Abstract:
BACKGROUND:In the United Kingdom, midwives will engage in discussions with the multidisciplinary team as to whether they can provide Obstetric High Dependency Care (OHDC) on the Delivery Suite or whether a woman's care should be escalated to the critical care team. This study aimed to explore the question: What factors influence midwives to provide OHDC or request care be escalated away from the obstetric unit in hospitals remote from tertiary referral centres? METHODS:Focus groups were undertaken with midwives (n = 34) across three obstetric units in England, with annual birth rates ranging from 1500 to 5000 per annum, in District General Hospitals. Three scenarios in the form of video vignettes of handover were used as triggers for the focus groups. Scenario 1; severe pre-eclampsia, physiologically unstable 2; major postpartum haemorrhage requiring invasive monitoring 3; recent admission of woman with chest pain receiving facial oxygen and requiring continuous electrocardiogram (ECG) monitoring. Two focus groups were conducted in each of the obstetric units with experienced midwives. Data were analysed using a qualitative framework approach. RESULTS:Factors influencing midwives' care escalation decisions included the care environment, a woman's diagnosis and fetal or neonatal factors. The overall plan of care including the need for ECG and invasive monitoring were also influential factors. Midwives in the smallest obstetric unit did not have access to the facilities for OHDC provision. Midwives in the larger obstetric units provided OHDC but identified varying degrees of skill and sometimes used 'workarounds' to facilitate care provision. Midwifery staffing levels, skill mix and workload were also influential. Some differences of opinion were evident between midwives working in the same obstetric units as to whether OHDC could be provided and the support they would enlist to help them provide it. Reliance on clinical guidelines appeared variable. CONCLUSIONS:Findings indicate that there may be inequitable OHDC provision at a local level. Organisationally robust systems are required to promote safe, equitable OHDC care including skills development for midwives and precise escalation guidelines to minimise workarounds. Training for midwives must include strategies that prevent skills fade.
journal_name
BMC Pregnancy Childbirthjournal_title
BMC pregnancy and childbirthauthors
James A,Cooper S,Stenhouse E,Endacott Rdoi
10.1186/s12884-019-2487-0subject
Has Abstractpub_date
2019-09-09 00:00:00pages
331issue
1issn
1471-2393pii
10.1186/s12884-019-2487-0journal_volume
19pub_type
杂志文章abstract:BACKGROUND:Antenatal corticosteroids have been proven to prevent adverse outcomes including respiratory morbidities in preterm neonates before 34 weeks of gestation. Recently, it has been suggested that antenatal corticosteroids may also be effective in singleton late preterm pregnancies, and guidelines recommend the u...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,多中心研究
doi:10.1186/s12884-019-2235-5
更新日期:2019-04-03 00:00:00
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journal_title:BMC pregnancy and childbirth
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-018-2153-y
更新日期:2019-01-10 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-020-02919-7
更新日期:2020-05-29 00:00:00
abstract:BACKGROUND:Annually, around 7.9 million children are born with birth defects and the contribution of congenital malformations to neonatal mortality is generally high. Congenital malformations in children born to mothers with hypertensive disorders during pregnancy has marginally been explored. METHODS:Country incidenc...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-016-0987-8
更新日期:2016-07-29 00:00:00
abstract:BACKGROUND:Because of the particularly severe perinatal outcomes associated with antenatal Zika virus infection, it is important for prenatal care providers to communicate Zika virus risks and strategies for prevention to their patients. Although face-to-face communication is ideal, clinic visits may not allow for in-d...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-017-1516-0
更新日期:2017-09-26 00:00:00
abstract:BACKGROUND:Information is still scarce on the birthing experience of women who participate in antenatal systematic education programs. The objective of the study was to report the experience of labor as described by nulliparous women who participated and who did not in a systematic Birth Preparation Program (BPP). MET...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2393-13-171
更新日期:2013-09-05 00:00:00
abstract:BACKGROUND:Little is known about the status of maternal, obstetric, and neonatal complications and the potential predictors of developing heart failure (HF) in mothers with underlying heart disease (HD) in Southwestern China. METHODS:The eligible records from the YiduCloud database from December 1, 2010 to December 31...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-020-03058-9
更新日期:2020-06-23 00:00:00
abstract:BACKGROUND:British women are increasingly delaying childbirth. The proportion giving birth over the age of 35 rose from 12% in 1996 to 20% in 2006. Women over this age are at a higher risk of perinatal death, and antepartum stillbirth accounts for 61% of all such deaths. Women over 40 years old have a similar stillbirt...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/1471-2393-12-145
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-016-0922-z
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Adequate antenatal care is important to both the health of a pregnant woman and her unborn baby. Given South Africa's high rate of cellphone penetration, mobile health interventions have been touted as a potentially powerful means to disseminate health information. This study aimed to increase antenatal heal...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/1471-2393-14-284
更新日期:2014-08-21 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-016-1058-x
更新日期:2016-09-27 00:00:00
abstract:BACKGROUND:Maternal and newborn mortality rates remain unacceptably high, especially where the majority of births occur in home settings or in facilities with inadequate resources. The introduction of emergency obstetric and newborn care services has been proposed by several organizations in order to improve pregnancy ...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/1471-2393-10-82
更新日期:2010-12-14 00:00:00
abstract:BACKGROUND:Prenatal balanced protein energy supplementation consumed by undernourished women improves mid-upper arm circumference in early infancy. This study aimed to identify whether locally produced maternal food-based supplementation improved anthropometric measures at birth and early infancy. METHODS:A village-ma...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-018-1915-x
更新日期:2018-07-04 00:00:00
abstract:BACKGROUND:Most low-risk pregnant women receive the standard model of prenatal care with frequent office visits. Research suggests that a reduced schedule of visits among low-risk women could be implemented without increasing adverse maternal or fetal outcomes, but patient satisfaction with these models varies. We aim ...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12884-015-0762-2
更新日期:2015-12-02 00:00:00
abstract:BACKGROUND:Despite marked improvements over the last few decades, maternal mortality in Tanzania remains among the world's highest at 454 maternal deaths per 100,000 live births. Many factors contribute to this disparity, such as a lack of attendance at antenatal care (ANC) services and low rates of delivery at a healt...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-017-1470-x
更新日期:2017-09-15 00:00:00
abstract:BACKGROUND:Use of skilled health provider (SBA) during and after childbirth has been reported to reduce maternal and newborn deaths; and is one of the key indicators monitored in Sustainable Development Goals (SDGs). Progress, levels and factors influencing utilization of SBA differ within and between countries. In Tan...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-020-03110-8
更新日期:2020-07-25 00:00:00
abstract:BACKGROUND:Low n-3 polyunsaturated fatty acids (PUFAs) has been linked to depression, but the preventive effect of n-3PUFAs supplementation on maternal depression needs further investigation. We aimed to evaluate the efficacy of a daily dose of n-3 PUFAs supplementation (fish oil) on the prevention of postpartum depres...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12884-017-1365-x
更新日期:2017-06-09 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-015-0789-4
更新日期:2016-03-02 00:00:00
abstract:BACKGROUND:The stillbirth rate is an indicator of quality of care during pregnancy and delivery. Good quality care is supported by a functional heath system. The objective of this study was to explore the risk factors for stillbirths, particularly those related to a health system. METHODS:This case-control study was c...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-018-1660-1
更新日期:2018-01-18 00:00:00
abstract:BACKGROUND:Research on outcomes of out-of-hospital breech birth is scarce. This study evaluates the outcomes of singleton term breech and cephalic births in a home or birth center setting. METHODS:This is a retrospective observational cohort study of 60 breech and 109 cephalic planned out-of-hospital term singleton bi...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-018-2033-5
更新日期:2018-10-11 00:00:00
abstract:BACKGROUND:Adverse pregnancy outcomes remain a prevalent health problem in Ethiopia. Mothers' use of preconception care service has the potential to avert many of the adverse outcomes. However, the use of this service and its determinants is not well investigated. Therefore, this study was conducted to assess the utili...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-019-2478-1
更新日期:2019-10-11 00:00:00
abstract:BACKGROUND:Centile charts of birthweight for gestational age are used to identify low birthweight babies. The charts currently used in Scotland are based on data from the 1970s and require updating given changes in birthweight and in the measurement of gestational age since then. METHODS:Routinely collected data of 10...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/1471-2393-8-5
更新日期:2008-02-25 00:00:00
abstract:BACKGROUND:The objective of this study was to identify high-yield screening risk factors for detecting maternal non-medical drug use during pregnancy. METHODS:A four year retrospective analysis was conducted at an academic medical center. Detailed chart review of both the newborn and mother's medical record was perfor...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/1471-2393-14-250
更新日期:2014-07-29 00:00:00
abstract:BACKGROUND:Vaginal seeding is the administration of maternal vaginal bacteria to babies following birth by caesarean section (CS), intended to mimic the microbial exposure that occurs during vaginal birth. Appropriate development of the infant gut microbiome assists early immune development and might help reduce the ri...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-020-03500-y
更新日期:2021-01-12 00:00:00
abstract:BACKGROUND:To date, the rates of potentially life-threatening condition (PTLC), maternal near miss (MNM) and maternal deaths in pregnant patients with type 1 diabetes mellitus (T1DM) and variables associated to it have not been studied. METHODS:This study was as a cross-sectional retrospective study conducted at São P...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-020-03392-y
更新日期:2020-11-10 00:00:00
abstract:BACKGROUND:Anaemia is a public health problem affecting over 1.62 billion people globally. It affects all age groups of people and is particularly more prevalent in pregnant women. Africa carries a high burden of anaemia; in Uganda 24 % of women of child bearing age have anaemia. Pregnant women living in poverty are at...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-016-0865-4
更新日期:2016-04-11 00:00:00
abstract:BACKGROUND:Childbirth confidence is an important marker of women's coping abilities during labour and birth. This study investigated socio-demographic, obstetric and psychological factors affecting self-efficacy in childbearing women. METHOD:This paper presents a secondary analysis of data collected as part of the BEL...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-015-0465-8
更新日期:2015-02-13 00:00:00
abstract:BACKGROUND:Maternal retention in HIV care is lower for women in the postpartum period than during pregnancy, but the reasons are poorly understood. We examined key differences in barriers to retention in HIV care during and after pregnancy. METHODS:We conducted semi-structured, in-depth interviews with 30 postpartum w...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-020-03067-8
更新日期:2020-07-17 00:00:00
abstract:BACKGROUND:Research shows evidence for the importance of physical and emotional closeness for the infant, the parent and the infant-parent dyad. Less is known about how, when and why parents experience emotional closeness to their infants in a neonatal unit (NU), which was the aim of this study. METHODS:A qualitative ...
journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/s12884-016-0955-3
更新日期:2016-07-19 00:00:00