PubMed Health⌕ Search

Biomedical subjects

Mary Newburn

Publications and source records attributed to Mary Newburn.

12 recordsLinked to original sources
PubMed2006

Feathering the nest: what women want from the birth environment.

The National Childbirth Trust wants all women to be able to give birth with confidence and dignity, and believes it is important for women to begin motherhood feeling fit and well, good about themselves, and valued and supported by others. Good health and positive experiences can act as a buffer against the tiredness and demands of looking after a new baby. This paper draws on surveys conducted in 2003 and 2005 to describe what women want and need from birth environments, and how these factors can help or hinder them in having the kind of birth experience they desire.

Delivery, Obstetric↗
PubMed2003

What men think of midwives.

It is now widely accepted that woman-centred maternity care is important. But surely planners and service providers should also examine the needs of expectant fathers? A postal survey of a randomly selected sample of 837 fathers-to-be throughout the UK found that midwives are not meeting all men's information and support needs. Although midwives were more highly rated than GPs and hospital doctors, men felt that midwives could still listen to them more, enable them to ask questions and explain things to help them better understand physical processes, clinical procedures, the baby's behaviour and their partner's needs. Most men wanted to be involved in their partner's pregnancy and care, but many felt left out by health professionals. Men play a pivotal role in supporting their partner during pregnancy and influence women's baby-feeding choices and esteem after giving birth. It is crucial that midwives see men not as an extra burden, but as individuals with needs of their own who are usually the main supporters of the women and babies at the centre of midwifery care.

Adolescent↗
PubMed2003

Culture, control and the birth environment.

These findings illustrate that women's needs are not being adequately met in many hospital birth units. Women, particularly those expecting their first baby, often know little about how the culture of hospitals varies, or the helpfulness of facilities and opportunities for control and one-to-one support that are more readily available at home or in a midwife-led unit. Nor do they know how much their opportunities for comfort and control may be compromised in a conventional hospital setting. If they are feeling anxious about whether they will be able to cope with the pain of labour and whether their baby will be born safely, it is perhaps not surprising that a significant proportion feel it is important to have access to an epidural service and a special care baby unit (House of Commons Health Committee 2003a). However, these facilities are not in themselves more likely to make labour straightforward and manageable. Midwives and organisations such as the NCT have a key role to play in sharing knowledge about what women actually find useful--or disruptive and unhelpful--during labour, so that all pregnant women can make choices that are informed by the full range of relevant information. The recommendations from the early 1990s, that women should have care from a known midwife, has not been realised consistently, although in environments that are highly medicalized neither knowing your midwife nor one-to-one support seem sufficient to affect labour outcomes substantially (Johanson et al 2002). Where there is strong midwifery leadership, a clear philosophy of normality and one-to-one support, outcomes are different (Biringer, Davies. Nimrod et al 2000). Women appear to be offered more choices than a decade ago, but the range of options available still tends to be dominated by a medical model of care. Women still do not receive adequate information on the significance of alternatives as good-quality, evidence-based information is not [table: see text] consistently available, nor are they given the support to choose freely from the full range of options (Singh and Newburn 2000). However, evidence-based information leaflets alone are known to be inadequate to overcome a range of cultural barriers (O'Cathain et al 2002; Stapleton et al 2002). A small and growing proportion of women are having home births and have access to a midwife-led unit. Use of a birthpool in labour has become more accepted in all birth settings, although access to suitable facilities and protocols for use in hospital units are sometimes restrictive. Further change is needed to provide care during labour as part of a midwifery model, so that the kinds of medical interventions women find intrusive can be limited as far as possible without compromising safety.

Cultural Characteristics↗
PubMed2001

Achieving sustainable quality in maternity services - using audit of incontinence and dyspareunia to identify shortfalls in meeting standards.

BACKGROUND: Some complications of childbirth (for example, faecal incontinence) are a source of social embarrassment for women, and are often under reported. Therefore, it was felt important to determine levels of complications (against established standards) and to consider obstetric measures aimed at reducing them. METHODS: Clinical information was collected on 1036 primiparous women delivering at North and South Staffordshire Acute and Community Trusts over a 5-month period in 1997. A questionnaire was sent to 970 women which included self-assessment of levels of incontinence and dyspareunia prior to pregnancy, at 6 weeks post delivery and 9 to 14 months post delivery. RESULTS: The response rate was 48%(470/970). Relatively high levels of obstetric interventions were found. In addition, the rates of instrumental deliveries differed between the two hospitals. The highest rates of postnatal symptoms had occurred at 6 weeks, but for many women problems were still present at the time of the survey. At 9-14 months high rates of dyspareunia (29%(102/347)) and urinary incontinence (35%(133/382)) were reported. Seventeen women (4%) complained of faecal incontinence at this time. Similar rates of urinary incontinence and dyspareunia were seen regardless of mode of delivery. CONCLUSION: Further work should be undertaken to reduce the obstetric interventions, especially instrumental deliveries. Improvements in a number of areas of care should be undertaken, including improved patient information, improved professional communication and improved professional recognition and management of third degree tears. It is likely that these measures would lead to a reduction in incontinence and dyspareunia after childbirth.

Journal Article↗