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Kira Neel, Roberta Goldman, Denise Marte, Gisel Bello, Melissa B Nothnagle
INTRODUCTION: A birth doula provides continuous informational, physical, and emotional support during pregnancy, labor, and immediately postpartum. Existing data on the benefits of doulas, especially for low-resource, high-need patients, do not address how and why individual practitioners decide to recommend this model of care. This project aims to describe best practices of integrating doulas into hospital-based maternity care teams to facilitate access to this evidence-based service for improving maternal health outcomes...
February 8, 2019: Birth
Matthijs van der Garde, Martine Hollander, Gert Olthuis, Frank Vandenbussche, Jeroen van Dillen
BACKGROUND: Some women decline recommended care during pregnancy and birth. This can cause friction between client and provider. METHODS: A designated outpatient clinic was started for women who decline recommended care in pregnancy. All women who attended were analyzed retrospectively. The clinic used a systematic multidisciplinary approach. During the first visit, women told their stories and explained the reasoning behind their birth plan. The second visit was used to present the evidence underpinning recommendations and attempt to reach a compromise if care within recommendations was still not acceptable to the woman...
February 8, 2019: Birth
Stacey E Iobst, Rachel B Breman, Debra Bingham, Carla L Storr, Shijun Zhu, Meg Johantgen
BACKGROUND: Admission in early labor is associated with increased likelihood of cesarean birth, but the context in which this occurs is unclear. Previous research has explored the relationship between dilatation at admission and the use of single intrapartum interventions; however, the majority of women in the United States receive multiple intrapartum interventions. The objective of this study was to examine the associations among cervical dilatation at admission, intrapartum care, and birth mode in low-risk, nulliparous women with spontaneous onset of labor...
January 28, 2019: Birth
Patience A Afulani, Raymond A Aborigo, Dilys Walker, Cheryl A Moyer, Susanna Cohen, John Williams
BACKGROUND: Few evidence-based interventions exist on how to improve respectful maternity care (RMC) in low-resource settings. We sought to evaluate the effect of an integrated simulation-based training on provision of RMC. METHODS: The pilot project was in East Mamprusi District in northern Ghana. We integrated specific components of RMC, emphasizing dignity and respect, communication and autonomy, and supportive care, into a simulation training to improve identification and management of obstetric and neonatal emergencies...
January 24, 2019: Birth
Louise M O'Brien, Jane Warland, Tomasina Stacey, Alexander E P Heazell, Edwin A Mitchell
BACKGROUND: Late stillbirth, which occurs ≥28 weeks' gestation, affects 1.3-8.8 per 1000 births in high-income countries. Of concern, most occur in women without established risk factors. Identification of potentially modifiable risk factors that relate to maternal behaviors remains a priority in stillbirth prevention research. This study aimed to investigate, in an international cohort, whether maternal sleep practices are related to late stillbirth. METHODS: An Internet-based case-control study of women who had a stillbirth ≥28 weeks' gestation within 30 days before completing the survey (n = 153) and women with an ongoing third-trimester pregnancy or who had delivered a live born child within 30 days (n = 480)...
January 18, 2019: Birth
Karilynn M Rockhill, Lucinda J England, Van T Tong, Andrea J Sharma
BACKGROUND: Prenatal smoking cessation has substantial health benefits for mothers and offspring, but concerns about weight gain may be a barrier to quitting. We quantified gestational weight gain associated with biochemically confirmed smoking cessation. METHODS: Data originated from a randomized controlled cessation trial: Smoking Cessation in Pregnancy project (1987-1991). We calculated gestational weight gain using self-reported prepregnancy weight and measured weight at 30-34 weeks of gestation...
January 11, 2019: Birth
Kristjana Einarsdóttir, Hekla Sigurðardóttir, Ragnheiður Ingibjörg Bjarnadóttir, Þóra Steingrímsdóttir, Alexander K Smárason
BACKGROUND: Rising cesarean rates call for studies on which subgroups of women contribute to the rising rates, both in countries with high and low rates. This study investigated the cesarean rates and contributing groups in Iceland using the Robson 10-group classification system. METHODS: This study included all births in Iceland from 1997 to 2015, identified from the Icelandic Medical Birth Registry (81 839). The Robson distribution, cesarean rate, and contribution of each Robson group were analyzed for each year, and the distribution of other outcomes was calculated for each Robson group...
January 9, 2019: Birth
Marlies Rijnders, Suze Jans, Inger Aalhuizen, Symone Detmar, Matty Crone
INTRODUCTION: In response to a relatively high perinatal mortality rate in The Netherlands, the Dutch Health Ministry recommended changes to maternity care, opening a pathway toward more integrated woman-centered services. Because of its potential to positively influence risk factors for adverse pregnancy outcomes, CenteringPregnancy (CP) group prenatal care was implemented. METHODS: We performed a retrospective cohort study (n = 2318) and survey on women's experiences (n = 222) in eight primary care midwifery practices to investigate outcome differences between CP and traditional individual prenatal care...
December 27, 2018: Birth
Stina Lou, Lone Hvidman, Niels Uldbjerg, Lone Neumann, Trine Fritzner Jensen, Joke-Gesine Haben, Kathrine Carstensen
BACKGROUND: Over the last decade, induction of labor (IOL) in postterm pregnancies has increased. Studies have shown the medical advantages of postterm IOL, but less is known about the perspectives of the pregnant women. This review aimed to summarize the current qualitative evidence on women's experience of postterm IOL. METHODS: A systematic literature search was performed in three databases. A total of 3193 publications were identified, but only eight studies met the inclusion criteria...
December 18, 2018: Birth
Marian F MacDorman, Eugene Declercq
BACKGROUND: Out-of-hospital births have been increasing in the United States, although past studies have found wide variations between states. Our purpose was to examine trends in out-of-hospital births, the risk profile of these births, and state differences in women's access to these births. METHODS: National birth certificate data from 2004 to 2017 were analyzed. Newly available national data on method of payment for the delivery (private insurance, Medicaid, self-pay) were used to measure access to out-of-hospital birth options...
December 10, 2018: Birth
Chloe M Barrera, Jennifer M Nelson, Ellen O Boundy, Cria G Perrine
BACKGROUND: Rooming-in, or keeping mothers and infants together throughout the birth hospitalization, increases breastfeeding initiation and duration, and is one of the Ten Steps to Successful Breastfeeding. METHODS: The Centers for Disease Control and Prevention's (CDC) Maternity Practices in Infant Nutrition and Care (mPINC) survey is a biennial census of all birth facilities in the United States and its territories. Data from the 2007-2015 mPINC surveys were used to assess trends in the prevalence of hospitals with most (≥90%) infants rooming-in more than 23 hours per day (ideal practice)...
December 2018: Birth
Edda Sveinsdottir, Helga Gottfredsdottir, Anna S Vernhardsdottir, Gudny B Tryggvadottir, Reynir T Geirsson
BACKGROUND: Obstetric anal sphincter injuries lead frequently to short- and long-term consequences for the mother, including perineal pain, genital prolapse, and sexual problems. The aim of the study was to evaluate whether the implementation of an intervention program in the second stage of labor involving altered perineal support techniques reduced severe perineal trauma. METHODS: All women reaching the second stage of labor and giving birth vaginally to singleton babies at Landspítali University Hospital (comprising 76% of births in Iceland in 2013) were enrolled in a cohort study...
November 16, 2018: Birth
Jeremy L Neal, Nicole S Carlson, Julia C Phillippi, Ellen L Tilden, Denise C Smith, Rachel B Breman, Mary S Dietrich, Nancy K Lowe
BACKGROUND: The presence of midwives in a health system may affect perinatal outcomes but has been inadequately described in United States settings. Our objective was to compare labor processes and outcomes for low-risk nulliparous women birthing in United States medical centers with interprofessional care (midwives and physicians) versus noninterprofessional care (physicians only). METHODS: We conducted a retrospective cohort study using Consortium on Safe Labor data from low-risk nulliparous women who birthed in interprofessional (n = 7393) or noninterprofessional centers (n = 6982)...
November 11, 2018: Birth
Nicole S Carlson, Jeremy L Neal, Ellen L Tilden, Denise C Smith, Rachel B Breman, Nancy K Lowe, Mary S Dietrich, Julia C Phillippi
BACKGROUND: Sixty percent of United States births are to multiparous women. Hospital-level policies and culture may influence intrapartum care and birth outcomes for this large population, yet have been poorly explored using a large, diverse sample. We sought to use national United States data to analyze the association between midwifery presence in maternity care teams and the birth processes and outcomes of low-risk parous women. METHODS: We conducted a retrospective cohort study using Consortium on Safe Labor data from low-risk parous women in either interprofessional care (n = 12 125) or noninterprofessional care centers (n = 8996)...
November 9, 2018: Birth
Emily White VanGompel, Susan Perez, Chi Wang, Avisek Datta, Valerie Cape, Elliott Main
BACKGROUND: Cesarean delivery rates in the United States vary widely between hospitals, which cannot be fully explained by hospital or patient factors. Cultural factors are hypothesized to play a role in cesarean overuse, yet tools to measure labor culture are lacking. The aim of this study was to revise and validate a survey tool to measure hospital culture specific to cesarean overuse. METHODS: A panel of clinicians and researchers compiled an item bank from validated surveys, added newly created items, and performed four rounds of iterative revision and consolidation...
November 8, 2018: Birth
Jennifer L Beauregard, Jennifer M Nelson, Heather C Hamner
BACKGROUND: Hospitals that provide maternity care can play an important role in providing or directing mothers to postdischarge breastfeeding support, which improves breastfeeding duration especially when providing multiple support modes. This study described 2007-2015 national trends in postdischarge breastfeeding supports among United States maternity care hospitals. METHODS: Data were from the Maternity Practices in Infant Nutrition and Care survey, a biennial census of maternity care hospitals in the United States and territories...
November 6, 2018: Birth
Janet E Perkins, Ahmed Ehsanur Rahman, Abu Bakkar Siddique, Mohammad Rifat Haider, Goutom Banik, Tazeen Tahsina, Shams El Arifeen
BACKGROUND: In Bangladesh, over half of women give birth at home, generally without the support of a skilled birth attendant. In this article, we examined the decision-making around birthplace and explored the reported reasons of preferring home birth over facility birth in a rural district of Bangladesh. METHODS: A cross-sectional household survey with 1367 women was conducted in Brahmanbaria district. Choice of birthplace and actual place of birth were the main outcomes of interest...
October 31, 2018: Birth
Holly Powell Kennedy, Katy B Kozhimannil, Carol Sakala
No abstract text is available yet for this article.
October 31, 2018: Birth
Charlotte Elvander, Mia Ahlberg, Malin Edqvist, Olof Stephansson
BACKGROUND: To examine risk of severe perineal trauma among nulliparous women and those undergoing vaginal birth after cesarean delivery (VBAC). METHODS: This is a population-based cohort study of all births to women with their two first consecutive singleton pregnancies in Stockholm-Gotland Sweden between 2008 and 2014. Risk of severe perineal trauma was compared between nulliparous women and those undergoing VBAC with severe perineal trauma being the main outcome measure...
October 22, 2018: Birth
Mandie Scamell, Aliyha Ghumman
BACKGROUND: Increasing numbers of childbearing women with a history of female genital mutilation (FGM) are accessing maternity services in high-income countries across the world. For many of these women, their first contact with the health services in their host country is when they are pregnant. While the clinical consequences of certain categories of FGM are well documented, how high-risk maternity services - designed to mitigate the obstetric consequences of FGM - impact upon women's experience of childbearing is less clear...
October 7, 2018: Birth
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