bluuebunny/crossref_metadata_2025 huggingface dataset:
Breastfeeding Fallacies: Their Relationship to Understanding Lactatlon
Authors: Auerbach Kathleen G.
Published: April 2007

ABSTRACT: When inaccurate information is the basis for clinical decision making, patient care is likely to be incomplete, inappropriate, and potentially harmful. We identified 17 fallacies relating to lactation and breastfeeding that exist in the professional and lay literature and that continue to be perpetuated among care providers and shared with new mothers. The inappropriateness and inaccuracy of these beliefs, and how they influence attitudes about, and practices relating to, breastfeeding, are discussed. Alternatives to these fallacies exist, and their use may contribute to more relevant care and advice giving, and to successful breastfeeding.
A Randomized, Controlled Evaluation of Early Postpartum Hospital Discharge
Authors: Carty Elaine M. , Bradley Christine F.
Published: April 2007

ABSTRACT: At approximately 37 weeks' gestation, 131 women were randomly assigned to one of three postpartum hospital discharge times: 12 to 24 hours, 25 to 48 hours, and 4 days. Depending on group assignment, the women received from one to five home visits by a maternity nurse clinician during the first 10 days postpartum. The results indicated the maternal and infant morbidity were low regardless of discharge time, although sample sizes were too small to detect significant differences in the outcomes. More early discharge mothers were breastfeeding without supplement at 1 month than were mothers in the long stay group. Mothers in the two early discharge groups were significantly more satisfied with their care than were those who remained longer. Those hospitalized longer scored higher on measures of depression and lower on scores of confidence at selected time periods.
Comparability of Reasons for Cesarean Sections in Patient Records and Mothers' Interviews
Authors: Hemminki Elina , Löfgren Tuuli
Published: April 2007

ABSTRACT: Reasons for cesarean sections from three different data sources were compared. One hundred mothers were interviewed, their patient records were read, and the discharge diagnoses were noted. In about 70% of cases at least two of the data sources gave similar reasons for cesarean section, but when all three sources were compared, in only one‐third was information similar. These figures cast doubt on the utility of recorded indications in studying reasons for cesarean sections.
The Relationship Between Childbirth Education Classes and Obstetric Outcome
Authors: Sturrock William A. , Johnson John A.
Published: April 2007

ABSTRACT: The records of 207 primigravid patients were reviewed over seven months to determine the relationship between childbirth education classes and the outcome of labor and delivery. Primiparous patients self‐selected into two groups, attenders and nonattenders of childbirth education classes; 114 attended at least two classes and 93 attended one or no classes. A significantly higher percentage of attenders were older, better educated, or of higher socioeconomic status. There were nonsignificant trends toward longer second stage of labor, increased use of assistance at delivery (forceps or vacuum), and increased use of medication in the group that attended prenatal classes. A benefit of attendance at childbirth education classes in reducing interventions during labor and delivery was not demonstrated.
A Controlled Study of the Effect of Prepared Childbirth Classes on Obstetric Outcomes
Authors: Hetherington Susan E.
Published: April 2007

ABSTRACT: After the development and initiation of prepared childbirth classes in a large, inner‐city hospital, a case‐controlled study was designed to assess their impact on obstetric outcomes. Prepared couples were matched with nonattenders on six variables: race, patient status (clinic or private), parity, marital status, age, and socioeconomic status. Statistically significant differences between the groups were found. Prepared couples were more likely to receive little or no pain medication and less conduction anesthesia than controls. Consequently, 79 percent of their deliveries were spontaneous, compared to 51 percent for controls (P < 0.001). Despite the increased pushing ability of the class attenders, over 80 percent of women in both groups had an episiotomy, which was, in turn, significantly associated with a second‐, third‐, or fourth‐degree laceration, thus bringing into question its routine use. Further studies to identify additional factors associated with positive obstetric outcomes are warranted.
Parents' Awareness of Their Unborn Infant in the Third Trimester
Authors: Stainton M. Colleen
Published: April 2007

ABSTRACT: An exploratory, grounded‐theory study revealed that parents develop a sense of their unborn infant's presence in an individualized manner. Four coexisting levels of cognitive and sensory awareness were delineated from a sample of primiparous and multiparous parents during the third trimester of pregnancy: awareness of the infant as an idea, awareness of the infant's presence, awareness of specific infant behavior, and awareness of the infant's interactive ability. Mothers controlled fathers' access to the unborn infant. Not all mothers interacted with their infant during pregnancy, indicating variability in style. These findings challenge current understanding of prenatal attachment.
Treatment Refusal, Noncompliance, and Substance Abuse in Pregnancy: Legal and Ethical Issues
Authors: Greenlaw Jane L.
Published: April 2007

ABSTRACT: Prenatal caregivers often note that the behavior of pregnant patients creates the risk of fetal harm. Three such cases are reviewed, together with care providers' responses and relevant law. Pregnant womens' rights to disregard medical advice are increasingly being overridden in courtrooms and bedside hearings. To preserve the patient‐provider relationship, and to avoid coercive actions that may have little legal basis, emphasis should be on helping the woman act in her own best interest and that of her fetus, rather than on the law or the courts as a means of directly or indirectly controlling her behavior.
Effects of Epidural Analgesia: Some Questions and Answers
Authors: Thorp James A. , McNitt Jay D. , Leppert Phyllis C.
Published: April 2007

ABSTRACT: The effects of epidural analgesia on first labors have been studied by Thorp and colleagues (1,2). One study has been published (3) and is the subject of a question‐and‐answer discussion, presented here. In this study 711 consecutive nulliparous women at term, with spontaneous onset of labor and cephalic presentation, were divided into one group (n = 447) who received epidural analgesia in labor and another group (n = 264) who received narcotics or no analgesia. The frequency of cesarean section for dystocia was significantly greater (p < 0.005) in the epidural group (10.3%) than in the nonepidural group (3.8%), even after selection bias was corrected and the variables of maternal age and race; gestational age; cervical dilatation on admission; use, duration, and maximum infusion rate of oxytocin; labor duration; presence of meconium; and birth weight were controlled. For both groups the frequency of cesarean section for fetal distress was similar (p < 0.20), and the frequency of low Apgar scores at 5 minutes and cord blood gas values showed no significant differences. The authors concluded that “epidural analgesia in labor may increase the incidence of cesarean section for dystocia in nulliparous women’(3).
The 1988 National Maternal and Infant Health Survey: Design, Content, and Data Availability
Authors: Sanderson Maureen , Placek Paul J. , Keppel Kenneth G.
Published: April 2007

ABSTRACT: The 1988 National Maternal and Infant Health Survey was conducted by the National Center for Health Statistics to study factors related to poor pregnancy outcome, such as adequacy of prenatal care; inadequate and excessive weight gain during pregnancy; maternal smoking, drinking, and drug use; and pregnancy and delivery complications. The survey is a nationally representative sample of 11,000 women who had live births, 4000 who had late fetal deaths, and 6000 who had infant deaths in 1988. Mothers were mailed questionnaires based on information from certificates of live birth, reports of fetal death, and certificates of infant death. Information supplied by the mother, prenatal care providers, and hospitals of delivery was linked with the vital records to expand knowledge of maternal and infant health in the United States. Data collection from the Longitudinal Followup of mothers in the survey began in January 1991. It provides information on health and development of low‐ and very low‐birthweight babies, child care and safety, maternal health, maternal depression, and plans for adoption and foster care. Both surveys will provide useful data for clinicians in maternal and child health.
Prenatal Education in a High‐Risk Population: The Effect on Birth Outcomes
Authors: Libbus M. Kay , Sable Marjorie R.
Published: April 2007

ABSTRACT: This case‐control investigation examined the relationship between absence of specific educational content during prenatal care and risk of adverse birth outcomes. A total of 1484 women from three regions with high rates of low birthweight and infant mortality participated in structured postpartum interviews. Analyses were performed for both the full sample and three regional subsamples. For the full sample an adjusted risk ratio of 2.87 (95% CI = 1.75, 4.71) was noted between risk of preterm low birthweight and lack of advice to call the health provider if preterm labor were suspected. For one subsample an adjusted risk ratio of 2.50 (95% CI = 1.11, 5.60) was noted between the risk of preterm low birthweight and lack of education on the signs and symptoms of preterm labor. This study reinforces a body of literature that stresses the importance of appropriate prenatal care in preventing preterm low birthweight. It further suggests that adequacy measures of prenatal care should reflect quality and content as well as timing and number of prenatal visits.
The Apgar Score: Evolution, Limitations, and Scoring Guidelines
Authors: Jepson Helen A. , Talashek Marie L. , Tichy Anna M.
Published: April 2007

ABSTRACT: The Apgar score has been useful for nearly four decades in focusing on five physiological signs (heart rate, respiratory effort, reflex irritability, muscle tone, color) that denote the condition of an infant during the first critical minutes of life. Before the development of the system, narcotic analgesia and sedation during labor, and general anesthesia for vaginal deliveries were commonly used. Research of the scoring method has focused on the effects of these interventions on the fetus and newborn and has been a major impetus for change in obstetric practices. The Apgar score has been used as a predictive index for neonatal mortality and morbidity and for later neurologic or developmental disability. Both the one‐ and five‐minute scores are predictors of mortality in normal‐birthweight infants, whereas in high‐risk low‐birthweight infants their score is limited. The score is an insensitive predictive index of long‐term neurologic or mental handicap, and lacks both sensitivity and specificity to reflect accurately the degree of acidosis. It can be used effectively, however, if these limitations are understood and considered.
Prenatal Care and Prematurity: Is There an Association in Uncomplicated Pregnancies?
Authors: Hulsey Thomas C. , Patrick Celeste H. , Alexander Greg R. , Ebeling Myla
Published: April 2007

ABSTRACT: A retrospective investigation examined patterns of use of prenatal care and pregnancy outcomes (low birthweight and preterm births) in 6176 pregnancies without antepartum medical complications. Prenatal care use patterns differed significantly by mother's age, marital status, race, education, method of payment, and gravidity. By controlling for these differences through a logistic regression procedure, results showed that prenatal care was associated with significant reductions in the number of infants who were delivered preterm or had low birthweight. Fewer very low‐birthweight (<1500 g) infants were among the preterm infants delivered to mothers with prenatal care compared with women who received no prenatal care. These data suggest that significant improvements in pregnancy outcomes are seen among women who use prenatal care, and these benefits occur in the absence of antepartum complications.
The Influence of Birth Setting on the Father's Behavior Toward His Partner and Infant
Authors: Westreich Ruta , Spector‐Dunsky Liliane , Klein Michael , Papageorgiou Apostolos , Kramer Michael , Gelfand Morrie
Published: April 2007

ABSTRACT: As part of a controlled, clinical trial conducted to compare medical and psychological outcomes of a birth room and a conventional hospital setting, we examined the behavior of fathers toward their partners and infants. One hundred fourteen couples were systematically assigned to either locale by strict alternation. They learned about this allocation on arrival at the hospital in labor. Observations of fathers' behavior were made at midlabor and during home visits at three months and one year. During labor, fathers assigned to the conventional setting were more involved in helping and encouraging their partners. Parenting behavior was not influenced by the birth setting. Unexpectedly, fathers were more involved with their infants when the mothers had expressed less satisfaction with childbirth. Compensation behavior may explain these results, which can be seen as appropriately adaptive in the face of perceived environmental deficiencies affecting the laboring woman and the infant.
Supporting Women in Labor: A Work Sampling Study of the Activities of Labor and Delivery Nurses
Authors: McNiven Patricia , Hodnett Ellen , O'Brien‐Pallas Linda Lee
Published: April 2007

ABSTRACT: Studies demonstrated that support during labor and birth has a positive impact on childbirth outcomes, and that women reported they received little supportive care from nurses during parturition. This study piloted a work sampling method that was adapted to determine the proportion of time the average intrapartum nurse at a Toronto teaching hospital spends in supportive care activities. Supportive care was operationally defined within four categories of activities: emotional support, physical comfort measures, instruction/information, and advocacy. Work sampling was an effective method of measuring support as a specific aspect of direct intrapartum care. The proportion of time that nurses spent in supportive versus all other activities was 9.9 percent (95% confidence interval 7.5% and 12%), based on a sample of 616 random observations of 18 nurses. Findings are discussed in terms of the social and political factors that affect the meaning and value of the supportive activities of work by obstetric nurses.
Sucking Technique and Its Effect on Success of Breastfeeding
Authors: Righard Lennart , Alade Margaret O.
Published: April 2007

ABSTRACT: We investigated the prognostic value of sucking technique (faulty vs correct) during the first week after birth in relation to the long‐term success of breastfeeding. At discharge from the maternity ward, 82 healthy mother‐infant pairs were observed for assessment of breastfeeding technique and followed for four months by regular telephone checkups. Correct sucking technique was defined as the infant having a wide‐open mouth, with the tongue under the areola, and expressing milk from the breast by slow, deep sucks; faulty technique was defined as superficial nipple sucking. The study population was divided into three groups: one in which faulty sucking technique was corrected when observed (n = 29), one with faulty but uncorrected technique (n = 25), and a control group with a correct technique (n = 28). At the four‐month follow‐up assessment, the faulty but uncorrected group was characterized by a greater proportion of mothers with breastfeeding problems and early cessation of breastfeeding than the other two groups. Regular use of a pacifier (>2 hrs/day) was more common among those with breastfeeding problems.
Short‐Term Morbidity Associated with Cesarean Delivery
Authors: Hillan Edith M.
Published: April 2007

This study describes the short‐term morbidity associated with cesarean delivery and women's knowledge of the reasons it was performed. It was conducted in a university teaching hospital that delivers approximately 4000 women per year. During 1986, 619 women (16%) were delivered by cesarean, 588 of whom were sent a questionnaire three months after delivery. The response rate was 76 percent. General questions were asked about the women's recovery and health state after the birth, and whether they had experienced more specific types of morbidity, including infection, backache, and depression, and the reasons for the cesarean delivery. Women's answers were then compared with the obstetric case record. In their comprehension of why the cesarean was necessary, 87 percent of women were right or partially right, 35 percent believed they had still not fully recovered, and 28 percent felt less healthy than before the pregnancy. Women experienced a wide variety of postnatal morbidity, most commonly backache (55%), constipation (49%), and depression (38%). The study showed that considerable maternal morbidity is associated with cesarean delivery, and it can persist long after the woman is discharged from hospital. Much more information is necessary about the health of women after delivery, and research is urgently required to determine the comparative rates of morbidity associated with different delivery methods.
Nausea and Vomiting During Pregnancy: Effects on the Quality of Women's Lives
Authors: O'Brien Beverley , Naber Sarah
Published: April 2007

ABSTRACT: More than 70 percent of all pregnant women experience nausea and vomiting during pregnancy, and 28 percent report that symptoms cause them to change their usual activities. We investigated the magnitude of problems that nausea and vomiting impose on the lifestyle of pregnant women and their families. Twenty‐seven women who were experiencing different degrees of nausea and vomiting were selected from 147 pregnant women and asked to participate in semistructured telephone interviews. All participants reported changes in family, social, or occupational functioning as a result of these symptoms. Nausea and vomiting can impose substantial lifestyle limitations on pregnant women that can have short‐ and long‐term consequences for them and their families. Both the duration and severity of symptoms were greater for many participants than is generally believed. All participants reported that recumbent rest or dietary alterations provided relief. Caregivers should recognize and validate the need for pregnant women to make changes in lifestyle that will enable them to achieve comfort.
Hmong Women: Characteristics and Birth Outcomes, 1990
Authors: Faller Helen Stewart
Published: April 2007

ABSTRACT: Current demographic characteristics and pregnancy outcomes of immigrant Hmong women in a small town in southeastern United States were documented in a retrospective study. Interviews and review of existing records were used to determine prenatal practices and perceived problems. Sixteen health professionals and two women from the community were interviewed, and the labor and delivery records from 1985 to 1990 were reviewed for parity, child spacing, and health status of the women and newborns. The greatest concerns voiced by health caregivers were multiparity and the need for contraceptive compliance. Seventy‐eight full‐term infants were born to 64 women in five years, with 2 stillbirths. No eclampsia, diabetes, or Rh incompatibilities were noted. Evidence is limited that birth frequency or outcome for Hmong women is a problem. Their perinatal difficulties were thought to be sociocultural rather than medical. Further study of the effects of acculturation on maternal family position, perinatal risks, and birth outcomes is imperative as lifestyle and environment change for these immigrant women.
Immersion in Water During labor and Birth: The Need for Evaluation
Authors: McCandlish Rona , Renfrew Mary
Published: April 2007

Despite widespread and increasing use of immersion in water during labor, birth, or both in many different countries, no reliable information is available about its advantages, hazards, and resource implications. We describe the development of immersion in water during labor and birth, the current use of this form of care in the United Kingdom, the research that has been conducted to date, and possible strategies for future research. Three approaches to research are suggested: a survey of existing practice, a randomized controlled trial, and a confidential register of serious adverse events.
Active Management A Continuing Benefit in Nulliparous labor
Authors: O'Herlihy Colm
Published: April 2007

At the Tenth Birth Conference in Boston, 1992, a randomized clinical trial of active management of labor that is being conducted at Brigham and Women's Hospital in Boston was described by principal investigator, Fredric Frigoletto, Jr., MD. The study of 1800 primiparous women will examine the effect of the active management protocol on the rate of cesarean section. Since the presentation generated such strong disagreement during the discussion that followed, a further examination of the benefits and risks of the method is presented in this two‐part roundtable. Part I comprises papers by Colm O'Herlihy, from National Maternity Hospital in Dublin where the active management of labor method originated, by Michael Klein, who moderated the Boston presentation and discussion, and by Henci Goer, who was an audience participant. Part II, to be published in the September issue, will contain papers by William Fraser, a Boston conference speaker who will discuss methodologic issues, by audience participant Karyn Kaufman presenting a midwife's perspective, by sociologist Barbara Katz Rothman, and by Marc J.N.C. Keirse, with a final comment.
Maternal Recall and Medical Records: An Examination of Events During Pregnancy, Childbirth, and Early Infancy
Authors: Githens Penny B. , Glass Cheryl A. , Sloan Frank A. , Entman Stephen S.
Published: April 2007

It is not currently known whether sufficiently precise data on a previous pregnancy, labor and delivery, and early infancy can be obtained retrospectively. We conducted a telephone survey in 1991 of women who delivered babies between 1984 and 1986 at two teaching hospitals in Nashville, Tennessee, to assess how well mothers recall information on factors predictive of an adverse birth outcome. The survey yielded 102 usable responses that were compared with hospital records for mothers and infants. Overall, 89 percent agreement was found between women's responses and their charts. Respondents were not reluctant to answer potentially sensitive questions, and their technical knowledge was typically better for their own health than about some prenatal diagnostic procedures and their infants' health. We found no difference in recall accuracy according to whether mothers experienced some adversity with the index pregnancy. Accurate perinatal information can generally be obtained with a recall period as high as four to six years. (BIRTH 20:3, September 1993)
What Are They Talking About? Is Something Wrong? Information Sharing During the Second Stage of Labor
Authors: McKay Susan , Smith Susan Yager
Published: April 2007

Twenty postpartal women were shown videotapes of their second stage labors and simultaneously interviewed. During separate interviews, their 25 caregivers were also shown the videotapes and interviewed. The interviews were analyzed for major themes, one of which was sharing information during labor. Although women and caregivers appeared to agree about what information laboring women require and how it should be given, caregiver perceptions of the quality of their information giving were more positive than mothers' perceptions. Many women wanted more informational support, especially in alleviating unvoiced fears about their baby's health. (BIRTH 20:3, September 1993)
Breastfeeding Preterm Twins: A Case Report
Authors: Biancuzzo Marie
Published: April 2007

ABSTRACT: This case report describes a primipara who successfully breastfed 35‐week‐gestation twins for over six months. Positive interactions, research‐based management strategies, and innovative problem solving helped her avoid the individual, interpersonal, and system factors that can injuence lactation failure. (BIRTH 21:2, June 1994)
The Psychological Effects of Counting Fetal Movements
Authors: Liston Robert M. , Bloom Kathleen , Zimmer Pamela
Published: April 2007

ABSTRACT: By identifying a change in fetal activity state, fetal movement counting may help to reduce the possibility of stillbirth. Concern has arisen that such a focus on fetal activity may cause undue maternal anxiety. A prospective, controlled trial was conducted to determine whether fetal movement counting induced anxiety or other deleterious psychological effects in low‐risk primigravidas. A sample of 613 healthy pregnant women was randomly assigned at 28 weeks' gestation to fetal movement counting, sleep recording, or a nonrecording control group. State and trait of anxiety, belief in sources of personal control, and attitudes toward pregnancy and infant were assessed at 28 and 37 weeks' gestation. Participation rates were high (91.4%) across all groups. Most women (90%) assigned to count fetal movements did so on a daily basis (95% of days). No significant changes in psychological status occurred in the three groups as a result of self‐monitoring conditions. Independent of group assignment, all women showed a slight increase in transient state and decrease in trait of anxiety from 28 to 37 weeks. Internal locus of control and positive attitudes toward the infant increased slightly, and feelings of well‐being decreased slightly for all women. It was concluded that women are willing to record fetal activity, and that fetal movement counting does not cause deleterious psychological effects in low‐risk pregnant women.
Smoking Among Low‐Income, Pregnant Women: Prevalence Rates, Cessation Interventions, and Clinical Implications
Authors: Albrecht Susan A. , Rosella John D. , Patrick Thelma
Published: April 2007

ABSTRACT:Smoking has a significant effect on the major causes of death and disability among women, including coronary heart disease, stroke, cancer, and osteoporosis. When pregnant women smoke, it adversely affects not only them but also the health, development, and functioning of their unborn and young children. Of the general population of pregnant women, between 20 and 45 percent smoke. Furthermore, among low‐income and less educated pregnant women, the increase in prevalence of postpartum smoking relapse rates, continued smoking, and initiation of smoking underlies the need for developing effective interventions for prevention and cessation. Although self‐help, stop‐smoking materials demonstrated success in several trials, interventions used in conjunction with these materials were brief with little follow‐up, and did not address the need for continued intervention to help maintain abstinence or cessation after birth. This article reviews the smoking cessation trials that have assessed the effects of various interventions on cessation rates among low‐income pregnant women, and describes future research needs for clinic‐based smoking interventions for those women and the clinical implications for health professionals.
Labor Experiences of Childhood Sexual Abuse Survivors
Authors: Rhodes Naomi , Hutchinson Sally
Published: April 2007

ABSTRACT:This field study used the ethnographic method to describe and analyze the labor experiences of childhood sexual abuse survivors. The sample included seven sexual abuse survivors, five nurse‐midwives, and three labor and delivery nurses. Data collection included in‐depth interviews, participant observation in labor and delivery over a period of six years, and anecdotal material from the literature. Analysis followed Spradley's Developmental Research Sequence and included domain, taxonomic, componential and theme analysis. Women reported both forgetting and remembering abusive incidents, and described labor sensations reminiscent of sexual abuse. A heuristic for appraising labor styles suggestive of past sexual abuse includes fighting, taking control, surrendering, and retreating. These styles are considered extremes of women's reactions to labor and are directly linked to posttraumatic stress disorder. This study demonstrated that it is important for perinatal caregivers to understand the link between childhood sexual abuse and childbirth so that they can assist women to have a positive birth experience
Female Genital Mutilation and Childbirth: A Case Report
Authors: McCleay Paul H.
Published: April 2007

ABSTRACT: Over 80 million women in more than 30 countries have undergone female genital mutilation, also called female circumcision, according to World Health Organization estimates. Over the past decade 70,000 Somalians have become residents in Canada, 50,000 of whom live in Toronto, Ontario. Many of the women are of childbearing age, and 99.5 percent of women in Somalia are reported to have been genitally mutilated. Canadian medical organizations have published position statements prohibiting the practice. This case report describes the pregnancy and childbirth of a Somalian woman with the infibulation type of procedure. When perinatal health professionals are aware of and sensitive to the cultural and medical implications and sequelae of female genital mutilation, they will give better care to affected women.
Self‐Esteem, Social Support, and Satisfaction Differences in Women With Adequate and Inadequate Prenatal Care
Authors: Higgins Patricia , Murray Michelle L. , Williams Elaine M.
Published: April 2007

ABSTRACT:This descriptive, retrospective study examined levels of self‐esteem, social support, and satisfaction with prenatal care in 193 low‐risk postpartal women who obtained adequate and inadequate care. The participants were drawn from a regional medical center and university teaching hospital in New Mexico. A demographic questionnaire, the Coopersmith self‐esteem inventory, the personal resource questionnaire part 2, and the prenatal care satisfaction inventory were used for data collection. Significant differences were found in the level of education, income, insurance, and ethnicity between women who received adequate prenatal care and those who received inadequate care. Women who were likely to seek either adequate or inadequate prenatal care were those whose total family income was $10,000 to $19,999 per year and high school graduates. Statistically significant differences were found in self‐esteem, social support, and satisfaction between the two groups of women. Strategies to enhance self‐esteem and social support have to be developed to reach women at risk for receiving inadequate prenatal care.
Mothers Touching Newborns: A Comparison of Rooming‐in versus Minimal Contact
Authors: Prodromidis Margarita , Field Tiffany , Arendt Robert , Singer Lynn , Yando Regina , Bendell Debra
Published: April 2007

ABSTRACT: We compared the maternal behaviors of women who had extended and early contact (rooming‐in) with their infants with those who had contact only during feedings. Thirty‐one young, unmarried, predominantly black, lower‐socioeconomic mothers and their infants were observed in the mother's hospital room for 15 minutes after a morning feeding approximately 18 hours after delivery. A time sample unit checklist was used to record each mother's behavior, looking, talking, and touching directed toward their infants and others, as well as watching television and talking on the telephone. Analyses of variance revealed that the rooming‐in mothers looked at, talked to, and touched their infants more, watched less television, and talked less on the telephone than mothers with minimal contact with their infants. These findings suggest that increased postpartum contact with infants leads not only to more interaction, but also to more touching as well as touching in more intimate places (face and head), thus highlighting the value of rooming‐in arrangements for mothers and infants.
Cesarean Delivery Rates in Women Cared for by Certified Nurse‐Midwives in the United States: A Review
Authors: Lydon‐Rochelle Mona
Published: April 2007

ABSTRACT: The frequency of cesarean deliveries for women attended by certified nurse‐midwives in the United States (1.8–10.4%) is lower than the rate for the general population of woman who gave birth in the United States in 1990 (23%). This paper describes the research that reported cesarean birth rates for certified nurse‐midwives. Major methodology limitations of the research suggest that significant information gaps exist regarding nurse‐midwifery care and its effect on cesarean delivery. Issues surrounding this common clinical procedure are complex, with its high cost and controversy over determinant factors. It is important to develop convincing evidence about the influence of nurse‐midwives' care on reducing the frequency of cesarean delivery in the United States.
What Predicts Breastfeeding Intention in Mexican‐American and Non‐Hispanic White Women? Evidence from a National Survey
Authors: Balcazar Hector , Trier Catherine M. , Cobas Jose A.
Published: April 2007

ABSTRACT: We examined the ejsects of a series of predictors on the prepartum intention to breasveed in both Mexican‐American and non‐Hispanic white women. A national sample included 430 Mexican‐American women and 3659 non‐Hispanic white women who had a pregnancy in 1988. Prenatal behavioral, sociodemographic, and biomedical information wus obtained through the 1988 National Maternal and Infant Health Survey. Two dependent variables were constructed to identify significant predictors of breastfeeding intention: exclusive versus partial and bottlefeeding, and exclusive and partial versus bottlefeeding. Results from the multiple logistic regression models indicated that advice to breastfeed at prenatal care was the strongest predictor of intentions in both Mexican‐American (OR = 2.15, OR = 1.86) and non‐Hispanic white mothers (OR = 2.29, OR = 3.61). In Mexican‐Americans the fatherS being Hispanic was negatively associated with breastfeeding intention (OR = 0.63). In non‐Hispanic whites the advice to formula feed at the Women, Infants, and Children's nutrition program was a significant negative predictor of breastfeeding intention (OR = 0.33, for exclusive and partial breastfeeding vs exclusive bottle‐feeding). These results have important implications for public health policy and practice.
Variables Related to Nausea and Vomiting During Pregnancy
Authors: O'Brien Beverley , Zhou Qiuping
Published: April 2007

ABSTRACT: Seventy to 90 percent of all pregnant women experience nausea, and 50 percent have at least one episode of vomiting or retching. A continuous measure was used to quantify symptoms of nausea with or without vomiting or retching during pregnancy in 126 women. Relationships between symptoms and selected variables were evaluated. Nausea with or without vomiting or retching was associated with maternal age, occupation, parity, cigarette smoking, infant gender and the personality trait of independence. Significant associations were entered into multiple regression equations. Fourteen percent of the variation in symptoms overall, 25.1 percent of the variation in nausea symptoms, and 16.6 percent of the variation in vomiting or retching symptoms were explained by a combination of these selected independent variables. Although this study found associations, independent variables contributed little to predicting or explaining the presence and severity of nausea and vomiting during pregnancy. More sensitive measures and evaluation are required to understand and treat this perplexing phenomenon.
Does a Twin Pregnancy Have a Greater Impact on Physical and Emotional Well‐Being than a Singleton Pregnancy?
Authors: Thorpe Karen , Greenwood Rosemary , Goodenough Trudy
Published: April 2007

ABSTRACT: A prospective, population‐based study was conducted to assess the impact of twin pregnancy on a woman's physical and emotional well‐being. It compared women's reports of their general health, experience of a range of specific symptoms, and emotional well‐being during pregnancy using the Edinburgh Postnatal Depression Scale. The subjects were 147 women expecting twins and 11,061 women expecting a single child who completed questionnaires at both 20 and 32 weeks’gestation as part of the Avon Longitudinal Study of Pregnancy and Childhood. Results suggested that women expecting twins experienced poorer physical well‐being but not poorer emotional well‐being than those expecting a single child, even though a significant association between poor health and emotional well‐being was found for the population as a whole. It was suggested that the transitory nature of a twin pregnancy, the “special’ status of a twin pregnancy, greater social support, and modified expectations about health may buffer the effects of poor physical health on emotional well‐being in a twin pregnancy. The findings should alert those who care for women expecting twins to the greater physical stress these women may feel.
Predicting the Duration of Lactation: Evidence from a National Survey
Authors: Piper Sharon , Parks Peggy L.
Published: April 2007

ABSTRACT:Background: Despite caregiver and policy support for breastfeeding, rates for initiation and duration of breastfeeding fell far short of Healthy People 2000 goals during the 1980s.Methods: Data from the 1988 National Maternal‐Infant Health Survey, collected from January 1989 through June 1991, were analyzed to examine predictors of duration of lactation for a sample of 2372 breastfeeding women. We conducted comparisons between women who fully breastfed and those who partially breastfed using logistic regression analysis.Results: Mothers were more likely to breastfeed for longer than six months if they fully breastfed during the first month postpartum, were nonsmokers, were of higher parity, were consistent in their prenatal intent to breastfeed fully or partially and in their postpartum behaviors, participated in childbirth education classes, and delayed their return to work postpartum.Conclusions: In this study sample, although rates did not meet Healthy People 2000 goals for duration of breastfeeding, some predictors of duration were identified that can be affected by programmatic support or public policy. Our findings indicated that variables that are associated with breastfeeding and longer duration of the practice are typically correlated with social status. To support the development of breastfeeding as the cultural norm, interventions targeting breastfeeding outcomes should consider social status, ethnicity, and cultural factors.
Postterm Pregnancy: Putting the Merits of a Policy of Induction of Labor into Perspective
Authors: Hannah Mary E. , Huh Caroline , Hewson Sheila A. , Hannah Walter J.
Published: April 2007

ABSTRACT: Background: Several randomized, controlled trials compared the policies of induction of labor and expectant management for women who reach 41 weeks' gestation, and although they suggest a better outcome for mothers and infants with such a policy in place, controversy continues as to which is the better form of care. The Canadian Multicenter Postterm Pregnancy Trial (CMPPT) enrolled 3407 women, of whom 1701 were randomized to a policy of induction of labor (induced group) and 1706 were randomized to a policy of expectant management (expectant group). Secondary analyses of data from the CMPPT were undertaken to explore a number of controversial issues. Methods: We used data from the CMPPT to explore further the timing of delivery for women enrolled between 41 0/7 and 41 6/7 weeks' gestation, the potential impact of more liberal use of prostaglandins on cesarean section rates, and the relative merits of induced versus spontaneous labor in the two groups. Results: Most women in the CMPPT (89%) were enrolled at 41 0/7 to 41 6/7 weeks' gestation, of whom 86.2 percent in the induced group and 63.6 percent in the expectant group gave birth before 42 weeks' gestation. Assuming that administration of prostaglandins would reduce the likelihood of cesarean section by 12 to 15 percent, cesarean section rates were reduced in the induction group from 21.2 percent to 20.8 to 20.9 percent, and in the expectant group from 24.5 percent to 23.3 to 24.2 percent. If labor was induced as part of a policy of expectant management, the cesarean section rate was much higher (33.5%) than if labor was either spontaneous or induced as part of a policy of induction (18.5%, 22.4%). Conclusions: Women should be informed of the benefits and risks associated with the policies of induction of labor and expectant management, and their preferences regarding these policies should be respected.
The Childbirth Experience: A Study of 295 New Mothers
Authors: Waldenström Ulla , Borg Ing‐Marie , Olsson Brita , Sköld Margareta , Wall Sigrid
Published: April 2007

ABSTRACT: Background: The childbirth experience is multidimensional, and therefore difficult to describe and explain. Studies of it have produced inconsistent findings, and the phenomenon is often confused with satisfaction with the care provided. This study aimed to clarify different aspects of the birth experience, and to identify factors that could explain the variation in women's overall assessment of it. Methods: All Swedish‐speaking women in a large city who gave birth during a two‐week period in 1994 were given a questionnaire one day after the birth, and 295 (91%) of the questionnaires were returned. Information about the labor process and medical interventions was collected from hospital records Results: Women usually experienced severe pain and various degrees of anxiety, and most were seized with panic for a short time or some part of their labor: Despite these negative feelings, most women felt greatly involved in the birth process, were satisfied with their own achievement, and thought they had coped better than expected. The overall experience was assessed as positive by 77 percent of women and negative by 10 percent. No statistical difference was observed between primiparas and multiparas in total birth experience, and few differences in the specific aspects of the birth. Of the 38 variables tested in regression analysis, the six that contributed to explaining womens overall birth experience were support from the midwife (sensitivity to needs), duration of labor; pain, expectations of the birth, involvement and participation in the birth process, and surgical procedures (emergency cesarean section, vacuum extraction, forceps, episiotomy). Conclusions: The study showed that negative and positive feelings can coexist, thus confirming the multidimensional character of the birth experience. Women's assessment of their childbirth is influenced by both physical and psychosocial factors, highlighting the importance of a comprehensive approach to care in labor.
Stillbirth Is No longer Managed as a Nonevent: A Nationwide Study in Sweden
Authors: R̊adestad Ingela , Nordin Conny , Steineck Gunnar , Sjögren Berit
Published: April 2007

ABSTRACT: Background: Giving birth to a stillborn child is a tragedy. The aim of this study is to investigate the meeting of mothers with their stillborn children and the women's experiences of support during and after the delivery. Methods: In a nationwide study in Sweden, data from 636 women who gave birth to a stillborn or live baby were collected by means of an anonymous postal questionnaire in 1994. Results: Among the 314 women who gave birth to a stillborn child, nearly every mother had seen her child, and 80 percent had caressed her baby. More than 90 percent of the mothers stated that the medical staff showed respect, and about 80 percent of the mothers stated that staff exhibited tenderness toward their dead children. The mother's assessment of respect and tenderness to her child by medical staff was almost identical between stillbirths and live births. Nearly 70 percent of the women reported that the hospital had good routines to support mothers of stillborn children. Feelings of sadness and having been deeply hurt or angered by the medical staff's behavior were reported by 37 percent of the women. A difficult balance is still to be achieved between women being forced to encounter the baby when not yet ready versus others who wish the staff had given more encouragement. The value of properly taken photographs is described. Conclusions: Treating stillbirth as a nonevent has been largely, if not entirely, abandoned in Sweden. Most mothers of a stillborn child experience that the medical staff treat their dead children appropriately.
Predicting Postnatal Depression Among Pregnant Women
Authors: Stamp Georgina E. , Williams Anne Sved , Crowther Caroline A.
Published: April 2007

ABSTRACT: Background: Depression after the birth of a baby is a common cause of maternal morbidity, and its prevalence in Australia is 10 to 15 percent at 6 to 9 months postpartum. This study assesses the prediction of postnatal depression at 6 weeks postpartum, Method: Women at 24 weeks' gestation or less were invited to complete a Modified Antenatal Screening Questionnaire (MASQ) that identified women more vulnerable to becoming depressed after childbirth. Of these 249 women, 144 (58%) screened more vulnerable, and were randomly allocated to receive either a supportive intervention to reduce postnatal depression or to receive no intervention. At 6 weeks postpartum the women completed the Edinburgh Postnatal Depression Scale (EPDS) to assess their mood after the birth. Results: No difference occurred at 6 weeks postpartum between the MASQ vulneruble group (return rate 64/68) and the MASQ less vulnerable group (return rate 44/51) in the frequency of those who screened as potential candidates for major depression using the EPDS. For major depression the MASQ's sensitivity was 73 percent, specificity 43 percent, positive predictive value 17 percent, and negative predictive value 91 percent; for minor depression its sensitivity was 81, 48, 34, and 89 percent, respectively. The MASQ was able to predict minor depression. More women in the vulnerable group scored at increased risk of minor depression on the EPDS at 6 weeks postpartum. Conclusion: Further studies are needed to extend this work and develop a screening test with higher specificity and greater positive predictive value.
The Experience of Precipitate Labor
Authors: Rippin‐Sisler Catherine S.
Published: April 2007

ABSTRACT: Background: Despite abundant research on psychosocial factors related to childbirth, no studies have focused on the specific phenomenon of a precipitate labor: A descriptive exploratory study was conducted to investigate this experience.Method: Semistructured interviews were conducted in 1992 with 11 women 3 to 4 months after they gave birth. Transcribed interviews were then analyzed using latent content analysis.Results: The experience of precipitate labor was categorized in terms of physical experience (perception of labor length and contractions), psychological experience (relationship of how women perceived birth to their prenatal expectations, and emotional trajectory of disbeliex alarm panic, and relief), and external factors (support persons and hospital system).Conclusions: Understanding the experience of precipitate labor is essential before caregivers can offer appropriate support to clients. Perinatal caregivers gain valuable insight into a woman's experience by comprehending the speed, intensity, and emotional impact specific to precipitate labor: (BIRTH 23:4, Decembel; 1996)