PubMed Health⌕ Search

Biomedical subjects

L M Barclay

Publications and source records attributed to L M Barclay.

6 recordsLinked to original sources
PubMed2001

Collaboration in maternity care: a randomised controlled trial comparing community-based continuity of care with standard hospital care.

OBJECTIVE: To test whether a new community-based model of continuity of care provided by midwives and obstetricians improved maternal clinical outcomes, in particular a reduced caesarean section rate. DESIGN: Randomised controlled trial. SETTING: A public teaching hospital in metropolitan Sydney, Australia. Sample 1089 women randomised to either the community-based model (n = 550) or standard hospital-based care (n = 539) prior to their first antenatal booking visit at an Australian metropolitan public hospital. MAIN OUTCOME MEASURES: Data were collected on onset and outcomes of labour, antenatal, intrapartum and postnatal complications, antenatal admissions to hospital and neonatal mortality and morbidity. RESULTS: There was a significant difference in the caesarean section rate between the groups, 13.3% (73/550) in the community-based group and 17.8% in the control group (96/539). This difference was maintained after controlling for known contributing factors to caesarean section (OR = 0.6, 95% CI 0.4-0.9, P = 0.02). There were no other significant differences in the events during labour and birth. Eighty babies (14.5%) from the community-based group and 102 (18.9%) from the control group were admitted to the special care nursery, but this difference was not significant (OR 0.75, 95% CI 0.5-1.1, P = 0.12). Eight infants died during the perinatal period (four from each group), for an overall perinatal mortality rate of 7.3 per 1000 births. CONCLUSION: Community-based continuity of maternity care provided by midwives and obstetricians resulted in a significantly reduced caesarean section rate. There were no other differences in clinical outcomes.

Adult↗
PubMed1996

The misery of motherhood: alternative approaches to maternal distress.

This paper was developed from a presentation delivered to the Marce Society Pacific Rim Conference, Childbearing and mental health: risks and remedies (Barclay & Lloyd 1995). Midwives involved in education and clinical care are challenged to carefully consider the implications of accepting a psychiatric approach to new motherhood. While acknowledging the importance of understanding and treating clinical depression, the authors question the appropriateness of extending the psychiatric model to the psychological and social changes inherent in parenting. We focus our discussion on new motherhood and illustrate our argument with quotations from our own research.

Female↗
PubMed1994

Sexuality and pregnancy. An interview study.

This paper reports the interview research which formed the basis for a large recently completed study of sexuality and pregnancy by questionnaire. Semistructured interviews were conducted with 25 couples who presented at a large hospital antenatal clinic in the first trimester. Of these couples, 15 participated in second trimester interviews and 12 couples were interviewed between 38 and 40 weeks' gestation. The results showed a substantial decline in sexual interest amongst women that was not matched by their male partners but was reflected in a marked reduction in frequency of intercourse. The range of sexual activities also diminished during pregnancy. The majority (19 or 76%) regularly practised oral sex and 3 men (12%) regularly practised anal intercourse. A key observation is that 7 males (28%) did not always achieve orgasm during sexual intercourse per se.

Adolescent↗
PubMed1993

A study of the services provided by the women's health nurses in a Sydney Area Health Service.

OBJECTIVES: To describe the client characteristics and nature of services provided by women's health nurses and to examine whether the goals set for the service are being met. DESIGN: A retrospective study of women's health nurse (WHN) records from 1987 to 1991. SETTING AND SUBJECTS: All women attending the women's health nurse in the Southern Sydney Area Health Service, 1987 to 1991. Older women and women of non English-speaking background are specific targets for this service. OUTCOME MEASURES: Pap test and breast self-examination practices were examined in relation to age and ethnic background. Use of general practitioner services was examined for all women attending the women's health nurse in 1991. RESULTS: Forty-five per cent of clients were aged over 50, and 29 per cent were from a non English-speaking background. Older women were more likely to return for subsequent visits to the women's health nurse. The practice of breast self-examination increased significantly between visits among all women. Forty-one per cent of women had not had a Pap test for at least three years, 93 per cent of these women were screened at their first visit. Eighty-seven per cent of women on their first visit and 86 per cent of women revisiting the women's health nurse had seen their general practitioner within the previous year. CONCLUSION: Women's health nurses are meeting the goals set for their service in relation to health promotion and the screening of women. Their services are perceived by their clients as complementary to those provided by their general practitioners.

Adolescent↗