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公益財団法人日本医療機能評価機構の医療事故情報収集等事業では医療機関から医療事故情報を収集し，毎年公表している．本研究は，この医療事故情報を用いて助産師における医療事故情報のデータを分析し，事故の影響，助産師経験年数による医療事故内容を比較検討することを目的とした．分析対象は，医療事故情報の報告年2010 ～ 2021 年，第1 当事者の職種は助産師とした．事故の発生状況等を収集し，事故の要因の根本原因分析を行った．第1 当事者が助産師による11 年間の医療事故は98 件，事故の概要は療養上の世話，発生場所は病室，発生時間は16 時以降18 時までの発生が多かった．事故後の医療は7 割に実施され，そのうち8 割は軽微から濃厚な治療を受けていた．医療事故の当事者は経験年数が平均10 年，3 ～ 15 年未満が5 割を占めた．医療事故の発生要因は，当事者に関わる要因が9 割を占め，そのなかで「確認を怠った」，「観察を怠った」要因が多かった．医療事故の影響と発生要因の比較では「連携ができていなかった」は事故の影響が有意に認められ，助産師の経験年数と発生要因の比較では3 ～ 15 年未満の助産師は「連携ができていなかった」が有意に多かった．助産師は経験年数に関わらず，医療を提供する時には，2 人以上で確認や観察を丁寧に行い，緊急時における早急な対応ができるような多職種との連携を強化することが医療安全につながる．, The Japan Council for Quality Health Care collects information on medical accidents from medical institutions to publish annually. This study aimed to analyze the data on medical accidents among midwives using information provided by the Council for Quality Health Care and to compare the impact of accidents and their content according to the years of midwifery experience. Medical accidents that occurred between 2010 to 2021, where the first party was a midwife, were included in the analysis for this study. Circumstances of the accidents were collected and a root cause analysis of the factors contributing to the accidents was conducted. There were 98 medical accidents in which the first party was a midwife. Most accidents were under nursing care, and occurred in hospital rooms between 16:00 and 18:00. Post-accident medical care was provided to 70% of the patients. Of these, 80% received minor to intensive treatment. Midwives had an average of 10 years of experience, and 50% had less than 3–15 years of experience. Factors related to the parties involved accounted for 90% of the medical accidents. Among these, “failure to check” and “failure to observe” were the most common factors. A comparison of the degree of the accident and the factors that caused it showed that “there was no coordination,” which had a significant impact on the accident. In a comparison of midwives' years of experience and the factors that caused, midwives with less than 3–15 years of experience were significantly more likely to say that “there was no coordination.” Regardless of their years of experience, midwives should carefully check and observe of mother and baby with two or more people and strengthen cooperation with multiple professions when providing medical care to respond promptly in an emergency and ensure medical safety.

Obstetric violence has been recognized as a major impediment to facility-based delivery, increasing the risk of preventable complications and maternal mortality. In Ghana, studies on women’s birth experiences reveal enormous and brutal acts of violence during delivery; however, inquiries into why midwives abuse women have not been extensively studied. This study explored the perspectives of midwives on the drivers of obstetric violence in the Western and Ashante Regions of Ghana. A qualitative study was conducted involving 30 in-depth interviews with midwives in eight health facilities. The data were analyzed thematically using NVivo 12. The results of the study reveal a normalization of violence in the delivery room and the intensity of violence is heightened during the second stage of labor. Midwives reported perpetrating or witnessing physical violence, abandonment of women, stigmatization of HIV women, verbal abuses such as shouting, and the detention of women in the health facilities. Midwives abuse women as a result of the pressures of the midwifery profession, poor maternal efforts of women, disrespect of midwives, women’s disobedience, and uncooperative attitudes. The culture of acceptability of obstetric violence is a major driver, contributing to its normalization. Midwives do not consider obstetric violence as abuse, but rather, as a delivery strategy which aids a successful delivery. It is therefore justified and viewed as a necessary part of the delivery process. There is a critical need for retraining midwives on alternative birthing strategies devoid of violence.

West Africa is engaged in a process of harmonising health workers’ training programmes as a means to regulate regional training standards and thus improve their quality. There is currently a lack of documented information regarding the adoption of these revised training programmes. In 2012 a harmonised programme, the WAHO competency-based curriculum, was introduced in Mali for training midwives. The present study explores the barriers and facilitators of the adoption of this programme and how the content, context, process, and actor-related factors influenced this. We used a qualitative research design consisting of document analysis (n = 25) and semi-structured interviews (n = 21) with policymakers, students, and those in charge of implementing the training programme. Information was collected on education and training policies, the context and process of the harmonised curriculum development, its adoption, and the actors involved in the adoption strategy, along with their role. The study shows that the adoption of the harmonised curriculum in Mali offered midwives an opportunity to attain a higher standard of training and level of qualification than before. It also displayed both the government’s and the public school’s willingness and commitment to improve maternal and child health through enhancing midwives’ training standards. The most salient factors that influenced adoption were the lack of available resources, and the lack of involvement of, and coordination with, relevant actors for successful policy adoption. Mali’s experience of adopting the harmonisation policy of training curricula demonstrates the need for the authorities to collaborate with relevant actors for information dissemination and in the adoption process. It also demonstrates the need for finding innovative ways to secure and diversify funding opportunities, as well as establish a supervisory body for health worker training.

Background: Anaemia in infants is a major public health concern particularly in low and middle-income countries. Delayed cord clamping (DCC) has been advocated as a strategy to decrease iron deficiency anaemia in infants because of the benefits that come with placental transfusion. Despite the documented benefits of delayed cord clamping in preventing anaemia the current practices of delayed cord clamping by midwives and obstetricians across countries and in different contexts is unclear. This narrative review assesses the literature on delayed cord clamping practices published from 2013 to February 2022, in order to examine current practice in birth units globally, and with a focus in low and middle-income countries (LMICs). Method: A search of four bibliographic databases Medline, Scopus (Elsevier), ProQuest, CINAHL and two network and search engines, Wiley and Google Scholar, was undertaken from 2013 to February 2022 using key terms related to delayed cord clamping and immediate cord clamping. A snowball method as well as backward and forward reference checking was also undertaken. Results: The search strategy identified 10 studies on umbilical cord clamping practices by midwives and obstetricians. Only two studies were conducted in low and middle-income countries. Conclusion: Despite the potential benefits of DCC in reducing anaemia, particularly in low and middle-income countries where the burden of anaemia is a public health concern, there is a paucity of literature on current DCC practices by obstetricians and midwives. Research to establish current DCC practices in these countries is needed to address this gap in the literature. Refereed/Peer-reviewed

目的：妊婦と助産師の双方向から妊娠期の母子感染症に関する保健指導を検討する．方法：調査は 2 段階で行い，研究Ⅰでは 3 施設の妊婦対象に質問紙法を行い，定量的分析，研究Ⅱでは助産師 5人に半構造化面接を行い質的帰納的に分析した .結果：研究Ⅰでは 116 名から有効回答を得た . 妊娠期の保健指導のニーズは体重管理，妊娠経過，育児技術などに集中し，母子感染症について 9 割は関心があっても保健指導の受講状況は 2 割で，認知度は CMV が最も低かった．情報源は WEB，テレビなど多岐に渡っていた．研究Ⅱの保健指導では，助産師らは母子感染症については個別対応に留まり，医師との棲み分けや施設の方針次第という消極的な傾向がみられた．また，近年の妊産婦がインターネットで調べすぎて，情報に混乱していると指摘した．COVID-19 感染拡大下で対面での保健指導が困難な状況で，WEB などに頼らざるを得ない状況が窺えた．正しい情報提供のための WEB 教材やオンライン指導などの工夫が必要である．

Background: Internationally, midwives’ professional autonomy is being challenged, resulting in their inability to practice to their full scope of practice. This situation contrasts with the increasing international calls for strengthening the midwifery profession. The aim of this study therefore is to explore Belgian midwives’ views on their current and future autonomy. Methods: An online survey among Belgian midwives was performed. Data were collected and analyzed using a quantitative approach, while quotes from respondents were used to contextualize the quantitative data. Results: Three hundred and twelve midwives from different regions and professional settings in Belgium completed the questionnaire. Eighty-five percentage of respondents believe that they are mostly or completely autonomous. Brussels’ midwives feel the most autonomous, while those in Wallonia feel the least. Primary care midwives feel more autonomous than hospital-based midwives. Older midwives and primary care midwives feel less recognized and respected by other professionals in maternity care. The majority of our respondents believe that in future midwives should be able to work more autonomously in constructive collaboration with other professionals. Conclusion: While Belgian midwives generally rated their own professional autonomy as high, a significant majority of respondents desire more autonomy in future. In addition, our respondents want to be recognized and respected by society and other health professionals in maternity care. It is recommended to prioritize efforts in enhancing midwives’ autonomy, while also addressing the need for increased recognition and respect from society and other maternity care professionals.

Clinical equipment is essential in a labour unit to assess, monitor, diagnose, and prevent complications during labour. The availability of good working equipment in the labour unit is needed to enhance optimal intrapartum monitoring and delivery for pregnant women. Thus, this paper employed a cross-sectional descriptive design using a quantitative research approach to ascertain how equipment impedes optimal intrapartum monitoring and delivery for pregnant women. A total of 59 midwives were recruited to participate in the study. Data collected using an electronic structured questionnaire were analysed with descriptive statistics using Statistical Package for Social Sciences (SPSS) version 25.0. The study reported that most midwives (68%) in labour units experienced barriers to using equipment when administering care to pregnant women. The barriers were perpetuated by various factors, such as bed capacity, in meeting patient demands, including examination lights, overhead radiant warmers, and examination weighing scales for newborns. Incorporating mandatory computerized maintenance management software is recommended to improve the quality of maternity equipment. In addition, there is a need for regular equipment inspections and maintenance by skilled technicians in selected hospitals of Limpopo Province, South Africa.

Pre-eclampsia is a severe disorder that can affect the health of pregnant women and their unborn babies. Early detection and appropriate interventions are crucial to prevent severe complications. In this context, the role of midwives is essential in managing pre-eclampsia. This study aims to explore the role of midwives in the early detection and intervention of pre-eclampsia. The research method employed in this study is a Systematic Literature Review utilizing academic journal search engines from online databases such as PubMed, Web of Science, and Scopus, published between 2007 and 2022. The role of midwives in the early detection and intervention of pre-eclampsia is essential to ensure that the condition is identified and managed effectively to safeguard the health of both the mother and the baby. Research findings indicate that midwives possess good knowledge of the signs and symptoms of pre-eclampsia, as well as early detection methods such as blood pressure measurement and monitoring vital signs. Midwives are also recognized to be critical in managing pre-eclampsia, including using safe and effective medications, appropriate medical interventions, and monitoring and addressing potential complications. Enhancing knowledge, skills, and interprofessional collaboration is critical to effectively managing pre-eclampsia. Through these measures, it is hoped that complications associated with pre-eclampsia can be reduced and healthier pregnancy outcomes can be achieved. However, midwives face several challenges in the early detection of pre-eclampsia, such as limited resources and infrastructure. Therefore, efforts are needed to enhance the knowledge and skills of midwives in monitoring and interpreting laboratory test results, such as urine protein levels.

Una de les principals funcions de la matrona és l’atenció i assistència de l’embaràs, el part i el puerperi en situacions fisiològiques. A Espanya, a diferència de la majoria dels països de la Unió Europea, les matrones han de formar-se primer com a infermers/es, adquirint un títol de graduades en Infermeria per a posteriorment especialitzar-se en infermeria obstètric-ginecològica (matrones). La formació de matrones es realitza, a Espanya, a través del sistema de residència en unitats docents multiprofessionals d’obstetrícia i ginecologia o en unitats docents de matrones, acreditades per a la formació especialitzada. Existeix una falta de matrones a Espanya, mentre que en la Comunitat Europea hi ha 69,8 matrones per cada 100 000 dones i 25,9 matrones per cada 1 000 naixements, a Espanya la xifra és de 31,6 matrones per cada 100 000 dones i 12,4 matrones per cada 1 000 naixements. Per evitar la sobremedicalització de l’embaràs i part i prevenir la violència obstètrica, és important reconèixer el naixement com un fet fisiològic del cicle de la vida i és inqüestionable que el professional de referència per a la seva atenció ha de ser la matrona, qui hauria de formar-se des d’una perspectiva holística que contempli els aspectes de salut procreativa com a part del cicle vital de la dona, reconeixent que la cura, l’acompanyament i l’atenció han d’ocupar un lloc primordial. És urgent la creació d’una formació independent de les matrones, mitjançant la creació d’un grau universitari que esmeni el dèficit existent d’aquests professionals., One of the main functions of the midwife is the care and assistance of pregnancy, delivery and puerperium in physiological situations. In Spain, unlike in most European Union countries, midwives must first be trained as nurses, acquiring a degree in Nursing and then specializing in obstetric-gynecological nursing (midwifery). In Spain, midwifery training is carried out through the residency system in multi-professional obstetrics and gynecology teaching units or in midwifery teaching units accredited for specialized training. There is a lack of midwives in Spain, while in the European Community there are 69.8 midwives per 100,000 women and 25.9 midwives per 1,000 births, in Spain the figure is 31.6 midwives per 100,000 women and 12.4 midwives per 1,000 births. In order to avoid overmedicalization of pregnancy and to prevent obstetric violence, it is important to recognize birth as a physiological fact of the life cycle and it is unquestionable that the professional of reference for its care must be the midwife, who should be trained from a holistic perspective that contemplates the aspects of procreative health as part of the vital cycle of the woman, recognizing that care, accompaniment and attention have to occupy a primordial place. It is urgent to create an independent training of midwives, through the creation of a university degree that will reduce the existing deficit of these professionals., Una de las principales funciones de la matrona es la atención y asistencia del embarazo, el parto y el puerperio en situaciones fisiológicas. En España, a diferencia de la mayoría de los países de la Unión Europea, las matronas deben formarse primero como enfermeros/as, adquiriendo un título de graduadas en Enfermería para posteriormente especializarse en enfermería obstétrico-ginecológica (matronas). La formación de matronas se realiza, en España, mediante el sistema de residencia en unidades docentes multiprofesionales de obstetricia y ginecología o en unidades docentes de matronas, acreditadas para la formación especializada. Existe una falta de matronas en España, mientras en la Comunidad Europea hay 69,8 matronas por cada 100 000 mujeres y 25,9 matronas por cada 1 000 nacimientos, en España la cifra es de 31,6 matronas por cada 100 000 mujeres y 12,4 matronas por cada 1 000 nacimientos. Para evitar la sobremedicalización del embarazo y parto y prevenir la violencia obstétrica es importante reconocer el nacimiento como un hecho fisiológico del ciclo de la vida y es incuestionable que el profesional de referencia para su atención debe ser la matrona, quien debería formarse desde una perspectiva holística que contemple los aspectos de salud procreativa como parte del ciclo vital de la mujer, reconociendo que el cuidado, el acompañamiento y la atención deben ocupar un lugar primordial. Es urgente la creación de una formación independiente de las matronas, mediante la creación de un grado universitario que subsane el déficit existente de estos profesionales.

Background, Midwifery involves building relationships with women, their families and the entire community. Midwives are driven by a strong conscience to provide the best care to their clients. Midwifery training is quite involving, encompassing theoretical and practical skills, thus it requires a well-managed curriculum to ensure quality training and products. Aim, the objective of this review is to highlight the challenges experienced by midwifery trainers in midwifery training. Methodology, a descriptive overview was undertaken through a rapid literature review of the relevant local and international literature to highlight the global challenges of midwifery trainers. Results, the challenges experienced in many training institutions by midwifery trainers range from infrastructural, financial resource and human resource. Discrimination of the midwifery profession, lack of motivation and poor well – being and lack of emotional resilience of the trainers and lack of/ or inequalities in the training and education opportunities are challenges in training. Clinical set up challenges include lack of support from the clinical setting, overcrowding of students or poorly resourced facilities. The emerging and re-emerging health issues poses a challenge to the midwifery trainers. Conclusion, Midwifery trainers experience and myriad of challenges, which could compromise on the quality of midwifery training.

Objective Social support, an individual's social relationships (both online and offline), may provide protection against adverse mental health outcomes, such as anxiety and depression, which are high in women who have been hospitalised with high-risk pregnancy. This study explored the social support available to women at higher risk of preeclampsia during pregnancy by examining personal social networks. Design Semi-structured interviews were accompanied by social network mapping using the web-based social networking tool GENIE. Setting England. Participants Twenty-one women were recruited, of whom 18 were interviewed both during pregnancy and postnatally between April 2019 and April 2020. Nineteen women completed maps pre-natally, 17 women completed maps pre-natally and post-natally. Women were taking part in the BUMP study, a randomised clinical trial that included 2441 pregnant individuals at higher risk of preeclampsia and recruited at a mean of 20 weeks’ gestation from 15 hospital maternity units in England between November 2018 and October 2019. Results Women's social networks tightened during pregnancy. The inner network changed most dramatically postnatally with women reporting fewer network members. Interviews revealed networks were primarily ‘real-life’ rather than online social networks, with members providing emotional, informational, and practical support. Women with a high-risk pregnancy valued the relationships they developed with health professionals during pregnancy, and would like their midwife to have a more central role in their networks by providing informational and, where needed, emotional support. The social network mapping data supported the qualitative accounts of changing networks across high-risk pregnancy. Conclusion Women with a high-risk pregnancy seek to build “nesting networks” to support them through pregnancy into motherhood. Different types of support are sought from trusted sources. Midwives can play a key role. Practice Implications As well as highlighting other potential needs during pregnancy and the ways in which they can be met, support from midwives has a key role. Through talking to women early in their pregnancy, signposting information and explaining ways to contact health professionals regarding informational or emotional support would fill a gap that currently is met by other aspects of their network.

INTRODUCTION Self-compassion and satisfaction derived from helping others is part of healthcare providers' professional quality of life. The aim of this study was to explore and psychometrically test two instruments measuring self-compassion and professional quality of life among midwives and nurse assistants. METHODS This was a cross-sectional study with midwives and nurse assistants working with intrapartum care at five different labor wards in Sweden. The Self-Compassion Scale (SCS) and the modified Professional Quality of Life Measurement (ProQOL) were validated and correlation analyses were calculated between the different subscales. Descriptive statistics, t-test, were calculated to analyze associations between the subscales of the SCS, the ProQOL and the background variables. RESULTS Midwives were more self-critical than nurse assistants, and the midwives who were negative towards the new clinical practice scored higher for compassion fatigue. The principal component analysis showed a two-factor solution for both the SCS and the modified ProQOL. The two SCS subscales were named 'self-criticism' (alpha=0.85) and 'self-kindness' (alpha=0.87). The two ProQOL subscales were named 'compassion satisfaction' (alpha=0.83) and 'compassion fatigue' (alpha=0.78). A negative correlation was found between self-kindness and compassion fatigue subscales, between compassion satisfaction and compassion fatigue, and between self-kindness and self-criticism. CONCLUSIONS The SCS and modified ProQOL are considered as valid questionnaires for use in a Swedish maternity setting and a correlation between the scales was found. Midwives are more self-critical than nurse assistants. Understanding and identifying compassion fatigue among midwives is important to managers responsible for quality improvement and practice changes.

Background: Most investigations of nurses’ and midwives’ psychological wellbeing during the COVID-19 pandemic have been conducted in a single setting. Aim: To assess and compare the psychological wellbeing of nurses and midwives in Australia and Denmark during the COVID-19 pandemic. Methods: Nurses and midwives employed at four metropolitan health services in Australia and one in Denmark completed an anonymous online survey, which assessed depression, anxiety, and stress symptoms (The Depression, Anxiety and Stress Scale - 21 Items (DASS-21)), and sociodemographic and employment factors. Findings: Completed surveys were received from 3001 nurses and midwives (1611 Australian and 1390 Danish). Overall, approximately one in seven of the nurses and midwives surveyed reported moderate to extremely severe levels of depression (n = 399, 13.5%), anxiety (n = 381, 12.9%) and stress (n = 394, 13.4%). Australian nurses’ and midwives’ scores on all DASS-21 subscales were significantly higher (representing higher levels of depression, anxiety and stress) than the scores for the Danish nurses and midwives. Fewer years of clinical experience, living in Australia and being employed on a part-time basis were significantly associated with higher levels of psychological distress. Discussion: A considerable proportion of nurses and midwives experienced distress during the COVID-19 pandemic; however, the proportion and severity varied by country. Australian nurses and midwives experienced higher levels of distress than their Danish colleagues. Conclusion: Nurses and midwives working in countries with relatively low numbers of COVID-19 cases and deaths are also likely to experience psychological distress. Nurses and midwives would benefit from targeted country-specific support and wellbeing initiatives.

Problem COVID-19 guidance from professional and health organisations created uncertainty leading to professional and personal stress impacting on midwives providing continuity of care in New Zealand (NZ). The COVID-19 pandemic resulted in massive amounts of international and national information and guidance. This guidance was often conflicting and not suited to New Zealand midwifery. Aim To examine and map the national and international guidance and information provided to midwifery regarding COVID-19 and foreground learnt lessons for future similar crises. Methods A systematic scoping review informed by Arksey and O’Malley’s five-stage framework. A range of sources from grey and empirical literature was identified and 257 sources included. Findings Four categories were identified and discussed: (1) guidance for provision of maternity care in the community; (2) guidance for provision of primary labour and birth care; (3) Guidance for midwifery care to women/wāhine with confirmed/suspected COVID-19 infection, including screening processes and management of neonates of infected women/wāhine (4) Guidance for midwives on protecting self and own families and whānau (extended family) from COVID-19 exposure. Conclusion Guidance was mainly targeted and tailored for hospital-based services. This was at odds with the NZ context, where primary continuity of care underpins practice. It is evident that those providing continuity of care constantly needed to navigate an evolving situation to mitigate interruptions and restrictions to midwifery care, often without fully knowing the personal risk to themselves and their own families. A key message is the need for a single source of evidence-based guidance, regularly updated and timestamped to show where advice changes over time.

Advancement towards the professionalism of midwifery is closely linked to midwives’ professional autonomy. Although the perspectives of Belgian midwives on their professional autonomy have been studied, the views of other maternity care stakeholders are a blind spot. The aim of this study, therefore, was to explore maternity care stakeholders’ views on Belgian midwives’ professional autonomy. A qualitative exploratory study was performed using focus group interviews. A heterogenous group of 27 maternity care stakeholders participated. The variation between midwives, with different levels of autonomy, was reported. The analysis of the data resulted in five themes: (1) The autonomous midwife is adequately educated and committed to continuous professional further education, (2) The autonomous midwife is competent, (3) The autonomous midwife is experienced, (4) The autonomous midwife assures safe and qualitative care, and (5) The autonomous midwife collaborates with all stakeholders in maternity care. A maternity collaborative framework, where all maternity care professionals respect each other’s competences and autonomy, is crucial for providing safe and quality care. To achieve this, it is recommended to implement interprofessional education to establish strong foundations for interprofessional collaboration. Additionally, a regulatory body with supervisory powers can help ensure safe and quality care, while also supporting midwives’ professional autonomy and professionalisation.

El objetivo de este artículo es identificar las formas de legitimación que emplean las medicinas tradicionales para defender su persistencia y desarrollo. La investigación se centra en el caso de la Asociación Médicos Descalzos (MeDes) de Chinique, Guatemala, una organización autogestiva de medicina maya k’iche’. Se realizó un trabajo de campo de cinco semanas de duración, utilizando principalmente el método etnográfico y el análisis de documentos históricos y contemporáneos. La contribución del artículo es la tipificación del proceso de sistematización y validación de conocimientos de medicina maya k’iche’ realizados por MeDes e ilustrados en la descripción de la labor de las comadronas. The aim of this article is to identify the forms of legitimation used by traditional medicines to defend their persistence and development. Research focuses on the case of the Medicos Descalzos (MeDes) of Chinique (Guatemala) Association, a self-managed organization of Mayan K’iche’ medicine. A field work of five weeks duration was carried out, mainly using the ethnographic method and the analysis of historical and contemporary documents. The contribution of the article is the typification of the process of systematization and validation of knowledge of Mayan K’iche’ medicine carried out by MeDes, illustrated in the description of the work of midwives.

IZVLEČEK Uvod: Predmenstrualna disforična motnja je motnja na področju duševnega zdravja, ki prizadene približno 2–8 % žensk v reproduktivni dobi. Je zelo huda oblika predmenstrualnega sindroma in zelo negativno vpliva na kakovost življenja žensk. Namen: Namen diplomskega dela je pridobiti vpogled v problematiko, s katero se soočajo ženske, ki imajo predmenstrualno disforično motnjo. Ugotoviti želimo, kako ta motnja vpliva na psihično počutje, in poudariti pomen vključevanja medicinskih sester. Metode dela: V diplomskem delu smo uporabili deskriptivno metodo dela s pregledom znanstvene in strokovne literature v slovenskem in angleškem jeziku na temo disforične motnje pri ženskah. Iskanje in pregled literature je potekalo od decembra 2021 do novembra 2022 s pomočjo oddaljenega dostopa v podatkovnih bazah knjižnice Zdravstvene fakultete Univerze v Ljubljani. Pri pregledu literature smo upoštevali naslednja merila: jezik, v katerem je članek napisan, strokovnost članka, prosta dostopnost do celotnega besedila, objave po letu 2000. Izključitveni kriteriji za uporabo literature so bili: vsebinsko neskladje literature z obravnavano temo, dvojniki in literatura, ki je objavljena pred letom 2000. Rezultati: Ženske, ki se borijo s predmenstrualno disforično motnjo, se spopadajo z uravnavanjem svojih čustev. Predvsem se soočajo z vedenjsko impulzivnostjo, oslabljeno socialno povezanostjo in s povečanim zaznanim stresom. Predmenstrualna disforična motnja je zelo močan dejavnik tveganja za samomorilnost. Povečuje tudi verjetnost poskusa samomora in misli o poskusu samomora za skoraj sedemkrat oziroma štirikrat. Razprava in zaključek: Predmenstrualna disforična motnja je resna motnja, ki se ne bi smela zanemarjati. Posameznice s to motnjo se srečujejo z ovirami, ki motijo njihov vsakdanjik. Pojavljajo se težave v službi, v partnerskih odnosih in drugje. Ženske nimajo dovolj podpore, motnja je velikokrat prezrta in se žal ne jemlje resno, hkrati je tudi slabo poznana. Izobraževanje medicinskih sester bi bistveno pripomoglo k temu, da bi se to stanje jemalo resno. Le tako bi se lahko pomagalo prizadetim ženskam. ABSTRACT Introduction: Premenstrual dysphoric disorder is a mental health disorder that affects approximately 2-8% of women of reproductive age. It is a very severe form of premenstrual syndrome, and has a very negative effect on the quality of life of women. Purpose: The purpose of the thesis is to gain insight into the problems faced by women who have premenstrual dysphoric disorder. We want to find out how that disorder affects psychological well-being and emphasize the importance of involving nurses. Methods: In the diploma thesis, we used a descriptive research method with a review of scientific and professional literature in Slovenian and English on the topic of dysphoric disorder in women. The literature search and review took place from December 2021 to November 2022 using remote access in the library database of the Faculty of Health science in Ljubljana. When reviewing the literature, we took into account the following criteria: the language in which the article was written, the expertise of the article, free access to the entire text, publications after 2000. Exclusion criteria for the use of literature were: content discrepancy of the literature with the topic under discussion, duplicates and literature that was published before 2000. Results: Women struggling with premenstrual dysphoric disorder struggle with regulating their emotions. In particular, they face behavioral impulsivity, weakened social cohesion and increased perceived stress. Prementrual dysphoric disorder is a very strong risk factor for suicide. This disorder remained the likelihood of suicide attempt and suicidal ideation by almost seven times or four times. Discussion and conclusion: Premenstrual dysphoric disorder is a serious disorder that should not be ignored. Individuals with that disorder face obstacles that disrupt their daily lives. Problems arise at work, in partner relationships and more. Women do not have enough support, the disorder is often ignored and unfortunately not taken seriously, and at the same time it is also poorly known. The education of nurses would significantly contribute to the fact that this condition is taken seriously and only in this way the affected women can be helped.

Plain Language summaryCOVID-19 has affected the delivery of healthcare services globally. Antenatal care is one of the healthcare services that has been impacted on a global scale. Little is known about how antenatal care provision has changed in the Netherlands during the pandemic period. Our project focuses on examining the effects of COVID-19 on existing antenatal care protocols, as well as the impacts on antenatal care providers, such as midwives and gynaecologists. This knowledge can be beneficial in adapting antenatal care provision in times of health emergencies, to be better prepared and more resilient. This research uses a qualitative approach to investigate changes in practice following COVID-19 pandemic. It involves 20 antenatal care providers, working in the Netherlands, which took part in semi-structured interviews, and 9 national protocols and guidelines which were analysed. This study indicates that antenatal care changed at different levels in the Netherlands. Many changes show that antenatal care is an essential service, which should not be cut back, but it should be implemented, to be prepared for a future health emergency.BackgroundCOVID-19 has greatly affected the delivery of all health care services globally. Antenatal care is one area of care that has been impacted, despite the fact that attending antenatal check-ups is essential for pregnant women and cannot be postponed. Little is known about how exactly ANC provision has changed in the Netherlands, or how the changes have impacted midwives and gynaecologists providing those services.MethodsThis study used a qualitative research design to investigate changes in individual and national practice following the onset of the COVID-19 pandemic. The study involved a document analysis of protocols and guidelines for ANC provision to evaluate how those changed following the onset of the COVID-19 pandemic and semi-structured interviews with ANC care providers (i.e., gynaecologists and midwives).ResultsGuidance was issued by multiple organizations, during the pandemic, on how to approach the risk of infection in pregnant women, recommending several changes to ANC to protect both pregnant women and ANC providers. Both midwives and gynaecologists reported changes in their practice. With less face-to-face consultations happening, digital technologies became critical in the care of pregnant women. Shorter and fewer visits were reported, with midwifery practices adjusting their guidelines further than hospitals. Challenges, with high workloads and lack of personal protective equipment were discussed.ConclusionsThe COVID-19 pandemic has had an immense impact on the health care system. This impact has had both negative and positive effects on the provision of ANC in the Netherlands. It is important to learn from the current COVID-19 pandemic and adapt ANC, as well as health care systems as a whole, to be better prepared for future health crises and ensure continuous provision of good quality care.

Quitèria Tarragó Casellas va ser la primera dona que va exercir com a regidora a l’Ajuntament de Terrassa. Des de la seva professió va lluitar intensament per aconseguir la dignificació i universalització dels serveis sanitaris per a tota la població, i especialment per als més desfavorits. Va treballar per augmentar el nivell educatiu i professional de la ciutadania, apostant fermament per les dones, ja que representaven el sector amb més analfabetisme, més infravalorat i amb menys possibilitats d’accedir a l’educació, a la política o als càrrecs públics.

Background Population-based expanded carrier screening (ECS) involves screening for multiple recessive diseases offered to all couples considering a pregnancy or during pregnancy. Previous research indicates that in some countries primary care professionals are perceived as suitable providers for ECS. However, little is known about their perspectives. We therefore aimed to explore primary care professionals’ views on population-based ECS. Methods Four online focus groups with 14 general practitioners (GPs) and 16 community midwives were conducted in the Netherlands. Results Our findings highlight various perspectives on the desirability of population-based ECS. Participants agreed that ECS could enhance reproductive autonomy and thereby prevent suffering of the child and/or parents. However, they also raised several ethical, societal, and psychological concerns, including a tendency towards a perfect society, stigmatization, unequal access to screening and negative psychosocial consequences. Participants believed that provision of population-based ECS would be feasible if prerequisites regarding training and reimbursement for providers would be fulfilled. most GPs considered themselves less suitable or capable of providing ECS, in contrast to midwives who did consider themselves suitable. Nevertheless, participants believed that, if implemented, ECS should be offered in primary care or by public health services rather than as hospital-based specialized care, because they believed a primary care ECS offer increases access in terms of time and location. Conclusions While participants believed that an ECS offer would be feasible, they questioned its desirability and priority. Studies on the desirability and feasibility of population-based ECS offered in primary care or public health settings are needed.

＜目的＞産科混合病棟で勤務する助産師に関する国内文献の研究内容を整理し，研究動向と今後の課題を明らかにする．＜方法＞医中誌Web 版で「産科混合病棟」AND「助産師」，「混合病棟」AND「助産師」をキーワードとして検索した．検索された102 文献のうち，研究目的に合致した17 文献を分析した．＜結果＞産科混合病棟で勤務する助産師に関する研究は，産科混合病棟に限らず助産師を対象とした研究結果の一部として記述された研究が多く，産科混合病棟で勤務する助産師に特化した研究は少なかった．研究内容は，ケアに対するジレンマや葛藤などの助産師の思いと，産科混合病棟におけるマネジメントに分類された．＜考察＞産科混合病棟で勤務する助産師のジレンマや葛藤の背景にある具体的なケア経験は明らかにされていなかった．産科混合病棟に特化した研究が少ないため，産科混合病棟で勤務する助産師を研究対象としてケア経験やケア能力を探求し，産科混合病棟の課題だけではなく得られる経験や能力にも着目する必要がある．

Background Respectful care of bereaved parents after stillbirth plays a pivotal role in enabling the grieving process and reducing the traumatic impact of this life-changing event. Unfortunately, professionals and midwives, in particular, are often emotionally unprepared and frequently left alone when dealing with these stressful events. Aim The BLOSSoM (Burnout after perinatal LOSS in Midwifery) study aims to address the levels of professional burnout in Italian midwives and evaluate the psychological impact of bereavement care on professionals. Methods Web-based cross-sectional study, including socio-demographic questionnaire, survey on the knowledge of guidelines for stillbirth management and two psychometric tests: Maslach Burnout Inventory (MBI) and Impact of Event Scale - Revised (IES-R). Findings Of 445 female midwives, mean age 35.1 (SD 9.9), working years 11.2 (SD 10.2), 149 (33.4%) reported specific training on stillbirth and 420 (94.6%) highlighted the need for further training and support. Medium to high levels of burnout (Emotional Exhaustion) were present in 65 midwives (15.9%) with a high prevalence of Reduced Personal Accomplishment (292, 64.2%). ‘Communicating the diagnosis of death’ was considered the hardest task, followed by ‘assisting the meeting with the baby’; 109 midwives (24.5%) reported high IES-R scores (>30), suggesting symptoms of PTSD related to stillbirth events; a good level of knowledge of guidelines favoured Personal Accomplishment (OR 0.3 [0.1 – 0.6]). The number of stillbirths assisted by midwives was not associated with burnout levels. Conclusion Midwives are particularly at risk of developing professional burnout, as early as after five years of work, with a significant association with the psychological impact exerted by stressful events (stillbirth).

Objective:Delivery rooms are places where problems rapidly develop and decisions are quickly taken. Therefore, patient safety practices are among the most important things. This study was conducted to discover patient safety practices of nurses and midwives who work in the delivery room.Methods:This descriptive study was conducted with 140 midwives and nurses working in eight hospitals in Ankara. Data were collected with a questionnaire, which was developed by reviewing the literature. Research data were analyzed by number and percentile distribution.Results:No controlled doors were found in 1/3 of the eight delivery rooms in hospitals, 21.1% of participants did not attach identity wristband while taking mothers to delivery rooms, 34.3% used room/bed numbers in detecting identity, and 63% did not register the given instructions during the emergency-sterile applications. Additionally, 8.6% left mothers and babies alone, 27.9% did not write the date of the birth on the identity wristband, 11.4% did not follow uterus involution.Conclusion: Our study results revealed that most targets for ensuring maternal and neonatal safety are achieved in delivery rooms. However, deficiencies were found in the application, such as identity control, applications registration, and drug administration. The majority of patient safety applications are routine practices of nurses and midwives. Training for midwives and nurses who work in delivery rooms for the safety of mother–newborn is recommended.

bjectiveThe MAMAACT intervention aims to reduce ethnic and social disparities in stillbirth and infant death by improving communication between pregnant women and midwives regarding warning signs of pregnancy complications. This study evaluates the effect of the intervention on pregnant women's health literacy (two domains from the Health Literacy Questionnaire) and complication management — interpreted as improved health literacy responsiveness among midwives.DesignCluster randomized controlled trial, 2018–2019.Setting19 of 20 Danish maternity wards.ParticipantsCross-sectional survey data were collected using telephone interviews (n = 4150 pregnant women including 670 women with a non-Western immigrant background).InterventionA six-hour training session for midwives in intercultural communication and cultural competence, two follow-up dialog meetings, and health education materials for pregnant women on warning signs of pregnancy complications — in six languages.Main outcome measuresDifferences in mean scores at post-implementation of the domains Active engagement with healthcare providers (Active engagement) and Navigating the healthcare system from the Health Literacy Questionnaire, and differences in the certainty of how to respond to pregnancy complication signs between women in the intervention and control group.ResultsNo difference was observed in women's level of Active engagement or Navigating the healthcare system. Women from the intervention group were more certain of how to respond to complication signs: Redness, swelling, and heat in one leg: 69.4 % vs 59.1 %; aOR 1.57 (95 % CI 1.32–1.88), Severe headache: 75.6 % vs 67.3 %; aOR 1.50 (95 % CI 1.24–1.82), and Vaginal bleeding: 97.3 % vs 95.1 %; aOR 1.67 (95 % CI 1.04–2.66).ConclusionThe intervention improved women's certainty of how to respond to complication signs, but was unable to improve pregnant women's health literacy levels of Active engagement and Navigating the healthcare system, likely due to barriers related to the organization of antenatal care. A reorganization of antenatal care and a care model sensitive to diversity within the entire healthcare system might help reduce disparities in perinatal health. Objective: The MAMAACT intervention aims to reduce ethnic and social disparities in stillbirth and infant death by improving communication between pregnant women and midwives regarding warning signs of pregnancy complications. This study evaluates the effect of the intervention on pregnant women's health literacy (two domains from the Health Literacy Questionnaire) and complication management — interpreted as improved health literacy responsiveness among midwives. Design: Cluster randomized controlled trial, 2018–2019. Setting: 19 of 20 Danish maternity wards. Participants: Cross-sectional survey data were collected using telephone interviews (n = 4150 pregnant women including 670 women with a non-Western immigrant background). Intervention: A six-hour training session for midwives in intercultural communication and cultural competence, two follow-up dialog meetings, and health education materials for pregnant women on warning signs of pregnancy complications — in six languages. Main outcome measures: Differences in mean scores at post-implementation of the domains Active engagement with healthcare providers (Active engagement) and Navigating the healthcare system from the Health Literacy Questionnaire, and differences in the certainty of how to respond to pregnancy complication signs between women in the intervention and control group. Results: No difference was observed in women's level of Active engagement or Navigating the healthcare system. Women from the intervention group were more certain of how to respond to complication signs: Redness, swelling, and heat in one leg: 69.4 % vs 59.1 %; aOR 1.57 (95 % CI 1.32–1.88), Severe headache: 75.6 % vs 67.3 %; aOR 1.50 (95 % CI 1.24–1.82), and Vaginal bleeding: 97.3 % vs 95.1 %; aOR 1.67 (95 % CI 1.04–2.66). Conclusion: The intervention improved women's certainty of how to respond to complication signs, but was unable to improve pregnant women's health literacy levels of Active engagement and Navigating the healthcare system, likely due to barriers related to the organization of antenatal care. A reorganization of antenatal care and a care model sensitive to diversity within the entire healthcare system might help reduce disparities in perinatal health. Trial registration: ClinicalTrials.gov identifier: NCT03751774.

Purpose: To develop a tailored newborn resuscitation course for midwifery students. Patients and Methods: A qualitative study using an explorative, abductive approach was applied. Co-creation through workshops was facilitated to develop a tailored newborn resuscitation course for midwifery students. Four workshops with midwifery students and midwives were conducted from May to October 2020. Twenty participants attended one workshop of their choice. Five out of Norway’s six midwifery education programmes participated, and included midwives from across Norway. All workshops were held digitally via the Zoom platform. A seven-step framework analysis method was applied to analyse the workshop data. Results: We identified four themes: 1) practice guidance, 2) technical skills 3) non-technical skills 4) innovative methods. Conclusion: Findings emphasize the importance of practice guidance, technical skills, non-technical skills and innovative methods to facilitate the learning process. However, these skills cannot be acquired without the context to facilitate them, and thus a supportive culture is essential to sustain newborn resuscitation expertise as a midwife/midwifery student. We found that midwives expressed the same need to learn, train and prepare themselves for newborn resuscitation as midwifery students. The importance of facilitating the learning of newborn resuscitation with low-dose, high-frequency training in a supportive culture thus matters to both midwifery students and expert midwives.

Background: Voluntary termination of pregnancy (VTP) is influenced by ethical convictions, religious orientations and knowledge of the law. The latter is essential for students to be improved in University curricula, in order to develop attitudes among future nurses and midwives with the objective to reduce stigma and reluctance in providing VTP. Previous research has shown that nursing and midwifery students' attitudes and knowledge can be improved. Aim: The aim of this study is to describe literature regarding knowledge and perception about abortion and voluntary termination of pregnancy in several countries of the world among nurses, midwives and university students. Methods: This is a scoping review of the literature conducted by following the recommendations of the PRISMA-ScR Statement. The authors selected studies in MEDLINE, Scopus, CINAHL, PsycINFO, Academic Search Index, Science Citation Index and ERIC, published in English and Italian in the last decade. Quality assessment was performed using the Jadad scale. Results: Initially, 434 studies were selected. A total of 11 articles met the inclusion criteria. The articles included in the scoping review deal with the issue of abortion from different perspectives. From the analysis it emerged that the barriers for VTP are the lack or inadequate knowledge of the legislation and of the practical / technical phases of the procedure. Conclusions: Health professionals and students have different perspectives and attitudes toward VTP. Nurses and midwives have inadequate knowledge of procedures and legislation. Therefore, it is recommended to implement university curricula on the topic. Keywords: knowledge, attitudes, voluntary termination of pregnancy, nurses, midwives, students.

U radu se proučavaju zapisi o isplatama u svesku Beneficiati e capellani di Tesoreria 1624–1646koji se tiču Ospedale delle partorienti. Rad toga hospitala stavlja se u širi kontekst dubrovačkih hospitala, posebno Hospitala milosrđa koji je izvorno namijenjen isključivo prihvatu napuštene izvanbračne djece, a naknadno je imao i ulogu rodilišta. Hospital milosrđa smatra se najstarijim rodilištem na hrvatskom području. Analizom novootkrivenih podataka pokušavaju se utvrditi neka obilježja Ospedale delle partorienti, vremenski okvir djelatnosti hospitala i motivi utemeljenja., The article examines the expenditure records in the volume Beneficiati e capellani di Tesoreria 1624–1646regarding the Ospedale delle partorienti, Lying-In Hospital in Dubrovnik, on the basis of which the operation of this institution is being placed within a broader context of Dubrovnik hospitals, particularly that of the Hospitale Misericordiae, originally indented for the admission of abandoned illegitimate children only. The mentioned hospital later also acquired the role of a lying-in home and is considered to be the oldest hospital of this kind on Croatian territory. The analysis of data concerning the operation of the Ospedale delle partorientiin the volume Beneficiati e capellani di Tesoreria 1624–1646 in the archive of the Opera piahas confirmed the activity of this hospital from 1627 to at least 1650. The hospital was probably founded after 1574, as it was not mentioned in the visitation of the apostolic visitor Giovanni Francesco Sormani. Ospedale delle partorienti was located within the city walls, near St. Domino Church. The hospital was staffed by midwives, who received a regular, though a modest monthly salary. That is the earliest dateable information on midwives in permanent service in Croatia. The hospital was equipped with a birthing stool, which is the first mention of specialised lying-in equipment on Croatian territory. The building of the Ospedale delle partorienti was damaged in the 1639 earthquake, and most probably was totally destroyed in the disastrous earthquake of 1667. The hospital was to provide medical care to poor parturient maids, and as such may be included among women’s hospitals. Unlike other hospitals intended for women, the accommodation at the Ospedale delle partorientiwas, in all likelihood, short, not longer than several months. The hospital offered medical assistance in childbirth, but of greater importance was its charitable dimension, as a shelter for parturients. Ospedale delle partorientipreceded the lying-in ward within the Hospitale Misericordiae, and is the earliest specialised maternity hospital in Croatia.

En este artículo, presento una lectura vinculada a los cuerpos de mujeres parteras que ejecutan el aborto, centrándome en los personajes de la Bruja, en Temporada de huracanes (2017), de Fernanda Melchor; la abuela en “Sangre coagulada” (2020) de Mónica Ojeda, y Ndizi, la comadrona, en “Matronas” (2012) de Yolanda Arroyo. Todas ellas son mujeres adultas que se enfrentan a la sanción social de ser vistas como pecadoras y delincuentes, de ser criminalizadas, de ser brujas. A partir de los personajes de las brujas-parteras y de las interrupciones voluntarias del embarazo presentes en estas obras, analizaré –sirviéndome de los planteamientos de los feminismos decoloniales–, las dimensiones opresivas de género, clase y raza en las que se enmarcan estos abortos “punitivos”, así como las posibilidades comunitarias y sororas de resistencia y de desafío al poder que conlleva la clandestinidad del aborto., I present an approach linked to the bodies of midwives who perform abortions, focusing on the characters of La Bruja, from Temporada de huracanes (2017), by Fernanda Melchor; the grandmother from “Sangre coagulada” (2020), by Mónica Ojeda, and Ndizi, the midwife, from “Matronas” (2012), by Yolanda Arroyo. These characters are adult women who face the social sanction of being seen as sinners and delinquents, criminalized, and witches. Therefore, from the characters of the witchesmidwives and the voluntary interruptions of pregnancy present in these texts, I analyze -from a decolonial feminist approach-, the oppressive dimensions of gender, class, and race, in which these “punitive” abortions take place. Taking into account, the possible resistance and challenge to power that the clandestinity of abortion entails, for the community and sisterhood.

Background: Antenatal care is essential for all expectant mothers and assists in reducing maternal mortality rates thus addressing the Sustainable Development Goal 3. Obstetric ultrasound complements antenatal care and is used in pregnancy to identify and monitor high-risk pregnancies. However, disparities exist and in low- and middle-income countries, ultrasound services are not readily available. This contributes to maternal and neonatal morbidity and mortality within these populations. Short ultrasound training programmes for midwives can be beneficial in alleviating some of the challenges experienced. Aim: The aim of this scoping review was to identify global ultrasound education programmes for midwives. Method: Articles containing suitable keywords were retrieved from databases suitable to nursing, education and ultrasound. Themes were developed based on the articles included in the review. Results: A total of 238 articles were identified, and after the duplicates and irrelevant studies were removed, 22 articles were included. Articles were analysed and discussed under the identified themes and categories. Conclusion: It is essential that sufficient training is provided to medical professionals performing obstetric ultrasound so that adequate and safe care is offered to expectant mothers. With the introduction of ultrasound in low- resource settings, the knowledge of safety and competencies required to operate the equipment necessitate adequate training. Developed programmes have been found to meet the demands of the ever-changing workforce and allow for midwives to perform focused obstetric ultrasound examinations. Contribution: This scoping review highlighted ultrasound training programmes for midwives and provided guidance on the development of future midwifery ultrasound training programmes.&nbsp

Το προτεινόμενο σύγγραμμα: Μαιευτική Φροντίδα Τοκετού: Από τη θεωρία στην κλινική άσκηση, μπορεί να καλύψει τις ανάγκες και απαιτήσεις του προπτυχιακού μαθήματος ‘Μαιευτική Φροντίδα Τοκετού’ που διδάσκεται αυτή τη στιγμή στα τρία τμήματα Μαιευτικής (Πανεπιστήμιο Δυτικής Μακεδονίας-Πτολεμαΐδα, Πανεπιστήμιο Δυτικής Αττικής-Αθήνα, Διεθνές Πανεπιστήμιο Ελλάδος-Θεσσαλονίκη). Τα κεφάλαια του προτεινόμενου βιβλίου είναι: Κεφάλαιο 1 Ο ρόλος της μαίας κατά την παραλαβή της επιτόκου και κατά την εισαγωγή στην αίθουσα τοκετών Κεφάλαιο 2 Φάρμακα που χρησιμοποιούνται κατά τον τοκετό Κεφάλαιο 3 Καρδιοτοκογραφία στην αίθουσα τοκετών Κεφάλαιο 4 Μαιευτική φροντίδα περινέου-Περινεοτομή Κεφάλαιο 5 Δυστοκία ώμων Κεφάλαιο 6 Ισχιακός τοκετός-Πρόπτωση ομφαλίδας Κεφάλαιο 7 Μη φαρμακολογικές μέθοδοι αντιμετώπισης του πόνου του τοκετού Κεφάλαιο 8 Φυσικές μέθοδοι ενίσχυσης του τοκετού Κεφάλαιο 9 Κολπικός τοκετός μετά από καισαρική τομή Κεφάλαιο 10 Βαρειά προεκλαμψία-εκλαμψία Κεφάλαιο 11 Ανώμαλες προβολές: Οπισθία ινιακή προβολή - Τοκετός 2ου διδύμου Κεφάλαιο 12 Αιμορραγία μετά τον τοκετό Ως προς τη θεματολογία, το προτεινόμενο βιβλίο θα καλύψει 12 αυτοτελείς ενότητες οι οποίες μπορεί να διδαχθούν στα πλαίσια του εξαμηνιαίου μαθήματος. Οι δύο συγγραφείς (κ. Παπουτσής-Παν/μιο Δυτ. Μακεδονίας, κα Αντωνάκου-Διεθνές Παν/μιο Ελλάδος) διδάσκουν ήδη το συγκεκριμένο μάθημα στα δικά τους πανεπιστημιακά τμήματα. Το προτεινόμενο σύγγραμμα υπολογίζεται πως θα έχει έκταση περίπου 300 σελίδων.

Vecmāte Veselības aprūpe Midwifery Health Care Mērķis: Noteikt trauksmes simptomu izplatību un saistību ar darba vides faktoriem vecmātēm. Pētījuma dizains: Neeksperimentāls kvantitatīvs šķērsgriezuma sakarību pētījums. Pētījuma metodes: Bakalaura darbā tika veikta vecmāšu anketēšana 7 dzemdību nodaļās. Trauksmes simptomu noteikšanai tika izmantota GAD-7 anketa, punktu skaits ≥10 liecina par klīniski nozīmīgiem trauksmes simptomiem. Psihosociālo darba faktoru noteikšanai tika izmantotas Kopenhāgenas psihosociālās aptaujas – vidējās versijas četras skalas – emocionālās prasības, atzinība, vadības un kolēģu sociālais atbalsts. Lai analizētu bakalaura darba datus, tika izmantota aprakstošā statistika un grupu salīdzināšanas testi. Rezultātiem tika noteikts būtiskuma līmenis (p)

In January this year, Region Västerbotten announced that the maternity ward in Lycksele would be closed until further notice. This paper is a case study of the closure of the maternity ward in Lycksele, located within the rural parts of northern Sweden. Previous research has focused on maternity ward closures in Canada and Australia whereas studies on maternity wards in northern Sweden is limited. Since large parts of northern Sweden consist of sparsely populated areas, the closure of Lycksele BB has resulted in women having to travel long distances to receive care. This paper seeks to provide a deeper understanding of the consequences of the closure of Lycksele BB by examining (1) what feelings women experience and how they manage these feelings, (2) the consequences of the maternity ward closure on women’s physical and mental health and (3) the consequences of the maternity ward closure in relation to the rural parts of northern Sweden. This study has been carried out by using a qualitative approach by conducting semi-structured interviews with two pregnant women, two mothers, and two midwives. The findings in this study show that women develop strategies to mitigate feelings of insecurity and anxiety. Both pregnant women and midwives create strategies to feel a stronger sense of control in an otherwise unpredictable situation. This contributes to major consequences for women’s mental and physical health as women are faced with new challenges, affecting their reproductive health and care. The findings also show that the closure of Lycksele BB is only a stepping stone for further welfare cuts which can result in people moving away from these sparsely populated areas. This study concludes that the issue goes beyond the closure of the maternity ward in Lycksele and raises bigger questions around the future of the rural parts of northern Sweden.

Scoping review protocol

ObjectivesImplementation of ultrasound in antenatal care (ANC) in low-income countries has been shown to increase pregnant women's compliance with ANC visits, and facilitate detection of high-risk pregnancies. In Rwanda, as in other low-income countries, access to ultrasound has increased significantly, but lack of training is often a barrier to its use. The aim of this study was to investigate Rwandan health professionals' experiences and views of obstetric ultrasound in relation to clinical management, resources and skills.MethodsA cross-sectional questionnaire study was undertaken between November 2016 and March 2017, as part of the CROss Country UltraSound Study (CROCUS). Data were collected at 108 health facilities located in both rural and urban areas of Rwanda, including provincial, referral, district and private hospitals as well as health centres. Participants were obstetricians (n = 29), other physicians (n = 222), midwives (n = 269) and nurses (n = 387).ResultsObstetricians/gynecologists/other physicians commonly performed ultrasound examinations but their self-rated skill levels implied insufficient training. Access to ultrasound when needed was reported as common in hospitals, but available to a very limited extent in health centres. The vast majority of participants, independent of health profession, agreed that maternity care would improve if midwives learned to perform basic ultrasound examinations.ConclusionsBarriers to provision of high quality ultrasound services include variable access to ultrasound depending on health facility level and insufficient skills of ultrasound operators. Physicians in general need more training to perform ultrasound examinations. Implementation of a general dating ultrasound examination seems to be a relevant goal as most health professionals agree that pregnant woman would benefit from this service. To further improve maternity care services, the possibility of educating midwives to perform ultrasound examinations should be further explored.

BACKGROUND: Prevention of mother-to-child transmission (PMTCT) of HIV services has become an integral part of antenatal services. Prevention of mother-to-child transmission was introduced in all the regions of Ghana, but mother-to-child transmission (MTCT) continued to increase. OBJECTIVES: To explore and describe midwives' perceptions and attitudes towards PMTCT of HIV services. METHOD: Quantitative research approach and descriptive cross-sectional design were used. The population includes all midwives between the ages of 21 and 60 years who work in antenatal care (ANC) clinics in 11 district hospitals in the Central Region of Ghana where the study was conducted. Forty-eight midwives were interviewed using a census sample process. Data were analysed using the Statistical Package for the Social Sciences version 21. Correlation analysis was performed to find the relationships between the attitudes and the perceptions of the midwives on PMTCT of HIV services. RESULTS: Seventy percent of midwives had positive perceptions of PMTCT of HIV services and 85% had positive attitudes towards the provision of PMTCT of HIV services. Midwives were screening all pregnant women who visited the ANCs and referring those who tested positive to other institutions where they can be monitored. Some of the concerns considered were views on retesting HIV-infected pregnant women throughout their pregnancy. There was a positive correlation between attitudes and perceptions of midwives on PMTCT of HIV services. CONCLUSION: Midwives had positive perceptions and positive attitudes towards the PMTCT of HIV services that they were providing to antenatal attendees. Also, as the attitudes of the midwives towards PMTCT of HIV services improved, their perceptions of PMTCT services also improved. CONTRIBUTION: Decentralisation of PMTCT of HIV services to community-based health facilities is appropriate to enable sub-district health facilities to test for HIV and provide counselling services to pregnant women.

Vecmāte Veselības aprūpe Midwifery Health Care Darba nosaukums. Vecmāšu apmierinātība ar darbu un psihosociālie darba vides riska faktori. Ievads. Ar darba vidi un to izraisītajiem riska faktoriem darbinieki pastāvīgi saskaras savā ikdienā, kas var ietekmēt gan veselības stāvokli, gan apmierinātību ar darbu. Pēc Valsts darba inspekcijas datiem, psihosociālie darba vides riska faktori ir visvairāk izplatīti tieši veselības aprūpes darbinieku vidū. Izprotot, ar kādiem darba vides psihosociāliem riska faktoriem saskaras vecmātes Latvijā, darba devējiem ir iespēja uzlabot darba vides apstākļus, kas veicinātu vecmāšu apmierinātību ar darbu un darba kvalitāti. Hipotēze. Pastāv statistiski nozīmīga saistība starp psihosociālajiem darba vides riska faktoriem un vecmāšu apmierinātību ar darbu. Darba mērķis. Izvērtēt vecmāšu apmierinātību ar darbu un psihosociālos darba vides riska faktorus. Pētījuma uzdevumi. 1. Noskaidrot, kādi ir nozīmīgākie vecmāšu psihosociālie darba vides riska faktori. 2. Noskaidrot, kāda ir vecmāšu apmierinātība ar darbu. 3. Aprakstīt un analizēt nozīmīgākos psihosociālos darba vides riska faktorus vecmātēm un vecmāšu apmierinātību ar darbu. Metode un instruments. Pētījuma dizains ir kvantitatīvs, neeksperimentāls, aprakstošs pētījums. Datu ievākšanai tika izmantota P. Spektora anketa “Apmierinātība ar darbu”, kā arī anketa “Psihosociālie darba vides riska faktori vecmātēm”, kuru mērķis bija noskaidrot nozīmīgākos psihosociālos darba vides riska faktorus un vecmāšu apmierinātību ar darbu. Pētījumā tika analizētas 50 vecmāšu atbildes. Rezultāti. Tika noskaidrots, ka nozīmīgākie psihosociālie darba vides riska faktori vecmātēm bija darba temps, atalgojums un darba apjoma un intensitātes prasības. Savukārt faktori, kas veicina vecmāšu apmierinātību ar darbu, bija darba saturs un attiecības darba vidē. Izmantojot Pīrsona korelācijas koeficientu, tika noskaidrots, ka starp psihosociālajiem darba vides riska faktoriem un apmierinātību ar darbu statistiski nozīmīga saistība nepastāv (r = – 0,134). Pētījuma raksturojums. Pētījums sastāv no 38 lapām, septiņām nodaļām, kurās ir ietvertas 16 tabulas un četri attēli, kā arī trīs pielikumi. Tika izmantoti 30 dažādi literatūras avoti. Title. Midwive’s job satisfaction and psychosocial work environment risk factors. Introduction. Every employee faces the working environment and its risk factors on a daily basis, which can have an impact on health and job satisfaction. According to the data of the State Labour Inspectorate, psychosocial risk factors of the work environment are the most common among health care workers. By understanding what are the psychosocial risk factors of the working environment that midwives face in their daily life in Latvia, employers would have the opportunity to improve the conditions of the working environment, which would contribute to the job satisfaction of midwives and the quality of work. Hypothesis. There is a statistically significant association between psychosocial risk factors in the working environment and the job satisfaction of midwives. The aim. Assess the job satisfaction of midwives and psychosocial risks to the working environment. Research tasks. 1. Find out what are the most important psychosocial risk factors of midwifery. 2. Find out how satisfied with job are midwifes. 3. Describe and analyse the major psychosocial risk factors of the working environment for midwives and the job satisfaction of midwives. Methods and tools. The design of the study is a quantitative, non-experimental descriptive study. The collection of data was based on the P. Spector questionnaire “Job Satisfaction” and the questionnaire “Psychosocial occupational environmental risk factors for midwives”, aimed at identifying the major psychosocial risk factors in the working environment and the job satisfaction of midwives. The study analyzed the responses of 50 midwives. Results. The study showed that the major psychosocial risk factors for midwives were the pace of work, payment, job intensity requirements. On the other hand, factors that have a positive impact on the job satisfaction were the content of the work and the relationship in the working environment. Using Pearson's correlation factor, it was found that there was no statistically significant relationship between psychosocial risk factors and job satisfaction (r = – 0,134). Description of the study. The study consists of 38 pages, seven chapters, a total of 16 tables and four images, as well as three attachments. 30 different sources of literature were used.

The authors study the institutionalization of midwife specialization among women in Russia in the period from the 18th through the early 20th centuries. The main sources are legislative acts, clerical documents, as well as reports on the activities of medical institutions and maternity departments. The authors use the approaches of gender history, and the concept of professionalization as developed by E. Freidson. Midwifery was the first area of womens work that was officially recognized by the state. There were three main stages on the way to professionalizing the midwifery profession among women. The first stage (covering the 18th century) is associated with attempts to study and systematize the activities of midwives. The practical experience of midwifes was actively sought by doctors whose theoretical knowledge was limited. The second stage of professionalization (corresponding to the first half of the 19th century) was associated with the normative regulation of midwife work and the formation of a professional hierarchy in midwifery. The third stage (comprising the second half of the 19th century and the early 20th century) saw a restriction of the midwives spheres of activity, as well as the active inclusion of male doctors in practical obstetrics and their rise to a dominant position. With the development of obstetric specialization, operative obstetrics, and the opening of maternity wards, midwives were relegated to a subordinate position in relation to doctors. In contrast to the United States and Western European countries, Russia did not have professional associations of midwives. Intra-professional communication was weak, and there was no corporate solidarity. In Soviet medicine, finally, the midwives subordinate place in relation to doctors was only cemented.

Background The aim of this study was to describe, explain, and compare the correlations between workload, job satisfaction, and occupational stress levels in Polish midwives working before and during the COVID-19 pandemic. Material and Methods This study was cross-lagged in nature and conducted in 2 phases at public health facilities. The first phase took place between March and August 2018 before the current pandemic, and the second in February 2021. In total, 133 midwives working before the COVID-19 pandemic and 92 midwives working during the pandemic were surveyed. Results Analysis revealed that working during the pandemic, personal SARS-CoV-2 infection and workload were positive predictors of occupational stress. Midwives working during the pandemic experienced significantly higher levels of occupational stress compared to the period before the pandemic. Job satisfaction was found to be a negative predictor of stress in both groups, and to mediate the correlation between workload and occupational stress. The positive influence of job satisfaction on coping with stress was stronger in the group working during the pandemic. Conclusions Workload increased, and job satisfaction decreased, occupational stress levels in both groups of midwives. The COVID-19 pandemic, directly and indirectly, increased midwives’ occupational stress levels, and reinforced the negative correlation between workload and job satisfaction. The results confirm the important role of working conditions in shaping occupational stress levels. Med Pr. 2021;72(6):623–32

Dieser Beitrag stellt einleitend die Geschichte und die Philosophie der Dualen Hochschule Baden-Württemberg (DHBW) dar. Zentral ist die Verzahnung von hochschulischer Ausbildung mit Praxisbetrieben, die durch klare Standards reglementiert ist und damit Qualität und Studierbarkeit gewährleistet. Diese Verzahnung ermöglicht ein rasches Reagieren auf sich wandelnde gesellschaftliche Anforderungen, die Globalisierung und die digitale Transformation. Für den Studienbereich Gesundheit der DHBW werden die Studienmodelle, die besonderen Rollen und Herausforderungen für die Dualen Partner, für die Studiengangleitung und die Studierenden beleuchtet. Dieser Artikel basiert auf dem Vortrag mit dem gleichen Titel gehalten am VFWG-Symposium «Sind duale Studiengänge der Hebammen ein Modell für die Therapieberufe?» vom 18. März 2021.

The paper presents educational videos as an interactive method of teaching nursing and midwifery students. As a part of the methods of online education, educational videos transform the learning content into a practical necessity for the formation ofstudents' professional competencies in the considered medical specialties. Correlation analysis identifies the degree of coherence between the observed features: "training with video films" and "professional competencies formation". Using x2statistics, it is decided whether the relationship between two nominal variables is statistically significant and how the strength of the relationship i.e., the extent of the effect, is valued using the coefficients Phi and Cramer’s V. The statistical processing of the performed didactic experiment proves a "strong" correlation between the studied features.

Obstetric violence has been recognized as a major impediment to facility-based delivery, increasing the risk of preventable complications and maternal mortality. In Ghana, studies on women’s birth experiences reveal enormous and brutal acts of violence during delivery; however, inquiries into why midwives abuse women have not been extensively studied. This study explored the perspectives of midwives on the drivers of obstetric violence in the Western and Ashante Regions of Ghana. A qualitative study was conducted involving 30 in-depth interviews with midwives in eight health facilities. The data were analyzed thematically using NVivo 12. The results of the study reveal a normalization of violence in the delivery room and the intensity of violence is heightened during the second stage of labor. Midwives reported perpetrating or witnessing physical violence, abandonment of women, stigmatization of HIV women, verbal abuses such as shouting, and the detention of women in the health facilities. Midwives abuse women as a result of the pressures of the midwifery profession, poor maternal efforts of women, disrespect of midwives, women’s disobedience, and uncooperative attitudes. The culture of acceptability of obstetric violence is a major driver, contributing to its normalization. Midwives do not consider obstetric violence as abuse, but rather, as a delivery strategy which aids a successful delivery. It is therefore justified and viewed as a necessary part of the delivery process. There is a critical need for retraining midwives on alternative birthing strategies devoid of violence.

The use of ultrasound to determine gestational age is fundamental to the optimum management of pregnancy and is recommended for all women by the World Health Organization. However, this modality remains unavailable to many women in low-income countries where trained practitioners are scarce. Although previous initiatives have demonstrated efficacy in training midwives and technicians to perform antenatal ultrasound, these programs have often been too long and too complex to be realistic within the specific constraints of this context, highlighting the need for a novel and pragmatic approach. We describe the development and piloting of a bespoke course to teach midwives 3 fundamental components of early antenatal ultrasound scanning: (1) to identify the number of fetuses, (2) to confirm fetal viability, and (3) to determine gestational age. Having established that 5 days is insufficient, we propose that the minimum duration required to train ultrasound-naive midwives to competency is 10 days. Our completed program therefore consists of one and one-half days of didactic teaching, followed by 8 and one-half days of supervised hands-on practical training in which trainees are assessed on their skills. This package has subsequently been successfully implemented across 6 sites in Malawi, where 28 midwives have achieved competency. By describing the processes involved in our cross-continental collaboration, we explain how unexpected challenges helped shape and improve our program, demonstrating the value of preimplementation piloting and a pragmatic and adaptive approach.

In recent years, Disrespectful Maternity Care of women seeking maternity services in the health facilities continues to gain recognition globally, given that it is a violation of women’s right. Growing evidence from both low- and high-income countries indicate that many women are discouraged from accessing health facilities due to substandard maternity services and the likelihood of disrespectful and abusive care from midwives and other health providers. This study’s aim was to explore midwives’ perception of respectful maternity care during childbirth in selected health facilities in Lagos state, Nigeria. The research study employed exploratory descriptive research design. Data generation was through semi structured individual interviews. The data underwent manual coding and thematic analysis. The findings revealed that participating midwives were newly acquainted with the term Respectful Maternity Care (RMC), but they had positive perception of RMC. Midwives perceived RMC as treating patients with dignity and respect, respect of patients’ culture, beliefs and values, maintain privacy and confidentiality, respect patients’ opinions, and non-abusive care. They also viewed RMC as explaining procedure to obtain consent, holistic and individualised care, client/relations involvement in care, empathic care, non-abandonment and non-discriminatory care. Findings further revealed that perceptions do not fully translate into practice.