Midwifery
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women have consistently rated postnatal care less favourably than other episodes of maternity care. Midwives have also reported concerns with postnatal care, with challenges related to workloads, busy environments and lack of staff. Given these concerns, a regional hospital in Victoria, Australia redesigned its postnatal care provision. The changes included cessation of routine postnatal observations and the use of clinical pathways for women who gave birth vaginally; promotion of rest through minimal disturbances before 9 am; discouraging the use of the call bell system except in emergency situations; introduction of 'one-to-one' time with women; and promotion of normalcy and independence. This paper examines midwives' views of the changes and their impressions of the effects of the changes on women and their infants. ⋯ overall, midwives were supportive of the changes and agreed that change to postnatal care was needed. Challenges remain around the most effective method of communication and documentation of postnatal care. It is important that when major changes to care provision are implemented that care providers' views and experiences are explored given their crucial role in the introduction and maintenance of changes and the potential impact on them as care providers.
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'Every pregnant woman needs a midwife'-the experiences of HIV affected women in Northern Ireland. ⋯ pregnancy in the context of HIV, whilst offering a much needed sense of normality, also increases woman's sense of anxiety and vulnerability and therefore the need for supportive interventions that affirm normality is intensified. A maternity team approach, with a focus on providing 'balanced care' could meet all of the woman and child's medical needs, whilst also emphasising the normalcy of pregnancy.
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the aim of this study was to explore and contextualise meanings, beliefs and practices surrounding maternal and infant nutrition in North West Pakistan and to use the findings to inform the development of a nutritional improvement programme adapted to local needs. ⋯ this study highlights that despite structural, cultural and practical barriers, a culturally sensitive health improvement programme has the potential to enhance maternal and infant nutritional practices. However, we should not underestimate the powerful influence of poverty and culturally embedded norms upon women's decisions and practices.
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despite an exponential rise in the number of medically initiated elective caesarean sections over the last two decades, women's experiences of this birth mode remain largely unknown. The aim of this study was to address this gap by describing women's experiences of medically necessary elective caesarean section. ⋯ our findings suggest that when women are ignored during childbirth, any fear they hold may escalate into peritraumatic disassociation, which in turn has implications for women's postnatal mental and emotional health in the short and long term. In addition, the separation of the mother-baby dyad was found to have a devastating impact on maternal-newborn attachment that lasted well into the postnatal period. To optimise women's childbirth satisfaction and foster their attachment to their baby, both of which are essential for ongoing emotional well-being, it is vital that they are located at the centre of their birth experience and that if at all possible they are not separated from their newborn.
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to explore how midwifery students and newly qualified midwives learnt to make clinical decisions. ⋯ learners need to work with mentors who actively encourage participation in decision-making and provide discussion and feedback on decision-making abilities. When a staged and active approach to decision-making is not provided this may have negative implications on the transition to qualified practitioner.