Background Induction of labour (IOL) is rising around the world, with little known about consequent outcomes in large cohorts of childbearing women. Aim To examine the impact of IOL vs spontaneous labour onset on maternal and perinatal outcomes, as reported by women in a national survey. Design A cross-sectional, online, maternal self-report survey, was open in Australia from March–December 2021. Participants 7791 women who had a spontaneous onset (n = 5230), or IOL (n = 2561) were included. Analysis Labour, birth and postnatal outcomes were classified as binary variables and percentages. Univariable and multivariable logistic regression analyses were performed, controlling for likely confounders. Results Compared with spontaneous onset of labour, survey respondents having an IOL were significantly more likely to experience: forceps or vacuum; episiotomy; emergency caesarean; excessive blood loss; physical pain and/or poor or decreased physical health; birth as traumatic; regrets about their birth experience; diagnosis of PTSD; obstetric violence; and less skin-to-skin contact with their babies. Neonatal outcomes following IOL included: significantly higher odds of being distressed during labour; having jaundice; and being given formula when the mother had chosen to breast feed. There was no difference in major perineal injury or pelvic floor outcomes, or admission of the baby to special care nursery or neonatal intensive care. Conclusions IOL was associated with significant negative physical and psychological health impacts for women and babies compared to spontaneous labour onset. There is a need for more research on clinical and psychological impacts of IOL for women, to ensure decision making is informed.
Problem Mentorship is recognised as an important strategy to support transition to practice, professional development and workforce retention in midwifery. However, little is known about the barriers and enablers influencing the implementation and sustainability of mentorship programmes. Background Midwifery workforce shortages, burnout and attrition continue to challenge maternity services internationally. Although mentorship is increasingly promoted to support midwives, the organisational and structural conditions required for sustainable mentorship remain unclear. Aim To identify and synthesise the barriers and enablers influencing the implementation and sustainability of mentorship in midwifery. Methods A scoping review was undertaken using the framework described by Arksey and O'Malley and reported in accordance with PRISMA-ScR guidance. Electronic database searches were conducted in CINAHL, MEDLINE and Scopus. Studies were screened against predetermined inclusion criteria, and data were charted and synthesised descriptively. Findings Seven studies met the inclusion criteria. Two overarching themes were identified: (1) organisational commitment and leadership as the foundation for sustainable mentorship and (2) formalised programme structures as enablers of effective mentorship implementation. Key enablers included leadership engagement, protected time, funding, mentor training, structured programme frameworks, mentor–mentee matching and programme evaluation. Barriers included workload pressures, limited organisational support, staffing shortages, lack of protected time and poorly defined programme structures. Discussion Mentorship programmes were most effective when embedded within organisational systems and supported through leadership, governance and structured programme design. Conclusion Sustainable mentorship in midwifery requires coordinated organisational investment, leadership engagement and formalised programme structures. Further research is needed to examine organisational and leadership perspectives on mentorship implementation.
Problem First Nations women in Australia continue to experience disproportionately harmful and inequitable maternity care shaped by systemic racism, intergenerational trauma, and culturally unsafe practices. Background In the Australian Capital Territory, maternity care is provided through Western biomedical systems that frequently fail to provide culturally safe, relational care. Racism, mistrust, and fear within these systems contribute to trauma, avoidance of care, and diminished wellbeing among First Nations women and families. Aim To explore First Nations women and families’ maternity care experiences in the Australian Capital Territory and understand their vision for restorative, culturally safe care. Methods Kapati Time Yarning, an Indigenous Research Method that centres relational storytelling, was used to gather the stories of 14 First Nations women, partners, and family members between October 2024 and March 2025. Transcribed data were analysed using reflexive thematic analysis. Findings Amid broader harms, participants recalled ‘pockets of compassion’ where health professionals listened, believed women, acknowledged grief and loss, validated prior harm, and remained present amid vulnerability, which participants described as transforming grief and trauma into healing. Discussion These findings suggest that compassionate care, as experienced by participants, can transform fear and grief into acts of solidarity, reinforcing the fundamental need for relational, restorative, and culturally safe care in maternity services. Despite its transformative potential, such care was limited and inconsistent, often provided after institutional harm. Conclusion These findings extend beyond maternity care, calling for restorative, compassionate practices to be structurally embedded across systems rather than relying on pockets of goodwill, establishing respectful, relational, and culturally safe care as the norm for First Nations families.
Background Adolescent mothers are particularly vulnerable to experiencing disrespectful maternity care because of their young age and social vulnerability. Aim This systematic review and qualitative evidence synthesis aimed to synthesise and interpret qualitative evidence on adolescent mothers' perceptions and experiences of respectful and disrespectful maternity care. Methods This study was conducted as a systematic review and qualitative evidence synthesis. A systematic search was performed in PubMed, Scopus and Web of Science to identify articles published between 2010 and 2026. Qualitative studies reporting adolescent mothers' experiences of prenatal, childbirth, or postpartum care were included. Study screening and selection are presented using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow chart. The methodological quality of the included studies was appraised using the Critical Appraisal Skills Programme (CASP) checklist. Data were analysed using the thematic synthesis approach described by Thomas and Harden (2008). Findings A total of 22 qualitative studies were included. Data analysis resulted in the identification of five analytical themes: Adolescence as a socially discrediting identity in maternity care, Struggling for voice, autonomy, and recognition, Violations of dignity, privacy, and emotional safety, Negotiating maternity care within unsupportive health systems, and Respectful relationships as pathways to trust, confidence, and empowerment. Conclusion Respectful maternity care experiences among adolescent mothers are shaped by the interplay of social stigma, caregiving relationships, and health system structures. These findings highlight the need for adolescent-responsive health systems that address stigma, uphold adolescents' dignity, autonomy, and participation, and remove structural barriers to equitable maternity care.
