted odds ratios = 8.67 and 4.34) and e-cigarette companies (adjusted odds ratios = 6.97 and 3.13) with information about the health effects of e-cigarettes than whites. The popularity of alternative tobacco products appears to be high and may offset recent observed decreases in cigarette use. Blacks and Asians appear to trust tobacco companies as sources of information when compared to whites. Higher levels of trust in tobacco companies among Asians and blacks may translate to greater susceptibility to utilize tobacco products among these groups, thereby increasing disparities. There is a need for social marketing and education efforts focused on increasing awareness of adverse health effects of using alternative tobacco products as well as on the untrustworthiness of tobacco and e-cigarette companies, especially among racial and ethnic minorities. © The Author

Birth experiences in adult women with a history of childhood sexual abuse.

PubMed

Leeners, Brigitte; Görres, Gisela; Block, Emina; Hengartner, Michael Pascal

2016-04-01

Although childhood sexual abuse (CSA) may seriously impair childbirth experiences, few systematic evaluations on associations, mediating influences, risk and protective factors are available. As such information is mandatory to improve obstetric care, the present study aimed to provide such data. The study compared childbirth experiences from 85 women after CSA and at least one pregnancy resulting in a life birth with those from 170 control women matched for nationality, personal age and children's age. Trained specialists from support centers investigated CSA. Obstetrical data were collected from the official personal clinical record of each pregnancy (Mutterpass) and data on CSA as well as childbirth experiences were examined by questionnaires. Childbirth was more often highly frightening (24.7 vs. 5.3%; p<0.01) and a negative experience (40.7 vs. 19.6%, p<0.01) in women with a history of CSA than in controls. Multivariate regression models support the hypothesis that at least part of this association was mediated by covariates (specifically, birth preparation classes, presence of a trusted person, participation in medical decision-making, pain relief, emergency during labor and extreme duration of labor), which represent important resources in improving obstetric care. In 41% of women with CSA, memories of traumatic experiences intruded during childbirth, whereas about 58% experienced dissociation. While dissociation may result in loss of contact with obstetric staff, it was also used to reduce labor pain. Childbirth following a history of CSA is associated with particular challenges. Creating a trusting environment by evaluating and integrating individual needs could ameliorate birth experiences. Copyright © 2016 Elsevier Inc. All rights reserved.

A Blessing and a Curse? Political Institutions in the Growth and Decay of Generalized Trust: A Cross-National Panel Analysis, 1980–2009

PubMed Central

Robbins, Blaine G.

2012-01-01

Despite decades of research on social capital, studies that explore the relationship between political institutions and generalized trust–a key element of social capital–across time are sparse. To address this issue, we use various cross-national public-opinion data sets including the World Values Survey and employ pooled time-series OLS regression and fixed- and random-effects estimation techniques on an unbalanced panel of 74 countries and 248 observations spread over a 29-year time period. With these data and methods, we investigate the impact of five political-institutional factors–legal property rights, market regulations, labor market regulations, universality of socioeconomic provisions, and power-sharing capacity–on generalized trust. We find that generalized trust increases monotonically with the quality of property rights institutions, that labor market regulations increase generalized trust, and that power-sharing capacity of the state decreases generalized trust. While generalized trust increases as the government regulation of credit, business, and economic markets decreases and as the universality of socioeconomic provisions increases, both effects appear to be more sensitive to the countries included and the modeling techniques employed than the other political-institutional factors. In short, we find that political institutions simultaneously promote and undermine generalized trust. PMID:22558122

Factors contributing to fear of childbirth among pregnant women in Hamadan (Iran) in 2016.

PubMed

Soltani, Farzaneh; Eskandari, Zahra; Khodakarami, Batoul; Parsa, Parisa; Roshanaei, Ghodratollah

2017-07-01

Fear of childbirth is a considerable mental, social, and physiological phenomenon among women as well as their families, which can be effective in choosing cesarean section for delivery. To determine some factors contributing to the fear of childbirth among pregnant women. This cross-sectional study was conducted on 335 pregnant women referred to health centers in Toyserkan in 2016. Pregnant women with the gestational age of 16-40 weeks filled out Harman's Childbirth Attitude Questionnaire (CAQ) as well as stating demographic and obstetrics characteristics. Data were analyzed by Software SPSS/19 through chi-square, ANOVA, and Pearson's correlation tests. The mean age and mean gestational age of the pregnant women were 26.5±4.9 years old and 26.52 weeks, respectively; 89.3% of the women reported fear of childbirth. There was a significant difference among the mean scores of the women's fear of childbirth and education level, household income adequacy, gravidity, being familiar with the delivery process, and pre-pregnancy cares (p<0.05). The present study found the relationship between women's fear of childbirth and their education level, household income, gravidity, familiarity with delivery process, and pre-pregnancy cares. It is necessary for health caregivers to take into consideration the vulnerable groups, especially nulliparous women during pre-pregnancy care as well as the social, and cultural status of women in order to identify the pregnant women exposed to fear of childbirth and reduce the chance of choosing cesarean section by providing appropriate services.

Blame and guilt - a mixed methods study of obstetricians' and midwives' experiences and existential considerations after involvement in traumatic childbirth.

PubMed

Schrøder, Katja; Jørgensen, Jan S; Lamont, Ronald F; Hvidt, Niels C

2016-07-01

When complications arise in the delivery room, midwives and obstetricians operate at the interface of life and death, and in rare cases the infant or the mother suffers severe and possibly fatal injuries related to the birth. This descriptive study investigated the numbers and proportions of obstetricians and midwives involved in such traumatic childbirth and explored their experiences with guilt, blame, shame and existential concerns. A mixed methods study comprising a national survey of Danish obstetricians and midwives and a qualitative interview study with selected survey participants. The response rate was 59% (1237/2098), of which 85% stated that they had been involved in a traumatic childbirth. We formed five categories during the comparative mixed methods analysis: the patient, clinical peers, official complaints, guilt, and existential considerations. Although blame from patients, peers or official authorities was feared (and sometimes experienced), the inner struggles with guilt and existential considerations were dominant. Feelings of guilt were reported by 36-49%, and 50% agreed that the traumatic childbirth had made them think more about the meaning of life. Sixty-five percent felt that they had become a better midwife or doctor due to the traumatic incident. The results of this large, exploratory study suggest that obstetricians and midwives struggle with issues of blame, guilt and existential concerns in the aftermath of a traumatic childbirth. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

A Fine Line: Ethical Issues Facing Childbirth Educators Negotiating Evidence, Beliefs, and Experience

PubMed Central

Morton, Christine H

2009-01-01

The trend toward evidence-based information in childbirth education has been ongoing for some time. Lamaze educators are encouraged to present evidence for the Six Care Practices That Support Normal Birth to pregnant women in their childbirth classes. In a previous article published in The Journal of Perinatal Education, my colleague and I provided an overview of the dilemmas facing American childbirth educators. Childbirth education is a domain in which many types of authoritative knowledge are used: evidence, beliefs, and experience. In our study, educators told us their goal is to provide class participants with unbiased information that allows women to choose what is best for them. In this article, I further analyze educators’ dilemmas and challenges in presenting unbiased information, and I discuss some ethical considerations in educators’ practices. PMID:19436597

Fear of childbirth in primiparous Italian pregnant women: The role of anxiety, depression, and couple adjustment.

PubMed

Molgora, Sara; Fenaroli, Valentina; Prino, Laura Elvira; Rollè, Luca; Sechi, Cristina; Trovato, Annamaria; Vismara, Laura; Volpi, Barbara; Brustia, Piera; Lucarelli, Loredana; Tambelli, Renata; Saita, Emanuela

2018-04-01

The prevalence of fear of childbirth in pregnant women is described to be about 20-25%, while 6-10% of expectant mothers report a severe fear that impairs their daily activities as well as their ability to cope with labour and childbirth. Research on fear of childbirth risk factors has produced heterogeneous results while being mostly done with expectant mothers from northern Europe, northern America, and Australia. The present research investigates whether fear of childbirth can be predicted by socio-demographic variables, distressing experiences before pregnancy, medical-obstetric factors and psychological variables with a sample of 426 Italian primiparous pregnant women. Subjects, recruited between the 34th and 36th week of pregnancy, completed a questionnaire packet that included the Wijma Delivery Expectancy Questionnaire, the Edinburgh Postnatal Depression Scale, the State-Trait Anxiety Inventory, the Dyadic Adjustment Scale, the Multidimensional Scale of Perceived Social Support, as well as demographic and anamnestic information. Fear of childbirth was treated as both a continuous and a dichotomous variable, in order to differentiate expectant mothers as with a severe fear of childbirth. Results demonstrate that anxiety as well as couple adjustment predicted fear of childbirth when treated as a continuous variable, while clinical depression predicted severe fear of childbirth. Findings support the key role of psychological variables in predicting fear of childbirth. Results suggest the importance of differentiating low levels of fear from intense levels of fear in order to promote adequate support interventions. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Childbirth and Trauma, 1940s-1980s.

PubMed

Michaels, Paula A

2018-01-01

This article analyzes trauma in mid-twentieth century hospital births, focusing on the United States, but with additional evidence drawn from Great Britain and France. As many as half of women today experience childbirth as traumatic and no evidence suggests that the figure was lower a half-century ago. Drawing on women's birth narratives and psychiatric literature, this article highlights the striking consistency over time in how women describe their experiences of traumatic birth. By the 1970s, however, women proved less ready to accept their trauma as the product of their own psychological shortcomings. Under the sway of second-wave feminism, they pushed back against care they defined as inhumane in both conventional maternity care and in natural childbirth. Psychiatry too demonstrates change over time. Hegemonic at midcentury, Freudian thinking began to yield to critiques that questioned gender norms and the preeminence of the subconscious. Based on private letters to maternity caregivers and between physicians, as well as a wide array of medical journal articles, popular magazines, and newsletters from childbirth education and birth advocacy organizations, this article argues that, despite different approaches to trauma in birth and clarity about how best to minimize it, contemporary maternity care has to date proven unable to heed the lessons of history. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The BetterBirth Program: Pursuing Effective Adoption and Sustained Use of the WHO Safe Childbirth Checklist Through Coaching-Based Implementation in Uttar Pradesh, India.

PubMed

Kara, Nabihah; Firestone, Rebecca; Kalita, Tapan; Gawande, Atul A; Kumar, Vishwajeet; Kodkany, Bhala; Saurastri, Rajiv; Pratap Singh, Vinay; Maji, Pinki; Karlage, Ami; Hirschhorn, Lisa R; Semrau, Katherine Ea

2017-06-27

Shifting childbirth into facilities has not improved health outcomes for mothers and newborns as significantly as hoped. Improving the quality and safety of care provided during facility-based childbirth requires helping providers to adhere to essential birth practices-evidence-based behaviors that reduce harm to and save lives of mothers and newborns. To achieve this goal, we developed the BetterBirth Program, which we tested in a matched-pair, cluster-randomized controlled trial in Uttar Pradesh, India. The goal of this intervention was to improve adoption and sustained use of the World Health Organization Safe Childbirth Checklist (SCC), an organized collection of 28 essential birth practices that are known to improve the quality of facility-based childbirth care. Here, we describe the BetterBirth Program in detail, including its 4 main features: implementation tools, an implementation strategy of coaching, an implementation pathway (Engage-Launch-Support), and a sustainability plan. This coaching-based implementation of the SCC motivates and empowers care providers to identify, understand, and resolve the barriers they face in using the SCC with the resources already available. We describe important lessons learned from our experience with the BetterBirth Program as it was tested in the BetterBirth Trial. For example, the emphasis on relationship building and respect led to trust between coaches and birth attendants and helped influence change. In addition, the cloud-based data collection and feedback system proved a valuable asset in the coaching process. More research on coaching-based interventions is required to refine our understanding of what works best to improve quality and safety of care in various settings.Note: At the time of publication of this article, the results of evaluation of the impact of the BetterBirth Program were pending publication in another journal. After the impact findings have been published, we will update this article with a

The BetterBirth Program: Pursuing Effective Adoption and Sustained Use of the WHO Safe Childbirth Checklist Through Coaching-Based Implementation in Uttar Pradesh, India

PubMed Central

Kara, Nabihah; Firestone, Rebecca; Kalita, Tapan; Gawande, Atul A; Kumar, Vishwajeet; Kodkany, Bhala; Saurastri, Rajiv; Pratap Singh, Vinay; Maji, Pinki; Karlage, Ami; Hirschhorn, Lisa R; Semrau, Katherine EA

2017-01-01

Shifting childbirth into facilities has not improved health outcomes for mothers and newborns as significantly as hoped. Improving the quality and safety of care provided during facility-based childbirth requires helping providers to adhere to essential birth practices—evidence-based behaviors that reduce harm to and save lives of mothers and newborns. To achieve this goal, we developed the BetterBirth Program, which we tested in a matched-pair, cluster-randomized controlled trial in Uttar Pradesh, India. The goal of this intervention was to improve adoption and sustained use of the World Health Organization Safe Childbirth Checklist (SCC), an organized collection of 28 essential birth practices that are known to improve the quality of facility-based childbirth care. Here, we describe the BetterBirth Program in detail, including its 4 main features: implementation tools, an implementation strategy of coaching, an implementation pathway (Engage-Launch-Support), and a sustainability plan. This coaching-based implementation of the SCC motivates and empowers care providers to identify, understand, and resolve the barriers they face in using the SCC with the resources already available. We describe important lessons learned from our experience with the BetterBirth Program as it was tested in the BetterBirth Trial. For example, the emphasis on relationship building and respect led to trust between coaches and birth attendants and helped influence change. In addition, the cloud-based data collection and feedback system proved a valuable asset in the coaching process. More research on coaching-based interventions is required to refine our understanding of what works best to improve quality and safety of care in various settings. (After publication of this article, the impact results of the BetterBirth intervention were published in the New England Journal of Medicine [volume 377, pages 2313-2324, doi: 10.1056/NEJMoa1701075]. The results showed that the intervention had

Food and trust in Australia: building a picture.

PubMed

Coveney, John

2008-03-01

To explore consumer trust in food, especially people's experiences that support or diminish trust in the food supply; consumer practices to strengthen trust in food; and views on how trust in the food supply could be increased. Adelaide, South Australia. In-depth qualitative research interviews and focus groups. Women and men who are primary food providers in families (n = 24). Media coverage of food scares and scandals and personal experience of food-borne illness challenged respondents' trust in the food system. Poor retail food handling practices and questionable marketing ploys by food manufacturers also decreased trust. Buying 'Made-in-Australia' produce and following food safety procedures at home were important practices to strengthen food trust. Knowledge of procedures for local food inspection and for national food regulation to keep food safe was scanty. Having a strong regulatory environment governing food safety and quality was considered by respondents to be of prime importance for trust building. The dimensions of trust found in this study are consistent with key theoretical aspects of trust. The need for trust in highly complex environments, in this case the food supply, was evident. Trust was found to be integral to food choice, and negative media reports, the sources of which themselves enjoy various levels of dependability, were found to easily damage trust relationships. The lack of visibility of authoritative monitoring and surveillance, misleading food advertising, and poor retail food handling practices were identified as areas that decreased consumer trust. Respondents also questioned the probity of food labelling, especially health claims and other mechanisms designed to guide food choice. The research highlights the role trust plays in food choice. It also emphasises the importance of a visible authoritative presence in the food system to strengthen trust and provide reassurance to consumers.

Women's authority during childbirth and Safe Motherhood in Yemen.

PubMed

Kempe, Annica; Noor-Aldin Alwazer, Fatoom A; Theorell, Töres

2010-11-01

In the effort to increase utilization of professional care during childbirth in low-income countries, few studies have taken a holistic approach to investigating women's perspective of safety and the link to perceived own authority at birth. The aim of the study was to examine women's authority at birth with reference to the intrapartum factors, the level of training of staff and the social and demographic background of women. A multistage (stratified-purposive-random) sampling process was used. We interviewed 220 women with childbirth experience in urban/rural Yemen. We performed bivariate chi-square tests and multiple logistic regression analysis. Women who had their questions answered and requests met during childbirth had 83% higher probability (95% CI 1.66-2.02) to perceive own authority. Women who reported skin-to-skin contact/newborn in arms had 28% higher (95% CI 1.03-1.59) and those who had more distant contact 15% lower (95% CI 0.75-0.95) probability. A graded negative association was found between the perceived authority of the woman in childbirth and the level of biomedical training of staff (p<.0001). Women's social and demographic background played no role for their perceived own authority at birth. This paper argues that supporting Yemeni women to exercise their own authority during childbirth would significantly facilitate their ability to give birth successfully and with personal satisfaction. In a country where women are routinely disempowered, their personal empowerment at birth is very important to them. Skilled birth assistants often, in women's perceptions, work against their personal power and authority, most especially MDs but also midwives. This failure results in women failing to seek medical care when needed. Supporting women to experience their own authority at birth would facilitate the accomplishment of both the Millennium Development Goals and those of the Safe Motherhood Initiative. We call for increased cooperation between modern

The OptiMUM-study: EMDR therapy in pregnant women with posttraumatic stress disorder after previous childbirth and pregnant women with fear of childbirth: design of a multicentre randomized controlled trial

PubMed Central

Baas, M. A. M.; Stramrood, C. A. I.; Dijksman, L. M.; de Jongh, A.; van Pampus, M. G.

2017-01-01

ABSTRACT Background: Approximately 3% of women develop posttraumatic stress disorder (PTSD) after giving birth, and 7.5% of pregnant women show a pathological fear of childbirth (FoC). FoC or childbirth-related PTSD during (a subsequent) pregnancy can lead to a request for an elective caesarean section as well as adverse obstetrical and neonatal outcomes. For PTSD in general, and several subtypes of specific phobia, eye movement desensitization and reprocessing (EMDR) therapy has been proven effective, but little is known about the effects of applying EMDR during pregnancy. Objective: To describe the protocol of the OptiMUM-study. The main aim of the study is to determine whether EMDR therapy is an effective and safe treatment for pregnant women with childbirth-related PTSD or FoC. In addition, the cost-effectiveness of this approach will be analysed. Method: The single-blind OptiMUM-study consists of two two-armed randomized controlled trials (RCTs) with overlapping design. In several hospitals and community midwifery practices in Amsterdam, the Netherlands, all eligible pregnant women with a gestational age between eight and 20 weeks will be administered the Wijma delivery expectations questionnaire (WDEQ) to asses FoC. Multiparous women will also receive the PTSD checklist for DSM-5 (PCL-5) to screen for possible PTSD. The clinician administered PTSD scale (CAPS-5) will be used for assessing PTSD according to DSM-5 in women scoring above the PCL-5 cut-off value. Fifty women with childbirth-related PTSD and 120 women with FoC will be randomly allocated to either EMDR therapy carried out by a psychologist or care-as-usual. Women currently undergoing psychological treatment or women younger than 18 years will not be included. Primary outcome measures are severity of childbirth-related PTSD or FoC symptoms. Secondary outcomes are percentage of PTSD diagnoses, percentage caesarean sections, subjective childbirth experience, obstetrical and neonatal complications

"Nothing's actually happened to me.": the experiences of fathers who found childbirth traumatic.

PubMed

Etheridge, Jody; Slade, Pauline

2017-03-07

Given the limited research into men's experiences of being present at childbirth this study explored the experiences of fathers who found childbirth traumatic. The aim of the research was to investigate how men coped with these experiences; the impact on their lives; and their views on what may have helped to reduce distress. Participants were recruited via websites relating to birth trauma and parenthood. A consent and screening questionnaire was used to ensure that participants met the inclusion criteria of: being resident in the UK; being 16 years or older; having been present at the birth and answering yes to the question "At some point during the childbirth I experienced feelings of intense fear, helplessness or horror". Semi-structured telephone interviews were completed with 11 fathers who reported finding childbirth traumatic. Participants also completed the Impact of Event Scale as a measure of trauma symptoms. Template Analysis was used to analyse the interview data. Childbirth was experienced as "a rollercoaster of emotion" because of the speed and unexpectedness of events. Men described fears of death, mirroring their partner's distress; trying 'to keep it together' and helplessly watching a catastrophe unfold. Fathers felt themselves abandoned by staff with a lack of information. Men were subsequently distressed and preoccupied with the birth events but tended to feel that their responses were unjustified and tried to cope through avoidance. Men described the need for support but reluctance to receive it. Fathers may experience extreme distress as a result of childbirth which is exacerbated by aspects of current maternity care. Maternity services need to be aware of the potential impacts of fathers' attendance at childbirth and attend to fathers', as well as mothers', emotional responses.

The Relationship between Perceived Social Support in the First Pregnancy and Fear of Childbirth.

PubMed

Azimi, Masoomeh; Fahami, Fariba; Mohamadirizi, Soheila

2018-01-01

Numerous empirical evidences have shown that social and environmental circumstances and social relations have an important impact on pregnancy outcomes, women's ability to cope with stressful situations, and childbirth pain management. The present study was conducted to determine the relationship between perceived social support and fear of childbirth. The present descriptive correlational study was conducted on 270 nulliparous pregnant women who referred for pregnancy care in 2016. The subjects were selected through convenience sampling method. The data collection tools were a demographic characteristics form, the Multidimensional Scale of Perceived Social Support (MSPSS), and the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ). The collected data were analyzed using descriptive and inferential statistics tests. The mean perceived social support score of the participants was 77.90 and a significant correlation was observed between the perceived social support score and fear of childbirth score (β = -0.18, p = 0.004). The participants' mean score of fear of childbirth was 36.8. The results of study after the evaluation of the effect of predictive variables on the fear of childbirth are as follows: pregnancy preparation classes: ( β = 3.50, p = 0.220); observation of natural childbirth videos: ( β = 5.26, p = 0.040); and use of educational software: ( β =5.82, p = 0.080). In order to reduce the fear of childbirth, women's social support structure during pregnancy should be assessed. Moreover, demographic characteristics form the structure and determine the extent of individuals' social network and, through the evaluation of these characteristics during pregnancy, the rate of effective support can be predicted in individuals.

Steps Toward Innovative Childbirth Education: Selected Strategies From the Blueprint for Action

PubMed Central

Jolivet, R. Rima; Corry, Maureen P.

2010-01-01

To mark the 50th anniversary of Lamaze International, Childbirth Connection celebrates landmark accomplishments in education for childbearing women and families, and takes stock of the changing educational needs and preferences of current childbearing families in looking toward the future. Childbirth Connection's multi-year, multi-stakeholder Transforming Maternity Care initiative resulted in two landmark reports: 2020 Vision for a High-Quality, High-Value Maternity Care System and Blueprint for Action: Steps Toward a High-Quality, High-Value Maternity Care System. Selected recommendations of greatest relevance to the field of childbirth education are discussed, and the new Transforming Maternity Care Partnership is introduced. PMID:21629389

Preparation for Childbirth. A Health Workers Manual. Appropriate Technologies for Development. Peace Corps Information Collection & Exchange Reprint R-55.

ERIC Educational Resources Information Center

Hansen, Miriam; And Others

This manual was developed to help Peace Corps volunteers who are serving as community health workers in developing nations to teach expectant mothers about pregnancy and childbirth. The material is organized in four sections corresponding to four prenatal classes plus a section on labor and delivery information for health care workers. Some of the…

Emergency Victim Care. A Training Manual for Emergency Medical Technicians. Module 11--Childbirth, Pediatric Emergencies. Revised.

ERIC Educational Resources Information Center

Ohio State Dept. of Education, Columbus. Div. of Vocational Education.

This training manual for emergency medical technicians, one of 14 modules that comprise the Emergency Victim Care textbook, covers childbirth and pediatric emergencies. Objectives stated for the two chapters are for the students to be able to describe: emergency procedures for normal childbirth, unusual childbirth emergencies, emergency care for…

Hypnotherapy for childbirth.

PubMed

Granger, Sheila

2012-09-01

The birthing process, although often a joyful and proud moment, can also create an overwhelming sense of anxiety. As a result some women are now turning to hypnobirthing to help them to cope. This practice is used to relax women before and during their labour. It also helps encourage a stress free birth and reduce the need for drugs and interventions, such as caesarean section. In this article, Sheila Granger helps to dispel some of the myths surrounding the use of hypnotherapy and looks specifically at its application to childbirth. The role of midwives and the benefits to them are also discussed.

(Dis)placing trust: the long-term effects of job displacement on generalised trust over the adult lifecourse.

PubMed

Laurence, James

2015-03-01

Increasing rates of job displacement (i.e. involuntary job loss from redundancy, downsizing, restructuring) have been suggested to be a key driver of declining macro-levels of generalised trust. This article undertakes the first test of how job displacement affects individuals' tendencies to (dis)trust over the adult lifecourse, using two-waves of the Great Britain National Child Development Study cohort data, on a sample of n=6840 individuals. Applying both lagged dependent variable logistic regression and two-wave change-score models, experiencing job displacement between the ages of 33 and 50 appears to significantly scar individuals' generalised trust, with depressed trust observable at least nine years after the event occurred. However, this effect is dependent on the value an individual places on work: the greater the attachment to employment the stronger the negative effect of displacement. A range of mediators, such as physical health, mental well-being, and personal efficacy, do not appear to account for the effect. Copyright © 2014 Elsevier Inc. All rights reserved.

Identifying Social Trust in Cross-Country Analysis: Do We Really Measure the Same?

ERIC Educational Resources Information Center

Torpe, Lars; Lolle, Henrik

2011-01-01

Many see trust as an important social resource for the welfare of individuals as well as nations. It is therefore important to be able to identify trust and explain its sources. Cross-country survey analysis has been an important tool in this respect, and often one single variable is used to identify social trust understood as trust in strangers,…

Treatment of severe fear of childbirth with haptotherapy: design of a multicenter randomized controlled trial.

PubMed

Klabbers, Gert A; Wijma, Klaas; Paarlberg, K Marieke; Emons, Wilco Hm; Vingerhoets, Ad Jjm

2014-10-08

About six percent of pregnant women suffer from severe fear of childbirth. These women are at increased risk of obstetric labour and delivery interventions and pre- and postpartum complications, e.g., preterm delivery, emergency caesarean section, caesarean section at maternal request, severe postpartum fear of childbirth and trauma anxiety. During the last decade, there is increasing clinical evidence suggesting that haptotherapy might be an effective intervention to reduce fear of childbirth in pregnant women. The present study has been designed to evaluate the effects of such intervention. Included are singleton pregnant women with severe fear of childbirth, age ≥ 18 year, randomised into three arms: (1) treatment with haptotherapy, (2) internet psycho-education or (3) care as usual. The main study outcome is fear of childbirth. Measurements are taken at baseline in gestation week 20-24, directly after the intervention is completed in gestation week 36, six weeks postpartum and six months postpartum. Secondary study outcomes are distress, general anxiety, depression, somatization, social support, mother-child bonding, pregnancy and delivery complications, traumatic anxiety symptoms, duration of delivery, birth weight, and care satisfaction. The treatment, a standard haptotherapeutical treatment for pregnant women with severe fear of childbirth, implies teaching a combination of skills in eight one hour sessions. The internet group follows an eight-week internet course containing information about pregnancy and childbirth comparable to childbirth classes. The control group has care as usual according to the standards of the Royal Dutch Organisation of Midwives and the Dutch Organization of Obstetrics and Gynaecology. This trial was entered in the Dutch Trial Register and registered under number NTR3339 on March 4th, 2012.

[Influence of childbirth experience and postpartum depression on quality of life in women after birth].

PubMed

Yeo, Jung Hee; Chun, Nami

2013-02-01

The purpose of this study was to identify influence of childbirth experience and postpartum depression on quality of life in women after birth. Two hundred and eleven postpartum women were asked to complete the questionnaires on their childbirth experience during their admission and on their postpartum depression and quality of life between one to three weeks after birth. Initial data were collected from February 1 to May 30, 2011 at two obstetric hospitals in Busan, Korea. Data were analyzed using t-test, ANOVA, Pearson correlation coefficients, and hierarchical multiple regression. The women's childbirth experience and postpartum depression were identified as factors influencing quality of life after birth. The model explained 50% of the variables. Results suggest that childbirth educators should include strategies to increase a positive childbirth experience and to decrease postpartum depression in their education programs in order to improve women's quality of life.

International Human Rights and the Mistreatment of Women During Childbirth

PubMed Central

Zampas, Christina; Vogel, Joshua P.; Bohren, Meghan A.; Roseman, Mindy; Erdman, Joanna N.

2016-01-01

Abstract International human rights bodies have played a critical role in codifying, setting standards, and monitoring human rights violations in the context of sexual and reproductive health and rights. In recent years, these institutions have developed and applied human rights standards in the more particular context of maternal mortality and morbidity, and have increasingly recognized a critical human rights issue in the provision and experience of care during and after pregnancy, including during childbirth. However, the international human rights standards on mistreatment during facility-based childbirth remain, in an early stage of development, focused largely on a discrete subset of experiences, such as forced sterilization and lack of access to emergency obstetric care. As a consequence, the range of mistreatment that women may experience has not been adequately addressed or analyzed under international human rights law. Identifying human rights norms and standards related to the full range of documented mistreatment is thus a first step towards addressing violations of human rights during facility-based childbirth, ensuring respectful and humane treatment, and developing a program of work to improve the overall quality of maternal care. This article reviews international human rights standards related to the mistreatment of women during childbirth in facility settings under regional and international human rights law and lays out an agenda for further research and action. PMID:28559681

The obstetrical and postpartum benefits of continuous support during childbirth.

PubMed

Scott, K D; Klaus, P H; Klaus, M H

1999-12-01

The purpose of this article is to review the evidence regarding the effectiveness of continuous support provided by a trained laywoman (doula) during childbirth on obstetrical and postpartum outcomes. Twelve individual randomized trials have compared obstetrical and postpartum outcomes between doula-supported women and women who did not receive doula support during childbirth. Three meta-analyses, which used different approaches, have been performed on the results of the clinical trials. Emotional and physical support significantly shortens labor and decreases the need for cesarean deliveries, forceps and vacuum extraction, oxytocin augmentation, and analgesia. Doula-supported mothers also rate childbirth as less difficult and painful than do women not supported by a doula. Labor support by fathers does not appear to produce similar obstetrical benefits. Eight of the 12 trials report early or late psychosocial benefits of doula support. Early benefits include reductions in state anxiety scores, positive feelings about the birth experience, and increased rates of breastfeeding initiation. Later postpartum benefits include decreased symptoms of depression, improved self-esteem, exclusive breastfeeding, and increased sensitivity of the mother to her child's needs. The results of these 12 trials strongly suggest that doula support is an essential component of childbirth. A thorough reorganization of current birth practices is in order to ensure that every woman has access to continuous emotional and physical support during labor.

International Human Rights and the Mistreatment of Women During Childbirth.

PubMed

Khosla, Rajat; Zampas, Christina; Vogel, Joshua P; Bohren, Meghan A; Roseman, Mindy; Erdman, Joanna N

2016-12-01

International human rights bodies have played a critical role in codifying, setting standards, and monitoring human rights violations in the context of sexual and reproductive health and rights. In recent years, these institutions have developed and applied human rights standards in the more particular context of maternal mortality and morbidity, and have increasingly recognized a critical human rights issue in the provision and experience of care during and after pregnancy, including during childbirth. However, the international human rights standards on mistreatment during facility-based childbirth remain, in an early stage of development, focused largely on a discrete subset of experiences, such as forced sterilization and lack of access to emergency obstetric care. As a consequence, the range of mistreatment that women may experience has not been adequately addressed or analyzed under international human rights law. Identifying human rights norms and standards related to the full range of documented mistreatment is thus a first step towards addressing violations of human rights during facility-based childbirth, ensuring respectful and humane treatment, and developing a program of work to improve the overall quality of maternal care. This article reviews international human rights standards related to the mistreatment of women during childbirth in facility settings under regional and international human rights law and lays out an agenda for further research and action.

Distribution and Correlates of Self-Reported Crimes of Trust

PubMed Central

Menard, Scott; Morris, Robert G.; Gerber, Jurg; Covey, Herbert C.

2012-01-01

This study examines the distribution and correlates of a special class of property crimes, crimes of trust, using longitudinal and cross sectional self-report data from a national sample. We begin by defining crimes of trust and consider their conceptual relationship to “conventional” property crimes, which we here characterize as crimes of stealth, and to white collar crimes, which are defined in terms of the social status of the perpetrators. Crimes of trust are here defined as property crimes that typically involve deliberate contact with the victim or, where there is more than one victim, with at least one or more victims, in which there is typically more of a focus on concealing the fact that a crime has been committed than on concealing the identity of the perpetrator (as is the case in crimes of stealth), without regard to the socioeconomic status of the perpetrator (thus including but not limited to white collar crimes). The focus here is on crimes of trust committed by individuals (as opposed to corporate crime). We first examine their distribution by sociodemographic characteristics, then examine the correlation of crimes of trust with other types of illegal behavior, using data from the National Youth Survey Family Study, including (1) longitudinal self-report data from a nationally representative panel of individuals who were 11–18 years old in 1976–77 and who were followed through early middle age (ages 36–44) in 2002–2003, plus (2) cross-sectional data on these individuals plus their parents, spouses, and children age 11 and older in 2002–2003 (total age range 11–88). The results suggest that crimes of trust have a different age-crime curve from conventional crimes, and that they are not as strongly correlated with problem substance use, gender, and other socioeconomic indicators as conventional crimes. PMID:22347761

Distribution and Correlates of Self-Reported Crimes of Trust.

PubMed

Menard, Scott; Morris, Robert G; Gerber, Jurg; Covey, Herbert C

2011-11-01

This study examines the distribution and correlates of a special class of property crimes, crimes of trust, using longitudinal and cross sectional self-report data from a national sample. We begin by defining crimes of trust and consider their conceptual relationship to "conventional" property crimes, which we here characterize as crimes of stealth, and to white collar crimes, which are defined in terms of the social status of the perpetrators. Crimes of trust are here defined as property crimes that typically involve deliberate contact with the victim or, where there is more than one victim, with at least one or more victims, in which there is typically more of a focus on concealing the fact that a crime has been committed than on concealing the identity of the perpetrator (as is the case in crimes of stealth), without regard to the socioeconomic status of the perpetrator (thus including but not limited to white collar crimes). The focus here is on crimes of trust committed by individuals (as opposed to corporate crime). We first examine their distribution by sociodemographic characteristics, then examine the correlation of crimes of trust with other types of illegal behavior, using data from the National Youth Survey Family Study, including (1) longitudinal self-report data from a nationally representative panel of individuals who were 11-18 years old in 1976-77 and who were followed through early middle age (ages 36-44) in 2002-2003, plus (2) cross-sectional data on these individuals plus their parents, spouses, and children age 11 and older in 2002-2003 (total age range 11-88). The results suggest that crimes of trust have a different age-crime curve from conventional crimes, and that they are not as strongly correlated with problem substance use, gender, and other socioeconomic indicators as conventional crimes.

PTSD after childbirth: early detection and treatment.

PubMed

Zauderer, Cheryl R

2014-03-13

Posttraumatic stress disorder (PTSD) following childbirth may be diagnosed as postpartum depression. With a thorough assessment, women with this condition can be diagnosed correctly and receive appropriate treatment, promoting a better outcome for both mother and baby.

Nature's Trust: A Paradigm for Natural Resources Stewardship

NASA Astrophysics Data System (ADS)

Wood, M. C.; Whitelaw, E.; Doppelt, B.; Burchell, A.

2007-12-01

scientists: each jurisdiction must cap and begin reducing total GHG emissions within the decade and continue reduction until they reach 80% below 1990 levels by 2050. The trust framework positions all nations of the world in a logical relationship that can guide international diplomacy. The atmosphere, oceans and the global hydrologic cycle are commonly held assets shared as property among all nations on Earth. Thus, all Nations are sovereign co-tenant trustees, each holding the fiduciary responsibility to not degrade the common asset and to accomplish proportionate carbon reduction.

The Relationship between Perceived Social Support in the First Pregnancy and Fear of Childbirth

PubMed Central

Azimi, Masoomeh; Fahami, Fariba; Mohamadirizi, Soheila

2018-01-01

Background: Numerous empirical evidences have shown that social and environmental circumstances and social relations have an important impact on pregnancy outcomes, women's ability to cope with stressful situations, and childbirth pain management. The present study was conducted to determine the relationship between perceived social support and fear of childbirth. Materials and Methods: The present descriptive correlational study was conducted on 270 nulliparous pregnant women who referred for pregnancy care in 2016. The subjects were selected through convenience sampling method. The data collection tools were a demographic characteristics form, the Multidimensional Scale of Perceived Social Support (MSPSS), and the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ). The collected data were analyzed using descriptive and inferential statistics tests. Results: The mean perceived social support score of the participants was 77.90 and a significant correlation was observed between the perceived social support score and fear of childbirth score (β = −0.18, p = 0.004). The participants' mean score of fear of childbirth was 36.8. The results of study after the evaluation of the effect of predictive variables on the fear of childbirth are as follows: pregnancy preparation classes: (β = 3.50, p = 0.220); observation of natural childbirth videos: (β = 5.26, p = 0.040); and use of educational software: (β =5.82, p = 0.080). Conclusions: In order to reduce the fear of childbirth, women's social support structure during pregnancy should be assessed. Moreover, demographic characteristics form the structure and determine the extent of individuals' social network and, through the evaluation of these characteristics during pregnancy, the rate of effective support can be predicted in individuals. PMID:29861764

Midlevel Maternity Providers' Preferences of a Childbirth Monitoring Tool in Low-Income Health Units in Uganda.

PubMed

Balikuddembe, Michael S; Wakholi, Peter K; Tumwesigye, Nazarius M; Tylleskär, Thorkild

2018-01-01

A third of women in childbirth are inadequately monitored, partly due to the tools used. Some stakeholders assert that the current labour monitoring tools are not efficient and need improvement to become more relevant to childbirth attendants. The study objective was to explore the expectations of maternity service providers for a mobile childbirth monitoring tool in maternity facilities in a low-income country like Uganda. Semi-structured interviews of purposively selected midwives and doctors in rural-urban childbirth facilities in Uganda were conducted before thematic data analysis. The childbirth providers expected a tool that enabled fast and secure childbirth record storage and sharing. They desired a tool that would automatically and conveniently register patient clinical findings, and actively provide interactive clinical decision support on a busy ward. The tool ought to support agreed upon standards for good pregnancy outcomes but also adaptable to the patient and their difficult working conditions. The tool functionality should include clinical data management and real-time decision support to the midwives, while the non-functional attributes include versatility and security.

A randomized controlled trial of a psycho-education intervention by midwives in reducing childbirth fear in pregnant women.

PubMed

Toohill, Jocelyn; Fenwick, Jennifer; Gamble, Jenny; Creedy, Debra K; Buist, Anne; Turkstra, Erika; Ryding, Elsa-Lena

2014-12-01

Childbirth fear is associated with increased obstetric interventions and poor emotional and psychological health for women. The purpose of this study is to test an antenatal psycho-education intervention by midwives in reducing women's childbirth fear. Women (n = 1,410) attending three hospitals in South East Queensland, Australia, were recruited into the BELIEF trial. Participants reporting high fear were randomly allocated to intervention (n = 170) or control (n = 169) groups. All women received a decision-aid booklet on childbirth choices. The telephone counseling intervention was offered at 24 and 34 weeks of pregnancy. The control group received usual care offered by public maternity services. Primary outcome was reduction in childbirth fear (WDEQ-A) from second trimester to 36 weeks' gestation. Secondary outcomes were improved childbirth self-efficacy, and reduced decisional conflict and depressive symptoms. Demographic, obstetric & psychometric measures were administered at recruitment, and 36 weeks of pregnancy. There were significant differences between groups on postintervention scores for fear of birth (p < 0.001) and childbirth self-efficacy (p = 0.002). Decisional conflict and depressive symptoms reduced but were not significant. Psycho-education by trained midwives was effective in reducing high childbirth fear levels and increasing childbirth confidence in pregnant women. Improving antenatal emotional well-being may have wider positive social and maternity care implications for optimal childbirth experiences. © 2014 The Authors. Birth Published by Wiley Periodicals, Inc.

Umbilical Cord Blood: Information for Childbirth Educators

PubMed Central

Waller-Wise, Renece

2011-01-01

Umbilical cord blood was once thought of as a waste product. Now, years after the first successful umbilical cord blood transplant, more families seek information about whether or not to save their newborn’s cord blood. Childbirth educators may be one of the main sources that an expectant family depends on to gain more knowledge about cord blood banking in order to make an informed decision. Preserving umbilical cord blood in public banks is advisable for any family; however, it is recommended that expectant families only consider private cord blood banking when they have a relative with a known disorder that is treatable by stem cell transplants. The childbirth educator is encouraged to be well versed on the topic of cord blood banking, so that as questions from class participants arise, the topic can be explored and addressed appropriately. PMID:22211060

Hypnosis Antenatal Training for Childbirth (HATCh): a randomised controlled trial [NCT00282204].

PubMed

Cyna, Allan M; Andrew, Marion I; Robinson, Jeffrey S; Crowther, Caroline A; Baghurst, Peter; Turnbull, Deborah; Wicks, Graham; Whittle, Celia

2006-03-05

Although medical interventions play an important role in preserving lives and maternal comfort they have become increasingly routine in normal childbirth. This may increase the risk of associated complications and a less satisfactory birth experience. Antenatal hypnosis is associated with a reduced need for pharmacological interventions during childbirth. This trial seeks to determine the efficacy or otherwise of antenatal group hypnosis preparation for childbirth in late pregnancy. A single centre, randomised controlled trial using a 3 arm parallel group design in the largest tertiary maternity unit in South Australia. Group 1 participants receive antenatal hypnosis training in preparation for childbirth administered by a qualified hypnotherapist with the use of an audio compact disc on hypnosis for re-enforcement; Group 2 consists of antenatal hypnosis training in preparation for childbirth using an audio compact disc on hypnosis administered by a nurse with no training in hypnotherapy; Group 3 participants continue with their usual preparation for childbirth with no additional intervention. Women > 34 and < 39 weeks gestation, planning a vaginal birth, not in active labour, with a singleton, viable fetus of vertex presentation, are eligible to participate. Allocation concealment is achieved using telephone randomisation. Participants assigned to hypnosis groups commence hypnosis training as near as possible to 37 weeks gestation. Treatment allocations are concealed from treating obstetricians, anaesthetists, midwives and those personnel collecting and analysing data. Our sample size of 135 women/group gives the study 80% power to detect a clinically relevant fall of 20% in the number of women requiring pharmacological analgesia - the primary endpoint. We estimate that approximately 5-10% of women will deliver prior to receiving their allocated intervention. We plan to recruit 150 women/group and perform sequential interim analyses when 150 and 300 participants

Hypnosis Antenatal Training for Childbirth (HATCh): a randomised controlled trial [NCT00282204

PubMed Central

Cyna, Allan M; Andrew, Marion I; Robinson, Jeffrey S; Crowther, Caroline A; Baghurst, Peter; Turnbull, Deborah; Wicks, Graham; Whittle, Celia

2006-01-01

Background Although medical interventions play an important role in preserving lives and maternal comfort they have become increasingly routine in normal childbirth. This may increase the risk of associated complications and a less satisfactory birth experience. Antenatal hypnosis is associated with a reduced need for pharmacological interventions during childbirth. This trial seeks to determine the efficacy or otherwise of antenatal group hypnosis preparation for childbirth in late pregnancy. Methods/design A single centre, randomised controlled trial using a 3 arm parallel group design in the largest tertiary maternity unit in South Australia. Group 1 participants receive antenatal hypnosis training in preparation for childbirth administered by a qualified hypnotherapist with the use of an audio compact disc on hypnosis for re-enforcement; Group 2 consists of antenatal hypnosis training in preparation for childbirth using an audio compact disc on hypnosis administered by a nurse with no training in hypnotherapy; Group 3 participants continue with their usual preparation for childbirth with no additional intervention. Women > 34 and < 39 weeks gestation, planning a vaginal birth, not in active labour, with a singleton, viable fetus of vertex presentation, are eligible to participate. Allocation concealment is achieved using telephone randomisation. Participants assigned to hypnosis groups commence hypnosis training as near as possible to 37 weeks gestation. Treatment allocations are concealed from treating obstetricians, anaesthetists, midwives and those personnel collecting and analysing data. Our sample size of 135 women/group gives the study 80% power to detect a clinically relevant fall of 20% in the number of women requiring pharmacological analgesia – the primary endpoint. We estimate that approximately 5–10% of women will deliver prior to receiving their allocated intervention. We plan to recruit 150 women/group and perform sequential interim analyses

Social capital, political trust and self-reported psychological health: a population-based study.

PubMed

Lindstrom, Martin; Mohseni, Mohabbat

2009-02-01

This study investigates the association between political trust (an aspect of institutional trust) in the Riksdag (the national parliament in Sweden) and self-reported psychological health, taking generalized (horizontal) trust in other people into account. The 2004 public health survey in Skåne in Southern Sweden is a cross-sectional postal questionnaire study that was answered by 27,757 respondents aged 18-80 yielding a 59% response rate. A logistic regression model was used to investigate the associations between political trust and self-reported psychological health adjusting for possible confounders (age, country of origin, education, economic stress and generalized trust in other people i.e. horizontal trust). We found that 13.0% of the men and 18.9% of the women reported poor psychological health. A total of 17.3% and 11.6% of the male and female respondents, respectively, reported that they had no trust at all in the national parliament, and another 38.2% and 36.2%, respectively, reported that their political trust was not particularly high. Respondents in younger age groups, born abroad, with high education, high levels of economic stress, low horizontal trust and low political trust had significantly higher levels of self-reported poor psychological health. There was a significant association between low political trust and low horizontal trust. After adjustments for age, country of origin, education and economic stress, the inclusion of horizontal trust reduced the odds ratios of self-reported poor psychological health in the "no political trust at all" category compared to the "very high political trust" category from 1.6 to 1.4 among men and from 1.7 to 1.4 among women. It is concluded that low political trust in the Riksdag seems to be significantly and positively associated with poor mental health.

Emotional Distress Following Childbirth: An Intervention to Buffer Depressive and PTSD Symptoms.

PubMed

Di Blasio, Paola; Miragoli, Sarah; Camisasca, Elena; Di Vita, Angela Maria; Pizzo, Rosalia; Pipitone, Laura

2015-05-01

Childbirth for some women is a negative experience associated with depressive and post-traumatic symptoms. The preventive actions focusing on helping mothers to cope with negative emotions experienced after childbirth are strongly recommended. It is also recommended both to intervene early and on all women to avoid the risk that these symptoms can worsen in the months after childbirth. The intervention described in the current study is focalized on the elaboration of post-partum negative thoughts and emotion through a writing task, with the purpose to help new mothers to reflect, understand, evaluate and, thus, reformulate the stressful situation with new beliefs and emotions. 176 women aged from 19 to 43 years (M = 31.55, SD = 4.58) were assessed for depression and PTSD in the prenatal phase (T1). In about 96 hours after childbirth they were randomly assigned to either "Making Sense condition" (MS: in which they wrote about the thoughts and emotions connected with delivery and childbirth) or "Control-Neutral condition" (NC: in which they wrote about the daily events in behavioural terms) and then reassessed for depression and PTSD (T2). A follow up was conducted 3 months later (T3) to verify depression and posttraumatic symptoms. The results showed that depressive symptoms decreased both at 96 hours and at 3 months as a result of making-sense task. Regarding the posttraumatic symptoms the positive effect emerged at three months and not at 96 hours after birth.

Emotional Distress Following Childbirth: An Intervention to Buffer Depressive and PTSD Symptoms

PubMed Central

Di Blasio, Paola; Miragoli, Sarah; Camisasca, Elena; Di Vita, Angela Maria; Pizzo, Rosalia; Pipitone, Laura

2015-01-01

Childbirth for some women is a negative experience associated with depressive and post-traumatic symptoms. The preventive actions focusing on helping mothers to cope with negative emotions experienced after childbirth are strongly recommended. It is also recommended both to intervene early and on all women to avoid the risk that these symptoms can worsen in the months after childbirth. The intervention described in the current study is focalized on the elaboration of post-partum negative thoughts and emotion through a writing task, with the purpose to help new mothers to reflect, understand, evaluate and, thus, reformulate the stressful situation with new beliefs and emotions. 176 women aged from 19 to 43 years (M = 31.55, SD = 4.58) were assessed for depression and PTSD in the prenatal phase (T1). In about 96 hours after childbirth they were randomly assigned to either “Making Sense condition” (MS: in which they wrote about the thoughts and emotions connected with delivery and childbirth) or “Control-Neutral condition” (NC: in which they wrote about the daily events in behavioural terms) and then reassessed for depression and PTSD (T2). A follow up was conducted 3 months later (T3) to verify depression and posttraumatic symptoms. The results showed that depressive symptoms decreased both at 96 hours and at 3 months as a result of making-sense task. Regarding the posttraumatic symptoms the positive effect emerged at three months and not at 96 hours after birth. PMID:27247653

Travel Time to Hospital for Childbirth: Comparing Calculated Versus Reported Travel Times in France.

PubMed

Pilkington, Hugo; Prunet, Caroline; Blondel, Béatrice; Charreire, Hélène; Combier, Evelyne; Le Vaillant, Marc; Amat-Roze, Jeanne-Marie; Zeitlin, Jennifer

2018-01-01

Objectives Timely access to health care is critical in obstetrics. Yet obtaining reliable estimates of travel times to hospital for childbirth poses methodological challenges. We compared two measures of travel time, self-reported and calculated, to assess concordance and to identify determinants of long travel time to hospital for childbirth. Methods Data came from the 2010 French National Perinatal Survey, a national representative sample of births (N = 14 681). We compared both travel time measures by maternal, maternity unit and geographic characteristics in rural, peri-urban and urban areas. Logistic regression models were used to study factors associated with reported and calculated times ≥30 min. Cohen's kappa coefficients were also calculated to estimate the agreement between reported and calculated times according to women's characteristics. Results In urban areas, the proportion of women with travel times ≥30 min was higher when reported rather than calculated times were used (11.0 vs. 3.6%). Longer reported times were associated with non-French nationality [adjusted odds ratio (aOR) 1.3 (95% CI 1.0-1.7)] and inadequate prenatal care [aOR 1.5 (95% CI 1.2-2.0)], but not for calculated times. Concordance between the two measures was higher in peri-urban and rural areas (52.4 vs. 52.3% for rural areas). Delivery in a specialised level 2 or 3 maternity unit was a principal determinant of long reported and measured times in peri-urban and rural areas. Conclusions for Practice The level of agreement between reported and calculated times varies according to geographic context. Poor measurement of travel time in urban areas may mask problems in accessibility.

Prevalence and risk factors of childbirth-related post-traumatic stress symptoms.

PubMed

Modarres, Maryam; Afrasiabi, Sedigheh; Rahnama, Parvin; Montazeri, Ali

2012-09-03

There is evidence that traumatic birth experiences are associated with psychological impairments. This study aimed to estimate the prevalence of childbirth-related post-traumatic stress symptoms and its obstetric and perinatal risk factors among a sample of Iranian women. This was a cross-sectional study carried out in Bushehr, Iran during a 3-months period from July to September 2009. Data were collected from all women attending eleven healthcare centers for postnatal care 6 to 8 weeks after childbirth. Those who had a traumatic delivery were identified and entered into the study. In order to assess childbirth-related post-traumatic stress, the Post-traumatic Symptom Scale-Interview (PSS-I) was administered. Data on demographic, obstetric and perinatal characteristics also were collected. Multivariate logistic regression was performed to examine the association between childbirth-related post-traumatic stress and demographic and obstetric and perinatal variables. In all, 400 women were initially evaluated. Of these, 218 women (54.5%) had a traumatic delivery and overall, 80 women (20%) were found to be suffering from post-partum post-traumatic stress disorder (PTSD). Multiple logistic regression analysis revealed that post-partum PTSD was associated with educational level, gestational age at delivery, number of prenatal care visits, pregnancy complications, pregnancy intervals, labor duration, and mode of delivery. The findings indicated that the prevalence of traumatic birth experiences and post-partum PTSD were relatively high among Iranian women. The findings also indicated that obstetric and perinatal variables were independently the most significant contributing factors to women's post-partum PTSD. It seems that a better perinatal care and supportive childbirth might help to reduce the burden of post-partum PTSD among this population.

Essential childbirth and postnatal interventions for improved maternal and neonatal health

PubMed Central

2014-01-01

Childbirth and the postnatal period, spanning from right after birth to the following several weeks, presents a time in which the number of deaths reported still remain alarmingly high. Worldwide, about 800 women die from pregnancy- or childbirth-related complications daily while almost 75% of neonatal deaths occur within the first seven days of delivery and a vast majority of these occur in the first 24 hours. Unfortunately, this alarming trend of mortality persists, as287,000 women lost their lives to pregnancy and childbirth related causes in 2010. Almost all of these deaths were preventable and occurred in low-resource settings, pointing towards dearth of adequate facilities in these parts of the world. The main objective of this paper is to review the evidence based childbirth and post natal interventions which have a beneficial impact on maternal and newborn outcomes. It is a compilation of existing, new and updated interventions designed to help physicians and policy makers and enable them to reduce the burden of maternal and neonatal morbidities and mortalities. Interventions during the post natal period that were found to be associated with a decrease in maternal and neonatal morbidity and mortality included: advice and support of family planning, support and promotion of early initiation and continued breastfeeding; thermal care or kangaroo mother care for preterm and/or low birth weight babies; hygienic care of umbilical cord and skin following delivery, training health personnel in basic neonatal resuscitation; and postnatal visits. Adequate delivery of these interventions is likely to bring an unprecedented decrease in the number of deaths reported during childbirth. PMID:25177795

Exploring Communication, Trust in Government, and Vaccination Intention Later in the 2009 H1N1 Pandemic: Results of a National Survey

PubMed Central

Parmer, John; Freimuth, Vicki S.; Hilyard, Karen M.; Musa, Donald; Kim, Kevin H.

2013-01-01

With the growing recognition of the critical role that risk communication plays in a public health emergency, a number of articles have provided prescriptive best practices to enhance such communication. However, little empirical research has examined perceptions of the quality of communication, the impact of uncertainty on changing communication, use of information sources, and trust in specific government spokespersons. Similarly, although there is significant conceptual focus on trust and communication as important in vaccination intent and acceptance, little research has explored these relationships empirically. We conducted an online survey in late January 2010 with a nationally representative sample (N=2,079) that included Hispanic and African American oversamples. The completion rate was 56%. We found that public health officials were the most trusted spokespersons, with President Obama being the most highly trusted elected official. Demographic variables, including race, accounted for 21% of the variance in trust of the president. Perceptions of the quality of communication were high, including significant understanding of uncertainty and appreciation for officials' openness about evolving information. Other factors that contributed to vaccination acceptance were quality of communication, closely following the news, and confidence in the vaccine because of a role model effect of the Obama daughters' immunizations; these factors significantly increased trust in government actions. Because the challenges of communication often vary over the course of a pandemic, there is a consistent need to pay close attention to both communication content and delivery and prepare public health officials at all levels to be effective communicators. PMID:23617721

A longitudinal study of women’s memories of their childbirth experiences at five years postpartum

PubMed Central

2014-01-01

Background Few studies have investigated whether women can accurately recall their birthing experiences after a long period. We investigated the consistency of women’s memories of their childbirth experiences between those at a few days postpartum and 5 years later. Methods This prospective cohort study comprised 1,168 women who delivered at a maternity hospital and four maternity homes in Japan between May 2002 and August 2003. Data were collected using structured interviews and transcriptions from medical records. The childbirth experience was assessed using the Childbirth Experience Scale (CBE-Scale) at a few days postpartum and 5 years later. Results We obtained 584 (50.0%) valid responses from women who completed the survey at a few days postpartum and 5 years later. Significant differences were observed in 16 out of 18 items on the CBE-Scale when responses were compared at both time points. Women who answered "yes" to any item on the CBE-Scale at the baseline survey tended to demonstrate a more precise recollection for that item 5 years after childbirth than those who answered "no" for the corresponding item. Conclusions We conclude that women remember their childbirth experience clearly at 5 years after the childbirth. PMID:24996683

Trust in the Medical Profession: Conceptual and Measurement Issues

PubMed Central

Hall, Mark A; Camacho, Fabian; Dugan, Elizabeth; Balkrishnan, Rajesh

2002-01-01

Objective To develop and test a multi-item measure for general trust in physicians, in contrast with trust in a specific physician. Data Sources Random national telephone survey of 502 adult subjects with a regular physician and source of payment. Study Design Based on a multidimensional conceptual model, a large pool of candidate items was generated, tested, and revised using focus groups, expert reviewers, and pilot testing. The scale was analyzed for its factor structure, internal consistency, construct validity, and other psychometric properties. Principal Findings The resulting 11-item scale measuring trust in physicians generally is consistent with most aspects of the conceptual model except that it does not include the dimension of confidentiality. This scale has a single-factor structure, good internal consistency (alpha=.89), and good response variability (range=11–54; mean=33.5; SD=6.9). This scale is related to satisfaction with care, trust in one's physician, following doctors' recommendations, having no prior disputes with physicians, not having sought second opinions, and not having changed doctors. No association was found with race/ethnicity. While general trust and interpersonal trust are qualitatively similar, they are only moderately correlated with each other and general trust is substantially lower. Conclusions Emerging research on patients' trust has focused on interpersonal trust in a specific, known physician. Trust in physicians in general is also important and differs significantly from interpersonal physician trust. General physician trust potentially has a strong influence on important behaviors and attitudes, and on the formation of interpersonal physician trust. PMID:12479504

"Doing Trust".

PubMed

Guillemin, Marilys; Gillam, Lynn; Barnard, Emma; Stewart, Paul; Walker, Hannah; Rosenthal, Doreen

2016-10-01

Trust in research is important but not well understood. We examine the ways that researchers understand and practice trust in research. Using a qualitative research design, we interviewed 19 researchers, including eight researchers involved in Australian Indigenous research. The project design focused on sensitive research including research involving vulnerable participants and sensitive research topics. Thematic analysis was used to analyze the data. We found that researchers' understanding of trust integrates both the conceptual and concrete; researchers understand trust in terms of how it relates to other similar concepts and how they practice trust in research. This provides a sound basis to better understand trust in research, as well as identifying mechanisms to regain trust when it is lost in research.

Addressing Sexuality and Pregnancy in Childbirth Education Classes

PubMed Central

Allen, Laura; Fountain, Lily

2007-01-01

A positive, nonjudgmental, and informed approach to sexual health during pregnancy promotes acceptance of the normal functioning of women's bodies. It also encourages the development of close and supportive relationships that are so essential during pregnancy and birth. Common concerns do not need to become problems. Concerns include issues of libido, positioning, and preterm labor or fetal health, as well as myths and cultural attitudes. Childbirth educators can use tools such as the PLISSIT model to approach the topic of sexuality during pregnancy. In addition, opportunities are available in every childbirth class to acknowledge or ignore sexual issues. Perinatal educators who take responsibility for addressing this often-taboo topic can enhance women's feelings of safety and their confidence in normal birth. PMID:18408809

'Trust my doctor, trust my pancreas': trust as an emergent quality of social practice.

PubMed

Cohn, Simon

2015-06-11

Growing attention is being paid to the importance of trust, and its corollaries such as mistrust and distrust, in health service and the central place they have in assessments of quality of care. Although initially focussing on doctor-patient relationships, more recent literature has broadened its remit to include trust held in more abstract entities, such as organisations and institutions. There has consequently been growing interest to develop rigorous and universal measures of trust. Drawing on illustrative ethnographic material from observational research in a UK diabetes clinic, this paper supports an approach that foregrounds social practice and resists conceiving trust as solely a psychological state that can be divorced from its context. Beyond exploring the less-than-conscious nature of trust, the interpretations attend to the extent to which trust practices are distributed across a range of actors. Data from clinical encounters reveal the extent to which matters of trust can emerge from the relationships between people, and sometimes people and things, as a result of a wide range of pragmatic concerns, and hence can usefully be conceived of as an extended property of a situation rather than a person. Trust is rarely explicitly articulated, but remains a subtle feature of experience that is frequently ineffable. A practice approach highlights some of the problems with adopting a general psychological or intellectualist conception of trust. In particular, assuming it is a sufficiently stable internal state that can be stored or measured not only transforms a diffuse and often ephemeral quality into a durable thing, but ultimately presents it as a generic state that has meaning independent of the specific relationships and context that achieve it. Emphasising the context-specific nature of trust practices does not dismiss the potential of matters of trust, when they emerge, to be transposed to other contexts. But it does highlight how, on each occasion

Factors influencing first-time fathers' involvement in their wives' pregnancy and childbirth: A correlational study.

PubMed

Xue, Weilin Lynn; He, Hong-Gu; Chua, Ying Jie; Wang, Wenru; Shorey, Shefaly

2018-07-01

To examine factors influencing first-time fathers' involvement in their wives' pregnancy and childbirth in Singapore. A cross-sectional descriptive correlational study was conducted in a public tertiary hospital in Singapore. A total of 182 first-time fathers whose wives were hospitalized at four obstetric wards were recruited from November 2015 to January 2016. Data were collected by three newly developed and validated instruments, namely Father's Involvement in Pregnancy and Childbirth, Father's Informational and Sources of Support, and Father's Attitude Towards Involvement in Pregnancy and Childbirth, as well as the 16-item Couple Satisfaction Index and Family of Origin Questionnaire. The participants were generally involved in their wives' pregnancy and childbirth, with 35.2% being highly involved. There was no significant difference in fathers' levels of involvement between or among any sociodemographic subgroups. Significant Spearman's correlations were found between fathers' levels of involvement and levels of informational support as well as fathers' attitudes towards involvement. However, the logistic regression showed the level of informational support was the only significant factor that influenced first-time fathers' high levels of involvement in their wives' pregnancy and childbirth. The study revealed the importance of providing sufficient informational support to first-time fathers so that they can be highly involved in their wife's pregnancy and childbirth. Future studies can develop technology-based intervention programmes to improve fathers' involvement in their wife's pregnancy and childbirth. Healthcare professionals should examine and improve the existing informational support for first-time fathers and ensure its relevance and convenient access. Copyright © 2018 Elsevier Ltd. All rights reserved.

Gastric emptying in patients with constipation following childbirth and due to idiopathic slow transit.

PubMed

MacDonald, A; Baxter, J N; Bessent, R G; Gray, H W; Finlay, I G

1997-08-01

Idiopathic slow transit constipation (ISTC) is considered to be a heterogeneous condition in which patients have varying sites and degrees of delayed gastrointestinal transit. The majority of patients have pancolonic disease, and colectomy with ileocolorectal anastomosis has been the mainstay of surgical treatment. Severe constipation following traumatic childbirth is now being recognized and this subgroup of patients may have delayed transit confined to the rectosigmoid colon. In theory, proximal transit in these patients should be normal. Gastric emptying was studied in patients with constipation following childbirth or ISTC and in controls. After an overnight fast, both patients and controls received breakfast, which consisted of cornflakes, sugar and milk. The liquid marker 111In-labelled di-ethylene tri-amine penta-acetic acid (DTPA) was added to the milk. A solid marker, 99mTc-labelled colloid, was impregnated on to paper and sealed with cellulose. The t1/2 for gastric emptying was calculated. Liquid phase emptying was normal in both constipation following childbirth and ISTC. Solid phase emptying was delayed significantly in ISTC compared with that in patients with constipation following childbirth and controls. In addition, half the patients with ISTC had delayed transit through the small bowel and proximal colon. Small bowel and colonic transit were normal in patients with constipation following childbirth. Patients with constipation following childbirth represent a distinct subgroup with normal proximal gastrointestinal function. Gastric emptying studies may be helpful in selecting patients for surgical management of severe constipation.

A Randomized Controlled Trial of a Psycho-Education Intervention by Midwives in Reducing Childbirth Fear in Pregnant Women

PubMed Central

Toohill, Jocelyn; Fenwick, Jennifer; Gamble, Jenny; Creedy, Debra K; Buist, Anne; Turkstra, Erika; Ryding, Elsa-Lena

2014-01-01

Background Childbirth fear is associated with increased obstetric interventions and poor emotional and psychological health for women. The purpose of this study is to test an antenatal psycho-education intervention by midwives in reducing women's childbirth fear. Methods Women (n = 1,410) attending three hospitals in South East Queensland, Australia, were recruited into the BELIEF trial. Participants reporting high fear were randomly allocated to intervention (n = 170) or control (n = 169) groups. All women received a decision-aid booklet on childbirth choices. The telephone counseling intervention was offered at 24 and 34 weeks of pregnancy. The control group received usual care offered by public maternity services. Primary outcome was reduction in childbirth fear (WDEQ-A) from second trimester to 36 weeks’ gestation. Secondary outcomes were improved childbirth self-efficacy, and reduced decisional conflict and depressive symptoms. Demographic, obstetric & psychometric measures were administered at recruitment, and 36 weeks of pregnancy. Results There were significant differences between groups on postintervention scores for fear of birth (p < 0.001) and childbirth self-efficacy (p = 0.002). Decisional conflict and depressive symptoms reduced but were not significant. Conclusion Psycho-education by trained midwives was effective in reducing high childbirth fear levels and increasing childbirth confidence in pregnant women. Improving antenatal emotional well-being may have wider positive social and maternity care implications for optimal childbirth experiences. PMID:25303111

Self-hypnosis: alternative anesthesia for childbirth.

PubMed

Ketterhagen, Debra; VandeVusse, Leona; Berner, Margaret Ann

2002-01-01

The purpose of this article is to inform nurses about the use of self-hypnosis in childbirth. Hypnosis is a focused form of concentration. Self-hypnosis is one form of hypnosis in which a certified practitioner or therapist teaches an individual to induce his or her own state of altered consciousness. When used for childbirth pain, the primary aim of self-hypnosis is to help the woman maintain control by managing anxiety and discomfort though inducing a focused state of relaxation. Before the widespread use of pharmaceuticals for pain, hypnosis was one of the few pain relief methods available for labor. However, as new technologies for pain relief emerged, hypnosis received less attention. Most nurses have little experience with hypnosis, and there is limited information available in the literature. However, because nurses are at laboring women's bedsides, it is important that nurses learn about self-hypnosis to be able to inform pregnant women fully about all pain control options and to maximize the benefits for the woman choosing hypnosis.

Impact of signals and experience on trust and trusting behavior.

PubMed

Chen, Ying-Hueih; Chien, Shu-Hua; Wu, Jyh-Jeng; Tsai, Pei-Yin

2010-10-01

Trust is an essential factor that drives virtual interaction and transactions on the Internet. Researchers have investigated the trust development process, and identified several important factors that form the basis for trust. This research combines the signal perspective and trust theory to examine the impact of market signals and past experience on trust formation and trusting behavior. Three market signals, including brand image, Web-site investment, and privacy policies, are identified and empirically tested to determine their impact on consumer trust. Based on 322 active Web users, the quantitative results suggest that brand image, Web-site investment, privacy policies, and past experience all positively impact trust formation. Furthermore, trust shows a positive effect on Web-site stickiness. Both theoretical and practical implications of the results are also offered.

The influence of a local, media covered hospital incident on public trust in health care.

PubMed

van der Schee, Evelien; de Jong, Judith D; Groenewegen, Peter P

2012-08-01

Incidents in health care happen every now and then. Incidents are often extensively covered by the news media. In this study, we investigated the impact of an incident in a Dutch hospital on public trust in health care in the population living in the vicinity of where the incident took place and in the national population. News media coverage of the incident started in Fall 2008. We collected data in three samples, using a postal questionnaire on public trust in health care. Two samples were a cross-section of the Dutch population; one was questioned in October 2006 and the other in October 2008. The third sample, also questioned in October 2008, consisted of 1000 people living in the surrounding area of the hospital where the incident occurred. The cross-sectional sample of October 2006 was a reference group, and at that time no incidents in health care were covered in the media. In the local population, the incident had a strong impact on public trust in the hospital and among the specialists working there. Also, in the local population, the impact of the incident was generalized to trust in hospitals and specialists in general. In the national population, no impact of the incident on the public's trust was found, despite national news media coverage. Local incidents have an impact on public trust in health care in the local population. However, these incidents do not influence public trust in health care in the national population.

[Childbirth in Cuba: analysis of the experience of medically supervised delivery from an anthropological perspective].

PubMed

García-Jordá, Dailys; Díaz-Bernal, Zoe; Acosta Álamo, Marlen

2012-07-01

Knowledge about pregnancy, childbirth, and postpartum in Cuba is currently deficient. Childbirth has been fundamentally studied as a medical event from its clinical aspects. Analysis of the reproductive process from the Medical Anthropology perspective could contribute to healthcare services providing more humane treatment and empowerment for women and men as the persons primarily responsible for their reproductive processes. This study investigated the experience and perception of childbirth in three hospitals in Havana. The scope of this research was to understand the representation and practice of childbirth and to describe the experiences of women during this event. Qualitative investigation techniques were used, together with interviews and participant observation of 36 women in labor, ten family members and nine obstetricians. The qualitative data was analyzed using Grounded Theory methodology. All the childbirths occurred with numerous medical interventions and the maternity experience was very intense. The participation of men was limited. From the anthropological perspective the routine use of some medical interventions and the institutional regulations described are considered manifestations of physical and gender violence.

TrustBuilder2: A Reconfigurable Framework for Trust Negotiation

NASA Astrophysics Data System (ADS)

Lee, Adam J.; Winslett, Marianne; Perano, Kenneth J.

To date, research in trust negotiation has focused mainly on the theoretical aspects of the trust negotiation process, and the development of proof of concept implementations. These theoretical works and proofs of concept have been quite successful from a research perspective, and thus researchers must now begin to address the systems constraints that act as barriers to the deployment of these systems. To this end, we present TrustBuilder2, a fully-configurable and extensible framework for prototyping and evaluating trust negotiation systems. TrustBuilder2 leverages a plug-in based architecture, extensible data type hierarchy, and flexible communication protocol to provide a framework within which numerous trust negotiation protocols and system configurations can be quantitatively analyzed. In this paper, we discuss the design and implementation of TrustBuilder2, study its performance, examine the costs associated with flexible authorization systems, and leverage this knowledge to identify potential topics for future research, as well as a novel method for attacking trust negotiation systems.

Women's acute anxiety variations before and after epidural anesthesia for childbirth.

PubMed

Fernández-Campos, Francisco J; Escrivá, Dolores; Palanca, José M; Ridocci, Francisca; Barrios, Carlos; Gallego, Juan

2017-06-01

This study assessed changes in anxiety during different phases of childbirth in a sample of women demanding epidural anesthesia. Prospective, longitudinal case series. A total of 133 women who demanded epidural anesthesia for childbirth answered the questionnaires. Anxiety state was measured using the State Trait Anxiety Inventory (STAI) questionnaire. The STAI-S (anxiety state) was administered in three phases during childbirth: Phase 1 was before applying epidural anesthesia, Phase 2 was 45 min after the application of epidural anesthesia and Phase 3 was at less than 24 h after delivery. Data were collected in two general hospitals: a third-level public hospital and a well-recognized private hospital. STAI scores. Anxiety state decreases significantly after applying the epidural anesthesia (Phase 2) compared to before anesthesia (Phase 1), and it remains low levels 24 h after childbirth (Phase 3). There were statistically significant differences in STAI scores between the different phases administrated (Phases 1 and 2: p < 0.001; effect size, d = 1.40; Phases 1 and 3: p < 0.001; effect size, d = 1.39). In Phase 3, women with cesarean section birth had significant differences in STAI scores relative to those with spontaneous birth (p = 0.037; d = 0.44). The type of health-care setting (public or private), the educational level and the numbers of previous births does not affect the level of anxiety state in women in any of the three phases. Women's anxiety decreases significantly after applying epidural anesthesia, and it remains low 24 h after delivery. Anxiety against childbirth was not influenced by the health system used by women, by the condition of primiparous or multiparous, or by the educational level. Women who received an epidural anesthesia with a cesarean section reported higher rates of anxiety state after birth.

Testing a cognitive model to predict posttraumatic stress disorder following childbirth.

PubMed

King, Lydia; McKenzie-McHarg, Kirstie; Horsch, Antje

2017-01-14

One third of women describes their childbirth as traumatic and between 0.8 and 6.9% goes on to develop posttraumatic stress disorder (PTSD). The cognitive model of PTSD has been shown to be applicable to a range of trauma samples. However, childbirth is qualitatively different to other trauma types and special consideration needs to be taken when applying it to this population. Previous studies have investigated some cognitive variables in isolation but no study has so far looked at all the key processes described in the cognitive model. This study therefore aimed to investigate whether theoretically-derived variables of the cognitive model explain unique variance in postnatal PTSD symptoms when key demographic, obstetric and clinical risk factors are controlled for. One-hundred and fifty-seven women who were between 1 and 12 months post-partum (M = 6.5 months) completed validated questionnaires assessing PTSD and depressive symptoms, childbirth experience, postnatal social support, trauma memory, peritraumatic processing, negative appraisals, dysfunctional cognitive and behavioural strategies and obstetric as well as demographic risk factors in an online survey. A PTSD screening questionnaire suggested that 5.7% of the sample might fulfil diagnostic criteria for PTSD. Overall, risk factors alone predicted 43% of variance in PTSD symptoms and cognitive behavioural factors alone predicted 72.7%. A final model including both risk factors and cognitive behavioural factors explained 73.7% of the variance in PTSD symptoms, 37.1% of which was unique variance predicted by cognitive factors. All variables derived from Ehlers and Clark's cognitive model significantly explained variance in PTSD symptoms following childbirth, even when clinical, demographic and obstetric were controlled for. Our findings suggest that the CBT model is applicable and useful as a way of understanding and informing the treatment of PTSD following childbirth.

Psychoprophylaxis during labor: associations with labor-related outcomes and experience of childbirth.

PubMed

Bergström, Malin; Kieler, Helle; Waldenström, Ulla

2010-06-01

To study whether use of psychoprophylaxis during labor affects course of labor and experience of childbirth in nulliparous women. Cohort study. Women were recruited from 15 antenatal clinics in Sweden between October 2005 and January 2007. A total of 857 nulliparous women with a planned vaginal delivery. Using data from a randomized controlled trial of antenatal education where the allocated groups were merged, we compared course of labor and experience of childbirth between women who used psychoprophylaxis during labor and those who did not. Data were collected by questionnaires in mid-pregnancy and three months after birth, and from the Swedish Medical Birth Register. Logistic regression was used to assess associations. Mode of delivery, augmentation of labor, length of labor, Apgar score, pain relief and experience of childbirth as measured by the Wijma Delivery Experience Questionnaire. Use of psychoprophylaxis during labor was associated with a lower risk of emergency cesarean section (adjusted odds ratio (OR) 0.57; 95% confidence interval (CI) 0.37-0.88), but an increased risk of augmentation of labor (adjusted OR 1.68; 95% CI 1.23-2.28). No statistical differences were found in length of labor (adjusted OR 1.32; 95% CI 0.95-1.83), Apgar score < 7 at five minutes (adjusted OR 0.82; 95% CI 0.33-2.01), epidural analgesia (adjusted OR 1.13; 95% CI 0.84-1.53) or fearful childbirth experience (adjusted OR 1.04; 95% CI 0.62-1.74). Psychoprophylaxis may reduce the rate of emergency cesarean section but may not affect the experience of childbirth.

Women's satisfaction and perception of control in childbirth in three Arab countries.

PubMed

Kabakian-Khasholian, Tamar; Bashour, Hyam; El-Nemer, Amina; Kharouf, Mayada; Sheikha, Salah; El Lakany, Nasser; Barakat, Rafik; Elsheikh, Ohoud; Nameh, Nadia; Chahine, Rabih; Portela, Anayda

2017-10-01

Women's satisfaction and perceived control in childbirth are important attributes of the childbirth experience and quality of care indicators. This article presents findings from the pre-intervention phase of a multi-centre implementation study in Egypt, Lebanon and Syria, to introduce a labour companionship model in these countries. A sample of 2620 women giving birth in three public teaching hospitals from November 2014 to July 2015 in Beirut and Mansoura, and from November 2014 to April 2015 in Damascus were interviewed by trained field workers. Additional information was abstracted from medical charts. An adapted version of the Mackey Childbirth Satisfaction Rating Scale was used to measure women's satisfaction and the shortened version of the Labor Agentry Scale was used to assess perception of control. The total satisfaction score was high in all sites with the lowest being in Egypt. Perceived control was directly related to satisfaction. Women with low education levels had higher levels of childbirth satisfaction. Women who had fewer children from Egypt and Lebanon, and those who received care by a team including both male and female physicians in the Syrian hospital were more likely to be dissatisfied than their counterparts. Variations in the management and provision of care between the three countries may explain the differences in satisfaction levels observed. Further qualitative research is needed to deepen our understanding of the concepts of control and satisfaction in the Arab culture as well as to establish the factors associated with women's positive childbirth experiences to inform the provision of quality maternity care.

Helpful Resources for Childbirth Educators and Parents

PubMed Central

Shilling, Teri

2008-01-01

In this column, reviewers offer perspectives and comments on a variety of books and CDs that address topics related to the politics of midwifery in the United States, preparing expectant parents for childbirth, babywearing techniques, breastfeeding guides, and a child's perspective of home birth.

Trust and Reflection in Primary Care Practice Redesign.

PubMed

Lanham, Holly Jordan; Palmer, Raymond F; Leykum, Luci K; McDaniel, Reuben R; Nutting, Paul A; Stange, Kurt C; Crabtree, Benjamin F; Miller, William L; Jaén, Carlos Roberto

2016-08-01

To test a conceptual model of relationships, reflection, sensemaking, and learning in primary care practices transitioning to patient-centered medical homes (PCMH). Primary data were collected as part of the American Academy of Family Physicians' National Demonstration Project of the PCMH. We conducted a cross-sectional survey of clinicians and staff from 36 family medicine practices across the United States. Surveys measured seven characteristics of practice relationships (trust, diversity, mindfulness, heedful interrelation, respectful interaction, social/task relatedness, and rich and lean communication) and three organizational attributes (reflection, sensemaking, and learning) of practices. We surveyed 396 clinicians and practice staff. We performed a multigroup path analysis of the data. Parameter estimates were calculated using a Bayesian estimation method. Trust and reflection were important in explaining the characteristics of practice relationships and their associations with sensemaking and learning. The strongest associations between relationships, sensemaking, and learning were found under conditions of high trust and reflection. The weakest associations were found under conditions of low trust and reflection. Trust and reflection appear to play a key role in moderating relationships, sensemaking, and learning in practices undergoing practice redesign. © Health Research and Educational Trust.

Personal Trust Increases Cooperation beyond General Trust

PubMed Central

Acedo-Carmona, Cristina; Gomila, Antoni

2014-01-01

In this paper we present a new methodology which, while allowing for anonymous interaction, it also makes possible to compare decisions of cooperating or defecting when playing games within a group, according to whether or not players personally trust each other. The design thus goes beyond standard approaches to the role of trust in fostering cooperation, which is restricted to general trust. It also allows considering the role of the topology of the social network involved may play in the level of cooperation found. The results of this work support the idea that personal trust promotes cooperation beyond the level of general trust. We also found that this effect carries over to the whole group, making it more cohesive, but that higher levels of cohesion rely on a particular topology. As a conclusion, we hypothesize that personal trust is a psychological mechanism evolved to make human social life possible in the small groups our ancestors lived in, and that this mechanism persists and plays a role in sustaining cooperation and social cohesion. PMID:25144539

Rethinking trust.

PubMed

Kramer, Roderick M

2009-06-01

Will we ever learn? We'd barely recovered from Enron and WorldCom before we faced the subprime mortgage meltdown and more scandals that shook our trust in businesspeople. Which raises the question: Do we trust too much? In this article, Stanford professor and social psychologist Kramer explores the reasons we trust so easily--and, often, so unwisely. He explains that genetics and childhood learning make us predisposed to trust and that it's been a good survival mechanism. That said, our willingness to trust makes us vulnerable. Our sense of trust kicks in on remarkably simple cues, such as when people look like us or are part of our social group. We also rely on third parties to verify the character of others, sometimes to our detriment (as the victims of Bernard Madoff learned). Add in our illusions of invulnerability and our tendencies to see what we want to see and to overestimate our own judgment, and the bottom line is that we're often easily fooled. We need to develop tempered trust. For those who trust too much, that means reading cues better; for the distrustful, it means developing more receptive behaviors. Everyone should start with small acts of trust that encourage reciprocity and build up. Having a hedge against potential abuses also helps. Hollywood scriptwriters, for instance, register their treatments with the Writers Guild of America to prevent their ideas from being stolen by the executives they pitch. To attract the right relationships, people must strongly signal their own honesty, proactively allay concerns, and, if their trust is abused, retaliate. Trusting individuals in certain roles, which essentially means trusting the system that selects and trains them, also works but isn't foolproof. And don't count on due diligence alone for protection; constant vigilance is needed to make sure the landscape hasn't changed.

Trust and satisfaction with physicians, insurers, and the medical profession.

PubMed

Balkrishnan, Rajesh; Dugan, Elizabeth; Camacho, Fabian T; Hall, Mark A

2003-09-01

Conceptual or theoretical analysts of trust in medical settings distinguish among markedly different objects or types of trust. However, little is known about how similar or different these types of trust are in reality and the relationship of trust with satisfaction. This exploratory study conducted a comparison among trust in one's personal physician, health insurer, and in the medical profession, and examined whether the relationship between trust and satisfaction differs according to the type of trust in question. Random national telephone survey using validated multi-item measures of trust and satisfaction. A total of 1117 individuals aged 20 years and older with health insurance and reporting 2 healthcare professional visits in the past 2 years. Rank-order correlation analyses find that both physician and insurer trust are sensitive to the amount of contact the patient has had and their adequacy of choice in selecting the physician or insurer. Trust in the medical profession stands out as being uniquely related to patients' desire to seek care and their preference for how much control physicians should have in making medical decisions. Adding satisfaction to the models reduced the number of significant predictors of insurance trust disproportionately. Consistent with theory, we found both substantial similarities and notable differences in the sets of factors that predict 3 different types of trust. Trust and satisfaction are much less distinct with respect to health insurers than with respect to physicians or the medical profession.

Lifetime sexual violence and childbirth expectations - A Norwegian population based cohort study.

PubMed

Henriksen, Lena; Schei, Berit; Lukasse, Mirjam

2016-05-01

this study aimed to explore the association between lifetime sexual violence and expectations about childbirth. Norwegian population-based cohort study. women presenting for routine ultrasound examinations were recruited to the Norwegian Mother and Child Cohort Study between 1999 and 2008. 78,660 pregnant women. sexual violence and expectations about childbirth were self-reported during pregnancy using postal questionnaires. Risk estimations were performed using multivariable logistic regression analysis and stratified by parity. fear of childbirth, the thoughts about pain relief, worries about the infant's health and looking forward to the arrival of the infant. of 78,660 women, 18.4% reported a history of sexual violence and 0.9% were exposed to sexual violence within the last 12 months, including during the current pregnancy. We found that nulliparous women who reported previous or recent sexual violence had a decrease in the odds of looking forward to the arrival of the infant with an AOR of 0.8 (95% CI 0.7-0.9) and 0.4 (95% CI 0.3-0.6), respectively, compared to non-abused women. The same pattern was observed among multiparous women and they were more likely to report worries about the infant's health. Severe sexual violence (rape) was associated with concerns about childbirth, especially for nulliparous women that were more likely to express fear of birth, a hope for a pain-free birth, a desire for caesarean section and worries about the infant's health than non-exposed women. women with a lifetime exposure to sexual violence, both past experiences and within the last 12 months, were less likely to look forward to the arrival of the infant than non-exposed women, and they were more likely to worry about the infant's health. Women with experiences of severe sexual violence (rape) had more concerns about childbirth than women without this experience. This finding shows that exploring women's attitudes toward childbirth may work as an approach when examining

Disrespect and abuse of women during childbirth in Nigeria: A systematic review.

PubMed

Ishola, Foluso; Owolabi, Onikepe; Filippi, Veronique

2017-01-01

Promoting respectful care at childbirth is important to improve quality of care and encourage women to utilize skilled delivery services. However, there has been a relative lack of public health research on this topic in Nigeria. A systematic review was conducted to synthesize current evidence on disrespect and abuse of women during childbirth in Nigeria in order to understand its nature and extent, contributing factors and consequences, and propose solutions. Five electronic databases were searched for relevant published studies, and five data sources for additional grey literature. A qualitative synthesis was conducted using the Bowser and Hill landscape analytical framework on disrespect and abuse of women during childbirth. Fourteen studies were included in this review. Of these studies, eleven were cross sectional studies, one was a qualitative study and two used a mixed method approach. The type of abuse most frequently reported was non-dignified care in form of negative, poor and unfriendly provider attitude and the least frequent were physical abuse and detention in facilities. These behaviors were influenced by low socioeconomic status, lack of education and empowerment of women, poor provider training and supervision, weak health systems, lack of accountability and legal redress mechanisms. Overall, disrespectful and abusive behavior undermined the utilization of health facilities for delivery and created psychological distance between women and health providers. This systematic review documented a broad range of disrespectful and abusive behavior experienced by women during childbirth in Nigeria, their contributing factors and consequences. The nature of the factors influencing disrespectful and abusive behavior suggests that educating women on their rights, strengthening health systems to respond to specific needs of women at childbirth, improving providers training to encompass interpersonal aspects of care, and implementing and enforcing policies on

Monitoring childbirth morbidity using hospital discharge data: further development and application of a composite measure.

PubMed

Korst, Lisa M; Fridman, Moshe; Lu, Michael C; Mitchell, Connie; Lawton, Elizabeth; Griffin, Flojaune; Gregory, Kimberly D

2014-09-01

The purpose of this study was to evaluate the use of a childbirth composite morbidity indicator for monitoring childbirth morbidity at hospital and regional levels in California. Study data were obtained from the 2005 linked maternal and neonatal discharge dataset for California hospitals. The study population was limited to laboring women with singleton, term (≥37 weeks' gestation), inborn, and live births. Women with and without pregnancy complications were stratified into high- and low-risk groups. The composite outcome was defined as any significant morbidity of the mother or newborn infant during the childbirth admission. Submeasures for maternal and neonatal composite morbidity and for severe maternal morbidity were examined with both aggregate and hospital-level analyses. Of 377,869 eligible deliveries, 120,218 (31.8%) were categorized as high risk and 257,651 (68.2%) were categorized as low risk. High-risk women had higher morbidity rates for all comparisons. The mean childbirth composite morbidity rate was 21% overall: 28% for high-risk women and 18% for low-risk women. For high- and low-risk strata, the rates of maternal complications were 18% and 13%, and the rates of severe maternal morbidity were 1.4% and 0.5%, respectively. There was substantial variation across hospitals for all measures. The childbirth composite morbidity rate is designed to report childbirth complication rates that combine maternal and neonatal morbidity. This measure and its submeasures met the criteria for quality indicator evaluation as specified by the Agency for Healthcare Research and Quality and can be used for benchmarking or for monitoring childbirth outcomes at regional levels. Copyright © 2014. Published by Elsevier Inc.

26 CFR 26.2654-1 - Certain trusts treated as separate trusts.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 14 2010-04-01 2010-04-01 false Certain trusts treated as separate trusts. 26... 1986 § 26.2654-1 Certain trusts treated as separate trusts. (a) Single trust treated as separate trusts—(1) Substantially separate and independent shares—(i) In general. If a single trust consists solely...

Influence of obstetrical events on satisfaction and anxiety during childbirth: a prospective longitudinal study.

PubMed

Floris, Lucia; Irion, Olivier; Courvoisier, Delphine

2017-09-01

The aim of this study was to investigate the feelings of anxiety and satisfaction among 79 primiparas who had uncomplicated pregnancies, at the time of hospital admission and after birth, considering the mode of delivery, analgesia, and pain levels. Questionnaires were completed at admission to the hospital and two months after delivery, using the State-Trait Anxiety Inventory (STAI) state scale and the Labour Agentry Scale. The mean (SD) STAI state score was higher at admission (36.7 (10.7)) than 4 months after childbirth (32.1 (9.7)) (paired Student's t-test, t = 2.93; df = 78; p = .004). However, the postnatal anxiety was not associated with the mode of delivery, epidural or pain. Regarding the satisfaction with the expectations of control during childbirth, the mean (SD) score was higher before childbirth (166.0 (21.8)) than after (157.5 (33.5)) (paired Student's t-test, t = -2.28; df = 77; p = .03). The satisfaction with the childbirth experience was significantly associated with the expectations of childbirth and the mode of delivery, but not with analgesia or pain. The postnatal anxiety was associated with physical health, pain and the Edinburgh Postnatal Depression Scale score during the postpartum period. It is important to consider the temporality of perinatal anxiety in order to understand its causes. Our results indicate that the experience of childbirth was predicted in this sample by the antenatal expectations and delivery outcomes.

Learning to trust: trust and attachment in early psychosis.

PubMed

Fett, A-K J; Shergill, S S; Korver-Nieberg, N; Yakub, F; Gromann, P M; Krabbendam, L

2016-05-01

Distrust and social dysfunction are characteristic in psychosis and may arise from attachment insecurity, which is elevated in the disorder. The relationship between trust and attachment in the early stages of psychosis is unknown, yet could help to understand interpersonal difficulties and disease progression. This study aimed to investigate whether trust is reduced in patients with early psychosis and whether this is accounted for by attachment avoidance and attachment anxiety. We used two trust games with a cooperative and unfair partner in a sample of 39 adolescents with early psychosis and 100 healthy controls. Patients had higher levels of attachment anxiety, but the groups did not differ in attachment avoidance. Basic trust was lower in patients than controls, as indicated by lower initial investments. During cooperation patients increased their trust towards levels of controls, i.e. they were able to learn and to override initial suspiciousness. Patients decreased their trust less than controls during unfair interactions. Anxious attachment was associated with higher basic trust and higher trust during unfair interactions and predicted trust independent of group status. Discussion Patients showed decreased basic trust but were able to learn from the trustworthy behaviour of their counterpart. Worries about the acceptance by others and low self-esteem are associated with psychosis and attachment anxiety and may explain behaviour that is focused on conciliation, rather than self-protection.

The emergence of trust in clinics of alternative medicine.

PubMed

Pedersen, Inge Kryger; Hansen, Vibeke Holm; Grünenberg, Kristina

2016-01-01

Demands for alternative medicine have increased since the 1970s in nations in which western scientific evidence has become the basis for health care. This paradox has been the impetus to examine how trust emerges in clinics of alternative medicine. Alternative practitioners are self-regulated and the clients pay out of their own pockets to attend non-authorised treatments with very limited scientific evidence of their effects. Trust is a key issue in this context. However, only a few studies have dealt with the ways in which alternative practitioners win their clients' trust. Drawing on three qualitative studies and informing the empirical findings with a sociological concept of trust, this article provides new empirical insights on how trust emerges in Danish clinics of acupuncture, reflexology and homeopathy. The analysis demonstrates how trust is situational and emerges through both clients' susceptibility and practitioners' individual skill development and strategies, as well as from objects, place and space. Trust is developed on relational and bodily as well as material grounds. It is argued that the dynamics and elements of trust identified do not only minimalise uncertainties but sometimes convert these uncertainties into productive new ways for clients to address their ailments, life circumstances and perspectives. © 2015 Foundation for the Sociology of Health & Illness.

Trust and Influence

DTIC Science & Technology

2012-03-05

DISTRIBUTION A: Approved for public release; distribution is unlimited. Program Trends •Trust in Autonomous Systems • Cross - cultural Trust...Trust & trustworthiness are independent (Mayer et al, 1995) •Trust is relational •Humans in cross - cultural interactions •Complex human-machine...Interpersonal Trustworthiness •Ability •Benevolence •Integrity Trust Metrics Cross - Cultural Trust Issues Human-Machine Interactions Autonomous

The Need to Trust and to Trust More Wisely in Academe

ERIC Educational Resources Information Center

Bowman, Richard F.

2012-01-01

Where trust is an issue, there is no trust. Trust in diverse organizations has never been lower. A shadow of doubt stalks one's every decision to trust collegially and institutionally. Still, colleagues sense intuitively that institutions cannot function optimally without a bedrock level of trust. In academic life, trust is a form of social…

Use of Big-Screen Films in Multiple Childbirth Education Classroom Settings

PubMed Central

Kaufman, Tamara

2010-01-01

Although two recent films, Orgasmic Birth and Pregnant in America, were intended for the big screen, they can also serve as valuable teaching resources in multiple childbirth education settings. Each film conveys powerful messages about birth and today's birthing culture. Depending on a childbirth educator's classroom setting (hospital, birthing center, or home birth environment), particular portions in each film, along with extra clips featured on the films' DVDs, can enhance an educator's curriculum and spark compelling discussions with class participants. PMID:21358831

Trust in automation: integrating empirical evidence on factors that influence trust.

PubMed

Hoff, Kevin Anthony; Bashir, Masooda

2015-05-01

We systematically review recent empirical research on factors that influence trust in automation to present a three-layered trust model that synthesizes existing knowledge. Much of the existing research on factors that guide human-automation interaction is centered around trust, a variable that often determines the willingness of human operators to rely on automation. Studies have utilized a variety of different automated systems in diverse experimental paradigms to identify factors that impact operators' trust. We performed a systematic review of empirical research on trust in automation from January 2002 to June 2013. Papers were deemed eligible only if they reported the results of a human-subjects experiment in which humans interacted with an automated system in order to achieve a goal. Additionally, a relationship between trust (or a trust-related behavior) and another variable had to be measured. All together, 101 total papers, containing 127 eligible studies, were included in the review. Our analysis revealed three layers of variability in human-automation trust (dispositional trust, situational trust, and learned trust), which we organize into a model. We propose design recommendations for creating trustworthy automation and identify environmental conditions that can affect the strength of the relationship between trust and reliance. Future research directions are also discussed for each layer of trust. Our three-layered trust model provides a new lens for conceptualizing the variability of trust in automation. Its structure can be applied to help guide future research and develop training interventions and design procedures that encourage appropriate trust. © 2014, Human Factors and Ergonomics Society.

Initiating a Caregiving Relationship: Pregnancy and Childbirth Factors as Predictors of Maternal Sensitivity

ERIC Educational Resources Information Center

Bernier, Annie; Jarry-Boileau, Veronique; Tarabulsy, George M.; Miljkovitch, Raphaele

2010-01-01

The aim of this study was to investigate the relations between pregnancy and childbirth factors and subsequent quality of maternal interactive behavior in a sample of 116 full-term infants and their mothers. Mothers reported on the conditions of childbirth when infants were 6-8 months of age, and their interactive behavior was observed during a…

Understanding and managing trust at the climate science-policy interface

NASA Astrophysics Data System (ADS)

Lacey, Justine; Howden, Mark; Cvitanovic, Christopher; Colvin, R. M.

2018-01-01

Climate change effects are accelerating, making the need for appropriate actions informed by sound climate knowledge ever more pressing. A strong climate science-policy relationship facilitates the effective integration of climate knowledge into local, national and global policy processes, increases society's responsiveness to a changing climate, and aligns research activity to policy needs. This complex science-policy relationship requires trust between climate science `producers' and `users', but our understanding of trust at this interface remains largely uncritical. To assist climate scientists and policymakers, this Perspective provides insights into how trust develops and operates at the interface of climate science and policy, and examines the extent to which trust can manage — or even create — risk at this interface.

The need for trust and safety inducing encounters: a qualitative exploration of women's experiences of seeking perinatal care when living as undocumented migrants in Sweden.

PubMed

Barkensjö, My; Greenbrook, Josephine T V; Rosenlundh, Josefine; Ascher, Henry; Elden, Helen

2018-06-07

Studies from around the world have shown that women living as undocumented migrants have limited and deficient access to perinatal care, increasing their risks of both physical and psychological complications during pregnancy and childbirth. Failures to provide equal access to healthcare have been criticized extensively by the United Nations. In 2013, undocumented migrants' rights to healthcare in Sweden were expanded to include full access to perinatal care. Research surrounding clinical encounters involving women living as undocumented migrants remains largely lacking. The present study aimed to provide a composite description of women's experiences of clinical encounters throughout pregnancy and childbirth, when living as undocumented migrants in Sweden. Taking an inductive approach, qualitative content analysis was implemented. Thirteen women from ten different countries were interviewed. Meaning-units were extracted from the data collected in order to identify emergent overarching themes. In clinical encounters where healthcare professionals displayed empathic concern and listening behaviours, women felt empowered, acknowledged, and encouraged, leading them to trust clinicians, diminishing fears relating to seeking healthcare services. Conversely, when neglectful behaviour on part of healthcare professionals was perceived in encounters, anxiousness and fear intensified. Vulnerability and distress induced by the women's uncertain living circumstances were apparent across themes, and appeared exacerbated by traumatic memories, difficulties in coping with motherhood, and fears of deportation. The present study contributes unique and important knowledge surrounding women's experience of being pregnant and giving birth when living as undocumented migrants. The overarching findings indicated that the needs of undocumented migrant women were largely similar to those of all expectant mothers, but that due to vulnerabilities relating to their circumstances, flexible

Implementing the WHO Safe Childbirth Checklist: lessons from a global collaboration

PubMed Central

Perry, WRG; Bagheri Nejad, S; Tuomisto, K; Kara, N; Roos, N; Dilip, TR; Hirschhorn, LR; Larizgoitia, I; Semrau, K; Mathai, M; Dhingra-Kumar, N

2017-01-01

The WHO Safe Childbirth Checklist (SCC) was developed to ensure the delivery of essential maternal and perinatal care practices around the time of childbirth. A research collaboration was subsequently established to explore factors that influence use of the Checklist in a range of settings around the world. This analysis article presents an overview of the WHO SCC Collaboration and the lessons garnered from implementing the Checklist across a diverse range of settings. Project leads from each collaboration site were asked to distribute two surveys. The first was given to end users, and the second to implementation teams to describe their respective experiences using the Checklist. A total of 134 end users and 38 implementation teams responded to the surveys, from 19 countries across all levels of income. End users were willing to adopt the SCC and found it easy to use. Training and the provision of supervision while using the Checklist, alongside leadership engagement and local ownership, were important factors which helped facilitate initial implementation and successful uptake of the Checklist. Teams identified several challenges, but more importantly successfully implemented the WHO SCC. A critical step in all settings was the adaptation of the Checklist to reflect local context and national protocols and standards. These findings were invaluable in developing the final version of the WHO SCC and its associated implementation guide. Our experience will provide useful insights for any institution wishing to implement the Checklist. PMID:29082003

Perceptions of barriers to paternal presence and contribution during childbirth: an exploratory study from Syria.

PubMed

Abushaikha, Lubna; Massah, Rana

2013-03-01

The barriers that face fathers during childbirth are an understudied phenomenon. The objective of our study was to explore Syrian parents' perceptions of barriers to paternal presence and contribution during childbirth. A descriptive phenomenological qualitative approach based on Colaizzi's method was used with a purposive sample of 23 mothers and 14 fathers recruited from a major public maternity hospital in Syria. In our study, four themes on barriers to paternal presence and contribution during childbirth were found: 1) sociocultural influences and rigidity; 2) being unprepared; 3) unsupportive policies and attitudes; and 4) unfavorable reactions and circumstances. Common and current sociocultural norms in Syria do not encourage fathers to be present or contribute during childbirth. Therefore, establishing culturally sensitive supportive policies and practices is a vital step toward overcoming these barriers. © 2013, Copyright the Authors Journal compilation © 2013, Wiley Periodicals, Inc.

The israeli virtual national health record: a robust national health information infrastructure based on a firm foundation of trust.

PubMed

Saiag, Esther

2005-01-01

In many developed countries, a coordinated effort is underway to build national and regional Health Information Infrastructures (HII) for the linking of disparate sites of care, so that an access to a comprehensive Health Record will be feasible when critical medical decisions are made [1]. However, widespread adoption of such national projects is hindered by a series of barriers- regulatory, technical, financial and cultural. Above all, a robust national HII requires a firm foundation of trust: patients must be assured that their confidential health information will not be misused and that there are adequate legal remedies in the event of inappropriate behavior on the part of either authorized or unauthorized parties[2].The Israeli evolving National HII is an innovative state of the art implementation of a wide-range clinical inter-organizational data exchange, based on a unique concept of virtually temporary sharing of information. A logically connection of multiple caregivers and medical organizations creates a patient-centric virtual repository, without centralization. All information remains in its original format, location, system and ownership. On demand, relevant information is instantly integrated and delivered to the point of care. This system, successfully covering more than half of Israel's population, is currently evolving from a voluntary private-public partnership (dbMOTION and CLALIT HMO) to a formal national reality. The governmental leadership, now taking over the process, is essential to achieve a full potential of the health information technology. All partners of the Israeli health system are coordinated in concert with each other, driven with a shared vision - realizing that a secured, private, confidential health information exchange is assured.

A proposed mother-friendly childbirth model for Taiwanese women, the implementation and satisfaction survey.

PubMed

Li, Yi-Ping; Yeh, Chih-Hsin; Lin, Shin-Yu; Chen, Tai-Chang; Yang, Ya-Ling; Lee, Chien-Nan; Kuo, Su-Chen

2015-12-01

Pleasant and humane childbirth is every mother's wish. We established one practicable and tailored Taiwanese mother-friendly childbirth model, and the objective of this study was to investigate the implementation, pregnancy outcomes, and women's satisfaction. We used the Taiwanese mother-friendly childbirth model. Women from eight hospitals were divided into an experimental group and control group. The experimental group received prenatal care modified by the Taiwanese mother-friendly childbirth model and the control group received routine prenatal care according to their hospital. We performed a quasi-experimental study of women's satisfaction toward this mother-friendly childbirth model by questionnaires and surveyed the practicality and effectiveness of this model. Seven hundred and fifty-one women from eight hospitals, including three medical centers and five regional hospitals were included. There was significantly different practices between the two groups, such as: (1) intermittent fetal monitoring for low-risk pregnancy; (2) no routine enema; (3) no perineal shaving; (4) less routine parenteral fluid support; (5) using an upright position; and (6) restrictive episiotomy. The mean maternal height, body weight gain, gestational age, birth weight, and episiotomy wound infection rate were indifferent. The epidural anesthesia rate and induction medication use were significantly lower in the experimental group. The self-reported pain score was higher in the experimental group and the self-reported satisfactory score was also higher in the experimental group, without statistical significance. Women receiving standardized prenatal care modified by the woman-friendly childbirth model of prenatal care had less epidural anesthesia, less induction medication, higher self-reported satisfaction score, and indifferent pregnancy outcomes such as gestational age, birth weight, and wound infection rate. Copyright © 2015. Published by Elsevier B.V.

Measuring facility capability to provide routine and emergency childbirth care to mothers and newborns: An appeal to adjust for delivery caseload of facilities

PubMed Central

Allen, Stephanie M.; Opondo, Charles; Campbell, Oona M. R.

2017-01-01

Background Measurement of Emergency Obstetric Care capability is common, and measurement of newborn and overall routine childbirth care has begun in recent years. These assessments of facility capabilities can be used to identify geographic inequalities in access to functional health services and to monitor improvements over time. This paper develops an approach for monitoring the childbirth environment that accounts for the delivery caseload of the facility. Methods We used data from the Kenya Service Provision Assessment to examine facility capability to provide quality childbirth care, including infrastructure, routine maternal and newborn care, and emergency obstetric and newborn care. A facility was considered capable of providing a function if necessary tracer items were present and, for emergency functions, if the function had been performed in the previous three months. We weighted facility capability by delivery caseload, and compared results with those generated using traditional “survey weights”. Results Of the 403 facilities providing childbirth care, the proportion meeting criteria for capability were: 13% for general infrastructure, 6% for basic emergency obstetric care, 3% for basic emergency newborn care, 13% and 11% for routine maternal and newborn care, respectively. When the new caseload weights accounting for delivery volume were applied, capability improved and the proportions of deliveries occurring in a facility meeting capability criteria were: 51% for general infrastructure, 46% for basic emergency obstetric care, 12% for basic emergency newborn care, 36% and 18% for routine maternal and newborn care, respectively. This is because most of the caseload was in hospitals, which generally had better capability. Despite these findings, fewer than 2% of deliveries occurred in a facility capable of providing all functions. Conclusion Reporting on the percentage of facilities capable of providing certain functions misrepresents the capacity to

Cost of hospitalization for childbirth in India: how equitable it is in the post-NRHM era?

PubMed

Tripathy, Jaya Prasad; Shewade, Hemant D; Mishra, Sanskruti; Kumar, A M V; Harries, A D

2017-08-15

Information on out-of-pocket (OOP) expenditure during childbirth in public and private health facilities in India is needed to make rational decisions for improving affordability to maternal care services. We undertook this study to evaluate the OOP expenditure due to hospitalization from childbirth and its impact on households. This is a secondary data analysis of a nationwide household survey by the National Sample Survey Organization in 2014. The survey reported health service utilization and health care related expenditure by income quintiles and type of health facility. The recall period for hospitalization expenditure was 365 days. OOP expenditure amounting to more than 10% of annual consumption expenditure was termed as catastrophic. Median expenditure per episode of hospitalisation due to childbirth was US$54. The expenditure incurred was about six times higher among the richest quintile compared to the poorest quintile. Median private sector OOP hospitalization expenditure was nearly nine times higher than in the public sector. Hospitalization in a private sector facility leads to a significantly higher prevalence of catastrophic expenditure than hospitalization in a public sector (60% vs. 7%). Indirect cost (43%) constituted the largest share in the total expenditure in public sector hospitalizations. Urban residence, poor wealth quintile, residing in eastern and southern regions of India and delivery in private hospital were significantly associated with catastrophic expenditure. We strongly recommend cash transfer schemes with effective pro-poor targeting to reduce the impact of catastrophic expenditure. Strengthening of public health facilities is required along with private sector regulation.

First childbirth experience of international marriage migrant women in South Korea.

PubMed

Chu, Min Sun; Park, Minna; Kim, Jung A

2017-08-01

Since the mid-1990s, a large number of foreign women have migrated from developing countries to South Korea by means of international marriages. These nulliparous foreign women may experience more difficulties in pregnancy and childbirth than native Koreans. This study aimed to describe the meaning of the first childbirth experiences of international marriage migrant women marrying Korean men in South Korea. This is a descriptive phenomenological study that included 10 participants using the purposive and snowball sampling in one multicultural support center in Seoul, South Korea. Colaizzi's data analysis method was used to inductively determine themes and formulate meanings. The meanings of first childbirth were categorized into four themes-'coming to a crisis,' 'depending on others,' 'searching for solutions,' and 'strengthening family unity.' Inadequate antenatal care is associated with obstacles such as language barriers, social isolation, lack of knowledge, different midwifery practice and dependent lifestyle. Meanwhile, their children were a source of energy for the women to fulfill their emotional needs and improve family relationships. Childbirth is a life-changing event for these women, in which they face challenges as well as opportunities to develop new coping skills and a new role identity in their family. It is important for healthcare providers and policy makers to identify obstacles and unmet needs to improve maternity care in light of the distinctive challenges of immigrant living in multicultural families. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Bioethics, Human Rights, and Childbirth.

PubMed

Erdman, Joanna

2015-06-11

The global reproductive justice community has turned its attention to the abuse and disrespect that many women suffer during facility-based childbirth. In 2014, the World Health Organization released a statement on the issue, endorsed by more than 80 civil society and health professional organizations worldwide.The statement acknowledges a growing body of research that shows widespread patterns of women's mistreatment during labor and delivery-physical and verbal abuse, neglect and abandonment, humiliation and punishment, coerced and forced care-in a range of health facilities from basic rural health centers to tertiary care hospitals. Moreover, the statement characterizes this mistreatment as a human rights violation. It affirms: "Every woman has the right to the highest attainable standard of health, which includes the right to dignified, respectful health care throughout pregnancy and childbirth."The WHO statement and the strong endorsement of it mark a critical turn in global maternal rights advocacy. It is a turn from the public health world of systems and resources in preventing mortality to the intimate clinical setting of patient and provider in ensuring respectful care. Copyright 2015 Erdman. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

Measuring women's childbirth experiences: a systematic review for identification and analysis of validated instruments.

PubMed

Nilvér, Helena; Begley, Cecily; Berg, Marie

2017-06-29

Women's childbirth experience can have immediate as well as long-term positive or negative effects on their life, well-being and health. When evaluating and drawing conclusions from research results, women's experiences of childbirth should be one aspect to consider. Researchers and clinicians need help in finding and selecting the most suitable instrument for their purpose. The aim of this study was therefore to systematically identify and present validated instruments measuring women's childbirth experience. A systematic review was conducted in January 2016 with a comprehensive search in the bibliographic databases PubMed, CINAHL, Scopus, The Cochrane Library and PsycINFO. Included instruments measured women's childbirth experiences. Papers were assessed independently by two reviewers for inclusion, and quality assessment of included instruments was made by two reviewers independently and in pairs using Terwee et al's criteria for evaluation of psychometric properties. In total 5189 citations were screened, of which 5106 were excluded by title and abstract. Eighty-three full-text papers were reviewed, and 37 papers were excluded, resulting in 46 included papers representing 36 instruments. These instruments demonstrated a wide range in purpose and content as well as in the quality of psychometric properties. This systematic review provides an overview of existing instruments measuring women's childbirth experiences and can support researchers to identify appropriate instruments to be used, and maybe adapted, in their specific contexts and research purpose.

Adequate trust avails, mistaken trust matters: on the moral responsibility of doctors as proxies for patients' trust in biobank research.

PubMed

Johnsson, Linus; Helgesson, Gert; Hansson, Mats G; Eriksson, Stefan

2013-11-01

In Sweden, most patients are recruited into biobank research by non-researcher doctors. Patients' trust in doctors may therefore be important to their willingness to participate. We suggest a model of trust that makes sense of such transitions of trust between domains and distinguishes adequate trust from mistaken trust. The unique position of doctors implies, we argue, a Kantian imperfect duty to compensate for patients' mistaken trust. There are at least three kinds of mistaken trust, each of which requires a different set of countermeasures. First, trust is mistaken when necessary competence is lacking; the competence must be developed or the illusion dispelled. Second, trust is irrational whenever the patient is mistaken about his actual reasons for trusting. Care must therefore be taken to support the patient's reasoning and moral agency. Third, some patients inappropriately trust doctors to recommend only research that will benefit them directly. Such trust should be counteracted by nurturing a culture where patients expect to be asked occasionally to contribute to the common good. © 2012 John Wiley & Sons Ltd.

Predictors of Early Childbirth Among Female Adolescents in Foster Care.

PubMed

King, Bryn; Van Wert, Melissa

2017-08-01

Placement into foster care is driven by a number of factors, many of which are associated with adolescent childbirth. Yet, there are few studies that identify the experiences and characteristics that predict adolescent childbirth among girls who spend time in foster care. A longitudinal, population-based data set was constructed by probabilistically matching California child protective service records for female foster youth to maternal information available on vital birth records for children born between 2001 and 2010. Rates of childbirth among girls in foster care after their 10th birthday were generated. Chi-square tests assessed differences and survival models were specified to determine the rate of childbearing across key characteristics. Among the 30,339 girls who spent time in foster care as adolescents, 18.3% (5,567) gave birth for the first time before their 20th birthday. At a bivariate level, significant differences (p < .001) in birth rates were observed across demographic characteristics, maltreatment history, and foster care placement experiences. In the fully adjusted survival model, the highest birth rates were observed among girls who entered care between ages 13 and 16 years; had been in care for relatively short periods of time; lived in congregate care at the estimated date of conception; had a history of running away; and were Latina, black, or Native American. The results suggest that there are identifiable risk factors associated with early childbirth among girls in foster care, which can help determine the timing and location of reproductive health services to minimize unintended pregnancy and maximize adolescent health and well-being. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Water law - Public Trust Doctrine

DOE Office of Scientific and Technical Information (OSTI.GOV)

Casey, E.S.

In a case involving California's Mono Lake, the State Supreme Court held that infringement of the values protected by the Public Trust Doctrine is a separate ground for challenging water appropriations, and that the continuing nature of the state's duty as trustee prevents the acquisition of a vested right to appropriations that injure navigation, commerce, and fisheries. The author summarizes the history and the competing claims of the Doctrine and the California Appropriative Water Rights System. The National Audubon suit now makes it possible for any member of the public to challenge any surface water diversion as injurious to themore » public trust, but it also offers the California courts an opportunity to redirect the state's water policies. 130 references.« less

Fear and experience of childbirth among women who conceived with donated oocytes: a prospective cohort study.

PubMed

Sälevaara, Mari; Punamäki, Raija-Leena; Poikkeus, Piia; Flykt, Marjo; Tulppala, Maija; Tiitinen, Aila

2016-07-01

The aim of this study was to compare the level of fear of childbirth, pregnancy-related anxiety and experience of childbirth in women who conceived with donated oocytes (OD), with that in women with in vitro fertilization/intra-cytoplasmic sperm injection (IVF/ICSI) and spontaneous conception (SC). This is a prospective cohort study. We compared women who received donated oocytes (n = 26) to matched controls, IVF/ICSI (n = 52) or SC (n = 52). Matching was made according to mothers' age, parity, plurality and the number of returned questionnaires. The participants completed the questionnaires during their second trimester and at 2 months postpartum. The Fear of Delivery Questionnaire and the Pregnancy Anxiety Scale served to study fear of childbirth, and the Delivery Satisfaction Scale served to study experience of childbirth. The level of fear of childbirth was lower in the women who received donated oocytes than in the women who received IVF/ICSI (p = 0.028), but similar to those in the SC group. The level of pregnancy-related anxiety was lower in the OD group than in the IVF/ICSI (p = 0.006) and SC groups (p = 0.019). The experience of childbirth did not differ between the groups. The mode of delivery was associated with the mothers' satisfaction with the delivery only in the OD group. Those who had an acute operative delivery were the most dissatisfied. After receiving adequate support prior to OD treatment, the women require no more support with fear of childbirth than other pregnant women, but they may require support after acute operative deliveries. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

How does delivery method influence factors that contribute to women's childbirth experiences?

PubMed

Carquillat, Pierre; Boulvain, Michel; Guittier, Marie-Julia

2016-12-01

whether delivery method influences factors contributing to women's childbirth experience remains debated. we compared subjective childbirth experience according to different delivery methods. this study used a cross-sectional design. the setting comprised two university hospitals: one in Geneva, Switzerland and one in Clermont-Ferrand, France. a total of 291 primiparous women were recruited from July 2014 to January 2015 during their stay in the maternity wards. The mean age of the participants was 30.8 (SD=4.7) years, and most were Swiss or European (86%). the 'Questionnaire for Assessing Childbirth Experience' was sent between four and six weeks after delivery. Clinimetric and psychometric approaches were used to assess childbirth experience according to delivery method. the mean scores of the four questionnaire dimensions varied significantly by delivery method. 'First moments with the newborn' was more negatively experienced by women from the caesarean section group compared to those who delivered vaginally (p<0.001). Similar results regarding the dimension of 'emotional status' were also observed, as women who delivered by caesarean section felt more worried, less secure, and less confident (p=0.001). 'Relationship with staff' significantly differed between groups (p=0.047) as more negative results were shown in the 'unexpected medical intervention groups' (i.e. emergency caesarean section and instrumental delivered vaginally). Women's 'feelings at one-month post partum' in the emergency caesarean section group were less satisfactory than the other groups. Delivery method and other obstetric variables explained only a low proportion of the total variance in the global scores (R 2 adjusted=0.18), which emphasized the importance of subjective factors in women's childbirth experience. a comparison of best expected positive responses to each item (clinimetric approach) showed useful results for clinicians. This research indicated that delivery method influenced

From the general to the specific: How social trust motivates relational trust.

PubMed

Robbins, Blaine G

2016-01-01

When people form beliefs about the trustworthiness of others with respect to particular matters (i.e., when individuals trust), theory suggests that they rely on preexistent cognitive schemas regarding the general cooperativeness of individuals and organizations (i.e., social trust). In spite of prior work, the impact of social trust on relational trust-or what Russell Hardin (2002) calls trust as a three-part relation where actor A trusts actor B with reference to matter Y-is not well established. Four vignette experiments were administered to Amazon.com Mechanical Turk workers (N = 1388 and N = 1419) and to public university undergraduate students (N = 995 and N = 956) in order to investigate the relationship between social trust and relational trust. Measures of general social trust and particular social trust produced statistically equivalent effects that were positively associated with relational trust. Political trust, however, was statistically unrelated to relational trust. These results support the idea that people rely on schemas and stereotypes concerned with the general cooperativeness and helpfulness of others when forming beliefs about another person's trustworthiness with respect to a particular matter at hand. Copyright © 2015 Elsevier Inc. All rights reserved.

African American Women’s Preparation for Childbirth From the Perspective of African American Health-Care Providers

PubMed Central

Abbyad, Christine; Robertson, Trina Reed

2011-01-01

Preparation for birthing has focused primarily on Caucasian women. No studies have explored African American women’s birth preparation. From the perceptions of 12 African American maternity health-care providers, this study elicited perceptions of the ways in which pregnant African American women prepare for childbirth. Focus group participants answered seven semistructured questions. Four themes emerged: connecting with nurturers, traversing an unresponsive system, the need to be strong, and childbirth classes not a priority. Recommendations for nurses and childbirth educators include: (a) self-awareness of attitudes toward African Americans, (b) empowering of clients for birthing, (c) recognition of the role that pregnant women’s mothers play, (d) tailoring of childbirth classes for African American women, and (e) research on how racism influences pregnant African American women’s preparation for birthing. PMID:22211059

Risk factors in pregnancy for post-traumatic stress and depression after childbirth.

PubMed

Söderquist, J; Wijma, B; Thorbert, G; Wijma, K

2009-04-01

The objective of this study was to find risk factors in pregnancy for post-traumatic stress and depression 1 month after childbirth. Furthermore, the relation between post-traumatic stress and depression was explored. A prospective longitudinal study. Pregnant women in Linköping and Kalmar, Sweden. A total of 1224 women were assessed in pregnancy, week 12-20 and 32, as well as 1 month postpartum. Post-traumatic stress and depression after delivery were assessed 1 month postpartum. Potential risk factors were assessed in early and late pregnancy. Variables measured during pregnancy were trait anxiety, depression, fear of childbirth, childbirth-related traumatic stress, stress coping capacity, social support, parity, educational level, age, gestation week, parity, educational level, civil status, previous psychological/psychiatric counselling, and previous experience of any traumatic events. Delivery mode was assessed from the medical records. Prevalence of post-traumatic stress (criteria A, B, C, D, E, and F according to DSM-IV) and depression (Beck's depression inventory). One month postpartum, 12 (1.3%) women had post-traumatic stress (met symptom criteria B, C, and D for post-traumatic stress disorder according to Diagnostic and statistical manual of mental disorders, 4th edition [DSM-IV]). The most important risk factors in pregnancy were depression in early pregnancy (OR=16.3), severe fear of childbirth (OR=6.2), and 'pre'-traumatic stress (in view of the forthcoming delivery) in late pregnancy (OR=12.5). The prevalence of depression was 5.6%. Post-traumatic stress and depression were positively related 1 month postpartum and were predicted by mainly the same factors. Risk factors for post-traumatic stress and depression after childbirth can be assessed in early pregnancy. Post-traumatic stress and depression also seem to share the same underlying vulnerability factors.

Disrespect and Abuse During Childbirth in Tanzania: Are Women Living With HIV More Vulnerable?

PubMed Central

Sando, David; Lyatuu, Goodluck; Ratcliffe, Hannah; McDonald, Kathleen; Mwanyika-Sando, Mary; Emil, Faida; Chalamilla, Guerino; Langer, Ana

2014-01-01

Introduction: HIV-related stigma and discrimination and disrespect and abuse during childbirth are barriers to use of essential maternal and HIV health services. Greater understanding of the relationship between HIV status and disrespect and abuse during childbirth is required to design interventions to promote women's rights and to increase uptake of and retention in health services; however, few comparative studies of women living with HIV (WLWH) and HIV-negative women exist. Methods: Mixed methods included interviews with postpartum women (n = 2000), direct observation during childbirth (n = 208), structured questionnaires (n = 50), and in-depth interviews (n = 18) with health care providers. Bivariate and multivariate regressions analyzed associations between HIV status and disrespect and abuse, whereas questionnaires and in-depth interviews provided insight into how provider attitudes and workplace culture influence practice. Results: Of the WLWH and HIV-negative women, 12.2% and 15.0% reported experiencing disrespect and abuse during childbirth (P = 0.37), respectively. In adjusted analyses, no significant differences between WLWH and HIV-negative women's experiences of different types of disrespect and abuse were identified, with the exception of WLWH having greater odds of reporting non-consented care (P = 0.03). None of the WLWH reported violations of HIV confidentiality or attributed disrespect and abuse to their HIV status. Provider interviews indicated that training and supervision focused on prevention of vertical HIV transmission had contributed to changing the institutional culture and reducing HIV-related violations. Conclusions: In general, WLWH were not more likely to report disrespect and abuse during childbirth than HIV-negative women. However, the high overall prevalence of disrespect and abuse measured indicates a serious problem. Similar institutional priority as has been given to training and supervision to reduce HIV-related discrimination

Disrespect and abuse during childbirth in Tanzania: are women living with HIV more vulnerable?

PubMed

Sando, David; Kendall, Tamil; Lyatuu, Goodluck; Ratcliffe, Hannah; McDonald, Kathleen; Mwanyika-Sando, Mary; Emil, Faida; Chalamilla, Guerino; Langer, Ana

2014-12-01

HIV-related stigma and discrimination and disrespect and abuse during childbirth are barriers to use of essential maternal and HIV health services. Greater understanding of the relationship between HIV status and disrespect and abuse during childbirth is required to design interventions to promote women's rights and to increase uptake of and retention in health services; however, few comparative studies of women living with HIV (WLWH) and HIV-negative women exist. Mixed methods included interviews with postpartum women (n = 2000), direct observation during childbirth (n = 208), structured questionnaires (n = 50), and in-depth interviews (n = 18) with health care providers. Bivariate and multivariate regressions analyzed associations between HIV status and disrespect and abuse, whereas questionnaires and in-depth interviews provided insight into how provider attitudes and workplace culture influence practice. Of the WLWH and HIV-negative women, 12.2% and 15.0% reported experiencing disrespect and abuse during childbirth (P = 0.37), respectively. In adjusted analyses, no significant differences between WLWH and HIV-negative women's experiences of different types of disrespect and abuse were identified, with the exception of WLWH having greater odds of reporting non-consented care (P = 0.03). None of the WLWH reported violations of HIV confidentiality or attributed disrespect and abuse to their HIV status. Provider interviews indicated that training and supervision focused on prevention of vertical HIV transmission had contributed to changing the institutional culture and reducing HIV-related violations. In general, WLWH were not more likely to report disrespect and abuse during childbirth than HIV-negative women. However, the high overall prevalence of disrespect and abuse measured indicates a serious problem. Similar institutional priority as has been given to training and supervision to reduce HIV-related discrimination during childbirth should be focused on

Preventing perineal trauma during childbirth: a systematic review.

PubMed

Eason, E; Labrecque, M; Wells, G; Feldman, P

2000-03-01

To review systematically techniques proposed to prevent perineal trauma during childbirth and meta-analyze the evidence of their efficacy from randomized controlled trials. MEDLINE (1966-1999), the Cochrane Library (1999 Issue 1), and the Cochrane Collaboration: Pregnancy and Childbirth Database (1995); and reference lists from articles identified. Search terms included childbirth or pregnancy or delivery, and perineum, episiotomy, perineal massage, obstetric forceps, vacuum extraction, labor stage-second. No language or study-type constraints were imposed. Randomized controlled trials (RCTs) of interventions affecting perineal trauma were reviewed. If no RCTs were available, nonrandomized research designs such as cohort studies were included. Studies were selected by examination of titles and abstracts of more than 1,500 articles, followed by analysis of the methods sections of studies that appeared to be RCTs. INTEGRATION AND RESULTS: Eligible studies used random or quasirandom allocation of an intervention of interest and reported perineal outcomes. Further exclusions were based on failure to report results by intention to treat, or incomplete or internally inconsistent reporting of perineal outcomes. Final selection of studies and data extraction was by consensus of the first two authors. Data from trials that evaluated similar interventions were combined using a random effects model to determine weighted estimate of risk difference and number needed to treat. Effects of sensitivity analysis and quality scoring were examined. Results indicated good evidence that avoiding episiotomy decreased perineal trauma (absolute risk difference -0.23, 95% confidence interval [CI] -0.35, -0.11). In nulliparas, perineal massage during the weeks before giving birth also protected against perineal trauma (risk difference -0.08, CI -0.12, -0.04). Vacuum extraction (risk difference -0.06, CI -0.10, -0.02) and spontaneous birth (-0.11, 95% CI -0.18, -0.04) caused less anal

Effect of Implementing a Birth Plan on Womens' Childbirth Experiences and Maternal & Neonatal Outcomes

ERIC Educational Resources Information Center

Farahat, Amal Hussain; Mohamed, Hanan El Sayed; Elkader, Shadia Abd; El-Nemer, Amina

2015-01-01

Childbirth satisfaction represents a sense of feeling good about one's birth. It is thought to result from having a sense of control, having expectations met, feeling empowered, confident and supported. The aim of this study was to implement a birth plan and evaluate its effect on women's childbirth experiences and maternal, neonatal outcomes. A…

Family leave after childbirth and the mental health of new mothers.

PubMed

Chatterji, Pinka; Markowitz, Sara

2012-06-01

Recent studies indicate that short maternity leave, and, more generally, full-time maternal employment during the first year of life, detract from children's health, cognitive development, and behavioral outcomes. Much less is known, however, about how early parental employment affects the mental and physical health of the mothers themselves. The purpose of this paper is to examine the association between short family leave length (less than 12 weeks of total leave after childbirth, less than 8 weeks of paid leave) and mental and physical health outcomes among new mothers. Data come from the Early Childhood Longitudinal Study--Birth Cohort (ECLS-B), a nationally representative sample of 14,000 children born in 2001 and followed until kindergarten entry. We focus on a sample of ECLS-B mothers from the first wave of the survey who had worked during pregnancy and who had returned to work by the time of the first follow-up interview, which was conducted about 9 months after childbirth. When examining the effects of paternal leave, we further restrict this sample to mothers who were married at the time of the first follow-up interview. The maternal health outcomes of interest are measures of depression and overall health status. We use standard OLS and ordered probit models, as well as two-stage least squares and two-stage residual inclusion methods which address the potential endogeneity of family leave with respect to maternal health. Our findings from the OLS and ordered probit models indicate that, for mothers who worked prior to childbirth and who return to work in the first year, having less than 12 weeks of maternal leave and having less than 8 weeks of paid maternal leave are both associated with increases in depressive symptoms, and having less than 8 weeks of paid leave is associated with a reduction in overall health status. Findings from models that address the potential endogeneity of maternal leave generally support these results, and suggest that longer

Tax-Saving Tips for Self-Employed Childbirth Educators

PubMed Central

Philipsen, Nayna Campbell

1999-01-01

A self-employed childbirth educator asks for advice on how to reduce her end-of-the-year tax payments. The answer includes some general advice and four specific suggestions that may help a small-business owner save money on taxes. PMID:22945998

The effects of a childbirth psychoeducation program on learned resourcefulness, maternal role competence and perinatal depression: a quasi-experiment.

PubMed

Ngai, Fei-Wan; Chan, Sally Wai-Chi; Ip, Wan-Yim

2009-10-01

Learned resourcefulness plays a significant role in facilitating maternal coping during the transition to motherhood. Given the growing evidence of perinatal depression and the frequent feeling of incompetence in the maternal role, the implementation of an effective intervention to promote maternal role competence and emotional well-being is essential. To determine the impact of a childbirth psychoeducation program based on the concept of learned resourcefulness on maternal role competence and depressive symptoms in Chinese childbearing women. A pretest-posttest, control group quasi-experimental design with repeated measures was used. The study was conducted in two regional public hospitals in Hong Kong that provide routine childbirth education programs with similar content and structure. One hospital was being randomly selected as the experimental hospital. A convenience sample of 184 Chinese pregnant women attending the childbirth education was recruited between October 2005 and April 2007. Inclusion criteria were primiparous with singleton and uneventful pregnancy, at gestation between 12 and 35 weeks, and did not have a past or familial psychiatric illness. The intervention was a childbirth psychoeducation program that was incorporated into the routine childbirth education in the experimental hospital. The experimental group (n=92) received the childbirth psychoeducation program and the routine childbirth education. The comparison group (n=92) received the routine childbirth education alone in the comparison hospital. Outcomes were measured by the Self-Control Schedule, Parenting Sense of Competence Scale-Efficacy subscale and Edinburgh Postnatal Depression Scale at baseline, immediately post-intervention, at 6 weeks and 6 months postpartum. Analysis was by intention to treat. Women receiving the childbirth psychoeducation program had significant improvement in learned resourcefulness at 6 weeks postpartum (p=0.004) and an overall reduction in depressive

To Trust or Not to Trust? What Drives Public Trust in Science in Social Media Engagement

NASA Astrophysics Data System (ADS)

Hwong, Y. L.; Oliver, C.; Van Kranendonk, M. J.

2017-12-01

The erosion of public trust in science is a serious concern today. This climate of distrust has real consequences, from the anti-vaccination movement to climate change denials. The age of social media promises opportunities for improved interactivity between scientists and the public, which experts hope will help improve public confidence in science. However, evidence linking social media engagement and public attitude towards science is scarce. Our study aimed to help fill this gap. We examined Twitter engagement and its impact on public trust in science, focusing on two related science issues: space science and climate change. Our datasets comprised of 10,000 randomly sampled tweets over a month's period in 2016. We used human annotation and machine learning to analyse the tweets. Results revealed the level of distrust was significantly higher in the climate change tweets. However, in the climate change network, people who engaged with science personalities trust science more than those who did not. This difference in trust levels was not present in the space science network. There the two clusters of people displayed similar levels of trust in science. Additionally, we used machine learning to predict the trust labels of tweets and conducted feature analysis to find the properties of trust-inspiring tweets. Our supervised learning algorithm was able to predict trust in science in our sample tweets with 84% accuracy. The strongest predictors of trust in science (as conveyed by tweets) were similarity, presence of URL and authenticity. Contrast this with the findings of our previous study investigating the features of highly engaging space science related social media messages, authenticity is the only feature that also inspires trust. This indicates that what works to promote engagement (e.g. `retweets', `Likes') does not necessarily build trust in science. Social media science communication is not as simple as `we engage, therefore they trust'. We suggest that

The paradox of vaginal examination practice during normal childbirth: Palestinian women's feelings, opinions, knowledge and experiences.

PubMed

Hassan, Sahar J; Sundby, Johanne; Husseini, Abdullatif; Bjertness, Espen

2012-08-28

Vaginal examination (VE), is a frequent procedure during childbirth. It is the most accepted ways to assess progress during childbirth, but its repetition at short intervals has no value. Over years, VE continued to be plagued by a nature that implies negative feelings and experiences of women. The aim of this exploratory qualitative study was to explore women's feelings, opinions, knowledge and experiences of vaginal examinations (VE) during normal childbirth. We interviewed 176 postpartum women using semi-structured questionnaire in a Palestinian public hospital in the oPt. Descriptive statistics were conducted; frequency counts and percentages for the quantitative questions. The association between the frequency of VE and age, parity, years of education, locale and the time of delivery was tested by Chi-squared and Fisher's Exact test. The open-ended qualitative questions were read line-by-line for the content and coded. The assigned codes for all responses were entered to the SPSS statistical software version 18. As compared with WHO recommendations, VE was conducted too frequently, and by too many providers during childbirth. The proportion of women who received a 'too high' frequency of VEs during childbirth was significantly larger in primipara as compared to multipara women (P = .037). 82% of women reported pain or severe pain and 68% reported discomfort during VE. Some women reported insensitive approaches of providers, insufficient means of privacy and no respect of dignity or humanity during the exam. Palestinian women are undergoing unnecessary and frequent VEs during childbirth, conducted by several different providers and suffer pain and discomfort un-necessarily. Adhering to best evidence, VE during childbirth should be conducted only when necessary, and if possible, by the same provider. This will decrease the laboring women's unnecessary suffering from pain and discomfort. Providers should advocate for women's right to information, respect

Maternal trait personality and childbirth: the role of extraversion and neuroticism.

PubMed

Johnston, R G; Brown, A E

2013-11-01

anxiety during pregnancy and childbirth can increase risk of complications and interventions for both mother and infant. Although considerable work has explored fear of childbirth and anxiety during labour and subsequent birth outcomes there has been less consideration of the role of more stable maternal personality upon childbirth. Traits of neuroticism and extraversion are however predictive of health outcomes in other fields potentially through biological, psychological and social mechanisms. The aim of the current research was thus to examine the relationship between trait personality and childbirth experience. seven hundred and fifty-five mothers with an infant aged 0-6 months completed a self-report questionnaire including the Ten Item Personality Measure and descriptions of birth experience including mode of birth [vaginal vs. caesarean section] and complications [failure to progress, fetal distress, post-partum haemorrhage, assisted birth and severe tear]. personality traits were significantly associated with birth experience. Specifically mothers scoring low in extraversion and emotional stability were significantly more likely to have a caesarean section and experience a number of complications during labour and birth including an assisted birth, fetal distress, failure to progress and a severe tear. Findings were independent of maternal age, education and parity. the personality traits of extraversion and emotional stability appear to facilitate likelihood of normal birth. Potential explanations for this include biological (physiological reactivity, pain thresholds, oxytocin and dopamine release) and psychological (coping mechanisms, social support, self-efficacy) factors. The findings have important implications for antenatal education and support during labour. Copyright © 2012 Elsevier Ltd. All rights reserved.

Gut reactions: moral conviction, religiosity, and trust in authority.

PubMed

Wisneski, Daniel C; Lytle, Brad L; Skitka, Linda J

2009-09-01

Theory and research point to different ways moral conviction and religiosity connect to trust in political authorities to decide controversial issues of the day. Specifically, we predicted that stronger moral convictions would be associated with greater distrust in authorities such as the U.S. Supreme Court making the "right" decisions regarding controversial issues. Conversely, we predicted that stronger religiosity would be associated with greater trust in authorities. We tested these hypotheses using a survey of a nationally representative sample of Americans (N = 727) that assessed the degree to which people trusted the U.S. Supreme Court to rule on the legal status of physician-assisted suicide. Results indicated that greater religiosity was associated with greater trust in the U.S. Supreme Court to decide this issue, and that stronger moral convictions about physician-assisted suicide were associated with greater distrust in the U.S. Supreme Court to decide this issue. Also, the processes underlying religious trust and distrust based on moral convictions were more quick and visceral than slow and carefully considered.

The effect of religious-spiritual support on childbirth self-efficacy

PubMed Central

Mohamadirizi, Shahla; Mohamadirizi, Marjan; Mohamadirizi, Soheila; Mahmoodi, Fatemeh

2018-01-01

BACKGROUND: Childbirth self-efficacy is one of the most important factors causing a shift in mothers do vaginal delivery. If the mother feels that she can cope well with stress, will be protected from the harmful effects of stress on your health. Self-efficacy contained individual's assessment of her ability to deal with stressful situations. Strengthen the spiritual beliefs of the patient causes her to be a good result every situation even incurable condition. This study aimed to determine the effect of religious-spiritual support on childbirth self-efficacy in primiparous women. METHODS: This is a quasi-experimental study carried on seventy primiparous women; participants were randomly divided into two intervention and control groups. The intervention group received the e-learning package based on religious-spiritual content. Self-efficacy questionnaire by both groups before and 4 weeks after it was completed. Collected data were entered into SPSS version 11 descriptive statistics, independent t-test, and paired t-test which were used for analysis of data. The significant level was considered <0.05. RESULTS: The results showed that the mean self-efficacy score before and after intervention in case group was 105.2 (27.01) and 110.12 (21.2), respectively, and in control group; 111.2 (23.12) and 116.9 (24.43). Paired t-test in two groups was significant (P = 0.042, P = 0.045) but independent t-test showed no significant difference in scores of childbirth self-efficacy before and after intervention in two groups (P = 0.061). CONCLUSION: In prenatal periods, religious-spiritual support through electronic package method can increase childbirth self-efficacy, so the planning and establishment of this training are recommended as an effective training. PMID:29417074

Childbirth, hospitalisation and sickness absence: a study of female twins

PubMed Central

Björkenstam, Emma; Alexanderson, Kristina; Narusyte, Jurgita; Kjeldgård, Linnea; Ropponen, Annina; Svedberg, Pia

2015-01-01

Objective To investigate associations of giving birth with morbidity in terms of hospitalisation and social consequences of morbidity in terms of sickness absence (SA), while taking familial (genetics and shared environmental) factors into account. Design Prospective register-based cohort study. Estimates of risk of hospitalisation and SA were calculated as HRs with 95% CIs. Setting All female twins, that is, women with a twin sister, born in Sweden. Participants 5118 Swedish female twins (women with a twin sister), born during 1959–1990, where at least one in the twin pair had their first childbirth (T0) during 1994–2009 and none gave birth before 1994. Main outcome measures Hospitalisation and SA during year 3–5 after first delivery or equivalent. Results Preceding the first childbirth, the mean annual number of SA days increased for mothers, and then decreased again. Hospitalisation after T0 was associated with higher HRs of short-term and long-term SA (HR for short-term SA 3.0; 95% CI 2.5 to 3.6 and for long-term SA 2.3; 95% CI 1.6 to 3.2). Hospitalisation both before and after first childbirth was associated with a higher risk of future SA (HR for long-term SA 4.2; 95% CI 2.7 to 6.4). Familial factors influenced the association between hospitalisation and long-term SA, regardless of childbirth status. Conclusions Women giving birth did not have a higher risk for SA than those not giving birth and results indicate a positive health selection into giving birth. Mothers hospitalised before and/or after giving birth had higher risks for future SA, that is, there was a strong association between morbidity and future SA. PMID:25573523

The longitudinal course of post-traumatic stress after childbirth.

PubMed

Söderquist, Johan; Wijma, Barbro; Wijma, Klaas

2006-06-01

Post-traumatic stress was assessed in early and late pregnancy, and 1, 4, 7, and 11 months postpartum by means of questionnaires among 1224 women. Thirty-seven women (3%) had post-traumatic stress (meeting criteria B, C, and D for PTSD) at least once within 1-11 months postpartum. In pregnancy, depression, severe fear of childbirth, 'pre'-traumatic stress, previous counseling related to pregnancy/childbirth, and self-reported previous psychological problems were associated with an increased risk of having post-traumatic stress within 1-11 months postpartum. Sum-scores of post-traumatic stress did not decrease over time among women who at least once had post-traumatic stress (criteria B, C, and D) within 1-11 months postpartum. Women with post-traumatic stress also showed a decrease in perceived social support over time postpartum.

Trust in the workplace: factors affecting trust formation between team members.

PubMed

Spector, Michele D; Jones, Gwen E

2004-06-01

The authors used survey data from 127 professional-level employees working in 8 industries to assess the effects of respondent's trusting stance and (a) the trustee's organization membership (internal or external), (b) the hierarchical relationship (supervisor or peer), and (c) the gender of the trustee, on initial trust level for a new project team member. The authors found that trusting stance was positively related to initial trust level. The authors also found an interaction effect between respondent gender and trustee gender on initial trust. Specifically, male initial trust level was higher for a new male team member and lower for a new female team member. The present study provided additional understanding of the formation of initial trust levels and its importance for team functioning.

Interpersonal Trust across Six Asia-Pacific Countries: Testing and Extending the ‘High Trust Society’ and ‘Low Trust Society’ Theory

PubMed Central

Ward, Paul R.; Mamerow, Loreen; Meyer, Samantha B.

2014-01-01

Background Trust is regarded as a necessary component for the smooth running of society, although societal and political modernising processes have been linked to an increase in mistrust, potentially signalling social and economic problems. Fukuyama developed the notion of ‘high trust’ and ‘low trust’ societies, as a way of understanding trust within different societies. The purpose of this paper is to empirically test and extend Fukuyama’s theory utilising data on interpersonal trust in Taiwan, Hong Kong, South Korea, Japan, Australia and Thailand. This paper focuses on trust in family, neighbours, strangers, foreigners and people with a different religion. Methods Cross-sectional surveys were undertaken in 2009–10, with an overall sample of 6331. Analyses of differences in overall levels of trust between countries were undertaken using Chi square analyses. Multivariate binomial logistic regression analysis was undertaken to identify socio-demographic predictors of trust in each country. Results Our data indicate a tripartite trust model: ‘high trust’ in Australia and Hong Kong; ‘medium trust’ in Japan and Taiwan; and ‘low trust’ in South Korea and Thailand. Trust in family and neighbours were very high across all countries, although trust in people with a different religion, trust in strangers and trust in foreigners varied considerably between countries. The regression models found a consistent group of subpopulations with low trust across the countries: people on low incomes, younger people and people with poor self-rated health. The results were conflicting for gender: females had lower trust in Thailand and Hong Kong, although in Australia, males had lower trust in strangers, whereas females had lower trust in foreigners. Conclusion This paper identifies high, medium and low trust societies, in addition to high and low trusting population subgroups. Our analyses extend the seminal work of Fukuyama, providing both corroboration and

What about me? The loss of self through the experience of traumatic childbirth.

PubMed

Byrne, Veronica; Egan, Jonathan; Mac Neela, Pádraig; Sarma, Kiran

2017-08-01

birth trauma has become an increasingly recognised maternal mental health issue and has important implications for both mother and infant. The importance of subjective birth experience in the development of birth trauma has been identified and may mediate the lack of theoretical consistency in this area. The current study aims to explore the subjective experience of birth trauma among first time mothers in Ireland. It aims to separate the potential effects of peripartum depression (PPD) from this in limiting this qualitative investigation to women who reported birth trauma, without PPD. mixed methods: Quantitative methods facilitated the recruitment of participants, the selection of a homogenous sample and addressed previous methodological flaws in birth trauma research. Interpretative Phenomenological Analysis (IPA) was used to explore the subjective experience of traumatic childbirth. seven, first- time mothers who reported a traumatic childbirth, without significant symptoms of PPD participated. screening measures of birth trauma and PPD were completed by participants. A semi-structured interview was then conducted with each participant about their childbirth experience. Interviews were transcribed and analysed using IPA. The primary superordinate theme recounted how the identity and individuality of women is ignored and discounted, throughout the process of childbirth. Identity is challenged and altered as a result of women's incompatibility with the maternity system. this study supports the existence of birth trauma in an Irish context and highlights the subjective experience of women as central to the development of birth trauma. acknowledgement and inclusion of the mother as an individual throughout the process of childbirth may be protective in limiting the experience of birth trauma. Copyright © 2017 Elsevier Ltd. All rights reserved.

Postpartum Depression: How Childbirth Educators Can Help Break the Silence

PubMed Central

Zauderer, Cheryl

2009-01-01

The voices of women suffering from postpartum depression are often silent. Women are reluctant to reveal to others that they are unhappy after the birth of their babies. Much has been written on possible causes, risk factors, and treatments for postpartum depression, but little has been done to investigate why women take so long to seek help. Early detection and treatment are key to a full recovery. Childbirth educators are in the position to offer anticipatory guidance on possible complications of the postpartum period, including postpartum depression. This article explores why women with postpartum depression choose to suffer in silence and suggests how childbirth educators can help new mothers find their voices. PMID:20190853

Measuring nursing support during childbirth.

PubMed

Gale, J; Fothergill-Bourbonnais, F; Chamberlain, M

2001-01-01

To examine the amount of support being provided by nurses to women during childbirth and factors that influence the provision of support. Exploratory, descriptive. Work sampling method was used to determine the percentage of time nurses spend in supportive care activities. Twelve nurses were observed over six nonconsecutive day shifts on a birthing unit of a Canadian teaching hospital in Quebec. A total of 404 observations were made. Nurses were also interviewed to determine their perceptions of what constitutes supportive nursing care and the factors that facilitate or inhibit the provision of this care. Nurses spent only 12.4% of their total time providing supportive care to laboring women. Interviews with nurses suggested that perceptions of the components of supportive care were comparable to this study's operational definition of support, namely: physical, emotional, and instructional/informational support and advocacy. Barriers to providing support identified by nurses included lack of time and insufficient staff. However, further content analysis of the interview data revealed that healthcare providers had a pervasive sense of control over laboring women and their partners. Although nursing support has been identified as an important aspect of nursing care in childbirth, this study demonstrated an incongruity between what nurses perceived as being supportive care and the amount of support that was actually provided. Barriers to the provision of supportive care in the practice setting as well as suggestions for its enhancement are discussed.

Negotiated Boundaries: Conceptual Locations of Pregnancy and Childbirth

ERIC Educational Resources Information Center

Houvouras, Shannon

2006-01-01

Dominant notions of reproduction perceive childbearing as physical processes that take place within womens bodies. This perception undermines non-physical components and removes men from the process. This project uses social constructionism to explore the locations women describe pregnancy and childbirth taking place in their childbearing…

Measuring posttraumatic stress following childbirth: a critical evaluation of instruments.

PubMed

Stramrood, Claire A I; Huis In 't Veld, Elisabeth M J; Van Pampus, Maria G; Berger, Leonard W A R; Vingerhoets, Ad J J M; Schultz, Willibrord C M Weijmar; Van den Berg, Paul P; Van Sonderen, Eric L P; Paarlberg, K Marieke

2010-03-01

To evaluate instruments used to assess posttraumatic stress disorder (PTSD) following childbirth with both quantitative (reliability analysis and factor analysis) and qualitative (comparison of operationalization) techniques. An unselected population of 428 women completed the Traumatic Event Scale-B (TES-B) and the PTSD Symptom Scale-Self Report (PSS-SR) 2-6 months after delivery. Assessment of internal consistency yielded similar results for the TES-B and PSS-SR (Cronbach's alpha = 0.87 and 0.82, respectively). Factor analysis revealed two rather than three DSM-IV symptom categories for both instruments: childbirth-related factors (re-experiencing/ avoidance) and symptoms of depression and anxiety (numbing/hyperarousal). Although the TES-B and the PSS-SR sum-scores show a strong relationship (Spearmans rho = 0.78), agreement between the instruments on the identification of PTSD cases is low (kappa = 0.24); discrepancy between TES-B and PSS-SR is largely due to differences in instruction to respondents, formulation of items, answer categories, and cut-off values. Large operationalization differences between TES-B and PSS-SR have been identified, i.e., in the formulation of questions, answer categories, cut-off values and instructions to respondents. Comparison between studies using different instruments for measuring PTSD following childbirth should be done with utmost caution.

“The Birthing From Within Holistic Sphere”: A Conceptual Model for Childbirth Education

PubMed Central

England, Pam; Horowitz, Rob

2000-01-01

An expanded conceptual model of childbirth education is offered, proposing the benefits of balancing informative teaching processes with creative, experiential, introspective learning processes for parents. The application of these two teaching dimensions to exploring four different perspectives of birth (the mother's, the father's, the baby's, and the culture's) is discussed, along with examples from “Birthing From Within” classes. Implications for current practice and the evolving role of childbirth educator are noted. PMID:17273200

Teaching childbirth with high-fidelity simulation. Is it better observing the scenario during the briefing session?

PubMed

Cuerva, Marcos J; Piñel, Carlos S; Martin, Lourdes; Espinosa, Jose A; Corral, Octavio J; Mendoza, Nicolás

2018-02-12

The design of optimal courses for obstetric undergraduate teaching is a relevant question. This study evaluates two different designs of simulator-based learning activity on childbirth with regard to respect to the patient, obstetric manoeuvres, interpretation of cardiotocography tracings (CTG) and infection prevention. This randomised experimental study which differs in the content of their briefing sessions consisted of two groups of undergraduate students, who performed two simulator-based learning activities on childbirth. The first briefing session included the observations of a properly performed scenario according to Spanish clinical practice guidelines on care in normal childbirth by the teachers whereas the second group did not include the observations of a properly performed scenario, and the students observed it only after the simulation process. The group that observed a properly performed scenario after the simulation obtained worse grades during the simulation, but better grades during the debriefing and evaluation. Simulator use in childbirth may be more fruitful when the medical students observe correct performance at the completion of the scenario compared to that at the start of the scenario. Impact statement What is already known on this subject? There is a scarcity of literature about the design of optimal high-fidelity simulation training in childbirth. It is known that preparing simulator-based learning activities is a complex process. Simulator-based learning includes the following steps: briefing, simulation, debriefing and evaluation. The most important part of high-fidelity simulations is the debriefing. A good briefing and simulation are of high relevance in order to have a fruitful debriefing session. What do the results of this study add? Our study describes a full simulator-based learning activity on childbirth that can be reproduced in similar facilities. The findings of this study add that high-fidelity simulation training in

The UK National Health Service's 'innovation agenda': lessons on commercialisation and trust.

PubMed

Sterckx, Sigrid; Cockbain, Julian

2014-01-01

The UK National Health Service (the 'NHS'), encouraged by the 2011 report Innovation Health and Wealth, Accelerating Adoption and Diffusion in the NHS, and empowered by the Health and Social Care Act 2012, is in the process of adopting a new agenda for stimulating innovation in healthcare. For this, the bodies, body materials, and confidential health information of NHS patients may be co-opted. We explain why this brings the NHS into a moral conflict with its basic goal of providing a universal healthcare service. Putting NHS databases at the disposal of industry, without addressing ethical concerns regarding the privacy, autonomy, and moral integrity of patients and without requiring a 'kick-back' to enhance the service that the NHS provides, is inappropriate. As this article shows, with reference to the commercial arena of direct-to-consumer genetic testing, it is crucial that patient and public trust in the NHS is not eroded. © The Author 2014. Published by Oxford University Press; all rights reserved. For Permissions, please email: journals.permissions@oup.com.

A cluster randomized implementation trial to measure the effectiveness of an intervention package aiming to increase the utilization of skilled birth attendants by women for childbirth: study protocol

PubMed Central

2014-01-01

Background Nepal is on track to achieve MDG 5 but there is a huge sub-national disparity with existing high maternal mortality in western and hilly regions. The national priority is to reduce this disparity to achieve the goal at sub-national level. Evidences from developing countries show that increasing utilization of skilled attendant at birth is an important indicator for reducing maternal death. Further, there is a very low utilization during childbirth in western and hilly regions of Nepal which clearly depicts the barriers in utilization of skilled birth attendants. So, there is a need to overcome the identified barriers to increase the utilization thereby decreasing the maternal mortality. The hypothesis of this study is that through a package of interventions the utilization of skilled birth attendants will be increased and hence improve maternal health in Nepal. Method/Design This study involves a cluster randomized controlled trial involving approximately 5000 pregnant women in 36 clusters. The 18 intervention clusters will receive the following interventions: i) mobilization of family support for pregnant women to reach the health facility, ii) availability of emergency funds for institutional childbirth, iii) availability of transport options to reach a health facility for childbirth, iv) training to health workers on communication skills, v) security provisions for SBAs to reach services 24/24 through community mobilization; 18 control clusters will not receive the intervention package. The final evaluation of the intervention is planned to be completed by October 2014. Primary study output of this study is utilization of SBA services. Secondary study outputs measure the uptake of antenatal care, post natal checkup for mother and baby, availability of transportation for childbirth, operation of emergency fund, improved reception of women at health services, and improved physical security of SBAs. Discussion The intervention package is designed to

A cluster randomized implementation trial to measure the effectiveness of an intervention package aiming to increase the utilization of skilled birth attendants by women for childbirth: study protocol.

PubMed

Bhandari, Gajananda P; Subedi, Narayan; Thapa, Janak; Choulagai, Bishnu; Maskey, Mahesh K; Onta, Sharad R

2014-03-19

Nepal is on track to achieve MDG 5 but there is a huge sub-national disparity with existing high maternal mortality in western and hilly regions. The national priority is to reduce this disparity to achieve the goal at sub-national level. Evidences from developing countries show that increasing utilization of skilled attendant at birth is an important indicator for reducing maternal death. Further, there is a very low utilization during childbirth in western and hilly regions of Nepal which clearly depicts the barriers in utilization of skilled birth attendants. So, there is a need to overcome the identified barriers to increase the utilization thereby decreasing the maternal mortality. The hypothesis of this study is that through a package of interventions the utilization of skilled birth attendants will be increased and hence improve maternal health in Nepal. This study involves a cluster randomized controlled trial involving approximately 5000 pregnant women in 36 clusters. The 18 intervention clusters will receive the following interventions: i) mobilization of family support for pregnant women to reach the health facility, ii) availability of emergency funds for institutional childbirth, iii) availability of transport options to reach a health facility for childbirth, iv) training to health workers on communication skills, v) security provisions for SBAs to reach services 24/24 through community mobilization; 18 control clusters will not receive the intervention package. The final evaluation of the intervention is planned to be completed by October 2014. Primary study output of this study is utilization of SBA services. Secondary study outputs measure the uptake of antenatal care, post natal checkup for mother and baby, availability of transportation for childbirth, operation of emergency fund, improved reception of women at health services, and improved physical security of SBAs. The intervention package is designed to increase the utilization of skilled

Online trust building through third party trust transfer and third party protection

NASA Astrophysics Data System (ADS)

Wandoko, Wanda; Saleh Abbas, Bahtiar; Budiastuti, Dyah; Kosala, Raymond

2017-03-01

The primary objective of this research is to develop an online trust building mechanism for SME (Small Medium Enterprise). Trust is very important in e-commerce. The nature of online shopping has a greater uncertainty than offline shopping. Seeing as there is an uncertainty that can produce risks, a prospective buyer’s trust is needed. A lot of people’s unwillingness to shop online is caused by their lack of trust toward e-commerce. E-commerce is said to be one of the ways for SME to compete with bigger companies. However, building trust requires immense time and cost. SME with limited resources may experience difficulties in building trust just with their own resources. Base on literature research that needs to be validated in next research, we found that trust can be built through trust transfer from the reputable and well-known trust-mark issuer, and third party protection such as escrow account service and credit card issuer.

Family Responsive Policies and Employee Retention Following Childbirth.

ERIC Educational Resources Information Center

Glass, Jennifer L.; Riley, Lisa

1998-01-01

Among 324 employed women in Indiana, followed from pregnancy through 12 months postpartum, job attrition after childbirth was significantly decreased by employer policies, particularly length of maternity leave and ability to avoid mandatory overtime upon return, and was also decreased by supervisor and coworker social support, greater educational…

Maternal Confidence for Physiologic Childbirth: A Concept Analysis.

PubMed

Neerland, Carrie E

2018-06-06

Confidence is a term often used in research literature and consumer media in relation to birth, but maternal confidence has not been clearly defined, especially as it relates to physiologic labor and birth. The aim of this concept analysis was to define maternal confidence in the context of physiologic labor and childbirth. Rodgers' evolutionary method was used to identify attributes, antecedents, and consequences of maternal confidence for physiologic birth. Databases searched included Ovid MEDLINE, CINAHL, PsycINFO, and Sociological Abstracts from the years 1995 to 2015. A total of 505 articles were retrieved, using the search terms pregnancy, obstetric care, prenatal care, and self-efficacy and the keyword confidence. Articles were identified for in-depth review and inclusion based on whether the term confidence was used or assessed in relationship to labor and/or birth. In addition, a hand search of the reference lists of the selected articles was performed. Twenty-four articles were reviewed in this concept analysis. We define maternal confidence for physiologic birth as a woman's belief that physiologic birth can be achieved, based on her view of birth as a normal process and her belief in her body's innate ability to birth, which is supported by social support, knowledge, and information founded on a trusted relationship with a maternity care provider in an environment where the woman feels safe. This concept analysis advances the concept of maternal confidence for physiologic birth and provides new insight into how women's confidence for physiologic birth might be enhanced during the prenatal period. Further investigation of confidence for physiologic birth across different cultures is needed to identify cultural differences in constructions of the concept. © 2018 by the American College of Nurse-Midwives.

[Crises of trust].

PubMed

Chen, Thai-Form; Tseng, Hsing-Chau

2006-02-01

Extensive media coverage is warning of a crisis of trust that has emerged as a serious issue in our society. This article explores the meaning of "crisis," concepts of crisis management, mechanisms for building trust, and the underlying significance of trust and distrust. Evidence is adduced to testify to the erosion of trust and factors in our society that reflect the potential for crises of trust. Organizational decision makers, including hospital managers, are urged to identify and reflect upon weaknesses in their organizations in order that remedial action can be taken to preempt such crises.

New Resources for Childbirth Educators and Parents

PubMed Central

Shilling, Teri

2008-01-01

In this column, reviewers offer perspectives and comments on a variety of new media resources for childbirth educators and for expectant and new parents. The topics of DVDs and books reviewed here include fatherhood, labor-support techniques, optimal labor positions, infant massage, breastfeeding, healthy nutrition during the childbearing year, understanding a newborn's cues, personal viewpoints on cesarean birth, and postpartum massage.

Attitudes of New Parents towards Child and Spouse with Lamaze or Non-Lamaze Methods of Childbirth.

ERIC Educational Resources Information Center

McClure, Robert F.; Brewer, R. Thomas

1980-01-01

Lamaze childbirth training was found to have no significant effects on attitudes towards spouse or child. It did have a significant anxiety-reducing effect with respect to childbirth. Parents using the Lamaze method had a more positive attitude about having a baby. (Author/CS)

Psychometric properties of the Swedish childbirth self-efficacy inventory (Swe-CBSEI)

PubMed Central

2014-01-01

Background Previous research has reported that women who are admitted to delivery wards in early labour process before an active stage of labour has started run an increased risk of instrumental deliveries. Therefore, it is essential to focus on factors such as self-efficacy that can enhance a woman’s own ability to cope with the first stage of labour. However, there was no Swedish instrument measuring childbirth self-efficacy available. Thus, the aim of the study was to translate the Childbirth Self-efficacy Inventory and to psychometrically test the Swedish version on first- time mothers within the Swedish culture. Methods The method included a forward-backward translation with face and content validity. The psychometric properties were evaluated using a Principal Component Analysis and by using Cronbach’s alpha coefficient and inter-item correlations. Descriptive statistics and non-parametric tests were used to describe and compare the scales. All data were collected from January 2011 to June 2012, from 406 pregnant women during the gestational week 35-42. Results The Swedish version of the Childbirth Self-Efficacy Inventory indicated good reliability and the Principal Component Analysis showed a three-component structure. The Wilcoxon Signed-Ranks Test indicated that the women could differentiate between the concepts outcome expectancy and self-efficacy expectatancy and between the two labour stages, active stage and the second stage of labour. Conclusions The Swedish version of Childbirth Self-efficacy Inventory is a reliable and valid instrument. The inventory can act as a tool to identify those women who need extra support and to evaluate the efforts of improving women’s self-efficacy during pregnancy. PMID:24383788

Farmers are the most trusted part of the Australian food chain: results from a national survey of consumers.

PubMed

Henderson, Julie; Coveney, John; Ward, Paul R; Taylor, Anne W

2011-08-01

Trust is a crucial component of food safety and governance. This research surveyed a random selection of the population to examine its level of trust in a variety of 'actors' and organisations in the food chain. A computer-assisted telephone interviewing (CATI) survey addressing trust in the food system was administrated during October to December 2009 to a random sample of 1,109 participants across all states (response rate 41.2%). Farmers enjoyed high levels of trust, whereas politicians were considered less trustworthy. Supermarkets were afforded more trust than media and news outlets. Logistic regression analysis determined that two socio-demographic variables - age and education level - were significantly associated with trust in food actors, with young people finding the media the least trustworthy. Our respondents invested the most trust in farmers, possibly indicating an awareness and appreciation of primary food production among the Australian public. The finding that young people's trust in the media is low challenges media use in social marketing campaigns aimed to improve health and nutrition in younger age groups. Health education, including nutrition education, needs to consider the channels of communication most suited to age and social grouping. © 2011 The Authors. ANZJPH © 2011 Public Health Association of Australia.

Airport and Airway Trust Fund: Issues Related to Determining How Best to Finance FAA

DOT National Transportation Integrated Search

1997-02-05

In December 1996, the General Accounting Office (GAO) reported to Congress on : the status of the Airport and Airway Trust Fund (Trust Fund) and on a proposal : by a coalition of the nation's largest airlines to replace the tax on domestic : airline ...

A Violent Birth: Reframing Coerced Procedures During Childbirth as Obstetric Violence.

PubMed

Borges, Maria TR

2018-01-01

In the United States, women are routinely forced to undergo cesarean sections, episiotomies, and the use of forceps, despite their desire to attempt natural vaginal delivery. Yet, the current American legal system does little to provide redress for women coerced to undergo certain medical procedures during childbirth. Courts and physicians alike are prepared to override a woman's choice of childbirth procedure if they believe this choice poses risks to the fetus, and both give little value to the woman's right to bodily autonomy. This Note proposes a solution for addressing the problem of coerced medical procedures during childbirth by importing a framework created in Venezuela and Argentina that characterizes this issue as "obstetric violence." First, this Note contains an overview of the shortcomings of the existing American legal framework to address the problem. Second, it explains the advantages of the obstetric violence framework and argues that its adoption in the United States would address many of the failures of the existing system. And third, this Note introduces a few legislative and litigation strategies that can be used to implement this framework in the United States and briefly addresses some of the challenges these strategies may pose.

Do people trust dentists? Development of the Dentist Trust Scale.

PubMed

Armfield, J M; Ketting, M; Chrisopoulos, S; Baker, S R

2017-09-01

This study aimed to adapt a measure of trust in physicians to trust in dentists and to assess the reliability and validity of the measure. Questionnaire data were collected from a simple random sample of 596 Australian adults. The 11-item General Trust in Physicians Scale was modified to apply to dentists. The Dentist Trust Scale (DTS) had good internal consistency (α = 0.92) and exploratory factor analysis revealed a single-factor solution. Lower DTS scores were associated with less trust in the dentist last visited, having previously changed dentists due to unhappiness with the care received, currently having dental pain, usual visiting frequency, dental avoidance, and with past experiences of discomfort, gagging, fainting, embarrassment and personal problems with the dentist. The majority of people appear to exhibit trust in dentists. The DTS shows promising reliability and validity evidence. © 2017 Australian Dental Association.

Listening to Mothers II: Knowledge, Decision-Making, and Attendance at Childbirth Education Classes

PubMed Central

Lothian, Judith A.

2007-01-01

In this column, a woman describes her concern that her childbirth classes did not provide the information she needed to make informed decisions during labor and birth. The results of the Listening to Mothers II survey suggest that this experience is not unusual. Although most women (97%) who participated in the survey wanted to know all or most of the potential risks of epidural, induction, and cesarean before consenting to have the intervention, the majority—including mothers who had experienced the intervention, women who were experienced mothers, and women who had attended childbirth classes—did not know the complications of induction or cesarean. These findings raise important questions about the outcomes of childbirth education. The factors that may contribute to these findings are discussed, and suggestions are made for insuring that women have the knowledge they need to make informed decisions about their maternity care. PMID:18769524

The influence of childbirth experiences on women׳s postpartum traumatic stress symptoms: A comparison between Israeli Jewish and Arab women.

PubMed

Halperin, Ofra; Sarid, Orly; Cwikel, Julie

2015-06-01

childbirth is a positive experience for most women yet some women express distress after birth. Traumatic experience can sometimes cause post-traumatic stress disorder (PTSD) in relation to childbirth. Prevalence of traumatic birth experience and PTSD after childbirth differs between cultures. to examine the subjective recall of childbirth experiences and PTSD symptoms of Israeli Jewish and Arab women; to examine comparatively the prevalence of PTSD symptoms six to eight weeks after childbirth and to establish the factors that predict PTSD symptoms. a prospective study was conducted in a region characterised by wide variations in ethnocultural groups. The study was comprised of two time points: Time 1 (T1) interviews were conducted at the bedside of the women in the maternity ward of each hospital 24-48 hours after childbirth. Time 2 (T2), all 171 women participating in T1 were interviewed by phone six to eight weeks after childbirth. 34 women (19.9%) reported their labour as traumatic 24-48 hours after birth (T1), and six to eight weeks later (T2) 67 women (39.2%) assessed their experience as traumatic. More Arab women (69.6%) than Jewish women (56.5%) had a positive memory of childbirth, but this difference only approached statistical significance (p=.09). Results showed rather low frequencies of PTSD symptoms, and no ethnic difference. PTSD symptoms were significantly and positively predicted by subjective recollection of childbirth experience (Time 2). PTSD symptoms were higher for women who did not have a vaginal birth, and more women with PTSD symptoms were not breast feeding. we found more similarities than differences between Arab and Jewish women׳s experience of their births and no differences between them on the prevalence of PTSD symptoms after birth. The results suggest that non-vaginal birth (instrumental or caesarean section) and negative recollection of the childbirth experience are important factors related to the development of PTSD symptoms after

Human rights in childbirth, narratives and restorative justice: a review.

PubMed

Lokugamage, A U; Pathberiya, S D C

2017-02-02

This review describes the emerging global debate on the role of human rights childbirth. It is also tailored to a UK perspective in view of the Montgomery v. Lanarkshire [2015] legal ruling and it implications to practice. We can never underestimate the power of humane care on health. The compassion and evidence based medicine agenda in healthcare is interconnected with human rights in healthcare, feeding into the principles of decision making and patient centred care. When this has not happened and there is been healthcare conflict, the power of storytelling serves to connect disparate parties to their common humanity. Narratives are an important aspect of restorative justice processes and we suggest that this could be beneficial in the field of human rights in childbirth.

Influences by Sound and Light to Mind and Body during Delivery, and Future of Childbirth Environment

NASA Astrophysics Data System (ADS)

Kameyama, Miyuki

I, who is a musician, was stimulated by own childbirth experience, and developed the ultimate “delivery room” which enabled relaxation support using sound and light. This paper explains regarding its development and the improvement of childbirth environment in Department of Obstetrics and Gynecology in Japan.

Observational Data on the Psychological Experience of Childbirth.

ERIC Educational Resources Information Center

Standley, Kay

This paper explores the effects of the childbirth environment and demographic variables on the laboring woman's expressions of tension and pain. Four observable physical measures were combined into a behavioral index of pain and tension: irregular breathing, tension of the upper extremities (rigid muscle flexion), vocalizations of pain (a cry,…

Social capital, political trust and purchase of illegal liquor: a population-based study in southern Sweden.

PubMed

Lindström, Martin

2008-05-01

To investigate the association between political trust in the Riksdag (the national parliament in Sweden) and having purchased illegal liquor during the past 12 months. The 2004 public health survey in Skåne is a cross-sectional postal questionnaire study answered by 27,757 respondents aged 18-80 with a 59% response rate. A logistic regression model was used to investigate the associations between political trust and having purchased illegal liquor during the past 12 months. Multivariate analyses of political trust and having purchased illegal liquor were performed in order to investigate the importance of possible confounders (including generalized/horizontal trust in other people). A 21.2% fraction of the men and 9.6% of the women had purchased illegal alcohol during the past 12 months. A total of 17.3% and 11.6% of the male and female respondents, respectively, reported that they had no trust at all in the national parliament, and another 38.2% and 36.2%, respectively, reported that their political trust was not particularly high. Respondents in younger age groups, with medium/low education, economic stress, low horizontal trust and not particularly high and no political trust at all and no opinion had significantly higher levels of having purchased illegal liquor. The significant odds ratios of having purchased illegal liquor in the not particularly high political trust and no political trust at all categories were somewhat reduced although still significant after multiple adjustments. The results suggest that political trust may have an independent effect on the propensity to purchase illegal liquor in Sweden.

Trusted Computing Management Server Making Trusted Computing User Friendly

NASA Astrophysics Data System (ADS)

Sothmann, Sönke; Chaudhuri, Sumanta

Personal Computers (PC) with build in Trusted Computing (TC) technology are already well known and widely distributed. Nearly every new business notebook contains now a Trusted Platform Module (TPM) and could be used with increased trust and security features in daily application and use scenarios. However in real life the number of notebooks and PCs where the TPM is really activated and used is still very small.

Improving Tanzanian childbirth service quality.

PubMed

Jaribu, Jennie; Penfold, Suzanne; Green, Cathy; Manzi, Fatuma; Schellenberg, Joanna

2018-04-16

Purpose The purpose of this paper is to describe a quality improvement (QI) intervention in primary health facilities providing childbirth care in rural Southern Tanzania. Design/methodology/approach A QI collaborative model involving district managers and health facility staff was piloted for 6 months in 4 health facilities in Mtwara Rural district and implemented for 18 months in 23 primary health facilities in Ruangwa district. The model brings together healthcare providers from different health facilities in interactive workshops by: applying QI methods to generate and test change ideas in their own facilities; using local data to monitor improvement and decision making; and health facility supervision visits by project and district mentors. The topics for improving childbirth were deliveries and partographs. Findings Median monthly deliveries increased in 4 months from 38 (IQR 37-40) to 65 (IQR 53-71) in Mtwara Rural district, and in 17 months in Ruangwa district from 110 (IQR 103-125) to 161 (IQR 148-174). In Ruangwa health facilities, the women for whom partographs were used to monitor labour progress increased from 10 to 57 per cent in 17 months. Research limitations/implications The time for QI innovation, testing and implementation phases was limited, and the study only looked at trends. The outcomes were limited to process rather than health outcome measures. Originality/value Healthcare providers became confident in the QI method through engagement, generating and testing their own change ideas, and observing improvements. The findings suggest that implementing a QI initiative is feasible in rural, low-income settings.

Association between childbirth attitudes and fear on birth preferences of a future generation of Australian parents.

PubMed

Hauck, Yvonne L; Stoll, Kathrin H; Hall, Wendy A; Downie, Jill

2016-12-01

The reality of childbirth fear is recognised for expectant parents but we lack knowledge about the childbirth attitudes of the next generation of Australian parents. Examination of adults' attitudes toward childbirth including influencing contributing factors, fear scores, birth preferences and reasons for this preference. A cross-sectional online study was conducted with 654 Western Australian students attending one tertiary institution. Students (male and female) were eligible to participate if they were less than 40 years of age and did not currently have children but confirmed their intention to become parents. To assess associations or comparison of means, bi-variable analyses (Chi square test, Fisher's Exact test, Independent Student's t-test or one way ANOVA) were used. Factors associated with childbirth fear and birth preferences were assessed with binary logistic regression analysis. Childbirth attitudes were shaped by family members' (82.0%) and friends' experiences (64.4%) plus media (TV, YouTube, and movies) (63.5%). Furthermore, 15.6% of adults indicated a preference for a caesarean birth, even without obstetric complications. Likewise, 26.1% reported elevated fear; students with elevated fear scores had 2.6 times greater odds of wanting a caesarean birth. Only 23.4% of students felt confident about their childbirth knowledge. Adults reported fear levels that warrant attention prior to a future pregnancy. Although the majority would choose a vaginal birth, they require awareness of benefits and risks for both vaginal and caesarean births to ensure their decisions reflect informed choice rather than influences of inadequate knowledge or fear. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Does capitation payment under national health insurance affect subscribers' trust in their primary care provider? a cross-sectional survey of insurance subscribers in Ghana.

PubMed

Andoh-Adjei, Francis-Xavier; Cornelissen, Dennis; Asante, Felix Ankomah; Spaan, Ernst; van der Velden, Koos

2016-08-24

Ghana introduced capitation payment for primary care in 2012 with the view to containing escalating claims expenditure. This shift in provider payment method raised issues about its potential impact on patient-provider trust relationship and insured-patients' trust in the Ghana National Health Insurance Scheme. This paper presents findings of a study that explored insured-patients' perception about, and attitude towards capitation payment in Ghana; and determined whether capitation payment affect insured-patients' trust in their preferred primary care provider and the National Health Insurance Scheme in general. We adopted a survey design for the study. We administered closed-ended questionnaires to collect data from insurance card-bearing members aged 18 years and above. We performed both descriptive statistics to determine proportions of observations relating to the variables of interest and chi-square test statistics to determine differences within gender and setting. Sixty-nine per cent (69 %) out of 344 of respondents selected hospital level of care as their primary care provider. The two most important motivations for the choice of a provider were proximity in terms of geographical access (40 %) and perceived quality of care (38 %). Eighty-eight per cent (88 %) rated their trust in their provider as (very) high. Eighty-two per cent (82 %) actively selected their providers. Eighty-eight per cent (88 %) had no intention to switch provider. A majority (91 %) would renew their membership when it expires. Female respondents (91 %; n = 281) were more likely to renew their membership than males (87 %; n = 63). Notwithstanding capitation payment experience, 81 % of respondents would recommend to their peers to enrol with the NHIS with rural dwellers (87 %; n = 156) being more likely to do so than urban dwellers (76 %; n = 188). Almost all respondents (92 %) rated the NHIS as (very) good. Health Insurance subscribers in Ghana have high

Explaining Changes in Mothers' Job Satisfaction Following Childbirth.

ERIC Educational Resources Information Center

Holtzman, Mellisa; Glass, Jennifer

1999-01-01

Pregnant women (n=227) interviewed before and six and 12 months after childbirth reported declines in job satisfaction following birth. The following factors positively or negatively affected satisfaction: length of leave, ability to work at home, 30 to 35-hour work week, evening/rotating shifts, supervisor support, and child-care environment. (SK)

Trust me, I'm a researcher!: The role of trust in biomedical research.

PubMed

Kerasidou, Angeliki

2017-03-01

In biomedical research lack of trust is seen as a great threat that can severely jeopardise the whole biomedical research enterprise. Practices, such as informed consent, and also the administrative and regulatory oversight of research in the form of research ethics committees and Institutional Review Boards, are established to ensure the protection of future research subjects and, at the same time, restore public trust in biomedical research. Empirical research also testifies to the role of trust as one of the decisive factors in research participation and lack of trust as a barrier for consenting to research. However, what is often missing is a clear definition of trust. This paper seeks to address this gap. It starts with a conceptual analysis of the term trust. It compares trust with two other related terms, those of reliance and trustworthiness, and offers a defence of Baier's attribute of 'good will' a basic characteristic of trust. It, then, proceeds to consider trust in the context of biomedical research by examining two questions: First, is trust necessary in biomedical research?; and second, do increases in regulatory oversight of biomedical research also increase trust in the field? This paper argues that regulatory oversight is important for increasing reliance in biomedical research, but it does not improve trust, which remains important for biomedical research. It finishes by pointing at professional integrity as a way of promoting trust and trustworthiness in this field.

Trust in the Internet as a Health Resource Among Older Adults: Analysis of Data from a Nationally Representative Survey

PubMed Central

Kirch, Matthias; Zheng, Kai; An, Lawrence C

2011-01-01

Background Distrust in the Internet as a source of health information remains common among older adults. The influence of this distrust on Internet use for health-related purposes, however, is unclear. Objective The objective of our study was to explore how older adults’ trust in the Internet influences their online health-related activities, and to identify potential targets for improving health-related Internet resources for older adults. Methods Data were obtained from a nationally representative, random digit-dial telephone survey of 1450 adults 50 years of age and older in the United States. A model was developed to conceptualize the hypothesized relationships among individual characteristics, distrust, and avoidance of the Internet as a health resource. Multivariate logistic regression analyses were conducted to examine the association between trust in online health information and use of the Internet for health-related purposes. Additional multivariate logistic regression analyses were conducted to identify the key characteristics associated with trust in online health information, adding sequentially the variables hypothesized to account for distrust among older adults: sociodemographic and health characteristics, inexperience and technical difficulties with the Internet, negative feelings toward the Internet, and lack of awareness about the sources providing the health information found online. Results The mean (SD) age of the study population was 63.7 (10.6) years. Of the 823 (56.8%) Internet users, 628 (76.3%) reported using the Internet as a health resource. Trust in the Internet as a source of health information was associated with using the Internet for a number of health activities, including searching for information about a specific health condition (adjusted OR 4.43, P < .001), purchasing prescription drugs (adjusted OR 2.61, P = .03), and talking with a health care provider about information found online (adjusted OR 2.54, P = .002). Older

Trust in the internet as a health resource among older adults: analysis of data from a nationally representative survey.

PubMed

Zulman, Donna M; Kirch, Matthias; Zheng, Kai; An, Lawrence C

2011-02-16

Distrust in the Internet as a source of health information remains common among older adults. The influence of this distrust on Internet use for health-related purposes, however, is unclear. The objective of our study was to explore how older adults' trust in the Internet influences their online health-related activities, and to identify potential targets for improving health-related Internet resources for older adults. Data were obtained from a nationally representative, random digit-dial telephone survey of 1450 adults 50 years of age and older in the United States. A model was developed to conceptualize the hypothesized relationships among individual characteristics, distrust, and avoidance of the Internet as a health resource. Multivariate logistic regression analyses were conducted to examine the association between trust in online health information and use of the Internet for health-related purposes. Additional multivariate logistic regression analyses were conducted to identify the key characteristics associated with trust in online health information, adding sequentially the variables hypothesized to account for distrust among older adults: sociodemographic and health characteristics, inexperience and technical difficulties with the Internet, negative feelings toward the Internet, and lack of awareness about the sources providing the health information found online. The mean (SD) age of the study population was 63.7 (10.6) years. Of the 823 (56.8%) Internet users, 628 (76.3%) reported using the Internet as a health resource. Trust in the Internet as a source of health information was associated with using the Internet for a number of health activities, including searching for information about a specific health condition (adjusted OR 4.43, P < .001), purchasing prescription drugs (adjusted OR 2.61, P = .03), and talking with a health care provider about information found online (adjusted OR 2.54, P = .002). Older adults (age ≥ 65 years) were less likely

Validation Study of Maternal Recall on Breastfeeding Duration 6 Years After Childbirth.

PubMed

Amissah, Emma Ayorkor; Kancherla, Vijaya; Ko, Yi-An; Li, Ruowei

2017-05-01

Breastfeeding duration is an important indicator commonly measured in maternal and child health and nutrition research. Maternal short-term recall for both initiation and duration of breastfeeding has been shown to be valid; however, validity of long-term recall is not well understood. Research aim: This study aims to assess the validity of maternal recall of breastfeeding duration 6 years after childbirth and its association with sociodemographic factors. Among 635 mother-child pairs, breastfeeding duration data collected monthly throughout the 1st year after childbirth in the Infant Feeding Practices Study II (IFPS II) were compared to recall data obtained 6 years later during the Year 6 Follow-Up. The intraclass correlation coefficient (ICC) and Bland-Altman plots were examined to study the agreement between the two data sets. Sociodemographic factors associated with accurate recall to within 1 month of the IFPS II breastfeeding duration were assessed using multivariable logistic regression modeling. Maternal recall of breastfeeding duration was found to be valid 6 years after childbirth with a small median overall bias (1 week) toward overestimation. The overall concordance was high (ICC = 0.84), except for high school graduates (ICC = 0.63) and smokers (ICC = 0.61). Smokers (adjusted odds ratio = 0.52; 95% confidence interval [0.4, 0.8]) and multiparous women (adjusted odds ratio = 0.57; 95% confidence interval [0.4, 0.9]) were also less likely to give an accurate recall of their breastfeeding duration to within 1 month. Our study found that maternal recall of breastfeeding duration varies by sociodemographic factors but is accurate 6 years after childbirth.

[Childbirth pain, perinatal dissociation and perinatal distress as predictors of posttraumatic stress symptoms].

PubMed

Boudou, M; Séjourné, N; Chabrol, H

2007-11-01

This prospective, longitudinal study investigated the contributive role of childbirth pain, perinatal distress and perinatal dissociation to the development of PTSD symptoms following childbirth. One hundred and seventeen women participated at the study. The first day after delivery they completed a questionnaire to evaluate pain, the peritraumatic distress inventory (PDI) and the peritraumatic dissociative experience questionnaire (PDEQ). Six weeks after birth, they completed the impact of event scale-revised (IES-R) to measure posttraumatic stress symptoms and the Edinburgh Postnatal Depression Scale (EPDS) to assess maternal depression. A multiple regression analysis revealed that only both components of perinatal distress, life-threat perception and dysphoric emotions were significant predictors of posttraumatic stress symptoms. In another multiple regression analysis predicting dysphoric emotions, affective dimension of pain was the only significant predictor. Perinatal distress was the best predictor of posttraumatic stress symptoms. Dysphoric emotions were associated with affective dimension of pain, suggesting that women distressed by the childbirth pain would have higher risk to develop posttraumatic stress symptoms.

Childbirth fear in Swedish fathers is associated with parental stress as well as poor physical and mental health.

PubMed

Hildingsson, Ingegerd; Haines, Helen; Johansson, Margareta; Rubertsson, Christine; Fenwick, Jennifer

2014-02-01

to compare self-rated health and perceived difficulties during pregnancy as well as antenatal attendance, birth experience and parental stress in fathers with and without childbirth related fear. a longitudinal regional survey. Data were collected by three questionnaires. three hospitals in the middle-north part of Sweden. 1047 expectant fathers recruited in mid-pregnancy and followed up at two months and one year after birth. childbirth fear was assessed using the Fear of Birth Scale (FOBS). Self-rated physical and mental health and perceived difficulties were assessed in mid pregnancy. Two months after birth antenatal attendance, mode of birth and the birth experience were investigated. Parental stress was measured using the Swedish Parental Stress Questionnaire (SPSQ). Crude and adjusted odds ratios were calculated between expectant fathers who scored 50 and above (childbirth fear) and those that did not (no fear). expectant fathers with childbirth related fear (13.6%) reported poorer physical (OR 1.8; 95% CI 1.2-2.8) and mental (OR 3.0; 1.8-5.1) health than their non-fearful counterparts. The fearful fathers were more likely to perceive difficulties in pregnancy (OR 2.1; 1.4-3.0), and the forthcoming birth (OR 4.3; 2.9-6.3) compared to fathers without childbirth fear. First-time fathers with fear attended fewer antenatal classes. Fathers with high fear reported higher mean scores in four of the five subscales of the SPSQ. Childbirth related fear was not associated with mode of birth or fathers' birth experience. expectant fathers with childbirth related fear had poorer health, viewed the pregnancy, birth and the forthcoming parenthood with more difficulties. They were less often present during antenatal classes and had higher parental stress. this study provides insight into the health of expectant fathers during pregnancy and highlights the importance of understanding how childbirth fear may affect expectant fathers in both the short and longer term. Copyright

Determinants of trust for public lands: Fire and fuels management on the Bitterroot National Forest

Treesearch

Adam Liljeblad; William T. Borrie; Alan E. Watson

2009-01-01

Management of public lands occurs today with high levels of scrutiny and controversy. To succeed, managers seek the support, involvement, and endorsement of the public. This study examines trust as an indicator of managerial success and attempts to identify and measure the components that most influence it. A review of trust literature yielded 14 attributes that were...

Money and trust: relationships between patients, physicians, and health plans.

PubMed

Goold, S D

1998-08-01

In response to three articles on managed care by Allen Buchanan, David Mechanic, and Ezekiel Emanual and Lee Goldman (this issue), I discuss doctor-patient and organization-member trust and the moral obligations of those relationships. Trust in managed care organizations (providers of and payers for health care) stands in stark contrast to the current contractual model of health insurance purchase, but is more coherent with consumer expectations and with the provider role of such organizations. Such trust is likely to differ from that between doctors and patients. Financial reimbursement systems for physicians, one example of organizational change in our health system, can be evaluated for their impact on both kinds of trust according to their intrusiveness, openness, and goals. Although involving managed care enrollees in value-laden decisions that affect them is commendable, restrictions on or regulation of physician incentive systems may be better accomplished on a national level.

Trust in Sources of Advice about Infant Care Practices: The SAFE Study.

PubMed

Hwang, Sunah S; Rybin, Denis V; Heeren, Timothy C; Colson, Eve R; Corwin, Michael J

2016-09-01

Objectives (1) Determine the prevalence of maternal trust in advice sources on infant care practices; (2) Investigate the association of maternal and infant characteristics with trust in advice sources on infant care practices. Methods Using probability sampling methods, we recruited mothers from 32 U.S. maternity hospitals with oversampling of Black and Hispanic women resulting in a nationally representative sample of mothers of infants aged 2-6 months. Survey questions assessed maternal trust in advice sources (physicians, nurses, family, friends, and media) regarding infant care practices including infant sleep practices (sleep position, bed sharing, and pacifier use), feeding, and vaccination. Weighted frequencies of maternal trust in advice sources were calculated to obtain prevalence estimates. Multivariable logistic regression was used to assess the association of maternal and infant characteristics with maternal trust in advice sources. Results Mothers had the greatest trust in doctors for advice on all infant care practices (56-89 %), while trust was lowest for friends (13-22 %) and the media (10-14 %). In the adjusted analyses, there were significant associations of maternal race/ethnicity, education, and age with trust in advice sources. Conclusions for Practice Maternal trust in advice about infant care practices varied significantly by source. A better understanding of which advice sources are most trusted by mothers, as well as the factors associated with maternal trust, may guide the development of more effective strategies to improve adherence to health promoting infant care practices.

Facilitators and barriers in the humanization of childbirth practice in Japan

PubMed Central

2010-01-01

Background Humanizing birth means considering women's values, beliefs, and feelings and respecting their dignity and autonomy during the birthing process. Reducing over-medicalized childbirths, empowering women and the use of evidence-based maternity practice are strategies that promote humanized birth. Nevertheless, the territory of birth and its socio-cultural values and beliefs concerning child bearing can deeply affect birthing practices. The present study aims to explore the Japanese child birthing experience in different birth settings where the humanization of childbirth has been indentified among the priority goals of the institutions concerned, and also to explore the obstacles and facilitators encountered in the practice of humanized birth in those centres. Methods A qualitative field research design was used in this study. Forty four individuals and nine institutions were recruited. Data was collected through observation, field notes, focus groups, informal and semi-structured interviews. A qualitative content analysis was performed. Results All the settings had implemented strategies aimed at reducing caesarean sections, and keeping childbirth as natural as possible. The barriers and facilitators encountered in the practice of humanized birth were categorized into four main groups: rules and strategies, physical structure, contingency factors, and individual factors. The most important barriers identified in humanized birth care were the institutional rules and strategies that restricted the presence of a birth companion. The main facilitators were women's own cultural values and beliefs in a natural birth, and institutional strategies designed to prevent unnecessary medical interventions. Conclusions The Japanese birthing institutions which have identified as part of their mission to instate humanized birth have, as a whole, been successful in improving care. However, barriers remain to achieving the ultimate goal. Importantly, the cultural values and

The influence of the systematic birth preparation program on childbirth satisfaction.

PubMed

Akca, Aysu; Corbacioglu Esmer, Aytul; Ozyurek, Eser Sefik; Aydin, Arife; Korkmaz, Nazli; Gorgen, Husnu; Akbayir, Ozgur

2017-05-01

The primary purpose of this study was to assess the influence of a systematic multidisciplinary birth preparation program on satisfaction with childbirth experience. A secondary aim was to detect factors that affect the childbirth satisfaction. In this prospective study, 77 pregnant women who completed the 4-month birth preparation program (Group 1) and 75 women in the control group (Group 2) were asked to fill out two questionnaires with face-to-face interviews within 48 h after labor. One of the questionnaires was the translated form of Salmon's Item List German (SIL-Ger), and SIL-Ger scores ≥70 was accepted as a satisfactory experience. There was no statistically significant difference between the groups in terms of sociocultural and intrapartum characteristics, and obstetric outcome parameters. The women who received antenatal education experienced significantly less pain (p = 0.01), had a better communication with midwife or obstetrician during delivery (p = 0.001), and participated more actively in decision-making before, during, and after childbirth (p < 0.001 for all). SIL score was significantly higher in Group 1 (105.7 ± 2.2 vs 80 ± 2.5, p < 0.01), and significantly more women had a SIL score ≥70 (96.1 vs 73.3%, p < 0.01). In multivariate logistic regression model, attending the birth preparation program and the level of pain perceived during labor were found to have a significant effect on the birth satisfaction. Systematic birth preparation program improves satisfaction with childbirth experience by enabling women to communicate better with healthcare providers and to participate in decision-making during labor, as well as by decreasing the perception of labor pain.

Flexible work arrangements and work-family conflict after childbirth.

PubMed

Grice, Mira M; McGovern, Patricia M; Alexander, Bruce H

2008-10-01

Previous research has revealed that work-family conflict negatively influences women's health following childbirth. To examine if flexible work arrangements were associated with work-family conflict among women, 1 year after childbirth. Employed women, aged >or=18, were recruited while hospitalized for childbirth. Flexible work arrangements were measured at 6 months and work-family conflict was measured at 12 months. General linear models estimated the association between flexible work arrangements and work-family conflict. Of 1157 eligible participants, 522 were included in this analysis giving a 45% response rate. Compared to women who reported that taking time off was very hard, those who reported it was not too hard (beta = -0.80, SE = 0.36, P < 0.05) and not at all hard (beta = -1.08, SE = 0.35, P < 0.01) had lower average job spillover scores. There was no association between taking time off and home spillover. The ability to change hours was associated with greater home spillover (beta = 0.46, SE = 0.18, P < 0.05) but not with job spillover. The ability to take work home was associated with increased home spillover (beta = 0.35, SE = 0.14, P < 0.05) but not with job spillover. The ability to change work hours and the ability to take work home were associated with increased home spillover to work. The ability to take time off was associated with decreased job spillover to home. Additional research is needed to examine the intentional and unintentional consequences of flexible work arrangements.

Childbirth Educators' Legal and Ethical Responsibilities to Women in Labor

PubMed Central

Philipsen, Nayna Campbell

2000-01-01

In answer to a reader's question, the author of this column addresses the legal and ethical responsibilities of a Lamaze Certified Childbirth Educator who agrees to attend her students' drug-free delivery. PMID:17273191

Predicting Social Trust with Binary Logistic Regression

ERIC Educational Resources Information Center

Adwere-Boamah, Joseph; Hufstedler, Shirley

2015-01-01

This study used binary logistic regression to predict social trust with five demographic variables from a national sample of adult individuals who participated in The General Social Survey (GSS) in 2012. The five predictor variables were respondents' highest degree earned, race, sex, general happiness and the importance of personally assisting…

Trust and Society: Suggestions for Further Development of Niklas Luhmann's Theory of Trust.

PubMed

Morgner, Christian

2018-05-01

This paper addresses an apparent gap in the work of Niklas Luhmann. While the issue of trust continues to receive widespread attention in the social sciences, Luhmann's interest in this topic declined following the development of his systems theory. It is argued that this decline does not reflect any diminished relevance of trust for systems theory, but rather that the architectural remodeling of theory cannot easily be applied to the issue of trust. Here, the issue of trust is reconceptualized as a connection medium. This entails a reconstruction of Luhmann's early theory of trust, especially with regard to function and social positioning. In this context, trust can in turn be linked to the concept of medium in Luhmann's late work. As a connection medium, trust mediates between the different levels of sociality-interaction, organization, and society. These theoretical considerations are employed to develop a more applied framework for empirical research, with a brief case study from southern Italy. From this perspective, the idea of trust as society's glue is seen to be overly simplistic. The common ethical understanding that more trust leads to a better society is also questioned on the grounds that social cooperation can also lead to social sclerosis. Finally, risk and trust are shown to accommodate the formation of different cultures of trust. The paper shows how Luhmann's updated version of trust can inspire current research and enhance our understanding of how trust operates in contemporary society. © 2018 Canadian Sociological Association/La Société canadienne de sociologie.

Natural childbirth ideology is endangering women and babies.

PubMed

Dietz, Hans Peter; Exton, Lynda

2016-10-01

Natural childbirth ideology has become dominant across much of the developed world. This ideology increasingly clashes with the reality of modern obstetrics, which is dealing with a demographic that is getting older and more obese, hence more complicated, and it has become a danger to the health of women and babies. The most visible expression of these trends is the focus on caesarean section rates which have become a key performance indicator of obstetric services. This trend is resulting in increasingly obvious negative consequences for morbidity and mortality, as chronicled in the Morecambe Bay Report, published in the UK last year. At the same time, there is mounting emphasis on patient autonomy in obstetric decision-making, which mandates informed consent. A 2015 Supreme Court decision in the UK (Montgomery vs Lanarkshire) is likely to impact on obstetric management in Australia and New Zealand. The 'paternalism in a skirt' of natural childbirth ideology is already exposing obstetricians and services to an ever-increasing degree of medicolegal risk. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

In regulation we trust.

PubMed

Wiig, Siri; Tharaldsen, Jorunn Elise

2012-01-01

The role of trust has been argued to play an increasingly important role in modern, complex, and ambivalent risk societies. Trust within organizational research is anticipated to have a general strategic impact on aspects such as organizational performance, communication and knowledge exchange, and learning from accidents. Trust is also an important aspect related to regulation of risk. Diverse regulatory regimes, their contexts and risks influence regulators use of trust and distrust in regulatory practice. The aim of this paper is to discuss the relationship between risk regulation and trust across diverse risk regulation regimes. By drawing from studies of risk regulation, risk perception, and trust the purpose is to discuss how regulation and trust are linked and used in practice to control risk across system levels in socio-technical systems in high risk industries. This paper provides new knowledge on 1) how functional and dysfunctional trust and distrust are grounded in the empirical realities of high risk industries, 2) how different perspectives on trust and distrust act together and bring new knowledge on how society control risk.

The geography of trust.

PubMed

Joni, Saj-nicole A

2004-03-01

Leaders who rely forever on the same internal advisers, entrusting them with issues of ever greater sensitivity and consequence, run the risk of being sold short and possibly betrayed. Alternatively, lone-wolf leaders who trust no one may make enormous, yet preventable, mistakes when trying to sort through difficult decisions. A sophisticated understanding of trust can protect leaders from both fates. During the past decade, author and consultant Saj-nicole Joni studied leadership in more than 150 European and North American companies. Her research reveals three fundamental types of trustpersonal trust, expertise trust, and structural trust. Executives may persevere in relationships that are based on personal trust, no matter how exalted their leadership roles become. But such relationships are unlikely to remain static. They also probably won't provide the kinds of deep, often specialized knowledge leaders need. In circumstances where advisers' competence matters as much as their character, expertise trust--reliance on an adviser's ability in a specific subject--enters the picture. In organizations, leaders develop expertise trust by working closely with people who consistently demonstrate their mastery of particular subjects or processes. Structural trust refers to how roles and ambitions influence advisers' perspectives and candor. It shifts constantly as people rise through organizations. High-level structural trust can provide leaders with pure insight and information--but advisers in positions of the highest structural trust generally reside outside organizations. These advisers provide leaders with insights that their organizations cannot. High-performing leaders' most enduring--and most valuable--relationships are characterized by enormous levels of all three kinds of trust.

Explaining the justice-performance relationship: trust as exchange deepener or trust as uncertainty reducer?

PubMed

Colquitt, Jason A; Lepine, Jeffery A; Piccolo, Ronald F; Zapata, Cindy P; Rich, Bruce L

2012-01-01

Past research has revealed significant relationships between organizational justice dimensions and job performance, and trust is thought to be one mediator of those relationships. However, trust has been positioned in justice theorizing in 2 different ways, either as an indicator of the depth of an exchange relationship or as a variable that reflects levels of work-related uncertainty. Moreover, trust scholars distinguish between multiple forms of trust, including affect- and cognition-based trust, and it remains unclear which form is most relevant to justice effects. To explore these issues, we built and tested a more comprehensive model of trust mediation in which procedural, interpersonal, and distributive justice predicted affect- and cognition-based trust, with those trust forms predicting both exchange- and uncertainty-based mechanisms. The results of a field study in a hospital system revealed that the trust variables did indeed mediate the relationships between the organizational justice dimensions and job performance, with affect-based trust driving exchange-based mediation and cognition-based trust driving uncertainty-based mediation.

Understanding childbirth practices as an organizational cultural phenomenon: a conceptual framework.

PubMed

Behruzi, Roxana; Hatem, Marie; Goulet, Lise; Fraser, William; Misago, Chizuru

2013-11-11

Understanding the main values and beliefs that might promote humanized birth practices in the specialized hospitals requires articulating the theoretical knowledge of the social and cultural characteristics of the childbirth field and the relations between these and the institution. This paper aims to provide a conceptual framework allowing examination of childbirth practices through the lens of an organizational culture theory. A literature review performed to extrapolate the social and cultural factors contribute to birth practices and the factors likely overlap and mutually reinforce one another, instead of complying with the organizational culture of the birth place. The proposed conceptual framework in this paper examined childbirth patterns as an organizational cultural phenomenon in a highly specialized hospital, in Montreal, Canada. Allaire and Firsirotu's organizational culture theory served as a guide in the development of the framework. We discussed the application of our conceptual model in understanding the influences of organizational culture components in the humanization of birth practices in the highly specialized hospitals and explained how these components configure both the birth practice and women's choice in highly specialized hospitals. The proposed framework can be used as a tool for understanding the barriers and facilitating factors encountered birth practices in specialized hospitals.

Understanding childbirth practices as an organizational cultural phenomenon: a conceptual framework

PubMed Central

2013-01-01

Understanding the main values and beliefs that might promote humanized birth practices in the specialized hospitals requires articulating the theoretical knowledge of the social and cultural characteristics of the childbirth field and the relations between these and the institution. This paper aims to provide a conceptual framework allowing examination of childbirth practices through the lens of an organizational culture theory. A literature review performed to extrapolate the social and cultural factors contribute to birth practices and the factors likely overlap and mutually reinforce one another, instead of complying with the organizational culture of the birth place. The proposed conceptual framework in this paper examined childbirth patterns as an organizational cultural phenomenon in a highly specialized hospital, in Montreal, Canada. Allaire and Firsirotu’s organizational culture theory served as a guide in the development of the framework. We discussed the application of our conceptual model in understanding the influences of organizational culture components in the humanization of birth practices in the highly specialized hospitals and explained how these components configure both the birth practice and women’s choice in highly specialized hospitals. The proposed framework can be used as a tool for understanding the barriers and facilitating factors encountered birth practices in specialized hospitals. PMID:24215446

DualTrust: A Distributed Trust Model for Swarm-Based Autonomic Computing Systems

DOE Office of Scientific and Technical Information (OSTI.GOV)

Maiden, Wendy M.; Dionysiou, Ioanna; Frincke, Deborah A.

2011-02-01

For autonomic computing systems that utilize mobile agents and ant colony algorithms for their sensor layer, trust management is important for the acceptance of the mobile agent sensors and to protect the system from malicious behavior by insiders and entities that have penetrated network defenses. This paper examines the trust relationships, evidence, and decisions in a representative system and finds that by monitoring the trustworthiness of the autonomic managers rather than the swarming sensors, the trust management problem becomes much more scalable and still serves to protect the swarm. We then propose the DualTrust conceptual trust model. By addressing themore » autonomic manager’s bi-directional primary relationships in the ACS architecture, DualTrust is able to monitor the trustworthiness of the autonomic managers, protect the sensor swarm in a scalable manner, and provide global trust awareness for the orchestrating autonomic manager.« less

Associations Between Mistreatment by a Provider during Childbirth and Maternal Health Complications in Uttar Pradesh, India.

PubMed

Raj, Anita; Dey, Arnab; Boyce, Sabrina; Seth, Aparna; Bora, Siddhartha; Chandurkar, Dharmendra; Hay, Katherine; Singh, Kultar; Das, Arup Kumar; Chakraverty, Amit; Ramakrishnan, Aparajita; Shetye, Mrunal; Saggurti, Niranjan; Silverman, Jay G

2017-09-01

Objectives This study assesses associations between mistreatment by a provider during childbirth and maternal complications in Uttar Pradesh, India. Methods Cross-sectional survey data were collected from women (N = 2639) who had delivered at 68 public health facilities in Uttar Pradesh, participating in a quality of care study. Participants were recruited from April to July 2015 and surveyed on demographics, mistreatment during childbirth (measure developed for this study, Cronbach's alpha = 0.70), and maternal health complications. Regression models assessed associations between mistreatment during childbirth and maternal complications, at delivery and postpartum, adjusting for demographics and pregnancy complications. Results Participants were aged 17-48 years, and 30.3% were scheduled caste/scheduled tribe. One in five (20.9%) reported mistreatment by their provider during childbirth, including discrimination and abuse; complications during delivery (e.g., obstructed labor) and postpartum (e.g., excessive bleeding) were reported by 45.8 and 41.5% of women, respectively. Health providers at delivery included staff nurses (81.8%), midwives (14.0%), and physicians (2.2%); Chi square analyses indicate that women were significantly more likely to report mistreatment when their provider was a nurse rather than a physician or midwife. Women reporting mistreatment by a provider during childbirth had higher odds of complications at delivery (AOR = 1.32; 95% CI 1.05-1.67) and postpartum (AOR = 2.12; 95% CI 1.67-2.68). Conclusions for Practice Mistreatment of women by their provider during childbirth is a pervasive health and human rights violation, and is associated with increased risk for maternal health complications in Uttar Pradesh. Efforts to improve quality of maternal care should include greater training and monitoring of providers to ensure respectful treatment of patients.

Opposing ends of the spectrum: Exploring trust in scientific and religious authorities.

PubMed

Cacciatore, Michael A; Browning, Nick; Scheufele, Dietram A; Brossard, Dominique; Xenos, Michael A; Corley, Elizabeth A

2018-01-01

Given the ethical questions that surround emerging science, this study is interested in studying public trust in scientific and religious authorities for information about the risks and benefits of science. Using data from a nationally representative survey of American adults, we employ regression analysis to better understand the relationships between several variables-including values, knowledge, and media attention-and trust in religious organizations and scientific institutions. We found that Evangelical Christians are generally more trusting of religious authority figures to tell the truth about the risks and benefits of science and technology, and only slightly less likely than non-Evangelicals to trust scientific authorities for the same information. We also found that many Evangelicals use mediated information and science knowledge differently than non-Evangelicals, with both increased knowledge and attention to scientific media having positive impacts on trust in scientific authorities among the latter, but not the former group.

A Methodology for Observation of the Childbirth Environment.

ERIC Educational Resources Information Center

Anderson, Barbara J.

This paper describes the development of an instrument designed to obtain systematic data on the physical state, medical and social interactions of a woman in active labor. Observations were made of primiparous women who were accompanied in the labor room by the father. Women who had received childbirth training and those who had not were included…

The Devon NUT Campaign against Trust Schools

ERIC Educational Resources Information Center

Clinch, Dave

2008-01-01

When the Devon County Council announced that six secondary schools in the South Devon area were to become "Pathfinder Schools" for trust status, the Devon National Union of Teachers set about organising a campaign to defend the county's comprehensive schools. This campaign has proved successful in the case of Tavistock College, causing…

Assessing Factors that affect Childbirth Choices of People living positively with HIV/AIDS in Abia State of Nigeria.

PubMed

Enwereji, Ezinne E; Enwereji, Kelechi O

2010-04-01

Poor interpersonal relationships with women especially those living positively with HIV/AIDS can make them take risks that would expose their new born and others to infection during childbirth. The factors that influence childbirth choices of people living positively with HIV/AIDS (PLWHA) deserve attention. Sometimes, women, especially PLWHA, for several reasons, resort to the use of other health care services instead of the general hospitals equipped for ante-natal care (ANC). This study aims to identify factors and conditions that determine childbirth choices of PLWHA in the Abia State of Nigeria. A cross-sectional descriptive study was carried out using a total sample of 96 PLWHA who attend meetings with the network of PLWHA and also a purposive convenience sample of 45 health workers. Data collection instruments were questionnaire, focus group discussions and interview guides. Data was analyzed both qualitatively and quantitatively using simple percentages. There was a low patronage for hospital services. A total of 79 (82%) PLWHA did not use hospital services due to the lack of confidentiality. In total, 61 (64%) PLWHA had their childbirth with Traditional Birth Attendants (TBAs) at home. Embarrassment, rejection, interpersonal conflicts with health workers, non-confidentiality, cultural stigma and stigmatization were among the factors that encouraged childbirth choices. On the whole, 82 (85%) of the PLWHA discontinued ANC services because of stigmatization. Poor interpersonal relationships between health workers and PLWHA facilitated PLWHA childbirth choices more than other factors. PLWHA and health workers termed management of belligerent tendencies against each other as their greatest concern. Therefore, concerted effort is needed to improve health workers/PLWHA relationship in hospitals. This would minimize factors and/or conditions that encourage HIV infection. Exposing PLWHA to factors that influence childbirth at home demonstrates high risks of mother

Assessing Factors that affect Childbirth Choices of People living positively with HIV/AIDS in Abia State of Nigeria

PubMed Central

Enwereji, Ezinne E.; Enwereji, Kelechi O.

2010-01-01

Objectives Poor interpersonal relationships with women especially those living positively with HIV/AIDS can make them take risks that would expose their new born and others to infection during childbirth. The factors that influence childbirth choices of people living positively with HIV/AIDS (PLWHA) deserve attention. Sometimes, women, especially PLWHA, for several reasons, resort to the use of other health care services instead of the general hospitals equipped for ante-natal care (ANC). This study aims to identify factors and conditions that determine childbirth choices of PLWHA in the Abia State of Nigeria. Methods A cross-sectional descriptive study was carried out using a total sample of 96 PLWHA who attend meetings with the network of PLWHA and also a purposive convenience sample of 45 health workers. Data collection instruments were questionnaire, focus group discussions and interview guides. Data was analyzed both qualitatively and quantitatively using simple percentages. Results There was a low patronage for hospital services. A total of 79 (82%) PLWHA did not use hospital services due to the lack of confidentiality. In total, 61 (64%) PLWHA had their childbirth with Traditional Birth Attendants (TBAs) at home. Embarrassment, rejection, interpersonal conflicts with health workers, non-confidentiality, cultural stigma and stigmatization were among the factors that encouraged childbirth choices. On the whole, 82 (85%) of the PLWHA discontinued ANC services because of stigmatization. Conclusion Poor interpersonal relationships between health workers and PLWHA facilitated PLWHA childbirth choices more than other factors. PLWHA and health workers termed management of belligerent tendencies against each other as their greatest concern. Therefore, concerted effort is needed to improve health workers/PLWHA relationship in hospitals. This would minimize factors and/or conditions that encourage HIV infection. Exposing PLWHA to factors that influence childbirth at

Health system support for childbirth care in Southern Tanzania: results from a health facility census

PubMed Central

2013-01-01

Background Progress towards reaching Millennium Development Goals four (child health) and five (maternal health) is lagging behind, particularly in sub-Saharan Africa, despite increasing efforts to scale up high impact interventions. Increasing the proportion of birth attended by a skilled attendant is a main indicator of progress, but not much is known about the quality of childbirth care delivered by these skilled attendants. With a view to reducing maternal mortality through health systems improvement we describe the care routinely offered in childbirth at dispensaries, health centres and hospitals in five districts in rural Southern Tanzania. We use data from a health facility census assessing 159 facilities in five districts in early 2009. A structural and operational assessment was undertaken based on staff reports using a modular questionnaire assessing staffing, work load, equipment and supplies as well as interventions routinely implemented during childbirth. Results Health centres and dispensaries attended a median of eight and four deliveries every month respectively. Dispensaries had a median of 2.5 (IQR 2–3) health workers including auxiliary staff instead of the recommended four clinical officer and certified nurses. Only 28% of first-line facilities (dispensaries and health centres) reported offering active management in the third stage of labour (AMTSL). Essential childbirth care comprising eight interventions including AMTSL, infection prevention, partograph use including foetal monitoring and newborn care including early breastfeeding, thermal care at birth and prevention of ophthalmia neonatorum was offered by 5% of dispensaries, 38% of health centres and 50% of hospitals consistently. No first-line facility had provided all signal functions for emergency obstetric complications in the previous six months. Conclusions Essential interventions for childbirth care are not routinely implemented in first-line facilities or hospitals. Dispensaries

NHS Trusts' clinical research activity and overall CQC performance - Is there a correlation?

PubMed

Jonker, L; Fisher, S J

2015-11-01

Since the late 2000's, the creation of the National Institute for Health Research (NIHR) has transformed clinical research activity in the United Kingdom. This study sought to establish if there is a link between clinical research activity and overall NHS Trust performance. Retrospective cohort study. Data for NHS Trust performance were obtained from public databases, namely the Care Quality Commission (CQC) 2013 risk rating for overall performance, and 2012-13 NIHR records for clinical research activity. Applying Spearman's rank analysis, none of the Trust categories showed a correlation with CQC risk rating: small hospitals, r = -0.062 (P = 0.76; n = 27); medium, r = -0.224 (P = 0.13; n = 47); large, r = -0.008 (P = 0.96; n = 57); academic, r = -0.18 (P = 0.41; n = 24). Similar results were observed when CQC risk rating was compared with the number of different clinical research studies conducted per Trust. The degree of NIHR National Portfolio clinical research activity is not significantly related to CQC risk rating, used as an indicator of overall NHS Trust performance. Other studies have previously shown that increased research activity correlates with improved mortality rates, one component of CQC risk rating scores. Alternative tools may have to be explored to evaluate the impact of clinical research on NHS Trusts and its patients. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Managing healthcare information: analyzing trust.

PubMed

Söderström, Eva; Eriksson, Nomie; Åhlfeldt, Rose-Mharie

2016-08-08

Purpose - The purpose of this paper is to analyze two case studies with a trust matrix tool, to identify trust issues related to electronic health records. Design/methodology/approach - A qualitative research approach is applied using two case studies. The data analysis of these studies generated a problem list, which was mapped to a trust matrix. Findings - Results demonstrate flaws in current practices and point to achieving balance between organizational, person and technology trust perspectives. The analysis revealed three challenge areas, to: achieve higher trust in patient-focussed healthcare; improve communication between patients and healthcare professionals; and establish clear terminology. By taking trust into account, a more holistic perspective on healthcare can be achieved, where trust can be obtained and optimized. Research limitations/implications - A trust matrix is tested and shown to identify trust problems on different levels and relating to trusting beliefs. Future research should elaborate and more fully address issues within three identified challenge areas. Practical implications - The trust matrix's usefulness as a tool for organizations to analyze trust problems and issues is demonstrated. Originality/value - Healthcare trust issues are captured to a greater extent and from previously unchartered perspectives.

Post-traumatic stress symptoms, parenting stress and mother-child relationships following childbirth and at 2 years postpartum.

PubMed

McDonald, Sarah; Slade, Pauline; Spiby, Helen; Iles, Jane

2011-09-01

This study examined the prevalence of childbirth-related post-traumatic stress (PTS) symptoms at 2 years postpartum and the relationship between such symptoms and both self-reported parenting stress and perceptions of the mother-child relationship. 81 women completed measures of childbirth-related PTS symptoms at 6 weeks and 3 months postpartum; these results were used in an exploration of their predictive links with mother-child relationship and parenting measures at 2 years. 17.3% of respondents reported some PTS symptoms at a clinically significant level at 2 years postpartum. However, these symptoms were only weakly linked to parenting stress and were not related to mothers' perceptions of their children. However earlier PTS symptoms within 3 months of childbirth did show limited associations with parenting stress at 2 years but no association with child relationship outcomes once current depression was taken into account. Implications for clinical practice and the concept of childbirth-related post-traumatic stress disorder are discussed.

Women's preferences for childbirth experiences in the Republic of Ireland; a mixed methods study.

PubMed

Larkin, Patricia; Begley, Cecily M; Devane, Declan

2017-01-10

How women experience childbirth is acknowledged as critical to the postnatal wellbeing of mother and baby. However there is a knowledge deficit in identifying the important elements of these experiences in order to enhance care. This study elicits women's preferences for the most important elements of their childbirth experiences. A mixed methods design was used. An initial qualitative phase (reported previously) was followed by a second quantitative one using a discrete choice experiment (DCE), which is reported on here. Participants who had experienced labour, were over 18 and had a healthy baby were recruited from four randomly selected and one pilot hospital in the Republic of Ireland. Data were collected by means of a DCE survey instrument. Questions were piloted, refined, and then arranged in eight pair-wise scenarios. Women identified their preferences by choosing one scenario over another. Nine hundred and five women were sent the DCE three months after childbirth, with a response rate of 59.3% (N =531). Women clearly identified priorities for their childbirth experiences as: the availability of pain relief, partnership with the midwife, and individualised care being the most important attributes. In the context of other choices, women rated decision-making, presence of a consultant, and interventions as less important elements. Comments from open questions provided contextual information about their choices. Most women did not want to be typified as wanting the dichotomy of 'all natural' or 'all technology' births but wanted 'the best of both worlds'. The results suggest that availability of pain relief was the most important element of women's childbirth experiences, and superseded all other elements including partnership with the midwife which was the second most important attribute. The preferences identified might reflect the busy medicalised hospital environments, in which the vast majority of women had given birth, and may differ in settings such as

Sources, responses and moderators of childbirth fear in Australian women: a qualitative investigation.

PubMed

Fenwick, J; Toohill, J; Creedy, D K; Smith, J; Gamble, J

2015-01-01

around 20% of women suffer childbirth fear causing them significant distress and often leading to requests for caesarean section. In Sweden, fearful pregnant women are offered counselling; however, in Australia, no dedicated service caters for the specific needs of these women. Indeed scant research has been conducted in Australia and little is known about women's concerns and if these align to those reported in the international literature. to describe the sources, responses and moderators of childbirth fear in a group of pregnant women assessed as having high levels of childbirth fear. comparative analysis was used to identify common concepts and generate themes that represented women's perspectives of childbirth fear. Data consisted of 43 tape recorded telephone conversations with highly fearful pregnant women who were participating in a large randomised controlled trial known as BELIEF (Birth Emotions, Looking to Improve Expectant Fear). women's fears were conceptualised into three themes: fear stimuli; fear responses; and fear moderators. Lack of confidence to birth, fear of the unknown, internalising other women's negative stories, perineal tearing and labour pain were common concerns for first time mothers. For multiparous women, not having had personal feelings resolved following their previous birth and negative experiences of last birth influenced current expectations for their upcoming birth. Themes common to both groups were: unmet information and support needs, feelings of loss of control and lack of input in to decision-making. Some women however, chose to avoid birth planning in order to cope during pregnancy. Australian women had similar childbirth concerns to those reported in the international literature. However unique to this study was finding two opposing discourses; one of preoccupation with negative events and the other; avoidance of planning for labour and birth. Provision of woman centred maternity models that minimise obstetric

Trust makers, breakers and brokers: building trust in the Australian food system

PubMed Central

2013-01-01

Background The importance of consumer trust in the food supply has previously been identified, and dimensions of consumer trust in food—who they trust and the type of trust that they exhibit—has been explored. However, there is a lack of research about the mechanisms through which consumer trust in the food supply is developed, maintained, broken and repaired. This study seeks to address this gap by exploring if, and how, consumer trust in the food supply is considered by the media, food industry and governments when responding to food scares. The aim of the research is to develop models of trust building that can be implemented following food scares. Methods Semi-structured interviews will be undertaken with media, public relations officials and policy makers in Australia, New Zealand and the United Kingdom. Participants will be recruited through purposive sampling and will be asked to discuss a hypothetical case study outlining a food incident, and any experiences of specific food scares. Models of trust development, maintenance and repair will be developed from interview data. Comment on these models will be sought from experts in food-related organizations through a Delphi study, where participants will be asked to consider the usefulness of the models. Participants’ comments will be used to revise the models until consensus is reached on the suitability and usability of the models. Discussion This study will contribute to the literature about systems-based trust, and explore trust as a social and regulatory process. The protocol and results will be of interest and use to the food industry, food regulators, consumer advocate groups, media seeking to report food-related issues and policy makers concerned with public health and consumer health and well-being. This research represents an important contribution to the translation of the theoretical conceptualizations of trust into practical use in the context of food. PMID:23496819

Trust makers, breakers and brokers: building trust in the Australian food system.

PubMed

Wilson, Annabelle; Coveney, John; Henderson, Julie; Meyer, Samantha; Calnan, Michael; Caraher, Martin; Webb, Trevor; Elliott, Anthony; Ward, Paul

2013-03-15

The importance of consumer trust in the food supply has previously been identified, and dimensions of consumer trust in food-who they trust and the type of trust that they exhibit-has been explored. However, there is a lack of research about the mechanisms through which consumer trust in the food supply is developed, maintained, broken and repaired. This study seeks to address this gap by exploring if, and how, consumer trust in the food supply is considered by the media, food industry and governments when responding to food scares. The aim of the research is to develop models of trust building that can be implemented following food scares. Semi-structured interviews will be undertaken with media, public relations officials and policy makers in Australia, New Zealand and the United Kingdom. Participants will be recruited through purposive sampling and will be asked to discuss a hypothetical case study outlining a food incident, and any experiences of specific food scares. Models of trust development, maintenance and repair will be developed from interview data. Comment on these models will be sought from experts in food-related organizations through a Delphi study, where participants will be asked to consider the usefulness of the models. Participants' comments will be used to revise the models until consensus is reached on the suitability and usability of the models. This study will contribute to the literature about systems-based trust, and explore trust as a social and regulatory process. The protocol and results will be of interest and use to the food industry, food regulators, consumer advocate groups, media seeking to report food-related issues and policy makers concerned with public health and consumer health and well-being. This research represents an important contribution to the translation of the theoretical conceptualizations of trust into practical use in the context of food.

Preventing post-traumatic stress disorder following childbirth and traumatic birth experiences: a systematic review.

PubMed

de Graaff, Lisanne F; Honig, Adriaan; van Pampus, Mariëlle G; Stramrood, Claire A I

2018-06-01

Between 9 and 44% of women experience giving birth as traumatic, and 3% of women develop a post-traumatic stress disorder following childbirth. Knowledge on risk factors is abundant, but studies on treatment are limited. This study aimed to present an overview of means to prevent traumatic birth experiences and childbirth-related post-traumatic stress disorder. Major databases [Cochrane; Embase; PsycINFO; PubMed (Medline)] were searched using combinations of the key words and their synonyms. After screening titles and abstracts and reading 135 full-text articles, 13 studies were included. All evaluated secondary prevention, and none primary prevention. Interventions included debriefing, structured psychological interventions, expressive writing interventions, encouraging skin-to-skin contact with healthy newborns immediately postpartum and holding or seeing the newborn after stillbirth. The large heterogeneity of study characteristics precluded pooling of data. The writing interventions to express feelings appeared to be effective in prevention. A psychological intervention including elements of exposure and psycho-education seemed to lead to fewer post-traumatic stress disorder symptoms in women who delivered via emergency cesarean section. No research has been done on primary prevention of traumatic childbirth. Research on secondary prevention of traumatic childbirth and post-traumatic stress disorder following delivery provides insufficient evidence that the described interventions are effective in unselected groups of women. In certain subgroups, results are inhomogeneous. © 2018 Nordic Federation of Societies of Obstetrics and Gynecology.

The Trust Project - Symbiotic Human Machine Teams: Social Cueing for Trust and Reliance

DTIC Science & Technology

2016-06-30

AFRL-RH-WP-TR-2016-0096 THE TRUST PROJECT - SYMBIOTIC HUMAN-MACHINE TEAMS: SOCIAL CUEING FOR TRUST & RELIANCE Susan Rivers, Monika Lohani, Marissa...30 JUN 2012 – 30 JUN 2016 4. TITLE AND SUBTITLE THE TRUST PROJECT - SYMBIOTIC HUMAN-MACHINE TEAMS: SOCIAL CUEING FOR TRUST & RELIANCE 5a. CONTRACT

New Resources for Childbirth Educators and Parents

PubMed Central

Shilling, Teri; Bingham, Stacie

2010-01-01

In this column, reviewers offer perspectives and comments on a variety of new media resources for childbirth educators and for expectant and new parents. The books, CD, and DVDs reviewed in this issue's column address the following topics: natural, safe, and healthy birth practices; doula care; breastfeeding; empowering women to make healthy lifestyle choices during pregnancy; encouraging mothers to bond with their babies before birth; and fathers' and partners' supportive role during labor and birth.

Preventing traumatic childbirth experiences: 2192 women's perceptions and views.

PubMed

Hollander, M H; van Hastenberg, E; van Dillen, J; van Pampus, M G; de Miranda, E; Stramrood, C A I

2017-08-01

The purpose of this study is to explore and quantify perceptions and experiences of women with a traumatic childbirth experience in order to identify areas for prevention and to help midwives and obstetricians improve woman-centered care. A retrospective survey was conducted online among 2192 women with a self-reported traumatic childbirth experience. Women were recruited in March 2016 through social media, including specific parent support groups. They filled out a 35-item questionnaire of which the most important items were (1) self-reported attributions of the trauma and how they believe the traumatic experience could have been prevented (2) by the caregivers or (3) by themselves. The responses most frequently given were (1) Lack and/or loss of control (54.6%), Fear for baby's health/life (49.9%), and High intensity of pain/physical discomfort (47.4%); (2) Communicate/explain (39.1%), Listen to me (more) (36.9%), and Support me (more/better) emotionally/practically (29.8%); and (3) Nothing (37.0%), Ask for (26.9%), or Refuse (16.5%) certain interventions. Primiparous participants chose High intensity of pain/physical discomfort, Long duration of delivery, and Discrepancy between expectations and reality more often and Fear for own health/life, A bad outcome, and Delivery went too fast less often than multiparous participants. Women attribute their traumatic childbirth experience primarily to lack and/or loss of control, issues of communication, and practical/emotional support. They believe that in many cases, their trauma could have been reduced or prevented by better communication and support by their caregiver or if they themselves had asked for or refused interventions.

Paternal age at childbirth and eating disorders in offspring.

PubMed

Javaras, K N; Rickert, M E; Thornton, L M; Peat, C M; Baker, J H; Birgegård, A; Norring, C; Landén, M; Almqvist, C; Larsson, H; Lichtenstein, P; Bulik, C M; D'Onofrio, B M

2017-02-01

Advanced paternal age at childbirth is associated with psychiatric disorders in offspring, including schizophrenia, bipolar disorder and autism. However, few studies have investigated paternal age's relationship with eating disorders in offspring. In a large, population-based cohort, we examined the association between paternal age and offspring eating disorders, and whether that association remains after adjustment for potential confounders (e.g. parental education level) that may be related to late/early selection into fatherhood and to eating disorder incidence. Data for 2 276 809 individuals born in Sweden 1979-2001 were extracted from Swedish population and healthcare registers. The authors used Cox proportional hazards models to examine the effect of paternal age on the first incidence of healthcare-recorded anorexia nervosa (AN) and all eating disorders (AED) occurring 1987-2009. Models were adjusted for sex, birth order, maternal age at childbirth, and maternal and paternal covariates including country of birth, highest education level, and lifetime psychiatric and criminal history. Even after adjustment for covariates including maternal age, advanced paternal age was associated with increased risk, and younger paternal age with decreased risk, of AN and AED. For example, the fully adjusted hazard ratio for the 45+ years (v. the 25-29 years) paternal age category was 1.32 [95% confidence interval (CI) 1.14-1.53] for AN and 1.26 (95% CI 1.13-1.40) for AED. In this large, population-based cohort, paternal age at childbirth was positively associated with eating disorders in offspring, even after adjustment for potential confounders. Future research should further explore potential explanations for the association, including de novo mutations in the paternal germline.

Trust-Building in Electronic Markets: Relative Importance and Interaction Effects of Trust-Building Mechanisms

NASA Astrophysics Data System (ADS)

Tams, Stefan

We examine the relative and complementary effectiveness of trust-building strategies in online environments. While prior research has examined various antecedents to trust, we investigated two trust-building mechanisms more in depth: Web site trust and vendor reputation. We tried to understand the relative effectiveness of these two important mechanisms to provide online businesses with a clear recommendation of how to establish trust in an effective and efficient manner. Drawing from the literature on trust, we proposed vendor reputation to be more effective than Web site trust. Moreover, we examined a potential complementary effect of these mechanisms so as to provide online businesses with a deeper understanding of how to derive superior trust. We hypothesize a small such effect. The study proposes a laboratory experiment to test the model.

[Fear of childbirth among nulliparous women: Relations with pain during delivery, post-traumatic stress symptoms, and postpartum depressive symptoms].

PubMed

Gosselin, P; Chabot, K; Béland, M; Goulet-Gervais, L; Morin, A J S

2016-04-01

Fear of childbirth is common in women who are pregnant with their first child and is associated with important consequences such as abortions and miscarriages. Twenty percent of nulliparous women seem to exhibit a mild or moderate fear, while 6% present an excessive and irrational fear known as tocophobia. Tocophobia is suggested to be associated with many negative consequences such as postpartum depression (PPD) and Post-traumatic stress (PTS). However, there is little empirical evidence to support these relationships. Recently, Fairbrother and Woody (2007) did not observe a link between the fear of childbirth and symptoms of PPD and PTS in nulliparous women. Some results, near the significance level, could be explained by a lack of statistical power. The present study focused on the link between the fear of childbirth and the process of delivery, the perception of pain, PPD and PTS. More specifically, it aimed to test three hypotheses: (i) fear of childbirth will be linked to the process of delivery, especially regarding the perception of pain, the use of anaesthesia and the use of Caesarean section; (ii) a high level of fear of childbirth will be associated with more negative postpartum consequences (namely PPD/PTS symptoms); (iii) the process of delivery and pain will also be related to post-delivery symptoms. Mediation effects were tested. Data from a longitudinal study were used to meet the hypotheses. A total of 176 nulliparous pregnant women responded to questionnaires at two time measurements (during pregnancy and at 5weeks postpartum). Fear of childbirth is related to the perception of pain at birth among women delivering vaginally, in the absence of anaesthesia. It is also linked to symptoms of PPD and PTS, regardless of whether or not anaesthesia was used. Fear of childbirth also appears to be strongly associated to symptoms of PTS in women who have experienced an unplanned caesarean section. Thus, symptoms of postpartum PTS could play a mediating role

Good practices in normal childbirth: reliability analysis of an instrument by Cronbach's Alpha.

PubMed

Gottems, Leila Bernarda Donato; Carvalho, Elisabete Mesquita Peres De; Guilhem, Dirce; Pires, Maria Raquel Gomes Maia

2018-01-01

to analyze the internal consistency of the evaluation instrument of the adherence to the good practices of childbirth and birth care in the professionals, through Cronbach's Alpha Coefficient for each of the dimensions and for the total instrument. this is a descriptive and cross-sectional study performed in obstetric centers of eleven public hospitals in the Federal District, with a questionnaire applied to 261 professionals who worked in the delivery care. The study was attended by 261 professionals, 42.5% (111) nurses and 57.5% (150) physicians. The reliability evaluation of the instrument by the Cronbach Alfa resulted in 0.53, 0.78 and 0.76 for dimensions 1, 2 and 3, after debugging that resulted in the exclusion of 11 items. the instrument obtained Cronbach's alpha of 0.80. There is a need for improvement in the items of dimension 1 that refer to attitudes, knowledge, and practices of the organization of the network of care to gestation, childbirth, and birth. However, it can be applied in the way it is used to evaluate practices based on scientific evidence of childbirth care.

Institutional (mis)trust in colorectal cancer screening: a qualitative study with Greek, Iranian, Anglo-Australian and Indigenous groups.

PubMed

Ward, Paul R; Coffey, Cushla; Javanparast, Sara; Wilson, Carlene; Meyer, Samantha B

2015-12-01

Colorectal cancer (CRC) has the second highest cancer mortality rate in Australia. The Australian National Bowel Cancer Screening Program (NBCSP) aims to increase early detection of CRC by offering free Faecal Occult Blood Testing (FOBT), although uptake is low for culturally and linguistically diverse (CALD) groups. To present data on trust and mistrust in the NBCSP by population groups with low uptake and thus to highlight areas in need of policy change. A qualitative study was undertaken in South Australia, involving interviews with 94 people from four CALD groups: Greek, Iranian, Anglo-Australian, and Indigenous peoples. Our study highlights the complexities of institutional trust, which involves considerations of trust at interpersonal, local and national levels. In addition, trust and mistrust was found in more abstract systems such as the medical knowledge of doctors to diagnose or treat cancer or the scientific procedures in laboratories to test the FOBTs. The object of institutional (mis)trust differed between cultural groups - Anglo-Australian and Iranian groups indicated a high level of trust in the government, whereas Indigenous participants were much less trusting. The level and nature of trust in the screening process varied between the CALD groups. Addressing program misconceptions, clarifying the FOBT capabilities and involving medical services in collecting and transporting the samples may increase trust in the NBCSP. However, broader and more enduring mistrust in services and institutions may need to be dealt with in order to increase trust and participation. © 2014 John Wiley & Sons Ltd.

Building trust-business essentials

Treesearch

Sandy MacIver

2008-01-01

(Please note: This paper only contains the abstract.) Trust is particularly vital in the leadership of organizations. Trust is built by working through "joy, fear, and vulnerability," especially as it relates to trust in others and in teams. Key is learning to trust the right people in the right way in the right circumstances. In addition...

Trust transitivity in social networks.

PubMed

Richters, Oliver; Peixoto, Tiago P

2011-04-05

Non-centralized recommendation-based decision making is a central feature of several social and technological processes, such as market dynamics, peer-to-peer file-sharing and the web of trust of digital certification. We investigate the properties of trust propagation on networks, based on a simple metric of trust transitivity. We investigate analytically the percolation properties of trust transitivity in random networks with arbitrary in/out-degree distributions, and compare with numerical realizations. We find that the existence of a non-zero fraction of absolute trust (i.e. entirely confident trust) is a requirement for the viability of global trust propagation in large systems: The average pair-wise trust is marked by a discontinuous transition at a specific fraction of absolute trust, below which it vanishes. Furthermore, we perform an extensive analysis of the Pretty Good Privacy (PGP) web of trust, in view of the concepts introduced. We compare different scenarios of trust distribution: community- and authority-centered. We find that these scenarios lead to sharply different patterns of trust propagation, due to the segregation of authority hubs and densely-connected communities. While the authority-centered scenario is more efficient, and leads to higher average trust values, it favours weakly-connected "fringe" nodes, which are directly trusted by authorities. The community-centered scheme, on the other hand, favours nodes with intermediate in/out-degrees, in detriment of the authorities and its "fringe" peers.

Trust Transitivity in Social Networks

PubMed Central

Richters, Oliver; Peixoto, Tiago P.

2011-01-01

Non-centralized recommendation-based decision making is a central feature of several social and technological processes, such as market dynamics, peer-to-peer file-sharing and the web of trust of digital certification. We investigate the properties of trust propagation on networks, based on a simple metric of trust transitivity. We investigate analytically the percolation properties of trust transitivity in random networks with arbitrary in/out-degree distributions, and compare with numerical realizations. We find that the existence of a non-zero fraction of absolute trust (i.e. entirely confident trust) is a requirement for the viability of global trust propagation in large systems: The average pair-wise trust is marked by a discontinuous transition at a specific fraction of absolute trust, below which it vanishes. Furthermore, we perform an extensive analysis of the Pretty Good Privacy (PGP) web of trust, in view of the concepts introduced. We compare different scenarios of trust distribution: community- and authority-centered. We find that these scenarios lead to sharply different patterns of trust propagation, due to the segregation of authority hubs and densely-connected communities. While the authority-centered scenario is more efficient, and leads to higher average trust values, it favours weakly-connected “fringe” nodes, which are directly trusted by authorities. The community-centered scheme, on the other hand, favours nodes with intermediate in/out-degrees, in detriment of the authorities and its “fringe” peers. PMID:21483683

Trust is a must: What is involved in trusting those who manage forest fires?

Treesearch

Adam Liljeblad; Bill Borrie; Alan Watson

2010-01-01

Trust is a complicated emotion. In the past, many social scientists have studied trust. They discovered that trust involves a number of beliefs and emotions. The scientists in this study were interested in learning more about trust. They believed that forest managers can do a better job if people trust them to do what is best for citizens and the environment (figure 1...

[Trust and power--three interrelationships].

PubMed

Grimen, H

2001-12-10

Trust is not always an idyllic phenomenon; it may also serve as a context in which power is exercised. Reflecting on power in relation to trust gives us a richer theoretical framework for analysing the social conditions for establishing, maintaining and eroding relations of trust. This article proposes three interrelationships between trust and power: power may create trust; unequal distribution of power may affect the conditions for establishing and maintaining relations of trust; the internal structure of interest and control is identical in some types of trust relations and some types of power relations.

NIH's National Institute of Nursing Research Is Changing Lives

MedlinePlus

... Issue Past Issues NIH's National Institute of Nursing Research Is Changing Lives Past Issues / Spring 2008 Table ... From childbirth to end-of-life care, nursing research is aimed at helping patients across the entire ...

The impact of childbirth-related post-traumatic stress on a couple's relationship: a systematic review and meta-synthesis.

PubMed

Delicate, A; Ayers, S; Easter, A; McMullen, S

2018-02-01

This review aimed to identify the impact of childbirth-related post-traumatic stress disorder (PTSD) or symptoms (PTSS) on a couple's relationship. Childbirth can be psychologically traumatic and can lead to PTSD. There is emerging evidence that experiencing a traumatic birth can affect the quality of the couple's relationship. This is an important issue because poor-quality relationships can impact on the well-being of partners, their parenting and the welfare of the infant. A systematic search was conducted of Amed, CENTRAL, Cinahl, Embase, Maternity and Infant Care, Medline, MITCognet, POPLINE, PsycARTICLES, PsycBITE, PsycINFO, Pubmed and Science Direct. Additionally, grey literature, citation and reference searches were conducted. Papers were eligible for inclusion if they reported qualitative data about parents who had experienced childbirth and measures of PTSD or PTSS and the relationship were taken. Analysis was conducted using meta-ethnography. Seven studies were included in the meta-synthesis. Results showed that childbirth-related PTSD or PTSS can have a perceived impact on the couple's relationship and five themes were identified: negative emotions; lack of understanding and support; loss of intimacy; strain on the relationship; and strengthened relationships. A model of proposed interaction between these themes is presented. The impact of childbirth-related PTSD or PTSS on the couple's relationships is complex. As the quality of the couple relationship is important to family well-being, it is important that healthcare professionals are aware of the impact of experiencing psychologically traumatic childbirth as impetus for prevention and support.

Anger after Childbirth: An Overlooked Reaction to Postpartum Stressors

ERIC Educational Resources Information Center

Graham, Jennifer E.; Lobel, Marci; DeLuca, Robyn Stein

2002-01-01

Other than postpartum depression, little is known about women's emotional responses to childbirth and subsequent stressors. Anger was explored on the basis of theory and evidence that it is a likely emotional response in this context. During their third trimester of pregnancy and approximately six weeks after delivery, 163 participants completed…

Maternal Age at Childbirth and Social Development in Infancy

ERIC Educational Resources Information Center

Koyama, Tomonori; Kamio, Yoko; Inada, Naoko; Inokuchi, Eiko

2011-01-01

Difficulties in social communication are not necessarily observed only in individuals with autism spectrum disorders (ASD), and there are many subclinical cases in the general populations. Although advanced parental age at childbirth has often been considered a possible risk factor of ASD, it might contribute to poor social functioning in…

Trust Discovery in Online Communities

ERIC Educational Resources Information Center

Piorkowski, John

2014-01-01

This research aims to discover interpersonal trust in online communities. Two novel trust models are built to explain interpersonal trust in online communities drawing theories and models from multiple relevant areas, including organizational trust models, trust in virtual settings, speech act theory, identity theory, and common bond theory. In…

A Sacred Trust: The Safety of Our Children.

ERIC Educational Resources Information Center

Momentum, 2002

2002-01-01

Provides the text of the National Catholic Educational Association Statement on Child Abuse. This document, titled A Sacred Trust: The Safety of Our Children, was generated in response to the growing number of both confirmed and alleged cases of pedophilia and sexual abuse within the Catholic Church. (RC)

26 CFR 26.2654-1 - Certain trusts treated as separate trusts.

Code of Federal Regulations, 2013 CFR

2013-04-01

... market value of the single trust immediately after the contribution by a fraction. The numerator of the... fraction is the fair market value of all the property in the single trust immediately after the transfer... law; and (A) The terms of the new trusts provide in the aggregate for the same succession of interests...

26 CFR 26.2654-1 - Certain trusts treated as separate trusts.

Code of Federal Regulations, 2012 CFR

2012-04-01

... market value of the single trust immediately after the contribution by a fraction. The numerator of the... fraction is the fair market value of all the property in the single trust immediately after the transfer... law; and (A) The terms of the new trusts provide in the aggregate for the same succession of interests...

26 CFR 26.2654-1 - Certain trusts treated as separate trusts.

Code of Federal Regulations, 2011 CFR

2011-04-01

... market value of the single trust immediately after the contribution by a fraction. The numerator of the... fraction is the fair market value of all the property in the single trust immediately after the transfer... law; and (A) The terms of the new trusts provide in the aggregate for the same succession of interests...

26 CFR 26.2654-1 - Certain trusts treated as separate trusts.

Code of Federal Regulations, 2014 CFR

2014-04-01

... market value of the single trust immediately after the contribution by a fraction. The numerator of the... fraction is the fair market value of all the property in the single trust immediately after the transfer... law; and (A) The terms of the new trusts provide in the aggregate for the same succession of interests...

Does childbirth cause psychiatric disorders? A population-based study paralleling a natural experiment.

PubMed

Munk-Olsen, Trine; Agerbo, Esben

2015-01-01

Childbirth is associated with increased risk of first-time psychiatric episodes, and an unwanted pregnancy has been suggested as a possible etiologic contributor. To what extent childbirth causes psychiatric episodes and whether a planned pregnancy reduces the risk of postpartum psychiatric episodes has not been established. We conducted a cohort study using data derived from Danish population registers, including all women having in vitro fertilization (IVF) treatment and their partners with recorded information in the IVF register covering fertility treatments in Denmark at all public and private treatment sites from January 1994 to December 2005. We compared parents and childless persons to examine whether childbirth is directly associated with onset of first-time psychiatric episodes, with incidence rate ratios (risk of first psychiatric inpatient or outpatient treatment) as the main outcome measures. The incidence rate for any type of psychiatric disorder 0 to 90 days postpartum was 11.3 per 1000 person-years (95% confidence interval = 8.2-15.0), and 3.8 (3.4-4.3) among women not giving birth. IVF-treated mothers had an increased risk of a psychiatric episode postpartum (incidence rate ratio [IRR] = 2.9 [2.0-4.2]) compared with the risk of psychiatric episodes in childless women. Risk of psychiatric episodes later than 90 days postpartum was decreased (IRR = 0.9 [0.7-1.0]). Using a study design paralleling a natural experiment, our results showed that childbirth is associated with first-time psychiatric disorders in new mothers, indicating that a planned pregnancy does not reduce risks of or prevent postpartum psychiatric episodes.

NEUROENDOCRINE FUNCTIONS OF PUERPERAE WITH POSTPARTUM DEPRESSION AGGRAVATED BY STRESSFUL CHILDBIRTH-RELATED EVENTS.

PubMed

Song, W; Yu, S

2015-01-01

In the period of gestation, delivery and post-delivery, fear and tension produced in puerperae are likely to evolve into depression as they worry too much about delivery pain. In recent years, it has been noted that stressful events during this period aggravate postpartum depression. To discuss the effect of these childbirth-related stressful events on neuroendocrine functions of patients with postpartum depression, 300 full-term puerperae who had been admitted to the Beijing Obstetrics and Gynecology Hospital, Capital Medical University between October, 2011 and October, 2013 and who had suffered from stressful childbirth-related events were enrolled as a study group. This group was divided into six subgroups, i.e., A, B, C, D, E and F, based on the number of stressful events they had suffered which were labeled by numbers 1 to 6. Additionally, 100 puerperae from the same hospital who had not suffered from childbirth-related stressful events were taken as controls. Relevant clinical indexes, including serum adrenocorticotropic hormone (ACTH), plasma 5-hydroxytryptamine (5-HT), noradrenaline ELISA (NE), dopamine (DA) and cortisol level were measured and compared. It was found that incidence probability of postpartum depression was significantly different between the study group (13.67%, 41/300) and the control group (7%, 7/100). Moreover, the incidence probability of postpartum depression of puerperae suffering from no less than 4 childbirth-related stressful events was higher than those suffering from no more than 3, and the difference was statistically significant (P<0.05). Thus, stress disorders caused by these events are one of the important pathogenic factors of postpartum depression.

Qualitative study of pregnancy and childbirth experiences in Somalian women resident in Sweden.

PubMed

Essén, B; Johnsdotter, S; Hovelius, B; Gudmundsson, S; Sjöberg, N O; Friedman, J; Ostergren, P O

2000-12-01

To explore the attitudes, strategies and habits of Somalian immigrant women related to pregnancy and childbirth, in order to gain an understanding as to how cultural factors might affect perinatal outcome. Interpreter assisted qualitative in depth interviews around topics such as attitudes and strategies regarding childbirth. Fifteen women from the Somalian community in a city in Sweden, between the ages of 20 and 55 years with delivery experience in Somalia and Sweden. The interviews describe how the women themselves perceived their experiences of childbirth in the migrant situation. Many voluntarily decreased food intake in order to have a smaller fetus, an easier delivery and to avoid caesarean section. The participants considered a safe delivery to be the same as a normal vaginal delivery They reduced food intake in order to diminish the growth of the fetus, thereby avoiding caesarean section and mortality. The practice of food intake reduction, while rational for the participants when in Somalia, was found less rational in Sweden and may lead to suboptimal obstetric surveillance. Somalian women have childbirth strategies that differ from those of Swedish women. These strategies should be seen as 'survival behaviours' related to their background in an environment with high maternal mortality. The hypothesis generated is that there is a relationship between the strategies during pregnancy and adverse perinatal outcome among Somalian immigrants. Considering the strong association of the habits to safe birth, it seems doubtful whether the women will change their habits as long as health care providers are unaware of their motives. We suggest a more culturally sensitive perinatal surveillance.

Hypnosis for pain management during labour and childbirth.

PubMed

Madden, Kelly; Middleton, Philippa; Cyna, Allan M; Matthewson, Mandy; Jones, Leanne

2012-11-14

This review is one in a series of Cochrane Reviews investigating pain management for childbirth. These reviews all contribute to an overview of systematic reviews of pain management for women in labour, and share a generic protocol. We examined the current evidence regarding the use of hypnosis for pain management during labour and childbirth. This review updates the findings regarding hypnosis from an earlier review of complementary and alternative therapies for pain management in labour into a stand-alone review. To examine the effectiveness and safety of hypnosis for pain management during labour and childbirth. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (11 January 2012) and the reference lists of primary studies and review articles. Randomised controlled trials and quasi-randomised controlled trials comparing preparation for labour using hypnosis and/or use of hypnosis during labour, with or without concurrent use of pharmacological or non-pharmacological pain relief methods versus placebo, no treatment or any analgesic drug or technique. Two assessors independently extracted data and assessed trial quality. Where possible we contacted study authors seeking additional information about data and methodology. We included seven trials randomising a total of 1213 women. All but one of the trials were at moderate to high risk of bias. Although six of the seven trials assessed antenatal hypnotherapy, there were considerable differences between these trials in timing and technique. One trial provided hypnotherapy during labour. No significant differences between women in the hypnosis group and those in the control group were found for the primary outcomes: use of pharmacological pain relief (average risk ratio (RR) 0.63, 95% confidence interval (CI) 0.39 to 1.01, six studies, 1032 women), spontaneous vaginal birth (average RR 1.35, 95% CI 0.93 to 1.96, four studies, 472 women) or satisfaction with pain relief (RR 1.06, 95% CI 0.94 to 1

Mental nerve anaesthesia; a complication of sickle cell crisis during childbirth.

PubMed

Stevenson, Helen; Boardman, Charlotte; Chu, Patrick; Field, Anne

2004-10-01

This report describes the case of an Afro-Caribbean lady diagnosed with sickle cell anaemia, who presented with permanent mental nerve anaesthesia as a result of a sickle cell crisis during childbirth.

Not all trust is created equal: dispositional and history-based trust in human-automation interactions.

PubMed

Merritt, Stephanie M; Ilgen, Daniel R

2008-04-01

We provide an empirical demonstration of the importance of attending to human user individual differences in examinations of trust and automation use. Past research has generally supported the notions that machine reliability predicts trust in automation, and trust in turn predicts automation use. However, links between user personality and perceptions of the machine with trust in automation have not been empirically established. On our X-ray screening task, 255 students rated trust and made automation use decisions while visually searching for weapons in X-ray images of luggage. We demonstrate that individual differences affect perceptions of machine characteristics when actual machine characteristics are constant, that perceptions account for 52% of trust variance above the effects of actual characteristics, and that perceptions mediate the effects of actual characteristics on trust. Importantly, we also demonstrate that when administered at different times, the same six trust items reflect two types of trust (dispositional trust and history-based trust) and that these two trust constructs are differentially related to other variables. Interactions were found among user characteristics, machine characteristics, and automation use. Our results suggest that increased specificity in the conceptualization and measurement of trust is required, future researchers should assess user perceptions of machine characteristics in addition to actual machine characteristics, and incorporation of user extraversion and propensity to trust machines can increase prediction of automation use decisions. Potential applications include the design of flexible automation training programs tailored to individuals who differ in systematic ways.

Trust-Effectiveness Patterns in Schools

ERIC Educational Resources Information Center

Forsyth, Patrick B.; Barnes, Laura L. B.; Adams, Curt M.

2006-01-01

Purpose: To investigate the consequences of relational trust, especially parent measured trust, for desirable school outcomes. Design/methodology/approach: Using a US Midwestern state sample of 79 schools, parent and teacher trust data are used to derive a trust-effectiveness typology. Trust was conceptualized as one party's willingness to be…

Implicit race attitudes predict trustworthiness judgments and economic trust decisions

PubMed Central

Stanley, Damian A.; Sokol-Hessner, Peter; Banaji, Mahzarin R.; Phelps, Elizabeth A.

2011-01-01

Trust lies at the heart of every social interaction. Each day we face decisions in which we must accurately assess another individual's trustworthiness or risk suffering very real consequences. In a global marketplace of increasing heterogeneity with respect to nationality, race, and multiple other social categories, it is of great value to understand how implicitly held attitudes about group membership may support or undermine social trust and thereby implicitly shape the decisions we make. Recent behavioral and neuroimaging work suggests that a common mechanism may underlie the expression of implicit race bias and evaluations of trustworthiness, although no direct evidence of a connection exists. In two behavioral studies, we investigated the relationship between implicit race attitude (as measured by the Implicit Association Test) and social trust. We demonstrate that race disparity in both an individual's explicit evaluations of trustworthiness and, more crucially, his or her economic decisions to trust is predicted by that person's bias in implicit race attitude. Importantly, this relationship is robust and is independent of the individual's bias in explicit race attitude. These data demonstrate that the extent to which an individual invests in and trusts others with different racial backgrounds is related to the magnitude of that individual's implicit race bias. The core dimension of social trust can be shaped, to some degree, by attitudes that reside outside conscious awareness and intention. PMID:21518877

Implicit race attitudes predict trustworthiness judgments and economic trust decisions.

PubMed

Stanley, Damian A; Sokol-Hessner, Peter; Banaji, Mahzarin R; Phelps, Elizabeth A

2011-05-10

Trust lies at the heart of every social interaction. Each day we face decisions in which we must accurately assess another individual's trustworthiness or risk suffering very real consequences. In a global marketplace of increasing heterogeneity with respect to nationality, race, and multiple other social categories, it is of great value to understand how implicitly held attitudes about group membership may support or undermine social trust and thereby implicitly shape the decisions we make. Recent behavioral and neuroimaging work suggests that a common mechanism may underlie the expression of implicit race bias and evaluations of trustworthiness, although no direct evidence of a connection exists. In two behavioral studies, we investigated the relationship between implicit race attitude (as measured by the Implicit Association Test) and social trust. We demonstrate that race disparity in both an individual's explicit evaluations of trustworthiness and, more crucially, his or her economic decisions to trust is predicted by that person's bias in implicit race attitude. Importantly, this relationship is robust and is independent of the individual's bias in explicit race attitude. These data demonstrate that the extent to which an individual invests in and trusts others with different racial backgrounds is related to the magnitude of that individual's implicit race bias. The core dimension of social trust can be shaped, to some degree, by attitudes that reside outside conscious awareness and intention.

The experience of pregnancy and childbirth for unmarried mothers in London, 1760-1866.

PubMed

Williams, Samantha

2011-01-01

This article explores the experience of pregnancy and childbirth for unmarried mothers in the metropolis in the eighteenth and nineteenth centuries. It draws upon, in particular, the infanticide cases heard at the Old Bailey between 1760 and 1866. Many of the women in these records found themselves alone and afraid as they coped with the pregnancy and birth of their first child. A great deal is revealed about the birthing body: the ambiguity surrounding the identification of and signs of pregnancy, labour and delivery, the place of birth and the degree of privacy, and the nature of, and dangers associated with, solitary childbirth.

Neural correlates of trust.

PubMed

Krueger, Frank; McCabe, Kevin; Moll, Jorge; Kriegeskorte, Nikolaus; Zahn, Roland; Strenziok, Maren; Heinecke, Armin; Grafman, Jordan

2007-12-11

Trust is a critical social process that helps us to cooperate with others and is present to some degree in all human interaction. However, the underlying brain mechanisms of conditional and unconditional trust in social reciprocal exchange are still obscure. Here, we used hyperfunctional magnetic resonance imaging, in which two strangers interacted online with one another in a sequential reciprocal trust game while their brains were simultaneously scanned. By designing a nonanonymous, alternating multiround game, trust became bidirectional, and we were able to quantify partnership building and maintenance. Using within- and between-brain analyses, an examination of functional brain activity supports the hypothesis that the preferential activation of different neuronal systems implements these two trust strategies. We show that the paracingulate cortex is critically involved in building a trust relationship by inferring another person's intentions to predict subsequent behavior. This more recently evolved brain region can be differently engaged to interact with more primitive neural systems in maintaining conditional and unconditional trust in a partnership. Conditional trust selectively activated the ventral tegmental area, a region linked to the evaluation of expected and realized reward, whereas unconditional trust selectively activated the septal area, a region linked to social attachment behavior. The interplay of these neural systems supports reciprocal exchange that operates beyond the immediate spheres of kinship, one of the distinguishing features of the human species.

Neural correlates of trust

PubMed Central

Krueger, Frank; McCabe, Kevin; Moll, Jorge; Kriegeskorte, Nikolaus; Zahn, Roland; Strenziok, Maren; Heinecke, Armin; Grafman, Jordan

2007-01-01

Trust is a critical social process that helps us to cooperate with others and is present to some degree in all human interaction. However, the underlying brain mechanisms of conditional and unconditional trust in social reciprocal exchange are still obscure. Here, we used hyperfunctional magnetic resonance imaging, in which two strangers interacted online with one another in a sequential reciprocal trust game while their brains were simultaneously scanned. By designing a nonanonymous, alternating multiround game, trust became bidirectional, and we were able to quantify partnership building and maintenance. Using within- and between-brain analyses, an examination of functional brain activity supports the hypothesis that the preferential activation of different neuronal systems implements these two trust strategies. We show that the paracingulate cortex is critically involved in building a trust relationship by inferring another person's intentions to predict subsequent behavior. This more recently evolved brain region can be differently engaged to interact with more primitive neural systems in maintaining conditional and unconditional trust in a partnership. Conditional trust selectively activated the ventral tegmental area, a region linked to the evaluation of expected and realized reward, whereas unconditional trust selectively activated the septal area, a region linked to social attachment behavior. The interplay of these neural systems supports reciprocal exchange that operates beyond the immediate spheres of kinship, one of the distinguishing features of the human species. PMID:18056800

Prolonged sexual abstinence after childbirth: gendered norms and perceived family health risks. Focus group discussions in a Tanzanian suburb.

PubMed

Mbekenga, Columba K; Pembe, Andrea B; Darj, Elisabeth; Christensson, Kyllike; Olsson, Pia

2013-01-15

Prolonged sexual abstinence after childbirth is a socio-cultural practice with health implications, and is described in several African countries, including Tanzania. This study explored discourses on prolonged postpartum sexual abstinence in relation to family health after childbirth in low-income suburbs of Dar es Salaam, Tanzania. Data for the discourse analysis were collected through focus group discussions with first-time mothers and fathers and their support people in Ilala, Dar es Salaam, Tanzania. In this setting, prolonged sexual abstinence intended at promoting child health was the dominant discourse in the period after childbirth. Sexual relations after childbirth involved the control of sexuality for ensuring family health and avoiding the social implications of non-adherence to sexual abstinence norms. Both abstinence and control were emphasised more with regard to women than to men. Although the traditional discourse on prolonged sexual abstinence for protecting child health was reproduced in Ilala, some modern aspects such as the use of condoms and other contraceptives prevailed in the discussion. Discourses on sexuality after childbirth are instrumental in reproducing gender-power inequalities, with women being subjected to more restrictions and control than men are. Thus, interventions that create openness in discussing sexual relations and health-related matters after childbirth and mitigate gendered norms suppressing women and perpetuating harmful behaviours are needed. The involvement of males in the interventions would benefit men, women, and children through improving the gender relations that promote family health.

Prolonged sexual abstinence after childbirth: gendered norms and perceived family health risks. Focus group discussions in a Tanzanian suburb

PubMed Central

2013-01-01

Background Prolonged sexual abstinence after childbirth is a socio-cultural practice with health implications, and is described in several African countries, including Tanzania. This study explored discourses on prolonged postpartum sexual abstinence in relation to family health after childbirth in low-income suburbs of Dar es Salaam, Tanzania. Methods Data for the discourse analysis were collected through focus group discussions with first-time mothers and fathers and their support people in Ilala, Dar es Salaam, Tanzania. Results In this setting, prolonged sexual abstinence intended at promoting child health was the dominant discourse in the period after childbirth. Sexual relations after childbirth involved the control of sexuality for ensuring family health and avoiding the social implications of non-adherence to sexual abstinence norms. Both abstinence and control were emphasised more with regard to women than to men. Although the traditional discourse on prolonged sexual abstinence for protecting child health was reproduced in Ilala, some modern aspects such as the use of condoms and other contraceptives prevailed in the discussion. Conclusion Discourses on sexuality after childbirth are instrumental in reproducing gender-power inequalities, with women being subjected to more restrictions and control than men are. Thus, interventions that create openness in discussing sexual relations and health-related matters after childbirth and mitigate gendered norms suppressing women and perpetuating harmful behaviours are needed. The involvement of males in the interventions would benefit men, women, and children through improving the gender relations that promote family health. PMID:23316932