Abstract:
INTRODUCTION:Continuity of care models are known to improve clinical outcomes for women and their babies, but it is not understood how. A realist synthesis of how women with social risk factors experience UK maternity care reported mechanisms thought to improve clinical outcomes and experiences. As part of a broader programme of work to test those theories and fill gaps in the literature base we conducted focus groups with midwives working within continuity of care models of care for women with social factors that put them at a higher chance of having poor birth outcomes. These risk factors can include poverty and social isolation, asylum or refugee status, domestic abuse, mental illness, learning difficulties, and substance abuse problems. OBJECTIVE:To explore the insights of midwives working in continuity models of care for women with social risk factors in order to understand the resources they provide, and how the model of care can improve women's outcomes. DESIGN:Realist methodology was used to gain a deeper understanding of how women react to specific resources that the models of care offer and how these resources are thought to lead to particular outcomes for women. Twelve midwives participated, six from a continuity of care model implemented in a community setting serving an area of deprivation in London, and six from a continuity of care model for women with social risk factors, based within a large teaching hospital in London. FINDINGS:Three main themes were identified: 'Perceptions of the model of care, 'Tailoring the service to meet women's needs', 'Going above and beyond'. Each theme is broken down into three subthemes to reveal specific resources or mechanisms which midwives felt might have an impact on women's outcomes, and how women with different social risk factors respond to these mechanisms. CONCLUSIONS/IMPLICATIONS FOR PRACTICE:Overall the midwives in both models of care felt the service was beneficial to women and had a positive impact on their outcomes. It was thought the trusting relationships they had built with women enabled midwives to guide women through a fragmented, unfamiliar system and respond to their individual physical, emotional, and social needs, whilst ensuring follow-up of appointments and test results. Midwives felt that for these women the impact of a trusting relationship affected how much information women disclosed, allowing for enhanced, needs led, holistic care. Interesting mechanisms were identified when discussing women who had social care involvement with midwives revealing techniques they used to advocate for women and help them to regain trust in the system and demonstrate their parenting abilities. Differences in how each team provided care and its impact on women's outcomes were considered with the midwives in the community-based model reporting how their location enabled them to help women integrate into their local community and make use of specialist services. The study demonstrates the complexity of these models of care, with midwives using innovative and compassionate ways of working to meet the multifaceted needs of this population.
journal_name
Midwiferyjournal_title
Midwiferyauthors
Rayment-Jones H,Silverio SA,Harris J,Harden A,Sandall Jdoi
10.1016/j.midw.2020.102654subject
Has Abstractpub_date
2020-05-01 00:00:00pages
102654eissn
0266-6138issn
1532-3099pii
S0266-6138(20)30027-9journal_volume
84pub_type
杂志文章相关文献
MIDWIFERY文献大全abstract:BACKGROUND:caseload midwifery and CenteringPregnancy™ (a form of group antenatal care) are two models of maternity care that are separately associated with better clinical outcomes, maternal satisfaction scores and positive experiences compared to standard care. One study reported exclusively on younger women׳s experie...
journal_title:Midwifery
pub_type: 杂志文章
doi:10.1016/j.midw.2015.01.009
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVES:To evaluate maternal labour pain, fatigue, duration of the second stage of labour, the women's bearing-down experiences and the newborn infant Apgar scores when spontaneous pushing is used in an upright position. DESIGN:Quasi-experimental study. SETTING:Medical centre in Taichung, Taiwan. PARTICIPANTS:66 ...
journal_title:Midwifery
pub_type: 杂志文章
doi:10.1016/j.midw.2010.08.009
更新日期:2011-12-01 00:00:00
abstract:OBJECTIVES:to establish levels of knowledge about pelvic floor exercises during pregnancy; reported practice of pelvic floor exercises in pregnancy; and prevalence of stress urinary incontinence in a sample of women in the third trimester of pregnancy. DESIGN:structured cross-sectional interview survey. PARTICIPANTS:...
journal_title:Midwifery
pub_type: 杂志文章
doi:10.1016/j.midw.2006.06.006
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVE:to examine the circumstances, experiences and needs of a local sample of low-income, childbearing women of Bangladeshi origin in the UK. DESIGN:qualitative interviews using a semi-structured questionnaire to obtain the interviewees' own accounts of the period around the birth of a baby. SETTING:a deprived a...
journal_title:Midwifery
pub_type: 杂志文章
doi:10.1016/j.midw.2004.09.003
更新日期:2005-03-01 00:00:00
abstract:OBJECTIVE:To examine breastfeeding experiences up to 6 weeks postpartum for mothers administered intranasal fentanyl, subcutaneous fentanyl or intramuscular pethidine for intrapartum analgesia. DESIGN:A secondary analysis was undertaken using the per-protocol dataset to examine the third phase of a larger randomised c...
journal_title:Midwifery
pub_type: 杂志文章
doi:10.1016/j.midw.2017.03.024
更新日期:2017-07-01 00:00:00
abstract:OBJECTIVES:psychosocial variables can be protective or risk factors for excessive gestational weight gain (GWG). Parity has also been associated with GWG; however, its effect on psychosocial risk factors for GWG is yet to be determined. The aim of this study was to investigate if, and how, psychosocial factors vary in ...
journal_title:Midwifery
pub_type: 杂志文章
doi:10.1016/j.midw.2015.09.009
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVE:to determine knowledge, attitudes and practices relating to emergency contraception among health-care providers (general practitioners, nurses and midwives). DESIGN:a cross-sectional design using face-to-face interview methods plus questionnaire in the work setting. Researchers were able to maintain privacy ...
journal_title:Midwifery
pub_type: 杂志文章
doi:10.1016/j.midw.2005.03.004
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:women who give birth in supine position are more likely to have an episiotomy than women who give birth in sitting position. A confounding effect may be that women in upright positions in second stage of labour are asked to lie down if a professional needs to perform an episiotomy. This prospective cohort st...
journal_title:Midwifery
pub_type: 杂志文章
doi:10.1016/j.midw.2016.01.010
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVE:to determine the adequacy of gestational weight gain for a cohort of Indigenous Australian women and investigate whether it is associated with pre-pregnancy body mass index. DESIGN:analysis of observational data collected from a longitudinal cohort study that follows Indigenous Australian women through pregn...
journal_title:Midwifery
pub_type: 已发布勘误
doi:10.1016/j.midw.2018.11.004
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVE:to elucidate women's experiences of prolonged labour. DESIGN:qualitative research interviews were conducted and thematic content analysis was applied. PARTICIPANTS:10 primiparae who, 1-3 months previously, had a prolonged labour with assisted vaginal or caesarean delivery. FINDINGS:the narratives about giv...
journal_title:Midwifery
pub_type: 杂志文章
doi:10.1016/j.midw.2005.05.003
更新日期:2006-03-01 00:00:00
abstract:OBJECTIVE:the aim of this research is to review the content, and describe the structural and contextual discourse around planned birthplace in six clinical practice manuals used to care for pregnant Aboriginal women in Australia׳s remote Northern Territory. The purpose is to better understand where, how and why planned...
journal_title:Midwifery
pub_type: 杂志文章
doi:10.1016/j.midw.2015.06.005
更新日期:2015-10-01 00:00:00
abstract::In a predictive study of early postpartum discharge data were collected to justify a proposal that was being developed by a city hospital and the Local Board of Health to provide maternity care for women who wished to be discharged early from hospital following childbirth. In this paper the findings of the predictive ...
journal_title:Midwifery
pub_type: 杂志文章
doi:10.1016/s0266-6138(05)80081-6
更新日期:1992-09-01 00:00:00
abstract:OBJECTIVE:to determine what impact the changes from consultant-led care to midwife-led care in a local maternity service have had on women using that service. DESIGN:case study, data were collected by postal questionnaire, semi-structured, tape-recorded interviews, observations and scrutiny of records. SETTING:a smal...
journal_title:Midwifery
pub_type: 杂志文章
doi:10.1016/s0266-6138(03)00018-4
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:birth plans detailing a woman׳s preferences for intrapartum care are a common feature in British maternity units, and are a means of encouraging the implementation of choice. Proforma versions may be incorporated routinely in antenatal case notes, or the woman may devise her own unique birth plan. Although w...
journal_title:Midwifery
pub_type: 杂志文章
doi:10.1016/j.midw.2014.03.004
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:the aim of this study was to gain an understanding of how midwifery students respond to a range of ethical dilemmas which they may encounter in clinical practice in relation to the use of reproductive technologies. DESIGN:during a series of focus groups, student midwives were asked to consider four novel sce...
journal_title:Midwifery
pub_type: 杂志文章
doi:10.1016/j.midw.2012.10.005
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVE:to explore midwives' reasons for performing or avoiding episiotomies and motivation to change episiotomy practice in a large tertiary maternity hospital. DESIGN:using purposive sampling, three focus groups were conducted to achieve theme saturation. Open-ended questions elicited personal reasons for performi...
journal_title:Midwifery
pub_type: 杂志文章
doi:10.1016/j.midw.2012.11.017
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVE:to explores preferences, characteristics and motives regarding place of birth of low-risk nulliparous women in the Netherlands. DESIGN:a prospective cohort study of low-risk nulliparous women and their partners starting their pregnancy in midwifery-led care or in obstetric-led care. Data were collected using...
journal_title:Midwifery
pub_type: 杂志文章
doi:10.1016/j.midw.2012.07.010
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:joint planning and decision-making within couples have evident effects on the well-being of the family. The purpose of this study was to investigate the level of pregnancy planning among pregnant women and their partners and to compare the coherence of pregnancy planning within the couples. METHODS:pregnant...
journal_title:Midwifery
pub_type: 杂志文章
doi:10.1016/j.midw.2015.06.009
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVE:A considerable proportion of pregnant women with a fetus in breech position refuses external cephalic version (ECV), with fear of pain as important barrier. As a consequence, they are at high risk for caesarean section at term. The current study investigated determinants of pain perception during ECV, with sp...
journal_title:Midwifery
pub_type: 杂志文章
doi:10.1016/j.midw.2013.11.005
更新日期:2014-03-01 00:00:00
abstract:OBJECTIVE:Develop and test a tool designed for use by pre-registration midwifery students to self-appraise their critical thinking in practice. DESIGN:A descriptive cohort design was used. PARTICIPANTS:All students (n=164) enrolled in a three-year Bachelor of Midwifery program in Queensland, Australia. METHODS:The s...
journal_title:Midwifery
pub_type: 杂志文章
doi:10.1016/j.midw.2017.04.010
更新日期:2017-07-01 00:00:00
abstract:OBJECTIVE:Our objective was to explore the socio-cultural factors that influence women's early and adequate utilisation of antenatal care (ANC) in rural Bangladesh. METHODS:A qualitative study was conducted in two rural settings of Bangladesh, including 32 in-depth interviews with pregnant or recently delivered women,...
journal_title:Midwifery
pub_type: 杂志文章
doi:10.1016/j.midw.2020.102881
更新日期:2021-02-01 00:00:00
abstract:OBJECTIVE:To evaluate a prenatal breast-feeding class developed and facilitated by peer Breast-feeding Buddies. DESIGN AND INTERVENTIONS:Non-equivalent control group quasi-experimental study comparing participants of the peer-led class (PLC) to those attending an established hospital-based breast-feeding nurse-led cla...
journal_title:Midwifery
pub_type: 杂志文章
doi:10.1016/j.midw.2010.11.005
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:to evaluate the effectiveness of continuing training for traditional birth attendants (TBAs) on their reproductive knowledge and performance. SETTING:Mzuzu Central Hospital in the northern region of Malawi. PARTICIPANTS AND ANALYSIS: a total of 81 TBAs trained during 2004 and 2006 in Mzuzu, Malawi received c...
journal_title:Midwifery
pub_type: 杂志文章
doi:10.1016/j.midw.2009.12.008
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVE:to describe women's experiences of an abortion in the second trimester. DESIGN:qualitative design using semi-structured interviews. SETTING/PARTICIPANTS:six women were interviewed after a second trimester abortion. METHODS:the women were interviewed in person after they were discharged from the hospital. I...
journal_title:Midwifery
pub_type: 杂志文章
doi:10.1016/j.midw.2011.07.011
更新日期:2012-10-01 00:00:00
abstract::The randomised controlled trial is currently the 'gold standard' that guides health-care practices. The implementation of new models of midwifery care often relies on results from randomised controlled trials. However, many randomised controlled trials exclude women who do not speak English or are designed in such a w...
journal_title:Midwifery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1054/midw.2000.0230
更新日期:2000-12-01 00:00:00
abstract:AIM:this study aimed to gain understanding of the views of community members in relation to obstetric fistula. DESIGN AND METHOD:a qualitative, grounded theory approach was adopted. Data were collected using in-depth interviews with 45 community members. The constant comparison method enabled generation of codes and s...
journal_title:Midwifery
pub_type: 杂志文章
doi:10.1016/j.midw.2016.10.001
更新日期:2016-11-01 00:00:00
abstract:OBJECTIVE:to evaluate a pilot project, which used a community participatory approach to introduce birth preparedness in rural Cambodia. DESIGN:a feasibility and outcome evaluation. This included observation, interview, document analysis and costing. SETTING:the project was undertaken in 15 villages linked to five hea...
journal_title:Midwifery
pub_type: 杂志文章
doi:10.1016/j.midw.2008.01.006
更新日期:2009-12-01 00:00:00
abstract::Statistics available in the UK and in North America indicate that violence towards women by their partner is widespread but under-reported. Research shows that violence is likely to begin or escalate during pregnancy. It is suggested that violence to pregnant women may be more common than gestational diabetes or place...
journal_title:Midwifery
pub_type: 杂志文章
doi:10.1016/s0266-6138(05)80040-3
更新日期:1991-09-01 00:00:00
abstract:OBJECTIVE:Assess the role of online resources and apps for women's help seeking and staff's response to concerns in the perinatal period. DESIGN:Online survey. Descriptive analysis of women's use and experiences of digital resources for self-diagnosis and help seeking, drawing on numerical and free-text responses. SE...
journal_title:Midwifery
pub_type: 杂志文章
doi:10.1016/j.midw.2020.102803
更新日期:2020-11-01 00:00:00
abstract:AIM:The aim of this exploratory qualitative analysis is to assess the perceptions of risks of cigarette and e-cigarette use during pregnancy. BACKGROUND:An important public health aim is a reduction of smoking at time of delivery (SATOD) from 10.6% to less than 6% by 2022 in the United Kingdom (UK). In order to succes...
journal_title:Midwifery
pub_type: 杂志文章
doi:10.1016/j.midw.2020.102917
更新日期:2020-12-26 00:00:00