Midwifery
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The objective of this study was to compare midwife-led and consultant-led obstetrical care for women with uncomplicated low-risk pregnancies. We estimated costs and maternal outcomes in both units to achieve a cost-effectiveness ratio. ⋯ Given the economical findings, this could contribute to reduce health expenditures for both women (out of pocket) and state (public payer via health care insurers).
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Migrant women are more likely to experience sub-optimal maternity outcomes and are often described in a problematised way. Communication is crucial in maternity and can be compromised if the language of that service is delivered in a language incomprehensible to migrant women. ⋯ Working with migrant women requires a salutary focus. Maternity care professionals involved in the care of this population need to consider individual internal and external resources and avoid treating migrant women as a problematic group. Maternity care provision needs to acknowledge migrant women's strengths, values and expectations and adapt local services. This is done by addressing individual woman's needs through a salutary focus, person-centredness and a system of care that values relationships and social connectedness.
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The developing world has a significantly high risk of women and babies dying during childbirth. Interprofessional simulation training has improved birth practices and outcomes by impacting clinical and non-technical skills like communication, teamwork, leadership and effective use of resources. While these programs have become a training requirement in many high-income countries, they have not been widely introduced in the low-income, low-resource settings. ⋯ Mobile obstetric and neonatal simulation training workshops were useful for medical and midwifery staff, and students in different health settings in India and may have a role as a routine training tool for health professionals involved in childbirth.
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This study examined the predictive validity of the prenatal and postnatal versions of the Postpartum Depression Predictors Inventory-Revised (PDPI-R) in European Portuguese women, considering two gold standards to determine postpartum depression (PPD). ⋯ Despite the low prevalence of PPD (albeit consistent with prior estimates of major depression at three months postpartum), this clinical condition has very serious consequences for the mother, the baby and the whole family when present. The PDPI-R is a valid screening tool to estimate the psychosocial risk for developing PPD among Portuguese women and can be used in research (e.g., for cross-cultural comparisons) and clinical practice. The recommended cut-off scores could assist health professionals (namely, midwives) in identifying the women who would benefit from appropriate referrals and/or closer monitoring to prevent them from developing PPD.
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The purpose of this study was to investigate possible associations between distress in pregnant women and their use of pain management and medical interventions. Furthermore, we assessed the effects of reported dissatisfaction in relationship with their partner, or weak social support. ⋯ Midwives need to acknowledge the possible association of distress and use of an epidural during childbirth and screen for distress early in pregnancy. It is important to offer counselling and help during pregnancy for expectant parents who are distressed or dissatisfied in their relationship.