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Objectives: To explore and understand perspectives of women expecting their first child and why they wanted to attend NHS antenatal education. This included what worries and concerns they wanted to be addressed and why this would be beneficial. It also included what they wanted their partners to be able to gain from attending classes., Design: A longitudinal qualitative study using Template Analysis was undertaken with data collection during pregnancy and postpartum. A semi-structured topic guide was used to guide data collection, either via focus groups or one to one interviews which were audio recorded and transcribed., Setting: National Health Service Trusts providing maternity services to women for labour and birth, purposively selected to allow the perspectives of specific groups of women to be included., Participants: Women expecting their first child from one of three groups: Women from the general population aged 20 years or more, women from ethnic minority groups and young women aged 16 to 19 years., Findings: Eighty-two pregnant women participated. Three substantive themes are reported: the search for information, the functions of antenatal classes, and the specific information desired. Women wanted to attend NHS antenatal education to access trustworthy information that would reassure, increase confidence, and help them feel prepared. Women wanted to meet others in the same situation to help normalise concerns and offer the potential for ongoing relationships. Classes were seen as a way to help partners engage more fully with the transition to parenthood. Specific information required and shared by all groups was around understanding the stages of labour, managing labour, and common interventions., Conclusions: Access to a wide range of information increases women's anxieties about labour that women want addressed through antenatal education. However, antenatal classes serve broader functions beyond information- giving and women anticipate that attending antenatal classes will address both their own and their partners' needs., Implications: Service providers should ensure their antenatal education provision provides the information required and is structured in a way that enables women to develop relationships and supports partners' engagement in the transition to parenthood., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022. Published by Elsevier Ltd.)

Objective: Midwifery student mental wellbeing is an important consideration for the sustainability of the profession, however it has seldom been the subject of empirical research. Previous studies of the lived experience of midwifery students have focused on the impact of transition experiences and student satisfaction, rather than specifically on mental health and students' views on support for their mental wellbeing., Design: A qualitative descriptive study using semi-structured interviews., Setting: A midwifery undergraduate programme in one university in the South of England., Participants: 20 BSc midwifery students., Findings: Two inductive themes were developed from our analysis. The theme of 'the rollercoaster' encapsulated students' experience over the length of the course, characterised by multiple culture shocks of being in different worlds, from one clinical placement to the next, from university to clinical placement. This experience was emotionally taxing. The theme of 'being noticed, feeling connected' encapsulated midwifery students' views on what could help them enjoy their training. They wanted to be seen as individuals by at least one educator, they wanted opportunities to connect with their peers and they wanted the support available to them to be consistent., Conclusions: Listening to students' insights into the lived experience of being a midwifery student can enable midwifery educators to improve the way courses are designed and support structures are put in place. The importance of having consistent contact with peers and educators cannot be underestimated., Implications for Practice: The emotional demands of midwifery training must be acknowledged. Educators should identify ways in which they can provide students with consistent individualised support and regular opportunities to meet with their peers., Competing Interests: Declaration of Competing Interest Some members of the research team had pastoral responsibilities for the student cohort from which participants were drawn. They had no role in recruitment, direct contact with research participants and did not see unanonymised versions of the study transcripts., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Objective: To explore barriers and facilitators for midwives working in a midwifery continuity of carer model, and to assess if an educational intervention could help address some of these barriers, designed to help achieve NHS England's target of majority of women receiving midwifery continuity of carer by March 2021., Design: Two-day workshops were co-designed by experienced continuity midwives, service managers and midwifery educators using implementation theory delivered to maternity staff, with barriers assessed prior to training and re-assessed at the end., Setting and Participants: 1407 maternity healthcare professionals from 62 different National Health Service trusts across England attended 56 different workshops., Findings: Perceived barriers to working in this model were reported more frequently than facilitators. Reported facilitators prior to training included perceived benefits to the midwife and to women. Reported barriers included personal and professional concerns, fear, issues with the national agenda and institutional and/or organisational issues. The educational intervention was able to address the majority of barriers raised. The training was well evaluated, with an average rating of 4.2 on a five-point Likert scale., Key Conclusions: While this specific educational intervention appears to have been useful in addressing concerns with working in a continuity model, further work is needed to identify barriers to change. This will aid more local designed interventions., Implications for Practice: If policy targets related to continuity of carer are to be achieved then working in this way needs to be sustainable and appeal to the current midwifery workforce., Competing Interests: Declaration of Competing Interest None, (Copyright © 2020. Published by Elsevier Ltd.)

Background: There are many parenting problems during infancy for Chinese primiparous women. As an important determinant of good parenting, maternal self-efficacy (MSE) should be paid more attention by researchers. At present, the limitations of previous research examining MSE during infancy are that most studies were conducted with a homogeneous sample and there were few studies with Chinese women. Secondly, the trajectory of change in MSE, postnatal depression symptoms and social support for Chinese primiparous women was not clear during the initial postpartum period in earlier studies., Objectives: This study aimed to describe changes in MSE, postnatal depression symptoms and social support among Chinese primiparous women in the first three months postnatally., Design: A quantitative longitudinal study using questionnaires was conducted., Setting: Obstetric wards at three hospitals in Xiamen City, South-East China., Participants: In total, 420 Chinese primiparous women were recruited., Methods: Initial baseline questionnaires to measure socio-demographic and clinical characteristics at three days postnatally were distributed to participants face-to-face by the researcher on the postnatal ward. Follow-up questionnaires at six and 12 weeks postnatally were sent via e-mail by the researcher to participants, including the Self-efficacy in Infant Care Scale (SICS), the Edinburgh Postnatal Depression Scale (EPDS) and the Postpartum Social Support Scale (PSSS) to measure MSE, postnatal depression symptoms and social support, respectively. These were returned by participants via e-mail. Quantitative data were analysed using SPSS., Results: The mean MSE score at six weeks postnatally was 74.92 (SD = 11.05), and increased to 77.78 (SD = 11.13) at 12 weeks postnatally. The mean social support scores at six and 12 weeks postnatally were 40.99 (SD = 9.31) and 43.00 (SD = 9.55). The mean EPDS scores decreased from 9.09 (SD = 4.33) at six weeks postnatally to 8.63 (SD = 4.40) at 12 weeks postnatally; the proportion of women with an EPDS score of ten or more and 13 or more at the two time points declined from 47.4% to 38.3%, and from 21.4% to 18.2%, respectively., Conclusions: In this study, Chinese primiparous women had a moderate level of MSE and received a moderate level of social support at six and 12 weeks postnatally, and a higher proportion of Chinese women had postnatal depression symptoms than did women in Western countries. From six to 12 weeks postnatally, the mean MSE scores and social support scores had a statistically significant increase; the mean EPDS scores had a statistically significant decrease., (Copyright © 2018 The Author. Published by Elsevier Ltd.. All rights reserved.)

Background: parenting during infancy is highly problematic for Chinese primiparous women. As an important determinant of good parenting, maternal self-efficacy (MSE) should be paid more attention by researchers. At present, the limitations of previous research about MSE during infancy are that the factors which influence MSE remained poorly explored, there were few studies with Chinese women, and the studies did not consider the effect of different cultures., Objectives: to explore factors which influence MSE in primiparous women in China in the first three months postnatally., Methods: a quantitative longitudinal study using questionnaires was conducted. In total, 420 Chinese primiparous women were recruited in obstetric wards at three hospitals in Xiamen City, Fujian Province of China. Initial baseline questionnaires to measure socio-demographic and clinical characteristics were distributed to participants face-to-face by the researcher on the postnatal ward at three days postnatally. Follow-up questionnaires at six and 12 weeks postnatally were sent via e-mail by the researcher to participants, including the Self-efficacy in Infant Care Scale (SICS), the Edinburgh Postnatal Depression Scale (EPDS) and the Postpartum Social Support Scale (PSSS) to measure MSE, postnatal depression symptoms and social support, respectively. These were returned by participants via e-mail. Quantitative data were analysed using SPSS., Results: the variables: social support, women's satisfaction with 'Doing the month', postnatal depression, maternal education, baby health, and maternal occupation had an influence on MSE at six weeks postnatally (Adjusted R 2 = 0.510, F = 46.084, P<0.01); and the variables: postnatal depression, social support, baby health, women's satisfaction with 'Doing the month', and baby fussiness were the factors influencing MSE at 12 weeks postnatally (Adjusted R 2 = 0.485, F = 41.082, P<0.01)., Conclusions: obstetric nurses and women's family members need to be aware of the significant contribution of social support, women's satisfaction with 'Doing the month' in positively influencing primiparous women's MSE, and the significant effect of postnatal depression symptoms in negatively impacting on first-time mothers' MSE; they should pay more attention to primiparous women with less education, unemployed mothers, women with unskilled occupations, women with an unhealthy baby, and women with a baby with a difficult temperament to improve their comparatively lower MSE levels during the initial postnatal period., (Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Objective: to explore women's views surrounding the use of nicotine replacement therapy (NRT) to aid smoking cessation., Design and Setting: a qualitative approach using semi-structured interviews undertaken on 10 pregnant women in a semi-rural area of England., Findings: the two main themes that emerged from the study were that NRT was an important component in stopping smoking, but this was in conjunction with support given by the midwife advisor. Both themes appeared to be equally important to the women in aiding their attempts at smoking cessation. Also, the importance of tailored interventions should not be dismissed when aiding women in smoking cessation., Conclusions: exploring the views of women enabled the researchers to gain a greater understanding of the problems and achievements that women encountered when using NRT as an aid to stop smoking during pregnancy. The study also demonstrated that smoking cessation strategies can be successful if they are tailored to the individual needs of each woman, taking into account her dependency, domestic circumstances and willingness to change., Implications for Practice: the findings of this study add to the available research surrounding the efficacy of NRT in pregnancy. There is little evidence that the views of pregnant women have been taken into account prior to this study; as such, this report offers a different dimension to the available evidence. Although these findings could be adopted and utilized by practitioners, there is still the need for further research in this area on a larger scale., (Copyright 2008 Elsevier Ltd. All rights reserved.)

Objective: to review the literature of women's use of nicotine replacement therapy (NRT) during pregnancy. The review will examine NRT and nicotine, interventions and barriers to smoking cessation and the literature exploring women's views on using NRT in pregnancy., Method: a structured review of the literature was undertaken by accessing internet and library sources, restricted to English written articles between 1989 and 2003. Keywords were used to refine the search: pregnancy, smoking, NRT and smoking cessation., Findings: several papers had examined interventions employed to aid pregnant women in smoking cessation and the efficacy of NRT. However, papers exploring the views of women on the use of NRT during pregnancy were limited., Conclusions: smoking cessation is unique to individual women; as such, appropriate support and advice should be tailored accordingly. Further research is needed to explore the views of women using NRT during pregnancy to aid smoking cessation., Implications for Practice: the findings from this structured review raise awareness of the importance of smoking cessation during pregnancy, and the inclusion of women's views when discussing the use of NRT. Understanding women's views may enhance the care and advice given by midwives, thus improving smoking cessation rates in pregnancy., (Copyright 2008 Elsevier Ltd. All rights reserved.)

Objective: to determine what impact the changes from consultant-led care to midwife-led care in a local maternity service have had on women using that service., Design: case study, data were collected by postal questionnaire, semi-structured, tape-recorded interviews, observations and scrutiny of records., Setting: a small town in rural England., Participants: all pregnant women eligible for a midwife-managed unit (MMU) birth in a small rural town in England., Findings: the women using the MMU were satisfied with the care they received and the MMU style of care. Women giving birth at the MMU and at home required less pain relief and were more likely to have an intact perineum than a similar group of women giving birth in hospital. Continuity of carer did not appear to be an issue for women as long as they felt supported by a known team of midwives. Transfer for complications during the birthing process was a cause for anxiety and stress for women and their partners. Women, whilst satisfied with the MMU, would prefer the consultant-led maternity hospital to be re-established in the town. The home-birth rate rose by 28% when the consultant unit closed., Implications for Practice: while the establishment of a midwife-managed unit has provided increased choice for a minority of women, the removal of the consultant unit in the town has disadvantaged the majority of pregnant women. While guidelines are needed when establishing these units the application of restrictive inclusion and exclusion criteria can sometimes force women to make less appropriate birth choices.

Objective: to determine community midwives' knowledge, attitudes and practice with regard to baby walkers., Design: survey, using questionnaires., Setting: primary care, East Midlands, UK., Participants: Sixty-five community midwives participating in a cluster randomised controlled trial to reduce baby walker use., Findings: there was a 94% response. Seventy per cent of the midwives, felt that it was part of their role to discuss baby walkers, and 62% felt that giving advice about walkers before birth acceptable. The midwives had a limited knowledge of baby walker injury risk and only one midwife had any baby walker-related health education material. Three attitude scales were computed and indicated that the midwives held a negative view of baby walkers and were positive about baby walker health education, believing that parents hold a positive attitude to baby walkers. Those midwives who had used a walker with their own children were more positive about baby walkers and less positive about baby walker health education., Key Conclusions and Implications for Practice: midwives are willing to be involved in baby walker health education during pregnancy. However, they require evidence-based knowledge and materials rather than relying on personal experience.

The apparent distress of a 3-month-old baby whilst feeding was investigated by his general medical practitioner. Swellings were noted in the parotid duct regions of the vestibule which enlarged and almost met in the midline when the baby cried. Incision of the swellings relieved the feeding difficulties.