Journal of midwifery & women's health
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J Midwifery Womens Health · Sep 2009
Decision making in patient-initiated elective cesarean delivery: the influence of birth stories.
Patient-initiated elective cesarean delivery is emerging as an urgent issue for practitioners, hospitals, and policy makers and for pregnant women. This exploratory qualitative study looks at the birth stories and cultural knowledge that women use to inform the decision about an elective cesarean without medical indication. Data collection consisted of exploratory qualitative in-depth interviews with 17 primiparous women in British Columbia, Canada. ⋯ Results indicate that women who participated in this study drew heavily from social and cultural knowledge in forming their decision to give birth by patient-initiated elective cesarean delivery. Although the numbers of women who request a cesarean delivery for social reasons is still small, the persuasive influence on parturient women of positive cesarean stories and negative vaginal stories must be considered. Care providers and childbirth educators need to become familiar with the social influences impacting women's decisions for mode of delivery so that truly informed choice discussions can be undertaken.
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J Midwifery Womens Health · Jul 2009
Obstetric triage: models and trends in resident education by midwives.
Four models of resident education in obstetric triage with midwifery faculty consultants are presented. Common trends in the structure and function of these models are reviewed. ⋯ This expanded midwifery teaching role extends beyond labor assessment to include a wide range of common obstetric and gynecologic conditions in the triage setting. Additional advantages include the ability of the midwife to bill for triage services and to provide a safety net to decrease medical errors which, in a busy triage unit, occur most often during patient transfers.
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J Midwifery Womens Health · Jul 2009
Innovative midwifery teaching for medical students and residents.
Many midwives are full-time faculty members of departments of obstetrics and gynecology in academic medical centers. As such, they contribute to the medical school's educational mission by teaching undergraduate and postgraduate medical students in both the clinical area and in didactic lectures. Midwives are also instrumental in the development of many innovative electives, workshops, and lectures, which provide students and residents with more exposure to the midwifery model of care. This article presents some of these innovations.
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Sleep disturbance during pregnancy can result in excessive daytime sleepiness, diminished daytime performance, inability to concentrate, irritability, and the potential for an increased length of labor and increased risk of operative birth. Sleep disturbance may be the result of a sleep disorder, such as leg cramps, a common yet benign disorder, or restless legs syndrome, a sensorimotor disorder. Both disrupt sleep, are distressing to the pregnant woman, and mimic one another and other serious disorders. During pregnancy, up to 30% of women can be affected by leg cramps, and up to 26% can be affected by restless legs syndrome.