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The National Health Service (NHS) England website provides guidance on foods/drinks to avoid or limit during pregnancy because of microbiological, toxicological or teratogenic hazards. The aims were to determine adherence and whether demographic characteristics were associated with adherence.
Design:
Cross-sectional study.
Setting:
Online survey of postpartum women resident in England during pregnancy.
Participants:
Recently, postpartum women resident in England during their pregnancy (n 598; median age 33 (IQR 30–36) years) completed an online questionnaire (April–November 2022). Questions included those on consumption of twenty-one food/drink items that the NHS advises pregnant women to avoid/limit. The study is part of the Pregnancy, the Environment And nutRition (PEAR) Study. Summary statistics were used to determine proportions adhering to the guidance. Adjusted logistic regression was used to model the associations of adherence with demographic characteristics.
Results:
Adherence was generally high (>90 % for eight of ten food/drink items to be avoided). However, among pre-pregnancy consumers, several items were not completely avoided, for example, 81 % (128/158) for game meat/gamebirds, 37 % (176/478) for cured meats and 17 % (81/467) for soft cheeses. Greater educational attainment (e.g. caffeinated soft drinks OR 2·25 (95 % CI 1·28, 3·94)), greater maternal age (e.g. oily fish 1·64 (1·05, 2·56)) and lower parity (e.g. caffeinated coffee 0.28 (0.11, 0.69)) were the most usual characteristics associated with adherence.
Conclusion:
Evidence of concerning levels of non-adherence for some food/drink items suggests a case for more education on some of the guidance, particularly for women with lower educational attainment, greater parity and greater maternal age. Further research on barriers to the implementation of the guidance is needed.
The aim of this study was to explore healthcare professionals’ experiences of working with extended home visits for parents.
Background:
It is essential to identify parents, both expectant and with a newborn child, who need support in their parenting abilities at an early stage because children’s health and well-being are affected by their home environment as well as by their parents’ health and social relationships. Home visits represent a cost-effective way of identifying and supporting families with a newborn. Further research is needed to explore healthcare professionals’ experiences working with extended home visits for parents.
Methods:
This was a qualitative interview study focusing on an intervention introduced in the Enhanced Parenting—Extended Home Visits project in Sweden. Data were collected via 13 semi-structured interviews with healthcare professionals who provide the intervention in antenatal care (midwives) and child health care (CHC nurses and family supporters), and a qualitative content analysis was performed.
Findings:
Data analysis resulted in one theme and four categories. The theme – to provide multidimensional adapted professional support, – and the four categories – strengthened collaboration between professionals enriches their work. Home visits provide time for conversation, which promotes continuity of care and relationships with parents; being humble guests in parents’ homes provides insight; and home visits provide the opportunity to strengthen parenting and participation in the family centre. The goals of the Enhanced Parenting—Extended Home Visits project were to strengthen parents’ confidence in their parenting abilities and to build trusting relationships with healthcare professionals. The conclusion of this study, from the participants’ perspective, is that these goals can be achieved with the intervention.
Implications for Practice:
Extended home visits seem to help healthcare professionals provide collaborative, multi-professional support for parents, both expectant and with a newborn child, with unique support needs.
Aichi prefecture, Japan is predicted to be hit by Mega-earthquake. Aichi Prefectural Association of Midwives has been making efforts to improve disaster preparedness for pregnant women. This project aims to acquire area data of pregnant women for simulated studies of rescue activities. Number of women in census survey areas in Nagoya City was acquired from nationwide data of pregnant women by machine learning (Cascade-Correlation Learning Architecture). Quite high correlation coefficients between actual data and estimation data were observed. Rescue simulations have been carried out based on the data acquired by this study.
Natural disasters have many effects on vulnerable groups, especially infants and children. Protecting breastfeeding in disasters is important, because artificial feeding puts a lot of risk to the child. In disasters, artificial nutrition is dangerous to children and its supplementation requires special equipment. There is little information on the nutritional status of infants after disasters in Iran.
Problem
The purpose of this study was to explore the barriers to appropriate lactation after disasters in Iran.
Method
This was a qualitative study using a content analysis method. A total of 19 midwives with disaster-relief experiences were approached for interview. Data were collected using semi-structured interviews. Data analysis was performed using the Graneheim’s approach.
Results
The categories of maternal factors, neonatal factors, management factors, and context-base factors were extracted from the data.
Conclusion
The challenges of social support, mothers’ self-efficacy, educated staff for disasters, and privacy for breastfeeding can be considered as important barriers to breastfeeding in disasters. Training programs, as well as health system support, can help overcome the breastfeeding barriers in disasters.
MirMohamadaliIeM, Khani JazaniR, SohrabizadehS, Nikbakht NasrabadiA. Barriers to Breastfeeding in Disasters in the Context of Iran. Prehosp Disaster Med. 2019;34(1):20–24.
Maternal mortality may increase after a disaster. Because midwives are at the frontline of offering reproductive health care services in disasters, they should be competent.
Methods
This was a cross-sectional, descriptive study carried out in 2015 in Tehran. The sample consisted of 361 midwives selected by use of a cluster random sampling method. Data were collected by using a questionnaire on professional competency for preventing maternal mortality in disasters.
Results
The midwives’ mean professional competency score was 177.74±31, which was an average level of professional competency. The level of knowledge and skills of the midwives was reported as inadequate for most items, particularly for the items of “managing mothers affected by chronic diseases,” “physical trauma,” “recognizing patients who needed to be referred,” and “stabilizing mothers when referring them.” Statistically significant relationships were observed between the midwives’ competencies and age (P=0.001), work experience (P=0.054), educational level (P= 0.043), previous experience in a disaster (P=0.014), and workplace (P=0.006). These data were drawn by using Spearman’s correlation, t-test, and ANOVA, respectively.
Conclusions
Given the average scores for midwives’ professional competency in disasters and the inadequacy of prior training courses, extra educational programs for midwives are recommended. (Disaster Med Public Health Preparedness. 2018; 12: 305–311)
Antenatal care for women with a low-risk pregnancy is predominately provided by midwives supported by maternity support workers and other professionals. The National Institute for Health and Clinical Excellence (NICE) has published guidance on the routine care of the healthy pregnant woman, outlining a schedule of appointments and the type of screening available. The care pathway provides details of antenatal care for women with an uncomplicated pregnancy. The establishment of Maternity Direct under the aegis of NHS Direct in certain parts of the country has led to a reduction in antenatal admissions. Midwives are the specialists of normality, and are trained to diagnose pregnancy and assess and monitor women holistically throughout the antenatal period. The majority of maternity services are using the Royal College of Obstetricians and Gynaecologists (RCOG) Maternity Dashboard. Maternity services should audit the percentage of women who booked by the 12th completed week of pregnancy.
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