Background/Aims The error room is a simulation designed to develop situational awareness and hazard recognition. This study aimed to evaluate students' performance during a maternity-focused error room simulation in Morocco. Methods A descriptive comparative study was conducted at the Moroccan Institute for Higher Health Sciences. A maternity error room scenario was implemented, incorporating 27 predefined errors and hazards. A total of 51 final-year student midwives participated in individual and team-based sessions, during which they identified as many errors as possible. Individual and team results were compared using the Wilcoxon signed-rank test. Results Visible environmental- and infection-related errors were more frequently identified, while emergency- and medication-related hazards were less commonly recognised in individual assessment. Team participation significantly improved overall error detection ( P <0.001). Participant feedback was highly positive, with 98% reporting satisfaction with the experience. Conclusions The error room is an effective educational tool for enhancing safety awareness among student midwives. Team participation significantly improves hazard recognition and supports development of situational awareness and teamwork skills essential for safe maternity care. Implications for practice Integrating error room simulations into midwifery education may strengthen safety culture and preparedness for obstetric emergencies.
George F Winter explores how pregnancy can affect oral health, as well as the potential impact of maternal behvaiour on dental outcomes for their children
Background/Aims Workplace culture, environment and interactions with team members can shape midwifery students’ experiences of clinical placement and the ideologies of the midwifery profession. The aim of this study was to explore midwifery students’ experiences of placement and identify their learning needs. Methods This qualitative exploratory study involved 43 pre-registration Australian midwifery students at Western Sydney University. An anonymous survey was used to collect data on the participants’ experiences of clinical placement, which were analysed thematically. Results The clinical environment impacted the participants’ learning, information processing, confidence, communication and interactions with women. Students had a more positive experience when they had a supportive midwife or mentor. Clearer communication between facilities and the university was needed to ensure students were meeting key competencies. Conclusions Students’ placement experiences shape the midwife they want to be. Supporting and mentoring students and providing opportunities for them to debrief may improve students’ experiences of clinical placement. Implications for practice Midwives require training, education and support in how to supervise and mentor students. Further research is needed to explore the education needs of midwives and students to ensure that students receive a tailored education programme that optimises learning outcomes.
Many Indonesian women encounter social barriers that inhibit access to maternal and neonatal healthcare, such as pregnancy taboos that discourage women from leaving the home during late pregnancy and myths regarding immunisation. This case study explores the care of a 22-year-old primigravid woman using a midwifery continuity of care model from the second trimester to the postnatal period, through home visits, health centre visits and telehealth, conducted via WhatsApp. This approach provided continuous communication and delivered education that respected the woman's cultural background, enabling her to attend third-trimester antenatal care and choose to use 3-month injectable postpartum contraception. However, full infant immunisation was not achieved because of family beliefs. This case highlights how continuity of care improved maternal service use, while also underscoring the need for women's empowerment, family involvement and stakeholder collaboration to overcome sociocultural barriers.
In the UK, hostile environment policies impact all areas of life for women seeking sanctuary, including access to healthcare. This reflective article uses a human rights-based approach to analyse how these policies impact maternity care. The theoretical concept of everyday bordering is used to reflect on how these policies prevent midwives from fulfilling the caring aspect of their profession. This article discusses three issues: charging for maternity care in the UK, PREVENT training and enforced destitution. Each topic is related back to the human rights framework and discussed alongside a critical view of the midwife as an agent of border control. The article concludes by calling for more primary research to evaluate the impact of hostile environment policies on midwives and women seeking sanctuary.
Ruth Oshikanlu reflects on the first national roundtable that discussed how to address fear of miscarriage and pregnancy loss
Background/Aims Virtual reality has emerged as an innovative educational technology in healthcare, offering immersive and interactive learning environments that can enhance students’ clinical skills and knowledge acquisition. In midwifery education, there is growing interest in integrating virtual reality to improve students’ preparedness for real-world clinical practice. This review’s aim was to evaluate the effectiveness of virtual reality technology as a learning tool by synthesising evidence from randomised controlled trials. Methods This systematic review explored the Scopus, PubMed, EBSCO, CINAHL, Science Direct and Google scholar databases for randomised controlled trials published between 2019 and 2024 that used virtual reality interventions in midwifery education. Data were systematically extracted and analysed in accordance with the review’s objectives. Results A total of 10 randomised controlled trials were included. The use of virtual reality in midwifery student education effectively enhanced learners’ knowledge and practical skills, particularly in maternal and newborn care, labour preparation and postnatal care. Conclusions Virtual reality has significant potential to improve both the cognitive and psychomotor competencies of midwifery students. This review provides valuable insights into how virtual reality can be strategically integrated into midwifery curricula. Implications for practice Virtual reality can be integrated into midwifery education to enhance students’ clinical competence, confidence and readiness for practice. It provides a safe environment for repeated skill practice and may complement traditional teaching methods to improve learning outcomes.
Background/Aims There is substantial evidence of the benefits of physical activity during pregnancy and the postpartum period. However, physical activity levels among perinatal women remain low, especially in deprived areas and among ethnic minorities. This study explored the experiences and perspectives of women from ethnically diverse and socioeconomically deprived backgrounds. Methods This qualitative ethnographic study involved 30 purposively sampled women who were either pregnant ( n =4) or had recently given birth ( n =26). Semi-structured interviews were carried out, focused on the participants’ experiences of physical activity. The data were analysed themetically. Results Participants were frustrated by limited local opportunities and minimal information on being active during and after pregnancy. Barriers included physical symptoms, lack of information, limited resources and cultural myths. Facilitators included clear advice, consistent healthcare guidance, community support, accessible resources and positive health beliefs. Conclusions There is a need for culturally sensitive, accessible interventions and greater support from healthcare and community resources. Implications for practice Healthcare professionals should provide clear, consistent physical activity guidance that considers cultural beliefs. Resources are needed that meet the needs of ethnically diverse communities, with clear language and culturally relevant illustrative examples. Partnering with trusted community organisations would enable delivery of culturally sensitive and accessible interventions.
While oral conditions in newborns and infants are rare, it is important to be aware of the most common presentations. Though most intra-oral conditions in infants require limited or no intervention, others may require treatment, including possible surgical intervention. The aim of this article is to provide an overview of oral conditions that can affect newborns. Midwives play a vital role in parent education, infant checks and monitoring, making awareness of intra-oral pathology and recommended patient pathways important. This article discusses several conditions, including their background, clinical presentation and management; these conditions are natal teeth, eruption cysts, Epstein pearls, Bohn's nodules, haemangiomas and vascular conditions, salivary gland anomalies and other rare oral conditions. Guidance on how to describe intra-oral lesions is also discussed to aid successful onward referral if necessary.
Catharine Sadler explores rising maternal death rates and inequalities in outcomes for women, based on the latest data from MBRRACE-UK
George F Winter discusses the use of antidepressants during pregnancy, exploring the arguments both for and against such use
George F Winter considers the ethical questions raised by developments in reproductive technology and the potential implications for maternity care
Background/Aims Perineal trauma is a common consequence of vaginal birth, affecting up to 90% of first-time mothers. Effective pain management during perineal suturing is essential, but many women report inadequate pain relief. Traditional methods, such as local infiltration with lidocaine, can cause additional discomfort, while epidural analgesia is not always available or effective. The aim of this literature review was to evaluate the efficacy, safety, dosage and practical implementation of topical lidocaine. Methods A structured search was conducted across PubMed, Medline, Cochrane and CINAHL for papers published between 2004 and 2024, using key terms related to topical anaesthetics and perineal suturing. Data were extracted and synthesised narratively. Results Topical lidocaine provides significant pain relief comparable to infiltrative lidocaine, with fewer adverse effects and higher patient satisfaction. However, its use remains inconsistent as a result of variations in clinical practice and a lack of standardised guidelines. Conclusions Topical lidocaine is a practical, non-invasive option for analgesia during perineal suturing and can be used as an alternative or adjunct to infiltration, especially in cases where there is no epidural or inadequate epidural block. It may offer similar pain relief with greater acceptability for some women by avoiding needle pain. Evidence supports a generally favourable safety profile when used appropriately, but regimens vary across studies. Implications for practice Practice would benefit from local protocols on indications for use, dose limits, timing/contact time and documentation, as well as staff training to standardise use. Further work is needed to define an optimal regimen and assess outcomes in routine care.
The strength of midwifery students’ motivation to learn in the practice environment is directly influenced by the standards for student supervision and assessment, but how they impact learning has not been explored. This article described the application of an interpretative macro theory of motivated learning in the evaluation of these standards. The findings of two independent studies that explored implementation of the standards for student supervision and assessment were interpretatively mapped to a macro, motivational and volitional process theory. Four motivational root problems emerged: an ambiguous goal system, low student interest and curiosity, decreased student and staff expectancies for success and negative emotionality associated with students’ non-self-regulation. The standards fail to distinguish between mastery and performance goals, influencing students’ motivation to learn.
Background/Aims Little is known about fathers' needs during the perinatal period. This patient and public involvement and engagement project's aim was to work with expectant and new fathers to shape objectives for a future research project exploring how to support them during their transition to parenthood. Methods Two discussion groups, one in person and one online, were held with a total of 10 fathers who had attended a Baby Steps antenatal programme. A discussion activity was undertaken by both groups and a scoring activity exploring topics important to the participants was undertaken by the in-person group. Participants' responses were analysed descriptively. Results The participants wanted to be heard and feel included. They highlighted a need for future research co-designed with fathers in the perinatal period to improve outcomes for them and their families. Conclusions This project highlights the importance of involving fathers in the development of studies to support their needs during the transition to parenthood. Implications for practice Key areas of focus for future work should include confidence in understanding and caring for their baby, the changing couple relationship and fathers' perinatal mental health.
Background/Aims Specialist perinatal mental health services are broadly offered across the UK, but factors influencing non-attendance are not well researched. This study examines demographic and diagnostic predictors of non-attendance in a specialist perinatal mental health service. Methods Data from 5363 scheduled appointments were analysed, examining associations between non-attendance, demographics and mental health diagnoses. Results Women diagnosed with mood disorders were more likely not to attend appointments ( P =0.008), while woman with anxiety disorders were more likely to attend ( P =0.018). Younger women (16–25 years old) had higher non-attendance rates than those who were older (≥26 years old) ( P ≤0.001). No major differences were observed by deprivation level or ethnicity. Conclusions This study highlights the importance of identifying groups at higher risk of non-attendance at specialist perinatal mental health services. The findings suggest that younger women and those with mood disorders may require more tailored engagement strategies to support attendance. Implications for practice Service providers could consider flexible appointment options, targeted reminders and proactive follow up to improve engagement and reduce missed appointments. Using routinely collected service data in this way can support service planning and improve the efficiency and accessibility of perinatal mental health care.
Background/Aims Membrane sweeping is a common intervention used to promote labour onset, but its impact on the active phase of labour in nulliparous women has not been investigated. This study's aim was to determine the effectiveness of membrane sweeping in reducing time to active labour and the need for augmentation in nulliparous women with an unfavourable cervix. Methods This randomised controlled trial involved 71 nulliparous women at ≥37 weeks' gestation with a Bishop score <7. Participants were allocated to membrane sweeping ( n =38) or expectant management ( n =33) and time to active labour (≥6cm dilation) was recorded. Results The membrane sweeping group had a significantly shorter mean time to active labour (8.3 vs 10.6 hours; P =0.03) and were 64% less likely to need oxytocin augmentation ( P =0.038). Caesarean section rates and maternal satisfaction were similar in both groups. Conclusions Membrane sweeping effectively reduced time to active labour and the need for pharmacological augmentation, supporting its use to minimise medicalisation. Implications for practice Implementation of membrane sweeping in clinical protocols could promote physiological birth and reduce unnecessary medicalisation in high-volume obstetric settings, potentially optimising resource allocation in public health systems.
With point-of-care ultrasound devices becoming ubiquitous, midwives can undertake late pregnancy scans. The effectiveness of the optical ultrasound simulation system has been demonstrated in doctors with minimal experience of ultrasound, but its effectiveness in training midwives is unknown. The Sono-Breech Study evaluated the usefulness of the Volutracer optical ultrasound simulation system as a training tool for midwives to perform scans for fetal presentation and viability. This article explores feedback from the midwives who took part in the study, who were highly satisfied that it improved their understanding of ultrasound and reported that they would recommend the training to others. This suggests that structured ultrasound simulation training programmes have the potential to teach midwives basic ultrasound skills and support the formulation of a pathway that can be implemented in midwifery training.
Background/Aims Gestational diabetes mellitus is a common metabolic disorder of pregnancy with significant implications for maternal and neonatal health. It increases the risk of complications such as macrosomia, pre-eclampsia and diabetes after birth. This study aimed to assess knowledge, beliefs, preferred sources of information and barriers to awareness among healthy pregnant women in southern Iraq. Methods This cross-sectional study was conducted with 540 pregnant women across 10 health sectors in Basrah. Data were collected through interviews and analysed using descriptive and inferential statistics and stepwise regression analysis. Results Women's mean scores demonstrated moderate knowledge (57.6 ± 23.6). Urban residence ( P =0.003), higher education ( P =0.001), higher income ( P <0.001), multiparity ( P =0.020) and older age ( P <0.001) significantly predicted higher knowledge scores. Family and friends (31.7%) and the internet (31.1%) were the most common sources of information and low knowledge was the most commonly reported barrier (40.0%). Conclusions Urban residence, education and higher income were associated with better knowledge. Targeted education could enhance awareness of gestational diabetes among women in southern Iraq. Implication for practice Empowering healthcare professionals with the tools and time to educate women and implement broader public awareness initiatives is essential to improving knowledge and maternal and child health outcomes.
