DOCSLIB.ORG

Experiences of Transition to Motherhood Among Pregnant Women Following Assisted Reproductive Technology: a Systematic Review Protocol of Qualitative Evidence

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Experiences of Transition to Motherhood Among Pregnant Women Following Assisted Reproductive Technology: a Systematic Review Protocol of Qualitative Evidence SYSTEMATIC REVIEW PROTOCOL Experiences of transition to motherhood among pregnant women following assisted reproductive technology: a systematic review protocol of qualitative evidence 1,2 1,2 1,2 1,2 1,2 Kunie Maehara Hiroko Iwata Mai Kosaka Kayoko Kimura Emi Mori 1Graduate School of Nursing, Chiba University, Chiba, Japan, 2The Chiba University Centre for Evidence Based Practice: a Joanna Briggs Institute Affiliated Group ABSTRACT Objective: This systematic review aims to identify and synthesize available qualitative evidence related to the experiences of transition to motherhood during pregnancy in women who conceived through assisted reproductive technology (ART). Introduction: Women who conceived through ART experience pregnancy-specific anxiety and paradoxical feelings, and face unique challenges in their identity transition to motherhood. It is important for healthcare professionals working with these women to understand the context and complexity of this special path to parenthood, including the emotional adaptation to pregnancy following ART. A qualitative systematic review can provide the best available evidence to inform development of nursing interventions to meet the needs of pregnant women after ART. Inclusion criteria: This review will consider any qualitative research data from empirical studies published from 1992–2019 in English or Japanese that described experiences of transition to motherhood during pregnancy in women who conceived with ART. Methods: This review will follow the JBI approach for qualitative systematic reviews. Databases that will be searched for published and unpublished studies include MEDLINE, CINAHL, PsycINFO, ProQuest Health & Medical Collection, Google Scholar and Open Access Theses and Dissertations (in English), and Ichushi-Web, CiNii and the Institutional Repositories Database (in Japanese). Titles and abstracts will be screened by two independent reviewers in full. The full-text of selected studies will be assessed in detail, and findings and their illustrations will be extracted and aggregated. Any disagreements between the reviewers that arise at each stage will be resolved through discussion, or by a third reviewer. Keywords Assisted reproductive technology; experience; motherhood; pregnant women; qualitative research JBI Evid Synth 2020; 18(1):74–80. Introduction procedures that include the in vitro handling of ore countries are providing access to assisted human oocytes and sperm or embryos for the M reproductive technology (ART) within their purpose of establishing pregnancy. In IVF, eggs healthcare systems, and an increasing number of are removed from a woman’s ovary and fertilized children are being conceived through ART. These with sperm outside of the body. The fresh or frozen technologies include in vitro fertilization and embryo is transferred to the woman’s uterus. In embryo transfer (IVF-ET), intracytoplasmic sperm ICSI, a single sperm is injected directly into each injection (ICSI) and gamete intrafallopian transfer egg in a laboratory procedure. Finally, GIFT is a (GIFT). These technologies are treatments or process where the eggs and sperm are mixed and then placed in the woman’s fallopian tubes to establish pregnancy. Among 52 countries, Japan Correspondence: Kunie Maehara, [email protected] reported the largest number of ART cycles in 1 The authors declare no conflict of interest. which follicles were punctured and aspirated. DOI: 10.11124/JBISRIR-D-19-00071 The percentage of total live births resulting from JBI Evidence Synthesis ß 2020 THE JOANNA BRIGGS INSTITUTE 74 ©2020 Joanna Briggs Institute. Unauthorized reproduction of this article is prohibited. SYSTEMATIC REVIEW PROTOCOL K. Maehara et al. ART in Japan has increased from 0.5% in 1996 to with women who spontaneously conceived. How- 5.5% in 2016.2 ever, methodological limitations and confounding Various studies have described experiences spe- factors may explain the inconsistencies in previous cific to pregnancy after ART. Women who become findings regarding the impact of ART. In particular, pregnant after infertility were reported to have previous systematic reviews only included quantita- greater specific anxiety, such as fetal survival and tive studies. A narrative review that included both normality3-6 and other complex issues.5,7 In early qualitative and quantitative studies indicated that pregnancy, these women reported experiencing par- women have higher levels of anxiety in pregnancy adoxical feelings such as joy and fear, or hope and after infertility treatment, and may experience some uncertainty,8,9 and had difficulty perceiving them- difficulties in the transition to parenthood, leading to selves as pregnant women.10,11 The transition to perinatal morbidity.20 Other qualitative studies sug- motherhood generally begins when a woman finds gested that the process of assuming a maternal out she is pregnant, and represents a process of active identity during the transition to motherhood may engagement.12 However, following ART, pregnant be qualitatively different for pregnant women who women must go through role acquisition and adjust- conceived through ART.11,13,14,16,21 Women who ment, while potentially experiencing anticipatory conceived via ART may also require more support anxiety about the potential loss of a pregnancy or from nurses/midwives to address anxiety during fetus, and feeling ambivalent over the transition pregnancy and allow them to express any negative from an ‘‘infertile’’ identity to a ‘‘pregnant’’ iden- feelings, review their infertility experiences and help tity.5,11,13,14 Women who have undergone ART may them prepare for parenthood.21-23 Understanding also delay developing an attachment to the fetus and the context and complexity of emotional adaptation preparing for the maternal role.15-17 Bernstein13 to pregnancy following ART is important for health- identified various factors that contribute to mother- care professionals working with these women. In ing disturbances after infertility, including a lack of particular, healthcare professionals need to remain appropriate role models for mothering after infertil- sensitive to the special path to parenthood for ity, delayed attachment to the baby, and the dispar- women after ART16 and their paradoxical care needs ity between the image and actual experience of during pregnancy.24 A qualitative systematic review motherhood. During pregnancy, women who have can provide the best available evidence to inform undergone ART face unique challenges in terms of development of nursing interventions to meet the their transition to motherhood. needs of this population. A quantitative systematic review by Hammarberg A preliminary search of PROSPERO, the JBI et al.18 explored the psychological and social aspects Database of Systematic Reviews and Implementa- of pregnancy after assisted conception. This review tion Reports, the Cochrane Database of Systematic concluded that after ART, women had higher anxi- Reviews, CINAHL and MEDLINE was conducted. ety about the survival of the fetus and more early This search identified two quantitative systematic parenting difficulties compared with women who reviews that addressed psychosocial aspects of preg- spontaneously conceived. However, evidence nancy after ART.18,19 However, no current or under- regarding women’s emotional adjustment to preg- way qualitative systematic reviews on experiences of nancy after ART is inconclusive, with some studies transition to motherhood during pregnancy among suggesting it is problematic and others indicating women who conceived through ART were identi- there are self-protective delays in believing in the fied, other than those focused on prenatal care by pregnancy,11,13,14 forming an emotional attachment midwives.25 In addition, previous systematic reviews to the fetus,11,17 and preparing for life with a baby.11 only covered literature published in the English Another quantitative systematic review by Gour- language,18,19 and although they included East Asian ounti19 revealed that women who conceived after studies, Japanese literature was excluded. In Japan, IVF had greater pregnancy-specific anxiety, lower nursing researchers often publish qualitative quality of life, the same or lower levels of depressive research findings in the Japanese language to dissem- symptomatology, the same level of self-esteem, more inate implications from narratives to clinical prac- positive attitudes toward pregnancy demands, and tice. The increasing practice of ART in Japan over higher levels of maternal-fetal attachment compared the previous two decades has produced a growing JBI Evidence Synthesis ß 2020 THE JOANNA BRIGGS INSTITUTE 75 ©2020 Joanna Briggs Institute. Unauthorized reproduction of this article is prohibited. SYSTEMATIC REVIEW PROTOCOL K. Maehara et al. number of Japanese studies regarding pregnancy becoming a mother26; psychosocial adaptation in after infertility.9,11,14,23 Findings from these studies pregnancy; expressed maternal identity; perceived have not been reflected in previous systematic maternal role and behaviors; and bonding with reviews. We conducted a preliminary search of the fetus during pregnancy. Studies where data were Ichushi-Web, a bibliographic database containing collected outside the pregnancy period, and those biomedical journals and other serial publications based on narratives from other people (e.g., pregnant published in Japan, and no qualitative systematic women’s mothers, partners, friends, siblings) will be reviews
Load more

Recommended publications
  • The Role of a Midwife in Assisted Reproductive Units
    Clinical Obstetrics, Gynecology and Reproductive Medicine Research Article ISSN: 2059-4828 The role of a midwife in assisted reproductive units O Tsonis1, F Gkrozou2*, V Siafaka3 and M Paschopoulos1 1Department of Obstetrics and Gynaecology, University Hospital of Ioannina, Greece 2Department of Obstetrics and Gynaecology, university Hospitals of Birmingham, UK 3Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Greece Abstract Problem: The role of midwifery in Assisted Reproductive Units remains unclear. Background: Midwives are valuable health workers in every field or phase of women’s health. Their true value has been consistently demonstrated and regards mainly their function in labour. Infertility is a quite new territory in which a great deal of innovating approaches has been made through the years. Aim: The aim of this study is to present the role of midwifery in Assisted Reproductive Units based on scientific data Methods: For this review 3 (three) major search engines were included MEDLINE, PubMed and EMBASE focusing on the role of midwives in the assisted reproductive units. Findings: It seems that midwives have three distinct roles, when it comes to emotional management of the infertile couple, being the representative of the infertile couple and also, performing assisted reproductive techniques in some cases. Their psychomedical support is profound and, in this review, we try to research their potential role in the assisted reproductive units. Discussion: In the literature, only few scientific articles have been conducted in search of the role of Midwifery in Infertility. Their importance is once again undeniable and further research needs to be conducted in order to increase their adequate participation into this medical field.
    [Show full text]
  • The Factors Affecting Amniocentesis Decision by Pregnant Women in the Risk Group and the Influence of Consultant
    A L J O A T U N R I N R A E L P Original Article P L E R A Perinatal Journal 2019;27(1):6–13 I N N R A U T A L J O ©2019 Perinatal Medicine Foundation The factors affecting amniocentesis decision by pregnant women in the risk group and the influence of consultant Kanay Yararbafl1 İD , Ayflegül Kuflkucu2 İD 1Department of Medical Genetics, Faculty of Medicine, Ac›badem Mehmet Ali Ayd›nlar University, Istanbul, Turkey 2Department of Medical Genetics, Faculty of Medicine, Yeditepe University, Istanbul, Turkey Abstract Özet: Risk grubundaki gebelerin amniyosentez karar› almas›ndaki faktörler ve genetik dan›flman›n etkisi Objective: The most frequent goal for prenatal diagnosis is to Amaç: Do¤um öncesi tan›da günümüzde en s›k amaçlanan hedef detect pregnancies with Down syndrome. Since karyotyping, which Down sendromlu gebelikleri tespit etmektir. Tan›da alt›n standart is the golden standard for the diagnosis, has not been replaced with yöntem olan karyotiplemenin yerini henüz non-invaziv bir yön- a non-invasive method, pregnant women in the risk group should tem dolduramad›¤›ndan, CVS, amniyosentez gibi bir yöntem için choose the method such as CVS and amniocentesis. Therefore, risk alt›ndaki gebelerin seçimi gereklidir. Bu amaçla giriflimsel ol- screening tests are performed by non-invasive method, and preg- mayan yöntemlerle tarama testleri yap›lmakta, riskli gebelere ge- nant women under risk are provided genetic consultation and the netik dan›flma verilerek invaziv giriflim karar› aileye b›rak›lmakta- family is expected to make a decision for invasive procedure.
    [Show full text]
  • Statement on Unassisted Birth Attended by a Doula
    Statement On Unassisted Birth Attended by a Doula _______________________________________________________ Definition Unassisted childbirth – the process of intentionally giving birth without the assistance of a medical or professional birth attendant – is a decision made by a very small percentage of parents. DONA International certified and member doulas provide physical, informational and emotional support. Any type of medical or clinical assistance is outside the scope of practice agreed upon by DONA International certified and member doulas. DONA International opines herein on the considerations a doula must make when accepting clients planning an unassisted birth. Introduction Unassisted childbirth (UC) refers to the process of intentionally giving birth without the assistance of a medical or professional birth attendant. UC is also sometimes referred to as free birth, DIY (do-it-yourself) birth, unhindered birth and couples birth. In response to the recent growth in interest over UC, several national medical societies, including the Society of Obstetricians and Gynaecologists of Canadai, the American College of Obstetricians and Gynecologistsii, and the Royal Australian and New Zealand College of Obstetricians and Gynaecologistsiii, have issued strongly worded public statements warning against the practice. Professional midwives' associations, including the Royal College of Midwivesiv and the American College of Nurse-Midwivesv also caution against UC. Those who promote UCvi claim the practice offers mothers-to-be a natural way of welcoming their child into the world, free from drugs, machinery and medical intervention. They also note that UC allows a woman to listen to her body's signals rather than coaching from an outsider. The women who are choosing UC may do so because they do not feel supported and respected in the obstetrical care facilities available in their areas, or they are unable to afford or obtain home midwifery or physician support, which is more in line with their philosophies.
    [Show full text]
  • Midwifery: a Career for Men in Nursing
    Midwifery: A career for men in nursing It may not be a common path men take, but how many male midwives are there? By Deanna Pilkenton, RN, CNM, MSN, and Mavis N. Schorn, RN, CNM, PHD(C) Every year, faculty at Vanderbilt University School of there are so few men in this profession. In fact, these Nursing reviews applications to the school’s nurse- conversations often lead to the unanimous sentiment midwifery program. The applicants’ diversity is always that men shouldn’t be in this specialty at all. Scanning of interest. A wide spectrum of age is common. A pleas- the web and reviewing blog discussions on this topic ant surprise has been the gradual improvement in the confirms that it’s a controversial idea, even among Eethnic and racial diversity of applicants. Nevertheless, midwives themselves. male applicants are still rare. It’s common knowledge that the profession of nurs- Many people wonder if there’s such thing as a male ing is female dominated, and the challenges and com- midwife. There are male midwives; there just aren’t plexities of this have been explored at length. many of them. When the subject of men in midwifery is Midwifery, however, may be one of the most exclusive- discussed, it usually conjures up perplexed looks. The ly and disproportionately female specialties in the field very idea of men in midwifery can create quite a stir, of nursing and it’s time to acknowledge the presence of and most laypeople don’t perceive it as strange that male midwives, the challenges they face, and the posi- www.meninnursingjournal.com February 2008 l Men in Nursing 29 tive attributes they bring to the pro- 1697, is credited with innovations fession.
    [Show full text]
  • Fetal Heart Rate Monitoring This Document Should Be Read in Conjunction with the Disclaimer
    King Edward Memorial Hospital Obstetrics & Gynaecology CLINICAL PRACTICE GUIDELINE Fetal heart rate monitoring This document should be read in conjunction with the Disclaimer This guideline must be read in conjunction with the Department of Health WA Mandatory Policy: MP 0076/18: Cardiotocography Monitoring Policy. The following Clinical Guideline complies with the Cardiotocography Monitoring Standard. Contents General requirements ........................................................................... 2 Indications for performing a cardiotocograph (CTG) ............................................... 2 Review, interpretation and signing of traces ........................................................... 4 Education and Fetal Surveillance Education Program (FSEP) practitioner levels ... 4 Storage ................................................................................................................... 4 Antenatal fetal heart rate (FHR) monitoring ........................................ 5 Key points ............................................................................................................... 5 Procedure ............................................................................................................... 5 Documentation ........................................................................................................ 5 Monitoring and additional information ..................................................................... 6 Escalation of care- antenatal ..................................................................................
    [Show full text]
  • Amniocentesis and CVS UHL Obstetric Guideline
    Amniocentesis and Chorionic Villus Sampling Maternity 1. Introduction and Scope This guideline is intended for the use of obstetric and midwifery staff involved in the care of pregnant women undergoing amniocentesis or chorionic villus sampling (CVS). It is estimated that around 5% of the pregnant population (approximately 30,000 women per annum in the UK) are offered a choice of invasive prenatal diagnostic tests. The type of test offered is dependent on several factors including gestational age, indication and placental position. Amniocentesis is the most common invasive antenatal diagnostic procedure undertaken in the United Kingdom (UK). Most amniocenteses are performed to obtain amniotic fluid for karyotyping. It is a procedure to remove amniotic fluid from the uterus. CVS involves aspiration or biopsy of placental villi and can be done via trans abdominal or trans cervical methods. In UHL this is done by a trans abdominal approach. 2. Recommendations 1. Women undergoing amniocentesis or CVS should be fully counselled prior to the procedure of the risks involved and informed consent documented. 2. Amniocentesis and CVS should be performed at the appropriate gestation. 3. A safe technique should be used to perform amniocentesis and CVS. 4. Operators performing amniocentesis and CVS should be trained to the local competencies expected, those expected by the Royal College of Obstetricians (RCOG) or an international equivalent. 5. Clinical considerations for performing amniocentesis or CVS for multiple pregnancy / in the third trimester / IUD / BBI. 1. Women undergoing amniocentesis or CVS should be fully counselled prior to the procedure and informed consent documented. Women should be advised of the risks of undergoing amniocentesis or CVS.
    [Show full text]
  • Timeline of Birth Work in the U.S. and California
    Timeline of Birth Work in the U.S. and California National 1850 California 1900 Half of all children born in the United States are delivered with the help of a midwife attendant. Granny Midwives, 1911 typically Black women in the south, assist in countless births Midwifery is legal but unregulated in the state from the late 1800s through the mid-1900s. Immigrant midwives from Europe, Mexico, and Japan practice birth work in other parts of the country. 1915 New York City opens the first municipally- sponsored Midwifery becomes an official independent American midwifery school, called Bellevue Hospital School profession due to an amendment to AB 1375, for Midwives. Births attended by Bellevue-trained midwives 1917 California’s Medical Practices Act, which have lower maternal and infant mortality rates than the creates a new category for state-certified city-wide average. midwives. Prominent obstetrician Dr. Joseph DeLee speaks out 1930 against midwives at the American Association for the Study and Prevention of Infant Mortality annual meeting, spreading the falsehood that midwives cannot safely At the request of the California Medical Board care for pregnant women. 1949 and medical lobby, SB 966 dismantles the midwifery licensing program and effectively Midwife-attended births drop to less than 15% of all births. makes midwifery illegal. Modern day concept of the “doula” emerges from the 1969 natural birth movement’s desire low low-intervention, unmedicated births. The term is first used by Dr. Dana Nurse-midwifery law passes in California that Raphael, a breastfeeding advocate who derives the term 1960s requires Certified Nurse Midwives to practice from the modern Greek term for “servant-woman.” and under the supervision of an obstetrician.
    [Show full text]
  • Community-Based Doulas and Midwives Key to Addressing the U.S
    GETTY MCLEISTER IMAGES/JOEY Community-Based Doulas and Midwives Key to Addressing the U.S. Maternal Health Crisis By Nora Ellmann April 2020 WWW.AMERICANPROGRESS.ORG Community-Based Doulas and Midwives Key to Addressing the U.S. Maternal Health Crisis By Nora Ellmann April 2020 Contents 1 Introduction and summary 5 Methodology 7 The role of community-based doulas and midwives in improving maternal health outcomes 9 The recentering of community and humanity in pregnancy-related care 15 Integration in the health care system and the role of government 21 Policy recommendations 27 Conclusion 28 About the author and acknowledgements 29 Endnotes Introduction and summary The United States is facing a maternal and infant health crisis fueled by structural rac- ism that drives significant racial disparities in maternal and infant morbidity and mor- tality. Particularly affected are Black and Indigenous birthing people:1 Black women and American Indian/Alaska Native women are three to four times more likely than non-Hispanic white women to die from pregnancy-related causes—during pregnancy, birth, and up to one year postpartum.2 What’s more, Black women are twice as likely as non-Hispanic white women to experience severe maternal morbidity, or life-threaten- ing pregnancy-related complications, which affect 50,000 women in the United States each year.3 While the data are mixed around maternal health outcomes for Hispanic women, studies show that particular subgroups of Hispanic women, including Puerto Rican women, experience higher rates of maternal mortality compared with non-His- panic white women.4 Studies also show higher rates of severe maternal morbidity for Hispanic women compared with non-Hispanic white women.5 Racism is the driving force of disparities in maternal mortality.
    [Show full text]
  • State Scope of Practice Laws, Nurse-Midwifery Workforce, and Childbirth Procedures and Outcomes
    Women's Health Issues xxx-xx (2016) 1–6 www.whijournal.com Policy matter State Scope of Practice Laws, Nurse-Midwifery Workforce, and Childbirth Procedures and Outcomes Y. Tony Yang, ScD, LLM, MPH a,*, Laura B. Attanasio, MS b, Katy B. Kozhimannil, PhD, MPA b a Department of Health Administration and Policy, George Mason University, Fairfax, VA b Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN Article history: Received 26 June 2015; Received in revised form 26 January 2016; Accepted 5 February 2016 abstract Background: Despite research indicating that health, cost, and quality of care outcomes in midwife-led maternity care are comparable with and in some case preferable to those for patients with physician-led care, midwifery plays a more important role in some U.S. states than in others. However, this variability is not well-understood. Objectives: This study estimates the association between state scope of practice laws related to the autonomy of midwifery practice with the certified nurse-midwifery (CNM) workforce, access to midwife-attended births, and childbirth-related procedures and outcomes. Methods: Using multivariate regression models, we analyzed Natality Detail File data from births occurring from 2009 to 2011. Each state was classified regarding autonomous midwifery practice (not requiring supervision or contractual agreements) based on Lexis legal search. Results: States with autonomous practice laws had an average of 4.85 CNMs per 1,000 births, compared with 2.17 in states where CNM practice is subject to collaborative agreement. In states with autonomous CNM practice, women had higher odds of having a CNM-attended birth (adjusted odds ratio [AOR], 1.59; p ¼ .004), compared with women in states where midwifery is subject to collaborative agreement.
    [Show full text]
  • Midwife, Home Birth and Non-Clinical Maternal Services – (A002)
    Administrative Policy Effective Date.............................................. 5/15/2020 Next Review Date ....................................... 2/15/2021 Administrative Policy Number ......................... A002 Midwife, Home Birth and Non-Clinical Maternal Services Table of Contents Related Coverage Resources Administrative Policy ............................................ 1 General Background ............................................ 3 References .......................................................... 4 PURPOSE Administrative Policies are intended to provide further information about the administration of standard Cigna benefit plans. In the event of a conflict, a customer’s benefit plan document always supersedes the information in an Administrative Policy. Coverage determinations require consideration of 1) the terms of the applicable benefit plan document; 2) any applicable laws/regulations; 3) any relevant collateral source materials including Administrative Policies and; 4) the specific facts of the particular situation. Administrative Policies relate exclusively to the administration of health benefit plans. Administrative Policies are not recommendations for treatment and should never be used as treatment guidelines. Administrative Policy MIDWIFE SERVICES Coverage of professional fees for midwife services are subject to the terms, conditions and limitations of the applicable benefit plan and may be limited based on health care professional certification/licensure requirements. In addition, coverage of midwife
    [Show full text]
  • Learning Lessons from a Traditional Midwifery Workforce in Western Kenya
    Midwifery 27 (2011) 324–330 Contents lists available at ScienceDirect Midwifery journal homepage: www.elsevier.com/midw Learning lessons from a traditional midwifery workforce in Western Kenya Elaine Dietsch, PhD, MN(WH), RM, RN (Midwifery Courses Coordinator)a,n, Luc Mulimbalimba-Masururu, MD, ND (Medical Director)b a School of Nursing, Midwifery & Indigenous Health, Charles Sturt University, Locked Bag 588, Wagga Wagga, NSW 2678, Australia b Mission in Health Care and Development, PO Box 1844, Bungoma 50200, Kenya article info abstract Article history: Objective: to learn lessons from a traditional midwifery workforce in Western Kenya. Received 10 September 2010 Design: with the assistance of an interpreter, qualitative data was collected during in-depth individual Received in revised form and group interviews with traditional midwives. English components of the interviews were 4 November 2010 transcribed verbatim and the data thematically analysed. Accepted 26 January 2011 Setting: a rural, economically disadvantaged area of Western Kenya. Participants: 84 participants who practise as traditional midwives. Keywords: Findings: it was common for these traditional midwives to believe they had received a spiritual gift Traditional birth attendant which enabled them to learn the skills required from another midwife, often but not always their Skilled birth attendant mother. The participants commenced their midwifery practice by learning through an apprenticeship Learning or mentoring model but they anticipated their learning to be lifelong. Lifelong learning occurred Knowing through experiential reflection and reciprocal learning from each other. Learning in colleges, hospitals and through seminars facilitated by non-government organisations was also desired and esteemed by the participants but considered a secondary, though more authoritative source of learning.
    [Show full text]
  • Experiences of a New Cadre of Midwives in Bangladesh: Findings from a Mixed Method Study Rashid U
    Zaman et al. Human Resources for Health (2020) 18:73 https://doi.org/10.1186/s12960-020-00505-8 RESEARCH Open Access Experiences of a new cadre of midwives in Bangladesh: findings from a mixed method study Rashid U. Zaman1* , Adiba Khaled2, Muhammod Abdus Sabur3, Shahidul Islam4, Shehlina Ahmed5, Joe Varghese6, Della Sherratt7 and Sophie Witter8 Abstract Background: Bangladesh did not have dedicated professional midwives in public sector health facilities until recently, when the country started a nation-wide programme to educate and deploy diploma midwives. The objective of the findings presented in this paper, which is part of a larger study, was to better understand the experience of the midwives of their education programme and first posting as a qualified midwife and to assess their midwifery knowledge and skills. Methods: We applied a mixed method approach, which included interviewing 329 midwives and conducting 6 focus group discussions with 43 midwives and midwifery students. Sampling weights were used to generate representative statistics for the entire cohort of the midwives deployed in the public sector health facilities. Results: Most of the midwives were satisfied with different dimensions of their education programme, with the exception of the level of exposure they had to the rural communities during their programme. Out of 329 midwives, 50% received tuition fee waivers, while 46% received funding for educational materials and 40% received free accommodation. The satisfaction with the various aspects of the current posting was high and nearly all midwives reported that a desire to work in the public sector in the long run. However, a significant proportion of the midwives expressed concerns with equipment, accommodation, transport and prospect of transfers.
    [Show full text]