bluuebunny/crossref_metadata_2025 huggingface dataset:
Food and Beverages in Labor. Part II: The Effects of Cessation of Oral Intake During Labor
Authors: Broach Jeannine , Newton Niles
Published: April 2007

Since the 1940s women have been prohibited from eating and drinking during labor because of the danger of aspirating stomach contents should general anesthesia be necessary. This is a critical review of the research on which prohibiting oral intake during labor has been based and includes studies demonstrating delay of gastric emptying in pregnant and laboring women. Problems in defining the scope of maternal mortality from aspiration during anesthesia are discussed, as well as other effects of prohibiting women from eating and drinking during labor. These include physiologic effects from short‐term deprivation of oral intake which has been largely overlooked in the literature and requires further investigation. Psychologic effects have been neglected altogether and should also be examined.
Different Rates of Prolonged First‐Stage Labor in Primiparas at Two Hospitals
Authors: Thomson Molly
Published: April 2007

ABSTRACT: In a study of difficult labor in primiparas at two Montreal hospitals, prolonged first stage labor was significantly less frequent at a community hospital (8%) than at a high risk referral hospital (14%), even though only women admitted for uncomplicated spontaneous labor were included. Prolonged labor was defined as longer than 15 hours from admission to full dilatation of the cervix. More labors were stimulated with oxytocin at the high risk referral hospital (61%) than at the community hospital (34%), meaning that frequent stimulation did not prevent prolonged labor. Common factors may lead both to the need for stimulation and to prolonged labor.
Views of Mothers and Midwives Participating in the Bristol Randomized, Controlled Trial of Active Management of the Third Stage of Labor
Authors: Harding Joanna E. , Elbourne Diana R. , Prendiville Walter J.
Published: April 2007

Abstract: Mothers and midwives who had participated in the Bristol randomized controlled trial of active versus physiologic management of the Third Stage of Labor were asked for their views. One hundred ninety‐one mothers (11% of the total randomized) and 49 midwives completed self‐administered questionnaires. Both mothers and midwives commented adversely about the length of the third stage under physiologic management. In general, their views were in accord with the conclusions of the main trial (based on clinical data, including maternal blood loss, length of third stage, need for therapeutic oxytocic agents, and specified neonatal morbidity) in favor of continuing with the current practice of active management.
A Randomized Trial of Electronic Fetal Monitoring in Preterm Labor: Mothers'Views
Authors: Killien Marcia Gruis , Shy Kirkwood
Published: April 2007

ABSTRACT: To determine if perceptions of preterm labor and birth differed between women who were monitored by electronic fetal monitoring (EFM) or by periodic auscultation, 135 subjects were randomly assigned to one of two treatment groups on admission to a tertiary perinatal care setting. The first group received external monitoring by continuous Doppler and tocodynamometer when membranes were intact, and with an internal fetal scalp electrode and pressure catheter once membranes were ruptured. The second group received periodic monitoring with a DeLee fetoscope or amplified Doppler. All women were cared for on a one‐to‐one basis by expert study nurses. Subjects completed a questionnaire about their labor experience during their postpartum hospital stay. There was no statistically significant difference between the two groups on the study measures [T2(7,81) = 13.65; F = 1.82; P > 0.05]. Forty‐four percent of the variance in women's global evaluation of labor was explained by their perceptions of nursing support. These findings suggest that mothers' perceptions of their preterm labor are less influenced by the technologic interventions used than by the supportive care received from nurses.
The Relationship of Maternal Age, Quickening, and Physical Symptoms of Pregnancy to the Development of Maternal‐Fetal Attachment
Authors: Lerum Carolyn W. , LoBiondo‐Wood Geri
Published: April 2007

ABSTRACT: In a study of maternal‐fetal attachment we explored three variables that could influence such attachment: maternal age, the experience of quickening, and the physical symptoms of pregnancy. A convenience sample of 80 pregnant women filled out the Cranley maternal‐fetal attachment scale and the pregnancy symptoms checklist. Maternal age and physical symptoms were not found to be significantly correlated to maternal‐fetal attachment, but quickening, as well as the degree and frequency of fetal movement, were correlated, at the P≤ 0.0001 level. Income, ultrasound, and planning of pregnancy were also found to be significantly related to maternal‐fetal attachment.)
The Effect on Father‐Infant Interaction of Demonstrating the Neonatal Behavioral Assessment Scale
Authors: Beal Judy A.
Published: April 2007

ABSTRACT: Forty‐four first‐time fathers who had attended prenatal classes and were present during labor and delivery of their healthy infants were divided randomly into an experimental group of 22 who observed the Brazelton neonatal behavioral assessment scale performed on their 2‐ to 3‐day‐old infants, or into a control group of 22 who did not receive this intervention. Paternal involvement in, and attitudes toward, infant caretaking and ratings of infant difficultness were compared in the two groups. Father‐infant interaction was measured by two‐minute videotape analysis at eight weeks postpartum. Paternal attitudes, caretaking activities, and perceptions of their infants were measured by questionnaire self‐reports. There were significant differences in the quality, but not quantity, of father‐infant interactions, and in one of four measures of infant difficultness (unpredictability) between the two groups.
Effects of Cesarean Delivery on Parental Depression, Marital Adjustment, and Mother Infant Interaction
Authors: Culp Rex E. , Osofsky Howard J.
Published: April 2007

Abstract: To further our understanding of the effects of cesarean delivery on maternal and paternal depression, marital adjustment, and mother‐infant interaction during perinatal and three‐month postpartum feeding, data were prospectively collected on 80 primiparous married women and their infants, and 76 of their husbands. There were 56 vaginal deliveries and 24 cesarean section deliveries. Data were collected by interview at the latter part of the second trimester and three months postpartum by examination of the mothers' and infants' medical records, and by observation of mother‐infant feedings at two days and three months postpartum. The infants' birthweight, weeks of gestation, and Apgar scores at five minutes, maternal age at delivery, and maternal and child health index risk scores were not significantly different between the two groups. Mothers who had cesarean delivery had significantly higher labor index risk scores than those with vaginal birth. The mothers and fathers were not significantly different on levels of depression or marital adjustment prenatally or at three months postpartum. There were no significant differences in mother‐infant behaviors during the feedings observed. That we found no differences after cesarean and vaginal delivery would support the theory that mothers respond to infants' behavioral repertoire and not to the mode of delivery.
An American Experience of Pregnancy and Childbirth in Japan
Authors: Sharts Engel Nancy
Published: April 2007

Abstract: Birth practices in modern Japan differ markedly from those currently observed in the United States and the outcomes are among the best in the world. A fundamental question is whether such practices could be exported apart from the underlying system of cultural values. While autonomy is cherished in America, birth practices in Japan directly and indirectly reflect the values of order and harmony in social groups. Strict adherence to traditional gender roles is seen as promoting the social order. I used a participant‐observer approach to study this phenomenon, teaching on a maternity nursing faculty in Japan for two years, providing childbirth counseling in the foreign community, touring various birth facilities, interviewing health professionals and Ministry of Health officials, and bearing my first child in that country.
Social Network Advice During Pregnancy: Myths, Misinformation, and Sound Counsel
Authors: Clair Patricia A. St. , Anderson Nancy A.
Published: April 2007

Abstract: One hundred eighty‐five low‐income, inner‐city women were interviewed after they gave birth. They were allowed to report on up to 30 members of their social networks, including household members, relatives, and friends. Questions were asked regarding the types and nature of health advice given to them by these individuals, the relationship of each advisor, and his or her age and sex. Respondents received between 0 and 211 (median 20) pieces of advice related to pregnancy health from 0 to 19 (median 5) members of their social networks. Both folk beliefs and information aligned with accepted medical views of health promotion were communicated to individual women. Most advice rendered was sound, but often the rationale for the recommended health action was poorly understood. Some respondents received advice that, if followed, could be harmful to health. This suggests that for some low‐income, inner‐city women, social networks serve as important resources for health information. However, the advice they convey may cause unnecessary worry or come into conflict with recommendations of health care providers. Therefore, new educational strategies are required to address the informational needs not just of individual women, but of their social networks as well.
Obstetric Outcomes at the Birth Place in Menlo Park: The First Seven Years
Authors: Eakins Pamela S. , O'Reilly Wenda Brewster , May Linda J. , Hopkins Joseph
Published: April 2007

Abstract: During its first seven years of operation, the Birth Place, a free‐standing birth center in California, registered 898 women, of whom 690 (77%) were admitted in labor and 150 (17%) were referred for hospital birth prior to onset of labor. Using carefully delineated screening criteria, the center had an overall 18% intrapartum transport rate to the hospital, primarily for prolonged or arrested labor, a 3% cesarean section rate, no maternal mortality, and one neonatal death resulting from Cornelia de Lange syndrome, a congenital mental retardation‐malformation syndrome of unknown etiology, which in this case was incompatible with life. Deliveries at the Birth Place were associated with low cost, a high level of maternal satisfaction, a low cesarean section rate, low neonatal mortality, and no maternal mortality. (BIRTH 16:3 September 1989)
Functional Assessment of Infant Breastfeeding Patterns
Authors: Walker Marsha
Published: April 2007

Abstract: As breastfeeding rates have increased in the United States, the need has arisen for coordinated approaches to the assessment of normal and problem situations. Since some difficulties are related to the manner in which baby feeds, guidelines are discussed for the visual assessment of breastfeeding. These include the when, why, and how of assessing seven common situations or problems: initial breastfeeding experiences, inadequate infant weight gain or low milk intake, insufficient milk supply (real or perceived), nipple problems, latch‐on and sucking disorganization, high‐risk situations, and the good baby syndrome.
Cesarean Section in the United States: Has It Changed Since 1979?
Authors: Marieskind Helen I.
Published: April 2007

Abstract: From 1965 to 1979 the cesarean section rate in the United States increased 264 percent. An analysis in 1979 identified several contributing factors, including fear of malpractice suits, the custom of repeat cesareans and operative delivery for breech‐presenting infants, increased diagnoses of dystocia and fetal distress, physician training, economic incentives, and the concept of “premium babies.” From 1979 to 1987 the cesarean section rate increased 48.8 percent to an annual rate of 24.4 percent. Current analysis finds the same factors still interacting to continue the upward trend. Growing use of vaginal birth after a previous cesarean, increased recognition of the imprecision of electronic fetal monitoring, greater public awareness, and professional peer review activities are beginning to slow the rate of increase.
Surgical and Nonsurgical Procedures Associated with Hospital Delivery in the United States: 1980–1987
Authors: Jean Kozak Lola
Published: April 2007

Abstract: Data from the National Hospital Discharge Survey were used to examine changes in the rates of procedures performed on women hospitalized for delivery from 1980 to 1987 in the United States. The rate of procedures reported per 100 deliveries increased 42 percent. Much of this increase was reported from 1984 to 1987, when there may have been more complete recording of secondary procedures due to the implementation of prospective payment systems. The reported rates of cesarean sections, repair of current obstetric lacerations, artificial rupture of membranes, and vacuum extraction increased throughout the whole period from 1980 to 1987, however, and thus are less likely to have risen because of changes in reporting practices.
Early Prenatal Care in Urban Black and White Women
Authors: Petitti Diana , Coleman Charlotte , Binsacca Donald , Allen Barbara
Published: April 2007

ABSTRACT: If the ultimate success of efforts to improve pregnancy outcome depends on assurance that prenatal care begins in the first trimester, it is important to identify potentially modifiable factors associated with the start of care as well as the groups in which it is most likely to be late. This topic was explored in a population‐based study of low birthweight in 766 black women and 462 white women who gave birth in Alameda County, California, in 1987. Variables related to insurance coverage and financial status showed the greatest difference between early and late attenders at prenatal care in both groups. At virtually every level of almost every variable studied, black women were less likely than white women to begin prenatal care in the first trimester. The data suggested that some of the difference in the timing of prenatal care may be due to lack of awareness of, or failure to pay attention to, the signs of early pregnancy. We conclude that, although addressing problems of insurance coverage and financial status is critical to the solution of the problem of late initiation of prenatal care, as financing difficulties are solved, attention should be paid to women's internal factors such as depression and denial as modifiers of the earliness of seeking prenatal care.
The Influence of Breast Surgery, Breast Appearance, and Pregnancy‐Induced Breast Changes on lactation Sufficiency as Measured by Infant Weight Gain
Authors: Neifert Marianne , DeMarzo Sandra , Seacat Joy , Young David , Leff Marilyn , Orleans Miriam
Published: April 2007

ABSTRACT: We conducted a prospective study of the associations between several biologic and surgical breast factors and the onset of lactation in 319 healthy, motivated, primiparous women who were breastfeeding term, healthy, appropriate for gestational age or large for gestational age infants. During the last trimester of pregnancy, subjects' breasts were examined for surgical incisions, size, symmetry, and nipple protuberance, and women estimated their prenatal breast enlargement. At two visits in the first two weeks postpartum, infants were weighed naked, and mothers reported the magnitude of postpartum breast engorgement when their milk came in. Breastfeeding was evaluated at each visit, and interventions were recommended for problems, with emphasis on maximizing milk yield. Lactation was deemed sufficient when an exclusively breastfed infant achieved an average weight gain of 28.5 g or more per day between the two visits. Infants gaining less than 28.5 g per day with breast milk exclusively, and those requiring formula supplement returned for a third visit at or before 21 days of age, when final lactation outcome was assessed based on weight gain between the second and third visits.

Within three weeks postpartum 85 percent of the mothers achieved sufficient lactation, whereas 15 percent had persistent milk insufficiency despite intensive intervention. Of the study population, 6.9 percent had undergone previous breast surgery. Women with periareolar breast incisions were nearly 5 times more likely to have lactation insufficiency than were those without surgery (relative risk [RR] = 4.55; 95 percent confidence interval [CI] = 2.21–9.43; P < 0.001). Insufficient lactation was significantly associated with minimal prenatal breast enlargement (P < 0.02) and minimal postpartum breast engorgement when milk came in (P < 0.001). Although not statistically significant, women with inverted nipples were more likely to have lactation insufficiency compared with those with normal nipples (RR = 2.94; 95% CI 1.05–8.20; P= .07). The findings from this study indicate that certain biologic and surgical breast variables are associated with lactation insufficiency.
Perinatal Predictors of Pain and Distress During labor
Authors: Wuitchik Michael , Hesson Kathlyn , Bakal Donald A.
Published: April 2007

ABSTRACT: We sought to determine whether women's attitudes and concerns, confidence in ability to control pain, and practice of pain‐control techniques would predict pain and coping or distress‐related thought during labor. During the third trimester of their pregnancies, 115 women completed the prenatal self‐evaluation inventory and measures of confidence and practice of pain‐control techniques. During the latent (≤3 cm), active (4–7 cm), and transition (≥ 7 cm) phases of labor, interviews were conducted to assess levels of pain and the content of women's cognitive activity on a continuum that ranged from coping‐related thought to distress‐related thought. Women's confidence in their ability to use relaxation techniques and their reported practice of pain‐control strategies did predict lower levels of pain and greater coping‐related thought during latent labor, but failed to account for pain or coping‐distress in active or transition phases of labor. High scores on the Prenatal Self‐Evaluation Inventory fear of pain and helplessness scale predicted high levels of distress during latent labor. Two other scales, concern for self and baby and acceptance of pregnancy, were significant predictors of pain and distress in active and transitional labor. The results suggest that, with the shift from latent to active labor, women's fundamental concerns and anxieties become manifest, and may take precedence over the skills acquired through childbirth education in moderating experienced pain and distress.
Women's Views of Second‐Stage Labor as Assessed by Interviews and Videotapes
Authors: McKay Susan , Barrows Teri , Roberts Joyce
Published: April 2007

ABSTRACT: Twenty women were selected from public and private maternity services and interviewed by nurses and nurse‐midwives on a research team. The women were shown videotapes of their second‐stage labors that for 15 of them had been recorded by 2 other members of the research team. Four videos were provided by mothers who had had home births and one from a mother whose birth was filmed at a birth center. The interviews were analyzed for major themes; the theme reported here is women's experiences of pushing. Women reported wide variations in sensations during the second stage. Whereas 9 of 16 women expressed feelings of relief or pressure and stretching, 7 described pushing as painful, miserable, or horrible. Thirteen of 19 women had well defined urges to push, 1 had an intermittent urge, and 5 had no urge. Women often felt unprepared for the sensations and work of second‐stage labor, and caregivers' instructions commonly did not seem to be in synchrony with physiological responses. We conclude that childbirth educators and caregivers must prepare women more realistically for the second stage. They would be more effective if they responded to maternal behavior, rather than giving arbitrary instructions about pushing.
Through a Glass Darkly: Ultrasound and Prenatal Bonding
Authors: Lumley Judith
Published: April 2007

ABSTRACT: Prenatal ultrasound scans are believed to enable mothers to form an early affectionate bond to their child, to provide a reassuring image of the fetus, and to promote improvements in mothers' health behaviors on the behalf of the fetus. Observational studies suggest that scans done early may slightly improve maternal‐fetal bonding but that those done after quickening are not associated with attachment. Short‐term effects on maternal health behaviors, including less smoking, less drinking of alcohol, and more visits to dentists, were detected in a randomized trial when detailed information was given during the scan. This trial also suggested that women's anxiety was actually increased during scans, and then allayed by positive feedback from the operator. Not all women considered scans reassuring in one interview study, and other authors found that mothers' interpretations of scans depended on their personal and social circumstances. As used in everyday practice, ultrasound scans are not always accompanied by feedback, and when feedback occurs it is sometimes in the form of slips of the tongue, incorrect diagnoses, identification of structures that cannot be deciphered, and language that is unfamiliar and alarming to mothers. This “diagnostic toxicity” of ultrasound scans of the fetus has not been studied.
Cesarean Delivery and Breastfeeding Outcomes
Authors: Kearney Margaret H. , Cronenwett Linda R. , Reinhardt Robert
Published: April 2007

ABSTRACT: Breastfeeding outcomes of 121 primiparas enrolled in a larger study were examined to determine the impact of cesarean delivery on time of first breastfeeding. Mothers giving birth by cesarean had a later first breastfeeding and expressed less satisfaction with the birth experience than did those who delivered vaginally. No relationships were found between delivery type and duration of breastfeeding or pain or fatigue related to breastfeeding. Time of first breastfeeding was not related to breastfeeding duration. Although some investigators have reported that mothers who have cesarean deliveries or delayed first feeding are less successful at breastfeeding, the high level of commitment to breastfeeding in this sample may have overcome the effect of perinatal events.
A Standardized Interview That Differentiates Pregnancy and Postpartum Symptoms from Perinatal Clinical Depression
Authors: Affonso Dyanne D. , Lovett Steven , Paul Steven M. , Sheptak Suann
Published: April 2007

ABSTRACT: In a prospective longitudinal study, 202 primigravidas were assessed for depression using the National Institute of Mental Health's (NIMH) standardized clinical interview, the Schedule for Affective Disorders and Schizophrenia (SADS), and Research Diagnostic Criteria (RDC) at four periods: 10 to 14 weeks of pregnancy, 30 to 32 weeks of pregnancy, 1 to 2 weeks postpartum, and 14 weeks postpartum. Women's responses did not fit the SADS standardized questions and prescribed ratings because pregnancy and postpartum symptoms often mimicked depression symptoms. This was addressed by adding questions and scoring criteria to separate out pregnancy and postpartum symptoms from depression symptoms. Results showed that, after accounting for pregnancy‐postpartum symptoms, women consistently claimed eight symptoms with high frequency and higher mean ratings: dysphoric mood, worrying, somatic and psychic anxiety, insomnia, fatigue, anger, and irritability. The findings suggest that 1) depression in pregnant and newly delivered women may be underdiagnosed if caregivers attribute their complaints or symptoms to time‐limited somatic conditions; 2) depression may be overdiagnosed if clinicians use self‐report measures solely, or without carefully interviewing women to separate the symptoms of depression from symptoms of pregnancy and postpartum; and 3) women's reactions to perinatal symptoms may have some bearing on the development of depression then or later. Simple clinical and social amelioration of the symptoms of distress might reduce their effect and diminish the rate of mistaken diagnoses of depression.
Postpartum Depressive Disorders: Changing Trends
Authors: Unterman Rosalind R. , Posner Norman A. , Williams Karen N.
Published: April 2007

ABSTRACT: For centuries, there has been speculation regarding the etiology of postpartum depression. An improved diagnostic classification has emerged, however, as the universality of the syndrome has been recognized and the role of hormonal, genetic, and obstetric variables considered. In addition, different cultures have different perceptions of the needs of the new mother. The emphasis in investigative work now appears to be in the psychosocial and psychodynamic areas. Our recent research focused on identification of risk factors early in pregnancy, including a history of depression, separation from one or both parents in childhood or adolescence, poor parental emotional support in childhood and adulthood, poor relationship with husband or partner, economic problems, and dissatisfaction with amount of education. We suggest that physicians, nurses, and mental health professionals be aware of the emotional status of their patients, familiarize themselves with the risk factors, and initiate a program of careful postpartum follow‐up. These measures will help to improve recognition and management of the woman at risk for postpartum depression.
Midwifery in Ontario: A Survey of Interest in Services
Authors: Soderstrom Bobbi , Chamberlain Marie , Kaitell Christabel , Stewart Paula J.
Published: April 2007

ABSTRACT: Maternity care for women in Ontario is provided almost exclusively by physicians, the majority of whom are obstetricians. Using a self‐administered questionnaire, pregnant women in one Ontario city were surveyed about their interest in midwifery care as an alternative to physician care. Although 3 percent of the women surveyed had used a midwife, 60 percent expressed an interest in midwifery care, particularly the counseling and support aspects. Over 11 percent showed an interest in complete primary midwifery care.
How Frequently Are Home Pregnancy Tests Used? Results from the 1988 National Maternal and Infant Health Survey
Authors: Jeng Lana L. , Moore Roscoe M. , Kaczmarek Ronald C. , Placek Paul J. , Bright Roselie A.
Published: April 2007

ABSTRACT: Many women use commercially available home pregnancy tests to determine their pregnancy status before seeking professional health care. Despite the increasing popularity of these products, no national estimates have been reported to date on their frequency of use. We analyzed available data from the 1988 National Maternal and Infant Health Survey to determine the frequency of use of home pregnancy tests during recent pregnancies of women of varying sociodemographic backgrounds. Approximately 33 percent (N= 4700) of the women surveyed used such a device. Use was most frequent among women who were white, married, over age 39 years, highly educated, or had a high family income. We conclude that home pregnancy testing appears to be a frequent procedure, especially among women of high socioeconomic background.
An Outcome Evaluation of the Content and Quality of Prenatal Care
Authors: Petitti Diana B. , Hiatt Robert A. , Chin Victor , Croughan‐Minihane Mary
Published: April 2007

ABSTRACT: Linkage of measures of the adequacy, content, and quality of prenatal care with pregnancy outcome is a long‐standing research challenge. We attempted to improve on prior studies by developing a measure of prenatal care that encompasses the specific items thought to mediate its relationship with birthweight and by then examining the association of this measure with birthweight. An eight‐item index of prenatal care was used to abstract information from the medical records of 63 white and 56 black women who gave birth to low‐birthweight (<2500 g) infants and 61 white and 101 black women who gave birth to normal‐weight (3000 + g) infants in 1987 at two Kaiser Permanente facilities. In univariate analyses the mean values for the index were higher in controls than in cases for both black and white women, but the difference was statistically significant only for blacks. In multivariate analysis the index was not significantly associated with the risk of low birthweight for whites or blacks. Prenatal care was extremely homogeneous in this population, which compromised the evaluation of the index as a correlate of low birthweight. We believe that this is a promising method for assessing the content of prenatal care and studying the association between content and outcome of care.
The Patient Observer: Does the Hands‐and‐Knees Posture During labor Help to Rotate the Occiput Posterior Fetus?
Authors: Biancuzzo Marie
Published: April 2007

ABSTRACT: Retrospective chart review was conducted for four low‐risk women with full‐term, healthy fetuses in the occiput posterior position. The first woman pushed for over two hours and delivered a 6 lb, 83/4 oz baby by cesarean section. The second woman delivered a 5 lb, 23/4 oz baby posteriorly by vacuum extraction and had a third‐degree laceration. The third and fourth women both assumed the hands‐and‐knees posture during labor; their infants weighed 7 lb, 73/4 oz and 7 lb, 113/4 oz, respectively. Both of these fetuses rotated to the anterior position and were born spontaneously without complications.
A Randomized Study of Two Methods of Teaching Perineal Massage: Effects on Practice Rates, Episiotomy Rates, and Lacerations
Authors: Mynaugh Patricia A.
Published: April 2007

ABSTRACT: This study examined the effects of two methods of teaching perineal massage on the rates of practice of perineal massage, of episiotomy, and of lacerations in primiparas at birth. Couples in 20 randomly selected sections of four prenatal class series received routine printed and verbal instruction and a 12‐minute video demonstration of perineal massage, or only the routine printed and verbal instruction. Women reported their practice rates in daily diary records, which were mailed to the researcher weekly. Hospital records provided delivery data. Of the 83 women, 23 (28%) practiced perineal massage: 16 (35.6%) in the experimental group, 7 (18.4%) controls. Even though the rate of practice almost doubled among experimental group women, the videotape instruction method was statistically nosignificant. Episiotomy and laceration rates were not affected by teaching method. More severe lacerations occurred among the experimental group; however, the control group had almost four times as many severe (21%) as minor (5.3%) lacerations. The experimental group had twice as many severe (28.9%) as minor (13.3%) lacerations. These results were also nosignificant.
A Randomized, Controlled Trial to Measure the Frequency of Use of a Hospital Telephone Line for New Parents
Authors: Rush Janet P. , Kitch Tracy L.
Published: April 2007

ABSTRACT: New parents have fewer supports today than in previous decades due to factors such as short postpartum hospital stay, fragmentation of services, and long‐distance families. This controlled trial evaluated the frequency of use of a 24‐hour, in‐hospital telephone line by 130 parents randomly invited to use the service and 130 who were not aware of this service. A special line with a separate extension was installed on the postpartum unit. Randomly arranged, sealed envelopes were given to 260 women at the time of discharge, containing a congratulations message or description of a new 24‐hour telephone line for advice given by postpartum nurses. Of 53 calls requesting help, 36 were received on the special line and 17 on regular ward telephones; 28 percent of those invited to call back did so, and 13 percent of those without an invitation called on the regular extension, (P = 0.015). Recommendations for future program planning are based on the results of this study.
Just Another Day in a Woman's Life? Women's Long‐Term Perceptions of Their First Birth Experience. Part I
Authors: Simkin Penny
Published: April 2007

ABSTRACT: This study explored and analyzed the long‐term impact of the birth experience on a group of 20 women from the natural childbirth culture of the late 1960s and early 1970s. The data consisted of 1) a structured labor and birth questionnaire and an unstructured account of their experiences written shortly after their babies were born; 2) a similar questionnaire and account written 15 to 20 years later; and 3) a transcribed one‐ to one‐and‐a‐half‐hour interview during which each woman's memories and perceptions were discussed. Women reported that their memories were vivid and deeply felt. Those with highest long‐term satisfaction ratings thought that they accomplished something important, that they were in control, and that the birth experience contributed to their self‐confidence and self‐esteem. They had positive memories of their doctors' and nurses' words and actions. These positive associations were not reported among women with lower satisfaction ratings.
Postnatal Depression: Its Nature, Effects, and Identification Using the Edinburgh Postnatal Depression Scale
Authors: Holden Jenifer M.
Published: April 2007

ABSTRACT: Postnatal depression, or clinical depression in mothers during the months after childbirth, occurs at a time when heavy demands are placed on these women's resources, and when infant learning and development are taking place. Identification and treatment are facilitated when health professionals and services are in close contact with the family and can provide beneficial intervention. Two studies examined whether women with nonpsychotic postnatal depression could be recognized and treated within existing services, using the Edinburgh Postnatal Depression Scale and a randomized, controlled trial of counseling intervention with health visitors.
Why Women Decide Not to Breastfeed
Authors: Dix Dustine N.
Published: April 2007

ABSTRACT: The reasons for the low frequency of breastfeeding at an urban medical center were evaluated in a study in which 81 women were interviewed concerning the factors affecting their choice of infant feeding method and attitudes toward breastfeeding. One‐half of the women made their decision during pregnancy, and 41 percent did so before conception. They received information on infant feeding methods from health care providers, family, and friends. In addition to their own thoughts and feelings, family members had the most influence on the feeding method. The influence of health care providers was minimal, yet most women received early and comprehensive prenatal care. Although they thought that breastfeeding was better for the baby, the majority chose to bottle feed due to negative attitudes toward breastfeeding, conflicting responsibilities or schedules, convenience, negative breastfeeding experiences, and health or medical reasons.
Warm Tub Bath After Spontaneous Rupture of the Membranes
Authors: Waldenström Ulla , Nilsson Carl‐Axel
Published: April 2007

ABSTRACT: Increasing numbers of pregnant women take a warm bath during labor. Yet few evaluations have addressed benefits claimed and possible risks of this practice. Using retrospective data from a continuing trial at a birth center in Stockholm, we compared 89 women who took a warm bath after spontaneous rupture of the membranes at term with 89 women who had the same interval from spontaneous membrane rupture to delivery and who did not bathe. No statistical difference was observed between the groups with respect to infections, asphyxia or respiratory problems in the newborn infant, or maternal signs of amnionitis. However, a tendency toward more complications was observed in the bathing group. Babies born more than 24 hours after rupture of membranes had significantly lower Apgar scores at 5 minutes in the bathing group than in the control group. As a result of our review of the sparse literature on this practice and the data from this study, we have modified the bathing policy at the birth center from a rather enthusiastic to a more cautious approach. Recommendations about the use of a warm bath in labor will require further investigation, such as randomized trials with large numbers of subjects. (BIRTH 19:2 June, 1992)
The Crisis of Pregnancy Loss: A Team Approach to support
Authors: Brown Yvonne
Published: April 2007

ABSTRACT: When a pregnancy loss occurs, a woman and her family may require help to facilitate grieving. Several support strategies can be recommended. We established a volunteer, hospital‐based perinatal crisis support group that provides intervention, assists clients in moving through the period of disorganization, and offers information and support. Four examples illustrate the work of the group and its collaboration with personnel in other departments and agencies. Guidelines are provided for the establishment of a support team. (BIRTH 19:2 June, 1992)
Prenatal Factors Associated with Breastfeeding Duration: Recommendations for Prenatal Interventions
Authors: O'Campo Patricia , Faden Ruth R. , Gielen Andrea C. , Wang Mei Cheng
Published: April 2007

This study of 198 urban breastfeeding women examined the psychosocial, demographic, and medical factors identified prenatally that may be associated with longer breastfeeding duration and may serve as suitable areas for prenatal breastfeeding promotion interventions. Of 11 psychosocial and demographic factors examined, 5 were important influences on breastfeeding duration: anticipated length of breastfeeding, normative beliefs, maternal confidence, social learning, and behavioral beliefs about breastfeeding. Methods of multivariate linear regression were used to identify prenatal factors that influenced anticipated length. Of the 10 factors entered into the regression model, parity, plans to return to work or school by six months postpartum, and maternal confidence were the most significant factors affecting anticipated length of breastfeeding. Our data suggest several factors amenable to intervention during the prenatal period that appear to influence breastfeeding duration. Prenatal promotion efforts could easily incorporate strategies that influence factors such as normative and behavioral beliefs and maternal confidence.
Sleep Disturbances, Vitality, and Fatigue Among a Select Group of Employed Childbearing Women
Authors: Lee Kathryn A. , DeJoseph Jeanne F.
Published: April 2007

Self‐reported sleep disturbances and levels of vitality and fatigue were studied in a secondary analysis of 25 pregnant and 29 postpartum employed women. Results indicate that pregnant women have problems initiating and maintaining sleep, and postpartum women have problems maintaining sleep, but not falling asleep. The primary reason for midsleep awakenings was urinary frequency among the pregnant women, and child care responsibilities among the postpartum women. Chronic sleep disturbance was indicated by a greater percentage of postpartum women who fell asleep easily, very few who felt highly energetic at work, and most who perceived a high level of fatigue during the past week. Even with these sleep disruptions, no differences occurred in the mean scores for perception of fatigue und vitality between the two groups. Clinicians can use these findings to educate women about some changes they may anticipate and how they might manage them during pregnancy and postpartum
Nurses' Care During labor: Its Effect on the Cesarean Birth Rate of Healthy, Nulliparous Women
Authors: Radin Tari G. , Harmon Judith S. , Hanson Dorothy A.
Published: April 2007

This retrospective study was designed to determine the influence of nurses' care during labor and delivery on the cesarean birth rate of healthy, nulliparous women. Labor and delivery nurses in a large, nonprofit hospital were grouped according to the cesarean birth rates of their healthy, nulliparous patients in spontaneous labor. Large differences in cesarean birth rates between nurses in the lowest quintile (near 4.9%) and the highest quintile (near 19%) were not explained by differences in maternal age and gravidity, attendance of mother at childbirth class, insurance status, reliance on public assistance, physician who attended labor, use of epidural anesthesia, augmentation of labor, dilation when the nurse assumed care, infant weight, or gestational age. In multivariate analysis, the elapsed time between when the nurse assumed care and birth was significantly shorter for patients of nurses in the lowest quintile of cesarean birth rate (4.4 hrs) compared with patients of nurses in the highest quintile (5.6 hrs). The former were also less likely to have forceps used to assist vaginal delivery than the latter (13% vs 26%). Nurses in the lowest quintile of cesarean birth rates were more likely to use a form to record psychosocial data than nurses in the highest quintile (35% vs 15%). The study suggests that nurses' care during labor is an important factor influencing cesarean birth rates.
Satisfaction with Childbirth: Theories and Methods of Measurement
Authors: Bramadat Ina J. , Driedger Mary
Published: April 2007

Two studies of women's birth experience emphasized the difficulty in evaluating satisfaction with the event. The first study used a quantitative, direct measure of satisfaction in which 91 postpartum women rated their satisfaction with labor and delivery overall and with different aspects of the experience. The second was a qualitative study that examined conceptual issues of women's satisfaction with childbirth using semistructured interviews with nine postpartum women. Content analysis was used to identify themes and categories that contributed to understanding why some women are satisfied and others dissatisfied with the birth experience. Both studies found support for a discrepancy theory of satisfaction. This paper discusses methodologic issues involved in measuring satisfaction with childbirth.
Does Breastfeeding Empower Women? Insights from a Select Group of Educated, Low‐Income, Minority Women
Authors: Locklin Maryanne P. , Naber Sarah J.
Published: April 2007

A grounded theory study examined the breastfeeding experiences of a small group of educated, low‐income, minority women. In‐depth interviews were used to collect data. The five themes that emerged as primary descriptors of the experience were against all odds, personal motivation, support, attachment, and telling the world. These themes help to identify the factors that enhanced successful breastfeeding among this select sample of women, and demonstrate that the perception of successful breastfeeding can have an empowering effect on women.
Nausea and Fatigue During Early Pregnancy
Authors: van Lier Donna , Manteuffel Brigitte , Dilorio Colleen , Stalcup Marsha
Published: April 2007

Nausea and fatigue are uncomfortable, sometimes almost debilitating, symptoms of pregnancy. Anecdotally, fatigue seems worse as nausea increases. This descriptive correlational study investigated the relationship between nausea and fatigue during early pregnancy. Fifty‐one women who received prenatal care at two obstetrics and gynecology nurse‐midwifery practices in a large metropolitan area participated. Each women completed a nausea questionnaire, the Pearson‐Byars fatigue feeling checklist, and a demographic data sheet at her first or second prenatal visit. Participants were at less than 17 weeks' gestation; 43 percent were pregnant for the first time, and48 percent reported nausea at the time they completed the questionnaire. Women with severe nausea had higher levels of fatigue than those with no or mild and moderate nausea. Severity of nausea and level of fatigue were positively correlated, indicating that as nausea increased so did the severity of fatigue.
Maternal‐Fetal Attachment and Perceived Relationships With Important Others in Adolescents
Authors: Wayland Jan , Tate Starla
Published: April 2007

We examined associations between maternal‐fetal attachment and the pregnant adolescent's perceived relationships with her mother and the baby's father. Questionnaires were administered in health department prenatal clinics to a sample of 61 Mexican‐American, African‐American, and Caucasian adolescents at 13 to 40 weeks' gestation. Each woman completed Cranley's maternal‐fetal attachment scale (MFAS), an investigator‐developed relationship with mother scale and a survey instrument that assessed living situation, perceptions of the relationship with the baby's father, and standard demographic variables. Scores on the MFAS significantly correlated with the adolescent's perceived close relationships with her mother and the baby's father, frequency of contact with the baby's father, gestation, and marital status. Mexican‐American adolescents scored significantly lower on the MFAS than Caucasian adolescents. The scale needs further testing in multiethnic groups of adults and adolescents.
Do Cabbage Leaves Prevent Breast Engorgement? A Randomized, Controlled Study
Authors: Nikodem V. Cheryl , Danziger Donna , Gebka Nicky , Gulmezoglu A. Metin , Hofmeyr G. Justus
Published: April 2007

A randomized, controlled trial was conducted to evaluate the effect of cabbage leaves on mothers' perceptions of breast engorgement and the influence of this treatment on breastfeeding practices. The subjects, 120 breastfeeding women 72 hours postpartum, were randomly allocated to an experimental group who received application of cabbage leaves to their breasts, or to a control group who received routine care. The experimental group tended to report less breast engorgement, but this trend was not statistically significant. At six weeks, women who received the cabbage leaf application were more likely to be breastfeeding exclusively, 76 and 58 percent (35/46 us 29/50; P =0.09), and their mean duration of exclusive breastfeeding was longer (36 us 30 days; P =0.04). The greater breastfeeding success in the experimental group may have been due to some beneficial effect of cabbage leaf application, or may have been secondary to reassurance and improved confidence and self‐esteem in these mothers.
Expectations and Experiences of Pain in Labor: Findings from a Large Prospective Study
Authors: Green Josephine M.
Published: April 2007

Data on expectations and experiences of pain in labor are presented from a prospective study of over 700 women who gave birth in six maternity units in southeast England. Most women preferred to keep drug use to a minimum, even though they expected labor to be “quite” or “very” painful. The ideal of avoiding drugs was unrelated to education or social class. Women who preferred to avoid drugs were more likely to do so, and were more satisfied with the birth overall than women who used drugs. In general, women tended to get what they expected. Breathing and relaxation exercises were widely used, and were most successful for those who had expected them to be so. Anxiety about the pain of labor was a strong predictor of negative experiences during labor, lack of satisfaction with the birth, and poor emotional well‐being postnatally.