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BMC Pregnancy and Childbirth Sep 2022Continuity of midwifery-led care during labour and birth is considered optimal. To ensure its sustainability in practice where limited evidence is available, the aim of...
BACKGROUND & OBJECTIVE
Continuity of midwifery-led care during labour and birth is considered optimal. To ensure its sustainability in practice where limited evidence is available, the aim of the present study was to explore midwives' lived experiences of delivering continuous midwife-led intrapartum care.
METHODS
This study took a qualitative approach in meeting its aim. Participants were midwives working in the labour wards of private and public hospitals in Iran. The data were purposefully collected in 2019 through in-depth, semi-structured, and face-to-face interviews with midwives (n = 10) aged between 26 and 55 years. A thematic analysis based on descriptive phenomenology was undertaken to make sense of the data collected.
RESULTS
"Wanting to lead continuous woman-centered care but being unable to" was identified as an overarching theme. Three other themes "emphasis on the non-interventional care", "midwifery-specific focus" and "barriers and challenges of midwifery care" were also identified. Ultimately, midwives described knowing how to and wanting to lead continuous 'woman'-centered care but being unable to. Perceived barriers included lack of familiarity with and knowledge in relation to childbirth, the insignificant role of midwives in decision making, obstetrician utilitarianism, high workloads along with work-related stress argument-driven communication between midwives and obstetricians and an absence of a 'triangle of trust' in care.
CONCLUSION
Future research strategies could usefully include obstetricians and focus on the upscaling of midwifery in Iran using continuity of care models, highlight the value of midwives, identify why uptake of antenatal education in Iran is poor and develop user friendly, evidence based, midwife-led programs. Initiatives aiming to promote mutual professional respect, trust and collegiality and increased remuneration for midwifery work would be also welcomed in pursuit of reducing maternal and infant mortality in Iran.
Topics: Adult; Delivery, Obstetric; Female; Humans; Iran; Middle Aged; Midwifery; Nurse Midwives; Parturition; Pregnancy; Qualitative Research
PubMed: 36151533
DOI: 10.1186/s12884-022-05040-z -
Maternal & Child Nutrition Apr 2022Household gender roles influence infant and young child feeding behaviours and may contribute to suboptimal complementary feeding practices through inequitable...
Household gender roles influence infant and young child feeding behaviours and may contribute to suboptimal complementary feeding practices through inequitable household decision-making, intra-household food allocation and limited paternal support for resources and caregiving. In Igabi local government area of Kaduna State, Nigeria, the Alive & Thrive (A&T) initiative implemented an intervention to improve complementary feeding practices through father engagement. This study describes household gender roles among A&T participants and how they influence maternal and paternal involvement in complementary feeding. We conducted 16 focus group discussions with mothers and fathers of children aged 6-23 months in urban and rural administrative wards and analysed them using qualitative thematic analysis methods. Most mothers and fathers have traditional roles with fathers as 'providers' and 'supervisors' and mothers as 'caregivers'. Traditional normative roles of fathers limit their involvement in 'hands-on' activities, which support feeding and caring for children. Less traditional normative roles, whereby some mothers contributed to the provision of resources and some fathers contributed to caregiving, were also described by some participants and were more salient in the urban wards. In the rural wards, more fathers expressed resistance to fathers playing less traditional roles. Fathers who participated in caregiving tasks reported respect from their children, strong family relationships and had healthy home environments. Our research findings point to the need for more context-specific approaches that address prevalent gender normative roles in complementary feeding in a variety of settings.
Topics: Child; Fathers; Female; Gender Role; Humans; Infant; Infant Nutritional Physiological Phenomena; Male; Mothers; Nigeria
PubMed: 35080111
DOI: 10.1111/mcn.13325 -
PloS One 2019Uranium (U) measurements in water, soil, and food related to gold mining activities in populated areas in Gauteng Province, South Africa, suggest the possibility of...
Uranium (U) measurements in water, soil, and food related to gold mining activities in populated areas in Gauteng Province, South Africa, suggest the possibility of exposure levels that may lead to adverse health consequences, including cancer. Theoretical considerations on pathways of human uptake of significant exposures are plausible, but few data on directly measured human exposure are available. A cross-sectional study was conducted using human measurements to compare U levels with other settings around the globe (based on literature review), to explore potential exposure variability within the province, and to test the feasibility of recruiting subjects partially coming from vulnerable and difficult-to-reach populations. Wards of potentially high (HE) and low exposure (LE) were identified. Composite hair samples representing the respective local populations were collected from regular customers of selected barber shops over a period of 1-2 months. A total of 70 U concentrations were determined in 27 composite samples from 1332 individuals. U concentrations ranged from 31 μg/kg to 2524 μg/kg, with an arithmetic mean of 192 μg/kg (standard deviation, 310 μg/kg) and a median of 122 μg/kg. Although HE wards collectively showed higher U levels than LE wards (184 vs 134 μg/kg), differences were smaller than expected. In conclusion, detected U levels were higher than those from most other surveys of the general public. The barber-based approach was an efficient hair collection approach. Composite hair samples are not recommended, due to technical challenges in measuring U, and individual hair samples are needed in follow-up studies to determine predictors of exposure.
Topics: Cross-Sectional Studies; Environmental Monitoring; Feasibility Studies; Female; Gold; Hair; Humans; Male; Mining; South Africa; Uranium
PubMed: 31247044
DOI: 10.1371/journal.pone.0219059 -
Trials Jul 2023Despite the benefits of breastfeeding, early weaning is a reality, so less than 50% of children worldwide and in Brazil are on exclusive breastfeeding in the sixth month...
BACKGROUND
Despite the benefits of breastfeeding, early weaning is a reality, so less than 50% of children worldwide and in Brazil are on exclusive breastfeeding in the sixth month of life. A strategy to counteract this scenario is breastfeeding counseling. This study aims to verify the effectiveness of individualized counseling by nurses trained in breastfeeding counseling, on the duration of exclusive breastfeeding, compared to standard care.
METHODS
Multicenter, randomized, parallel, and open clinical trial, with primiparous women aged over 18 years, hospitalized in rooming-in wards at participating centers and hemodynamically stable, aware, and oriented, who had a single-fetus pregnancy and gave birth, regardless of the type of delivery, with live child, gestational age of 37 to 42 weeks and birth weight greater than 2500 g. The women will be initially approached in rooming-in wards and, upon consent to participate in the study, will be allocated through randomization by blocks composed of eight participants in two groups: intervention and control. The randomization lists will be organized by a central without involvement with the study, which will manage the allocation groups and be prepared in the Randon® program. Women allocated to the intervention group will receive breastfeeding counseling by trained nurses, and those in the control group will receive standard care at the center participating in the study.
DISCUSSION
The results can contribute to breastfeeding by evidencing possible exclusivity and duration of the counseling trained nurses provide.
TRIAL REGISTRATION
REBEC RBR-4w9v5rq (UTN: U1111-1284-3559) ( https://ensaiosclinicos.gov.br/rg/RBR-4w9v5rq ). Posted on March 20, 2023.
Topics: Pregnancy; Child; Humans; Female; Adult; Middle Aged; Infant; Breast Feeding; Hospitals; Parturition; Parity; Counseling; Randomized Controlled Trials as Topic; Multicenter Studies as Topic
PubMed: 37454111
DOI: 10.1186/s13063-023-07490-y