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Midwifery Care: Improvement of Maternal and Newborn Health

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A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Women's Health Care".

Deadline for manuscript submissions: closed (30 June 2024) | Viewed by 13053

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Special Issue Editors

Dr. Maria Dagla

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Guest Editor

Department of Midwifery, School of Health & Care Sciences, University of West Attica, 122 43 Egaleo, Greece
Interests: postpartum midwifery care; neonatal care; breastfeeding; bioethics; parents’ support in NICUs; parent-infant bonding; perinatal mental health; antenatal classes; fathers’ role in perinatal period

Dr. Ewa Andersson

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Co-Guest Editor

Department of Women's and Children's Health, Karolinska Institutet, 17177 Stockholm, Sweden
Interests: midwifery; midwifery education; community health; prenatal care; mental health; fathers' support

Dr. Maria Iliadou

E-Mail Website
Co-Guest Editor

Department of Midwifery, School of Health & Care Sciences, University of West Attica, 122 43 Egaleo, Greece
Interests: breastfeeding; antenatal education; neonatal care; midwifery care; perinatal mental health

Special Issue Information

Dear Colleagues,

Midwifery care has an essential contribution to high-quality maternal and newborn services. To ensure high-quality and safe care of reproduction and early life, especially for expectant and new parents during the perinatal period, midwives engage in a variety of healthcare interventions every day taking decisions based on their knowledge, clinical expertise, and professional judgment. According to research, midwife-led care models promote maternal and newborn infant health and are linked to advantages such as a rise in spontaneous vaginal deliveries, a decrease in the need for instrumental births, a rise in breastfeeding rates, etc.

In order to further develop new midwifery care approaches in clinical settings and communities, directed by research outcomes, and reinforce the midwifery care quality worldwide, this Special Issue of Healthcare aims to emphasize the a) assessment of existing midwifery-led models and compare them with new ones, b) measurement of the effectiveness of midwifery-interventions for timely prevention or management of complications in reproductive period, c) assessment of women and partners’ needs, experiences and satisfaction from midwifery practice, d) research of best midwifery practices that enhance the understanding of the interaction between mother’s psychosocial/physical health and newborn/infant’s health, e) highlight of recent advances and challenges in the provision of midwifery care.

We look forward to receiving your contributions on the above topics.

Dr. Maria Dagla
Dr. Ewa Andersson
Dr. Maria Iliadou
Guest Editors

Manuscript Submission Information

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Keywords

midwifery care
midwifery education
childbirth experience
antenatal care
postpartum/postnatal care
breastfeeding
perinatal mental health
mother-infant bonding/attachment
preterm birth/preterm infant
motherhood/parenthood
bioethics

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Published Papers (10 papers)

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11 pages, 426 KiB

Open AccessArticle

The Effect of Room Arrangement on the Mood and Milk Volume of Mothers Who Had Cesarean Delivery and Were Not with Their Infants

by Nilüfer Ataç, Emine Serap Çağan and Rabia Genç

Healthcare 2024, 12(17), 1693; https://doi.org/10.3390/healthcare12171693 - 25 Aug 2024

Viewed by 634

Abstract

This study aimed to compare the effect of room arrangement on the mood and milk volume of mothers who gave birth by cesarean section and whose babies were not with them. The study included 89 mothers with and without infants living in the same room (Group 1) and 94 mothers without and without infants living in the same room (Group 2) (n = 183). The expression of milk was performed twice (0–6 h after birth and 36–48 h before discharge) using an electric breast pump. Expression lasted 15 min for each breast separately. The mean first milk volume of the mothers (Group 1: 5.56 ± 5.03 cc, Group 2: 3.76 ± 3.73 cc) and the mean last milk volume (Group 1: 18.78 ± 15.43 cc, Group 2: 10.64 ± 14.12 cc) were determined, and a significant difference was found between the groups. The mean milk volume of Group 1 was found to be significantly higher than Group 2 (Group 1: 13.21 cc ± 14.62 cc, Group 2: 6.88 cc ± 13.56 cc) (p < 0.05). A statistically significant difference was found between the two groups in terms of positive and negative mood (p = 0.003). In conclusion, it was determined that the milking behavior of mothers was negatively affected due to the lack of stimulation in the room where there was no baby, and this situation negatively affected the start time of the first milking and the average milk volume. Full article

(This article belongs to the Special Issue Midwifery Care: Improvement of Maternal and Newborn Health)

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12 pages, 1844 KiB

Open AccessArticle

Comfortable Seatbelts for Pregnant Women with Twins in Japan: A Cross-Sectional Observational Study on Seatbelt Usage

by Sachi Tsuchikawa, Yui Miyajima, Yumiko Tateoka and Masahito Hitosugi

Healthcare 2024, 12(16), 1590; https://doi.org/10.3390/healthcare12161590 - 9 Aug 2024

Viewed by 795

Abstract

Optimal seatbelt practices for pregnant women with twins at different gestational ages remain uncertain. To offer recommendations for a comfortable seatbelt system, this cross-sectional observational study explored seatbelt usage and driving habits among women with twins across various pregnancy stages through an online survey that explored driving conditions and comfortable seatbelts at different stages of pregnancy. Women who drove daily before their pregnancy with twins decreased their driving frequency as the pregnancy progressed. Correct seatbelt usage was lower and no seatbelt usage was higher among pregnant women with twins than those with singleton pregnancies. They adapted their seatbelt-wearing techniques to minimise pressure on the chest in the first and third trimesters and the abdomen from the second trimester onwards. The comfortable seatbelts were those that could alleviate belt pressure, featuring waist belts to reduce pressure, wider belts to avoid localised pressure, and shoulder belts resembling a backpack type. When wearing a seatbelt, avoiding pressure on the thorax and abdomen is key for pregnant women with twins. This study suggests that the suitability of driving for pregnant women with twins in their last trimester and the reliability of seatbelts designed for such women should be further examined and validated. Full article

(This article belongs to the Special Issue Midwifery Care: Improvement of Maternal and Newborn Health)

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12 pages, 265 KiB

Open AccessArticle

The Associations of Perceived Self-Efficacy with Emotional Intelligence, Personality, Resilience, and Attitudes Towards Death among Midwives

by Evangelos Tzamakos, Dimitra Metallinou, Maria Tigka, Aikaterini Lykeridou, Antigoni Sarantaki and Christina Nanou

Healthcare 2024, 12(11), 1129; https://doi.org/10.3390/healthcare12111129 - 31 May 2024

Cited by 1 | Viewed by 661

Abstract

Midwives’ self-efficacy can significantly affect the provided care and, therefore, maternal and neonatal outcomes. The aim of the present study was to investigate associations of perceived self-efficacy with emotional intelligence, personality, resilience, and attitudes towards death among midwives in Greece. From 2020 to 2022, a total of 348 midwives were recruited in this descriptive cross-sectional study. The participants were employed as independent professionals, in public hospitals or regional health authorities. Data collection involved five research instruments: the General Self-Efficacy Scale (GSES), the Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF), the Eysenck Personality Questionnaire (EPQ), the Connor-Davidson Resilience scale (CD-RISC), and the Death Attitude Profile-Revised (DAP-R) scale. The mean score for the GSES was 29.1 (SD = 4.2), suggesting a moderately elevated level of self-efficacy among midwives. The results revealed that higher scores on the GSES were significantly associated with higher scores on the Extraversion subscale (p < 0.001) and lower scores on the Neuroticism (p < 0.001) and Lie (p = 0.002) subscales of the EPQ. Additionally, high self-efficacy was significantly correlated with high emotional intelligence (p < 0.001), high neutral acceptance of death (p = 0.009), and high resilience (p < 0.001). These findings highlight the relationship between the self-efficacy of Greek midwives and various psychological factors, as well as the multifaceted nature of self-efficacy and its importance for midwives’ psychological well-being and professional functioning. Full article

(This article belongs to the Special Issue Midwifery Care: Improvement of Maternal and Newborn Health)

18 pages, 907 KiB

Open AccessArticle

Healthcare Professionals’ Beliefs and Views towards Exercise during Pregnancy: A Cross-Sectional Study in Greece

by Vasileios Daglas, Nikolaos Kostopoulos, Irina Mrvoljak-Theodoropoulou, Aikaterini Lykeridou and Evangelia Antoniou

Healthcare 2024, 12(11), 1089; https://doi.org/10.3390/healthcare12111089 - 25 May 2024

Viewed by 796

Abstract

Background: Healthcare professionals appear to play a key role in shaping pregnant women’s views and attitudes towards lifestyle issues, such as exercise. The aim of this study is to investigate the views and beliefs of Greek midwives and obstetricians regarding exercise during pregnancy. Methods: This is a cross-sectional study conducted during the period of January 2022–March 2023. For this study, 237 Greek midwives and obstetricians employed in healthcare settings in Attica, Greece completed an anonymous and self-report questionnaire. Four different/independent models of multivariate analyses of variance were conducted. Results: The vast majority of these healthcare professionals (88.6%) believed that exercise during pregnancy is generally beneficial. According to the multivariate analyses, healthcare professionals with postgraduate/doctoral studies were more likely to believe that (a) exercise is generally beneficial (p = 0.03), (b) pregnant women should be informed about it (p = 0.028), (c) informing pregnant women is necessary/useful (p = 0.023), and (d) pregnant women showed interest in it (p = 0.034). Also, freelance midwives were more likely to believe that pregnant women should be informed about exercise (p = 0.006), and that they showed interest in it (p = 0.034). In addition, (a) freelance midwives (p = 0.050), and those who had experience in antenatal counselling (p = 0.037), as well as (b) obstetricians who were largely experienced in monitoring normal pregnancies (p = 0.001), were less likely to associate exercise during pregnancy with the occurrence of placental abruption. Conclusion: Alongside healthcare professionals’ educational level, their professional setting and professional experience emerge as key factors and need to be considered when designing innovative interventions to support exercise during pregnancy. Full article

(This article belongs to the Special Issue Midwifery Care: Improvement of Maternal and Newborn Health)

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11 pages, 466 KiB

Open AccessArticle

Perinatal Outcomes and Level of Labour Difficulty in Deliveries with Right and Left Foetal Position—A Preliminary Study

by Magdalena Witkiewicz, Barbara Baranowska, Maria Węgrzynowska, Iwona Kiersnowska, Katarzyna Karzel, Grażyna Bączek, Dorota Sys, Anna Scholz, Susan Crowther, Justyna Teliga-Czajkowska and Urszula Tataj-Puzyna

Healthcare 2024, 12(8), 864; https://doi.org/10.3390/healthcare12080864 - 22 Apr 2024

Viewed by 1505

Abstract

Background: Many studies have shown the negative influence of the foetus’s occiput posterior position during birth on the final perinatal outcome. This study aims to add to the discussion on the impact of foetus positioning on the course of labour and subjective assessment of the level of labour difficulty. Methods: The cross-sectional study took place from February 2020 to September 2021, and consisted of filling out observation forms and the assessment by the midwives and women of the level of labour difficulty. This study is based on the observation of 152 labours in low-risk women. Findings: When compared to left foetal positioning, labours in which the foetus was in the right position were longer and more frequently failed to progress (in 11.3% vs. 37.5%), and epidural was more frequently administrated (in 30.4% vs. 52.7%). Both women and midwives subjectively evaluated deliveries with a foetus in the right position as more difficult. Conclusions: The right positioning of the foetus was related to greater labour difficulty and worse perinatal outcomes. The position of the foetus’ head in relation to the pelvis should be considered as an indicator of the difficulty of labour and a support plan for the woman should be offered accordingly. Full article

(This article belongs to the Special Issue Midwifery Care: Improvement of Maternal and Newborn Health)

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10 pages, 258 KiB

Open AccessArticle

The Impact of Mode of Delivery and Postpartum Conditions on Breastfeeding: A Cross-Sectional Study

by Anita Hulman, Annamária Pakai, Tímea Csákvári, Viola Keczeli and Katalin Varga

Healthcare 2024, 12(2), 248; https://doi.org/10.3390/healthcare12020248 - 18 Jan 2024

Viewed by 1614

Abstract

Breast milk is the optimal and essential source of nutrients for babies. Many women, however, do not breastfeed or stop early after giving birth, often due to lack of support. For newborns delivered by caesarean section, there is often a delay, or no skin-to-skin contact after birth; thus, early breastfeeding is not achieved. Separation, complementary feeding or pacifier use also limits the mother’s ability to breastfeed. A quantitative, cross-sectional study was conducted. Sociodemographic data, the mode of delivery and postpartum circumstances, information on breastfeeding, and the method and duration of feeding were collected (n = 2008). Two-thirds of children born by caesarean section did not have skin-to-skin contact after birth (p < 0.001). Lack of rooming-in placement increased the incidence of more frequent complementary feeding (p < 0.001) and shortened the duration of exclusive breastfeeding (p < 0.001). The duration of breastfeeding may also be negatively affected by scheduled feeding (p = 0.007) and pacifier utilization (p < 0.001). The mode of delivery and postpartum circumstances directly affecting the mother and the newborn can affect the feasibility of breastfeeding and the duration of exclusive and partial breastfeeding. For positive breastfeeding outcomes, skin-to-skin contact immediately after birth, rooming-in and unrestricted, demand breastfeeding, as well as the avoidance of the use of pacifiers, are recommended. Full article

(This article belongs to the Special Issue Midwifery Care: Improvement of Maternal and Newborn Health)

16 pages, 825 KiB

Open AccessArticle

Differences in Changes in Game Usage Time and Game Use-Related Factors Depending on Parity in a Prospective Study of Pregnant Women in Japan

by Hiroko Sato and Toshiyuki Yasui

Healthcare 2023, 11(23), 3017; https://doi.org/10.3390/healthcare11233017 - 22 Nov 2023

Viewed by 963

Abstract

Game usage has recently been increasing, but the actual situation of game usage and issues among pregnant women are not clarified. The purpose of this prospective longitudinal study was to examine changes in game usage, lifestyle, and thoughts about game usage during pregnancy depending on parity and to clarify the characteristics of pregnant women who continue to use games. We conducted three web surveys in early, mid- and late pregnancy in 238 pregnant women. For primiparous women who continued to use games, there was a significant increase in game usage time from early to late pregnancy (p = 0.022), and 25.0% of those women had anxiety that they might have a game addiction. For primiparous women in mid-pregnancy and multiparous women in early and late pregnancy, the proportions of women who thought that they could not use gaming sufficiently due to pregnancy and child-rearing were significantly higher in women who continued to use games. In both primiparous women and multiparous women, the proportion of partners who used games was significantly higher in women who continued to use games. It is necessary for midwives to discuss with pregnant women and their partners about game usage and to provide advice about control of game usage in daily life. Full article

(This article belongs to the Special Issue Midwifery Care: Improvement of Maternal and Newborn Health)

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12 pages, 293 KiB

Open AccessArticle

The Relation between Neonatal Intensive Care Units and Postpartum Post-Traumatic Stress Disorder after Cesarean Section

by Eirini Orovou, Panagiotis Eskitzis, Irina Mrvoljak-Theodoropoulou, Maria Tzitiridou-Hatzopoulou, Maria Dagla, Christiana Arampatzi, Maria Iliadou and Evangelia Antoniou

Healthcare 2023, 11(13), 1877; https://doi.org/10.3390/healthcare11131877 - 28 Jun 2023

Cited by 5 | Viewed by 1612

Abstract

Background: The experience of a neonate hospitalized in the NICU is an understandably traumatic experience for parents, especially for the mothers of neonates. This mental distress resulting from preterm birth and/or NICU hospitalization can be understood as post-traumatic symptomatology, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5 version). The aim of this study is to investigate the impact of the admission of a neonate to the NICU (forany reason) on the development of postpartum PTSD in a sample of women after cesarean section.Methods: A total of 469 women who gave birth with cesarean section from July 2019 to June 2020 participated in this study out of the original sample of 490 women who consented to participate. Data were obtained from the researcher’s socio-demographic questionnaire and the post-traumatic stress checklist (PCL-5) from the Diagnostic and Statistical Manual of Mental Disorders DCM-5 version. Results: In total,11.7% of the sample experienced postpartum PTSD. There is a strong relationship between the inclusion of a neonate to the NICU due to perinatal stress, breathing difficulties, infections, and IUGR with postpartum PTSD (37.7%) in relation to the perinatal stress Criterion A (fear for the life of the neonate), the first criterion of postpartum PTSD. Conclusions: Additional measures must be taken for mothers of children who have been admitted to the neonatal intensive care unit with psychological support interventions and a reassessment of their mental state. Full article

(This article belongs to the Special Issue Midwifery Care: Improvement of Maternal and Newborn Health)

14 pages, 1021 KiB

Open AccessArticle

“Breastfeeding at Night Is Awesome” Mothers’ Intentions of Continuation of Breastfeeding Extreme and Very Preterm Babies upon Discharge from a Kangaroo Mother Care Unit of a Tertiary Hospital in South Africa

by Sphiwe Madiba, Perpetua Modjadji and Busisiwe Ntuli

Healthcare 2023, 11(7), 1048; https://doi.org/10.3390/healthcare11071048 - 6 Apr 2023

Cited by 2 | Viewed by 2194

Abstract

Kangaroo mother care (KMC) is effective in increasing mothers’ initiation and maintenance of breastfeeding (BF) for extreme and very preterm (VLBW) infants. Although South Africa has implemented KMC for more than two decades, little is known about mothers’ perspectives on KMC. The purpose of this study was to describe the BF intentions and practices of mothers of VLBW infants at home following discharge and assess the role long stay in KMC has on their decision to BF beyond discharge. This qualitative study was conducted at the KMC unit of a tertiary hospital in Pretoria, South Africa. Focus group interviews were conducted with 38 mothers of VLBW infants who had transitioned from neonatal intensive care (NICU) to KMC. We analysed transcripts following the five steps for qualitative thematic data analysis. Mothers were knowledgeable of the importance and value of BF preterm infants and conceded that breast milk has advantages over formula. Mothers had positive feelings toward BF their preterm infants. The stay in KMC increased the direct BF of their preterm infants, mothers’ BF efficacy, and had a positive influence on mothers’ intentions to continue BF following discharge and to exclusively breastfeed for six months. Their BF intentions, efficacy, and practices were influenced by the skilful BF counselling, training, and support they received from the nursing staff. High intention to BF among these mothers is suggestive of their knowledge and confidence in BF for their VLBW infants. It is important that nursing staff in NICU and KMC appreciate the significant role they play in mothers’ readiness and confidence to breastfeed beyond discharge. Full article

(This article belongs to the Special Issue Midwifery Care: Improvement of Maternal and Newborn Health)

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12 pages, 476 KiB

Open AccessSystematic Review

Perinatal Exposure to Tobacco Smoke and Its Association with the Maternal and Offspring Microbiome: A Systematic Review

by Eleni Falara, Dimitra Metallinou, Christina Nanou, Maria Vlachou and Athina Diamanti

Healthcare 2024, 12(18), 1874; https://doi.org/10.3390/healthcare12181874 - 19 Sep 2024

Viewed by 1066

Abstract

Background: The human microbiome, comprising trillions of microorganisms, significantly influences human health and disease. During critical periods like the perinatal phase, the microbiome undergoes significant changes, impacting lifelong health. Tobacco smoke, a known environmental pollutant, has adverse effects on health, particularly during pregnancy. Despite this, its association with the perinatal microbiome remains understudied. Methods: We conducted a systematic review to integrate findings on perinatal tobacco smoke exposure and its association with the maternal and neonatal microbiomes. We conducted a comprehensive literature search in the PubMed, Scopus, and Web of Science databases from January 2000 to February 2024. We selected studies that met predefined inclusion criteria and performed data extraction. Results: The review included eight studies that revealed diverse associations of perinatal tobacco exposure with the maternal and neonatal microbiome. Active smoking during pregnancy was linked to alterations in microbiome composition and diversity in children. Maternal smoking correlated with increased Firmicutes abundance and decreased Akkermansia muciniphila abundance in offspring. Additionally, exposure to thirdhand smoke in neonatal intensive care units was related to infant microbiome diversity. Infants exposed to tobacco smoke showed various microbial changes, suggesting potential implications for childhood health outcomes, including obesity risk. Conclusions: Perinatal exposure to tobacco smoke exerts significant influence on the maternal and neonatal microbiomes, with potential implications for long-term health outcomes. Addressing socioeconomic and psychological barriers to smoking cessation, implementing stricter smoking regulations, and promoting public health campaigns are essential steps towards reducing tobacco-related harm during the perinatal period. Further longitudinal studies and standardized assessment methods are needed to validate these findings and guide the development of effective preventive measures. Full article

(This article belongs to the Special Issue Midwifery Care: Improvement of Maternal and Newborn Health)

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