Physical Activity in Pregnancy: Women's Perceptions, Practices, and Influencing Factors (original) (raw)
Related papers
Midwifery, 2010
Objective: to present critical cues, related factors, knowledge and experience used by midwives when deciding whether or not to suture perineal and associated trauma after childbirth. Design: an exploratory descriptive study using in-depth interviews to collect data using the Critical Decision Method. Setting: birth units in Greater Western Sydney. Participants: 19 volunteer midwives experienced in deciding whether or not to suture or in making referrals to suture childbirth trauma. Findings: the main findings were the cues of bleeding and trauma with their accompanying specific attributes, and woman-and midwife-centred factors considered when deciding whether or not to suture perineal and associated trauma. Furthermore, the knowledge and experience that supported decision-making, such as detailed knowledge of anatomical structures, workshops and observing highly skilled clinicians, were identified. Conclusion: the cues and related factors can be formed into an inventory and tested for content validity using a panel of expert midwives. Implications for practice: such an inventory has the potential to minimise inappropriate intervention and alleviate unnecessary discomfort, thus increasing safety and quality of care for women following childbirth. In addition, midwifery educators and those coaching less-experienced midwives can use the collected clinical information to aid the development of students' and midwives' decision-making skills regarding whether or not to suture childbirth trauma.
Journal of Midwifery & Women's Health, 2009
From recalled childbirth cases, a series of cues and related factors were previously identified that were used by midwives when making decisions to suture or not suture perineal and associated trauma incurred during spontaneous vaginal delivery. This study aimed to determine the validity of these cues and related factors. A panel of 18 experienced midwives evaluated their content validity using the criteria of "necessity" and "sufficiency." The two main cue categories-"bleeding" and "birth trauma"-were considered by 18 (100%) of the panel members to be necessary to assess. At least 16 (89%) panel members considered the following specific cues necessary to assess: in the bleeding category-type, flow, amount, and effect of application of pressure or ice; in the birth trauma category-trauma sites, trauma types, dimensions of trauma, types of tissue, alignment of tissue, edema, and bruising. Seventeen (94%) panel members considered seven woman-centred related factors that were necessary to assess and 14 (78%) considered the combination of all cues in bleeding, birth trauma, and related factors sufficient for making the decision to suture or not. The availability of these validated cues and related factors has the potential to guide a comprehensive assessment on which the decision to suture or not suture depends. This addition to the domain of midwifery knowledge enables educational preparation of midwives who will have the capacity to more adequately support women in childbirth. J Midwifery Womens Health 2009;54:65-72
Midwives’ perspectives on perineal suturing in midwifery practice
2021
Perineal suturing is the repair of perineal trauma which is caused by a tear or an episiotomy. This small-scale quantitative research project aimed to investigate midwives’ perspectives on perineal suturing in midwifery practice. This was achieved through the following objectives: to identify effective ways of teaching and supporting midwives in implementing perineal suturing as a midwifery skill and to identify the barriers and facilitators associated with implementing perineal suturing in local midwifery practice. A total of 40 midwives recruited by convenience sampling, were selected from a labour ward of a local general hospital. A total of 35 questionnaires were returned resulting in an 87.5% response rate. Analysis of closed-ended questions was carried out manually using simple descriptive statistics and analysis of open-ended questions was carried out using content analysis. Results suggested that midwives believe that perineal suturing should be carried out by midwives who s...
Journal of Midwifery & Womens Health, 2005
Genital tract trauma following spontaneous vaginal childbirth is common, and evidence-based prevention measures have not been identified, beyond minimizing the use of episiotomy. This study randomized 1211 healthy women in midwifery care at the University of New Mexico teaching hospital to one of three care measures late in the second stage of labor:1) warm compresses to the perineal area, 2) massage with lubricant, or 3) no touching of the perineum until crowning of the infant's head. The purpose was to assess whether any of these measures was associated with lower levels of obstetric trauma. After each birth, the clinical midwife recorded demographic, clinical care, and outcome data, including the location and extent of any genital tract trauma. The frequency distribution of genital tract trauma was equal in all three groups. Individual women and their clinicians should decide whether to use these techniques based on maternal comfort and other considerations. . precis: Selected midwifery strategies for management of the perineum in childbirth (warm compresses, massage with lubricant, or hands off until crowning) were not associated with more or fewer spontaneous lacerations.
Abdi dosen, 2023
Pregnancy is a process that a woman looks forward to, but during pregnancy, there are various complaints that are felt due to physical and psychological changes and cause discomfort. Changes that occur due to changes in hormones and the psychology of pregnant women Increasing gestational age results in increasingly diverse complaints in pregnant women, especially in the third trimester. The complaints that are often experienced are back pain caused by excessive bending, walking without rest, and lifting weights. Midwives have an important role in improving the health of pregnant and postpartum women to overcome discomfort during pregnancy, childbirth, and the early postpartum period. This community service is carried out so that midwives can reduce discomfort for pregnant women, so they need to receive training in pregnancy and early postpartum exercises to improve their skills. There were 18 participants in the course, all of whom are currently employed as midwives for the Siloam Hospital Group. The course was considered successful after receiving an improving score from all participants.
Getting evidence into obstetric and midwifery practice: reducing perineal trauma
Australian Health Review, 2006
Problem: Frequent obstetric perineal morbidity in a hospital setting with service providers inexperienced in getting evidence into practice. Design: Clinical practice improvement methodology in a tertiary referral obstetric unit. Strategies for change: To cease active instruction to push in the second stage of labour; encourage the adoption of the left lateral position when delivering on a bed; use of the vacuum extractor rather than forceps where instrumental delivery indicated. Effects of change: Improved perineal outcomes with a 21.5% increase in intact perineum rate and a 100% reduction in fourth degree perineal tears. Lessons learned: Clinical practice improvement methodology is a useful tool for getting evidence into practice, resulting in improved clinical outcomes.
Women’s experiences of perceived traumatic vaginal birth in Australian maternity settings
International journal of healthcare, 2019
Objective: Before the beginning of medicalisation in Australia during the 1950s, childbirth was the sole domain of women. Contemporary birthing practices have posed a more medicalised technological environment on women resulting in both good and bad outcomes. In recent surveys, 45.5% of Australian women reported experiencing birth as traumatic; with nearly 20% experiencing postnatal depression. While there have been some studies on women's trauma experiencing a caesarean section, minimal research has been completed into perceived traumatic experiences related to normal vaginal births. Methods: This study utilized a qualitative methodology to explore psychological and emotional impact of women's experiences with perceived traumatic normal births. The research used an in-depth semi-structured interview and analysed the data within the phenomenological paradigm. The data analysis revealed nine themes: I was determined to birth naturally; Not telling me what they were doing; I just had to force her to be born; it was really horrific; I know that is just what the system is like.. . they're hospital midwives.. . they're medical; I didn't feel connected to them; She stood up for me; After the birth, just horrible; I deserve a better birth. Results: Although the rates are unclear, these findings highlight that some women suffer trauma from their experience of a normal vaginal birth. The perceived causes include: midwives not always being with women and supporting physiological childbirth; women not being fully informed; power asymmetries and hegemony inside the birthing room; and a fetocentric model of care that left women feeling disrespected, disempowered and objectified. Conclusions: The findings indicate a need for midwives to truly be with women and provide continuity of care, as well as supporting the physiological process of childbirth, medical and midwifery professional education on trauma awareness following birth, a rethinking of antenatal education programs to include coping strategies and greater midwifery support in the hospital post-natal stay.
BMC Pregnancy and Childbirth, 2014
Background: The occurrence of obstetric anal sphincter injuries (OASIS) has increased in most high-income countries during the past twenty years. The consequences of these injuries can be devastating for women and have an impact on their daily life and quality of health. The aim of this study was to obtain a deeper understanding of midwives' lived experiences of attending a birth in which the woman gets an obstetric anal sphincter injury. Methods: A qualitative study using phenomenological lifeworld research design. The data were collected through in-depth interviews with 13 midwives. Results: The essential meaning of the phenomenon was expressed as a deadlock difficult to resolve between a perceived truth among midwives that a skilled midwife can prevent severe perineal trauma and at the same time a coexisting more complex belief. The more complex belief is that sphincter injuries cannot always be avoided. The midwives tried to cope with their feelings of guilt and wanted to find reasons why the injury occurred. A fear of being exposed and judged by others as severely as they judged themselves hindered the midwives from sharing their experience. Ultimately the midwives accepted that the injury had occurred and moved on without any definite answers. Conclusions: Being caught between an accepted truth and a more complex belief evoked various emotions among the midwives. Feelings of guilt, shame and the midwife's own suspicion that she is not being professionally competent were not always easy to share. This study shows the importance of creating a safe working environment in which midwives can reflect on and share their experiences to continue to develop professionally. Further research is needed to implement and evaluate the effect of reflective practices in relation to midwifery care and whether this could benefit women in childbirth.
Perineal management: Midwives’ confidence and educational needs
Midwifery, 2020
Objective: The overall aim of this study was to collate information to inform the updating of a perineal management educational programme for midwives. This paper explores midwives' confidence and educational needs in managing the woman's perineum during the second stage of labour, focusing on future quality initiatives to improve midwives' experiences and expertise in the prevention of perineal trauma during birth. Design: A mixed-methods sequential exploratory design was used. Participants and Setting: Midwives and clinical midwife managers assisting with births in the labour ward of a large urban university stand-alone maternity hospital in the Republic of Ireland with approximately 9,0 0 0 births per year participated in the study. Measurements: A questionnaire and two focus groups were used to collect the data. Findings: Fifty-two midwives from a total of 64 eligible labour ward midwives completed the questionnaire, a response rate of 81.2%. Midwives indicated that perineal management workshops did not cover prevention of perineal trauma, and mainly focused on suturing and repair of the perineum. The majority of midwives (85%) indicated that they would like further education on the prevention of perineal trauma. Higher levels of confidence in making a decision to perform an episiotomy, infiltrating the perineum and at performing an episiotomy were reported in experienced midwives. Midwives want improved and additional education in the management of women's perinea during the second stage of labour and made various recommendations regarding the content, format, timing and frequency of the workshop. Suggestions for further education included techniques for preventing perineal trauma during labour and birth and how to perform an episiotomy.