Academic literature on the topic 'Obstetrics|Women's studies|Nursing'

A violência obstétrica consiste em qualquer conduta ou ato que leva à apropriação indevida dos processos corporais e reprodutivos das mulheres. O objetivo do presente estudo foi identificar as formas de violência obstétrica apontadas na literatura brasileira. Tratou-se de uma revisão integrativa da literatura, através das bases de dados Scientific Eletronic Library Online (Scielo), Latino Americana e do Caribe em Ciências da Saúde (Lilacs), Base de Dados de Enfermagem (BDENF). Constatou-se que há mais de 40 caracterizações da violência obstétrica dentre os estudos revisados. Os tipos de violência física, verbal e psicológica, assim como a realização de procedimentos desnecessários estão presentes em 100% das pesquisas. Concluiu-se que há necessidade de divulgação do tema através de políticas públicas e conscientização da população sobre o parto normal humanizado, assim como a mudança de modelo assistencial e na formação dos profissionais, pois ambos se baseiam em práticas intervencionistas.Descritores: Violência, Parto, Obstetrícia. The broad conceptualization of obstetric violence: an integrative reviewAbstract: Obstetric violence consists of any conduct or act that leads to the misappropriation of women's bodily and reproductive processes. The objective of the present study was to identify the forms of obstetric violence pointed out in the Brazilian literature. This was an integrative review of the literature, using the Scientific Electronic Library Online (Scielo), Latin American and Caribbean in Health Sciences (Lilacs), Nursing Database (BDENF) databases. It was found that there were more than 40 characterizations of obstetric violence among the reviewed studies. The types of physical, verbal and psychological violence, as well as the performance of unnecessary procedures are present in 100% of the researches. Concludes that there is a need for disclouse the topic through public policies and public awareness about normal humanized delivery, as well as a change in care model and the training of professionals, since both are based on interventionist practices.Descriptors: Violence, Parturition, Obstetrics. La amplia conceptualización de la violencia obstétrica: una revisión integrativaResumen: La violencia obstétrica consiste en cualquier conducta o acto que conduzca a la apropiación indebida de los procesos corporales y reproductivos de las mujeres. El objetivo de este estudio fue identificar las formas de violencia obstétrica señaladas en la literatura brasileña. Esta fue una revisión integradora de la literatura, a través de la Biblioteca Electrónica Científica En Línea (Scielo), bases de datos latinoamericanas y caribeñas en Ciencias de la Salud (Lilacs), Base de Datos de Enfermería (BDENF). Se encontró que hay más de 40 caracterizaciones de violencia obstétrica entre los estudios revisados. Los tipos de violencia física, verbal y psicológica, así como la realización de procedimientos innecesarios están presentes en el 100% de los estudios. Se llegó a la conclusión de que es necesario difundir el tema a través de políticas públicas y la concienciación de la población sobre la prestación normal humanizada, así como el cambio de modelo de atención y la formación de los profesionales, porque ambos se basan en prácticas Intervencionista.Descriptores: Violencia, Parto, Obstetricia.

Every patient has a right to be treated with dignity, respect and high quality pain management (Olivier, et al., 2012). Pain continues to be inadequately treated by healthcare providers (Zuccaro, et al., 2012). The purpose of this DNP project was to determine if perinatal nurses’ intent to medicate pregnant women with chronic pain was affected by knowledge of pain, attitude, or demographics. This will explore the theoretical application of Ajzen’s theory of planned behavior which suggests that attitude correlates with intention to act.

A quantitative, cross-sectional correlation study used a pencil and paper survey to measure knowledge about pain, attitudes, and intent to medicate pregnant women with chronic pain. One hundred perinatal nurses who worked in labor and delivery, mother baby, or the neonatal intensive care unit from four hospitals in northern New Jersey participated in the study. Each hospital provided a different level of perinatal care from community basic, to intermediate, intensive, and regional perinatal center.

Increased levels of education positively impact perinatal nurses’ knowledge of pain, attitude, and intent to medicate pregnant women with chronic pain. The perinatal nurse’s intent to medicate was not statistically correlated to age, years of nursing experience, or level of perinatal care. The perinatal nurse’s intent to medicate a pregnant woman with chronic pain is positively correlated to increased knowledge of pain (r (100) = 0.463, p ≤ 0.001). Attitude scores were positively correlated with an increased intent to medicate a pregnant woman with chronic pain (r (100) = 0.583, p ≤ 0.001).

Women involved with the criminal justice system face higher rates of unintended pregnancy than the general population, yet less than one-third use a consistent method of contraception. One study found that among women leaving detention, 43% had conceived within one year of release. Pregnancies that do occur are often high risk and result in poor outcomes for both mother and child. Lack of focus on family planning needs post-incarceration are due to competing factors women face related to daily survival and the added demands of meeting the requirements of probation.

This study examined the influences of pregnancy attitude, reproductive autonomy, personal factors and prior related behaviors on the use of effective birth control among women on probation living in southern New Mexico including the U.S.- Mexico border region. Using a quantitative correlational design framed by Pender's Health Promotion Model, 52 women were surveyed at five different Adult Probation and Parole Offices in two U.S.-Mexico border counties and two additional counties in southern New Mexico. Data analysis was conducted using descriptive statistics and logistic regression (single, multivariate, and hierarchical) to answer the following questions about women on probation: Do personal characteristics (contraceptive self-efficacy, birth control method prior to incarceration, age, ethnicity, and parity) significantly predict current birth control method? Which combination of personal characteristics (ethnicity, contraceptive self-efficacy, age, and parity) best predicts higher negative pregnancy attitudes and higher reproductive autonomy? Do pregnancy attitude and reproductive autonomy significantly predict current birth control method.

Results indicated a significant relationship between increased levels of reproductive autonomy (an interpersonal influence) and effective use of birth control among women on probation. While statistical significance was attained for two additional variables, contraceptive self-efficacy and prior birth control use, the results were not decisive due to widened confidence intervals. Use of a hierarchical logistic regression was effective for entering predictor variables into the regression based upon Pender's theoretical framework as a guide. Implications for nursing research, education, and practice were discussed. Future studies using larger sample sizes and additional settings would increase validity and generalizability.

A qualitative study was conducted to explore the phenomenon of uncertainty in women experiencing a first uncomplicated pregnancy. Ten subjects, three from each of the first two pregnancy trimesters and four from the third pregnancy trimester, comprised the sample. Subjects ranged in age from 19 years to 30 years and lived in a southwestern city. Interviews were conducted in the subjects' homes or in the researcher's office over a four month period. Constant comparative analysis of data permitted the researcher to elicit specific uncertainties by trimester and the meaning of uncertainty to women involved in a normal change process. Implications for nursing highlight the need to provide continuity of care from office to hospital and within the hospital environment itself. Providing support by functioning as a mediator between the physician and the patient, nurses could contribute to the pregnant woman's positive perception of her experience. In addition to traditional third trimester childbirth education, classes for first and second trimester women are recommended.

Background: Each year, perinatal loss affects one million women and their families (National Vital Statistic Reports, 2011). Perinatal loss is the death of a fetus/infant during pregnancy or soon thereafter (Koppmans, Wilson, Cacciatore & Flenady, 2013). There are several different types of perinatal loss, including miscarriage, stillbirth, and neonatal death. Bereavement education related to miscarriage will be the main focus of this project. Miscarriage, also known as spontaneous abortion, is the body's natural termination of a pregnancy before 20 weeks gestation (Geller, Psaros, & Kornfield, 2010).

Objective: The clinical problem to be addressed by this project is the lack of a system of evidence based bereavement education for women who experience miscarriage and subsequent treatment when they are admitted to the hospital through the Pre-Admission Unit (PAU)at WVU Healthcare. The project plan involves the development, implementation, and evaluation of an evidence based bereavement education system for women who are treated in the PAU prior to surgical intervention for a miscarriage. This intervention has been designed to address knowledge, skills, and attitudes of staff in the PAU related to providing bereavement support for women who experience a miscarriage.

Methods: A computerized literature search of CINAHL, PUBMED, National Guideline Clearinghouse, and the Cochrane Library data bases were performed using the key words miscarriage, spontaneous abortion, emotional experience, grief, education of providers, and bereavement education. Search limits were set which included the dates of 2002–2013, peer reviewed, full text, and English language. Selection criteria included the provision of grief interventions to women and their families who have suffered a perinatal loss and staff who cared for women who suffered a miscarriage. These searches produced 58 hits. After reviewing abstracts and article fourteen articles were chosen for the review. There were five systematic reviews, two randomized controlled trial (RCT) studies, six descriptive qualitative studies, and one non-experimental, correlational study.

Results: Strong evidence existed that grief education could assist healthcare providers to be able to provide evidence based interventions to women and families with a miscarriage. This project validated the literature by indicating that healthcare providers that were given bereavement education were much more comfortable presenting this education to women who suffered a miscarriage and required surgical intervention. The increase in knowledge of the healthcare providers was established with a pre-test, intervention of providing bereavement education, and a post-test. A t-test was used to compare means of the pre and post-tests and conclude that there was statistical significance in the mean scores of the pre and post-tests.

The purpose of this study was to describe the prenatal and postpartum health care beliefs and practices of Arab student wives in a small Southwestern university town. The study also explored whether temporary migration to the United States altered or complicated any of the traditional beliefs and practices. The sample consisted of five Moslem Arab women (all from different regions of the Middle East) who had experienced at least one pregnancy prior to the interview. An ethnographic method was used in guiding questions which dealt with beliefs and practices during the prenatal and postpartum periods. Analysis of data showed the importance of upholding traditional beliefs regarding pregnancy, and beliefs in religion and God, which determine the health of the pregnancy and the postpartum period, the importance of following advice of mothers, and the support system of female family members during the postpartum period.

Research has demonstrated that breastfeeding decreases the mortality of infants and supports the health of mothers. In America breastfeeding rates fall below the Healthy People 2020 goals. This qualitative study explored the lived experience of registered nurses (RNs) who had breastfed their children and the support they gave to postpartum mothers.

Fourteen postpartum RNs from a California hospital volunteered for interviews regarding personal experiences with breastfeeding. The sample was multicultural with Kenyan, Middle Eastern, Hispanic, Asian, Caucasian, and Filipino women. Themes discouraging breastfeeding included pain, lack of breastfeeding support, and the need to return to work. Participants with difficult breastfeeding experiences reported empathy with postpartum mothers.

Participants were unprepared for the pain and difficulty associated with breastfeeding. Women whose cultures expected breastfeeding tolerated the pain as part of the maternal experience. Efforts should focus on reducing pain during breastfeeding and improving postpartum care by engaging those with breastfeeding experience.

Health care providers’ (N = 421) implicit perceptions of pregnant women based on age, race or ethnicity, marital status, and socioeconomic status are assessed through a true-experiment design. Ordinal and binary regression analyses revealed that respondents felt more pity for an unmarried than married pregnant woman and more anger toward an unemployed pregnant woman without health insurance compared to a pregnant woman who was employed with health insurance. Male, Asian, and Hispanic respondents were less likely to help the pregnant woman, Black and protestant respondents were more likely to express some degree of anger toward the pregnant woman, and male and protestant respondents assigned more responsibility to the woman for her pregnancy. Additionally, respondents’ open-ended suggestions varied based on the pregnant woman’s characteristics. Implications and future directions are discussed.

Background: In the United States, currently about half (49%) of the 6.7 million pregnancies are reported as mistimed or unplanned, and this rate of unintended pregnancy is significantly higher than the rate in most other developed countries. Abortion services are critical to the prevention and management of unintended pregnancies. Abortion in the United States has been legal since the 1973; however this right has little meaning without access to safe abortion care and access is declining. Medication abortion, the use of medications to induce abortion and terminate an early pregnancy, has been legal in the United States since 2000, is ideal for the outpatient setting, and allows for increased provision of and access to abortion services. The literature assessing the provision of medication abortion has largely been conducted in populations of physicians, and combined groups of advanced practice clinicians including physician assistants (PAs), certified nurse midwives (CNMs), and nurse practitioners (NPs). No studies exist assessing provision of and barriers to medication abortion by NPs and CNMs (Advance Practice Registered Nurses or APRNs) in the state of Vermont. Purpose: This study sought to fill this gap in the literature. Data was collected in order to determine whether APRNs are providing care to women at risk for unintended pregnancy and are providing medication abortion, the characteristics of these providers, and perceived barriers or supports to practice. Methods: The design was a cross-sectional survey, using purposive sampling methods. Between July 2014 and September 2014, 21 eligible participants completed an anonymous, self-administered online survey, recruited via notifications sent out through professional listserv. The survey assessed their personal characteristics, beliefs and clinical practice related to reproductive health care and unintended pregnancy prevention and management. All participants had current APRN certification with prescriptive authority in the state of Vermont. Results: Ninety percent of respondents reported care for women of reproductive age as at least one-third of their clinical work and 85% of respondents reported seeing women with unintended pregnancies as part of their practice. Eighty-five percent agreed or strongly agreed that medication abortions fall within the scope of practice of an APRN and of a primary care provider, and 85% would like to be trained to provide medication abortions to manage unintended pregnancy. Lack of training opportunities, clinical facility constraints, and legal uncertainties were the most frequently reported barriers to provision of medication abortion. Conclusions: Many APRNs in Vermont may be interested in receiving medication abortion training. APRNs are experienced and highly trained health care professionals that have the competence and skills to provide comprehensive reproductive health care, including medication abortion. The perceived barriers of training, clinical facility constraints, and legal uncertainties are amenable to change, and can be decreased through inclusion of these topics into APRN education. The political and social climate of Vermont, combined with the findings of this preliminary study, suggest that the state of Vermont is ready, willing, and able to serve as a model for the primary provision of and improved population access to, comprehensive reproductive health care including abortion services.

Midwifery has re-emerged as a birthing system and women are again seeking midwives as their birth attendants. This pluralization of the U.S. medical system and its birthing system is on one level of interpretation is attributable to some primarily middle class women's and couples' dissatisfaction with hospital maternity care and with physicians' activist attitude and interventionist approach to child birth. The practice of lay or independent midwifery began to emerge in the late 1960's, in conjunction with, and as a response to, these women's demands for unmedicated birth experiences. It is argued that these women's dissatisfactions with medicalized birth and the lay midwife's alternative definition of and approach to birth are expressions of the more generalized dissatisfaction with the institutions of modernity, the materialistic explanation of science, and the rational solutions of technology. Consciously or unconsciously, the women who choose and the lay midwives who attend their alternative births are, by their decisions and actions, joining a larger social discourse which involves not only a rethinking of the efficacy of obstetrics as a total system for doing birth and the deconstruction of the institutions and practice of technological birth but a rethinking of the mechanistic worldview and of the Enlightenment enterprise of reconstructing society to conform with the principles of natural law and social relationships to conform with the theory of complementary gender relationships. The practice of midwifery was progressively taken over by men as the occupations were professionalized; but it was the elimination of the dualism in this society's social roles and interpersonal relationships, that disqualified the midwife as a birth attendant. The re-emergence of the midwife is not only associated with the deconstruction of the mechanistic worldview but the emergence of alternatives to the complementary gender relationships of modernity. The lay midwife's solution is to return to the dualistic roles characteristic of colonial America's traditional medical relationships. The nurse-midwife, by education and experience, works and thinks in such a way that the categories which characterize the particular genders and their respective realm of the caring and curing are harmonized rather than dichotomized.

Information and communication technologies include computers, telecommunication, digital networks, and television. Using informatics in healthcare systems can improve the quality of healthcare through the effective use of information systems. Nursing Informatics (NI) is a component of health informatics, and it has become a widely used tool in the nursing profession. Information technology has begun to be employed in the field of women’s health. The perinatal period is one of the topics related to women’s health, as well as to that of their newborn infants. Information technology in patients’ health education process empowered patients, and enhanced their self-management skills. However, applications of health informatics in perinatal care for women and their newborn infants have not been reported widely in research studies and projects. Thus, there is a gap of knowledge related to this topic on the Internet.