Objective: To provide a rich description of women's experiences of augmentation of labour with synthetic oxytocin within the Irish context. Methods: Fourteen one-to-one semi-structured interviews were conducted. Data were analysed using qualitative content analysis. Results: Two themes emerged from the data: ‘Birthtrayal’ and ‘Rebirth’. Women described feeling pressured to consent to have their labour augmented or lacking insufficient information to give genuine informed consent. They repeatedly highlighted the atypical and intense pain of the augmented contractions. Over time, many women regretted not having asked more questions, having been too trusting of healthcare professionals and accepting to undergo augmentation of labour with synthetic oxytocin. In subsequent pregnancies and births, women adopted different strategies to avoid undergoing augmentation of labour with synthetic oxytocin again. Conclusion: Augmentation of labour with synthetic oxytocin has key implications on women's birth experiences and may have long-term consequences in their trust in healthcare professionals and future birth choices.
Introduction Infertility is a global health concern affecting millions of persons, and is associated with psychological strains, including anxiety, stress and depressive symptoms. Women undergoing investigation and Artificial Reproductive Technologies may seek complementary interventions, such as yoga, to support psychological well-being. Aim The aim of this scoping review was to map and synthesize the existing research on the use of yoga among women undergoing investigation and/or treatment for infertility, and to identify reported outcomes and research gaps. Method A scoping review was conducted according to JBI methodology and reported in accordance with the PRISMA-ScR checklist. Systematic searches were performed in CINAHL, PubMed and Web of Science for articles published between 2014 and 2025. Studies examining yoga interventions among women with infertility were included and charted. Results Three studies involving a total of 297 women met the inclusion criteria. The studies were conducted in Canada, Italy and Turkey and applied different yoga interventions, primarily Hatha yoga. The findings of this study are presented under two main categories: Characteristics of study samples and interventions and Impact of yoga on mental health indicators and quality of life. None of the included studies assessed pregnancy or fertility treatment outcomes. Conclusion Yoga appears to be a promising complementary intervention for reducing psychological distress among women experiencing infertility. However, the limited number of valuable studies and heterogeneity of study designs highlight the need for further research, particularly regarding long-term effects and reproductive outcomes.
INTRODUCTION:Hyperemesis Gravidarum affects 0.3-3.6% of women during pregnancy and has a significant impact on maternal health. Investigation of both the immediate and longer-term effects remains a high research priority. However, there is limited research on postpartum recovery after hyperemesis gravidarum. AIM:To explore the postpartum recovery experiences of women who had hyperemesis gravidarum. METHODS:A large descriptive qualitative study was conducted using semi-structured interviews to explore the postpartum experiences of women who had hyperemesis gravidarum within the previous 5 years in Ireland. Data were analysed using reflexive thematic analysis. RESULTS:Forty-one women participated, and four themes were identified: (1) Nutritional and physical recovery of the body, describing challenges to recovery following HG (2); Infant feeding decisions influenced by recovery, highlighting how physical depletion impacted infant feeding choices (3); Recovery overlooked in postpartum care, reflecting limited follow-up and predominantly infant-focused postpartum care and (4); Negotiating social expectations with interpersonal support, showing how social expectations and relationships influenced recovery. DISCUSSION:This study showed that recovery after hyperemesis gravidarum is multifaceted, impacted not only by ongoing physical health consequences but also by participant-identified gaps in postpartum care and by varied interpersonal support. CONCLUSION:Hyperemesis gravidarum leaves a postpartum legacy. Proactive postpartum follow-up, postpartum guidelines and information resources for women and their families are needed to support recovery after HG.
Oral contraceptives are widely used in the US, but prescription requirements are an access barrier, particularly for adolescents and young adults. Over-the-counter availability of norgestrel 0.075 mg (OPill) was anticipated to improve contraceptive access. This cross-sectional study assessed OPill availability in 17 Boston zip codes, stratified by Social Vulnerability Index (SVI). Among 33 pharmacies, 75.8% presented at least one barrier to access. OPill was available in all stores in low-SVI neighborhoods but not stocked in 13.6% of pharmacies in high-SVI neighborhoods, compounding low access to resources including healthcare. These findings underscore the gap between regulatory approval and equitable real-world contraceptive access.
Well-being and being competent as a newly educated midwife are essential for ensuring safe and high-quality maternity care and for facilitating a confident transition into professional practice. Aim To examine Danish midwifery students' well-being and self-reported clinical competences, perceived importance of the clinical competences, and the supportiveness of the clinical learning environment. Method An online national questionnaire was distributed to Danish midwifery students at the three midwifery schools in Denmark with graduating midwifery students during their last months of education during the year 2025. Danish midwifery students graduate twice a year in January and in June. Self-reported information on their basic characteristics including well-being, and clinical competences, the supportiveness of the clinical learning environment was collected. Results A total of 158/203 (78%) students participated in the survey. The students were mainly female (99.4%), born in Denmark (95.6%), and had no children (77.9%). Their mean age was 27.7, and 33.5% had risk of stress or depression according to the WHO-5 score.The students in general ranked the medical competences high and several of the basic midwifery competences low despite ranking the competences important. In general, low ranking of competence was followed by low ranking of supportiveness from the learning environment to achieve these competences. Conclusions A substantial proportion of the students did not feel competent in basic midwifery skills such as assisting women in flexible birth position, caring for women with non-pharmacological pain-relief, and suturing a second-degree perineal tear. Objective learning goals can ensure achievement of diverse midwifery competences.
OBJECTIVE:Women with type 1 diabetes (T1D) tend to have fewer children and the postnatal period can be particularly challenging, as the rapid decline in pregnancy-induced insulin resistance often complicates diabetes management. The aim of this study was to explore postnatal experiences of women with T1D and their perspectives regarding future pregnancies. METHODS:This qualitative study is part of the "Reproductive health in diabetes and prediabetes-study". Individual interviews using a semi-structured interview guide were conducted with 17 women with T1D, with or without pregnancy experience, aged 18-45 years. For the present analysis, we included a sub-sample of eight women who had previously given birth. Data were analysed employing thematic analysis. RESULTS:Three themes were identified, each with two corresponding sub-themes. 1) The women faced challenges in early postnatal diabetes management, dealing with unpredictable blood glucose and hypoglycaemia. 2) They expressed a sudden shift in the level of diabetes support after birth and that the health care providers at the maternity ward lacked diabetes competence. 3) Although they did not want diabetes to affect family planning, they acknowledged that T1D complicated their lives and influenced their pregnancy timing. CONCLUSION:Women with T1D experienced considerable challenges in postnatal diabetes management, primarily due to unpredictable blood glucose levels and insufficient postnatal follow-up. These findings highlight the importance of more systematic and individualized postnatal support. Moreover, the impact of diabetes on family planning underscores the need for comprehensive information and tailored guidance in reproductive health decision making.
Background The intrauterine device (IUD) is a widely used method for reversible contraception. Research indicates that IUD insertion is frequently experienced as highly painful – an aspect often underrecognized by clinicians - particularly among younger, nulliparous women. Moreover, fear of a painful insertion is a major barrier for women considering an IUD. While pre-procedural oral analgesia is standard practice, it does not always provide sufficient pain relief, leaving many women in need of additional measures. Methods We developed the Modified Wiebe as a simplified and safer version of an established intracervical block for use during IUD insertion in primary care. The technique consists of one superficial and two deep intracervical injections. We combined a literature review with a retrospective descriptive case series of consecutive IUD insertions in which this technique was applied in routine general practice. Results In our case series, we applied the Modified Wiebe intracervical block in 57 IUD insertions. Most participants (93%) were nulliparous. The mean NRS pain score was 2.0 (median 2). Vasovagal symptoms were reported in 11 patients (19%), with no cases of syncope. No allergic reactions or other immediate complications were observed. All participants (100%) indicated willingness to undergo a future IUD insertion. Conclusion In this pilot study, use of the Modified Wiebe was associated with remarkably low pain scores during IUD insertion. The technique is safe, quick to learn, rapidly effective, and requires only inexpensive, readily available materials. The Modified Wiebe may therefore be a promising option for wider implementation in both primary and secondary care.
INTRODUCTION:Women's experiences of accessing information and navigating healthcare during menopause remain underexplored in the Irish context. While menopause-related information is increasingly available through diverse sources, variations in access, quality, and healthcare support may shape women's experiences. This study aimed to examine menopause knowledge among midlife women in Ireland, investigate how they acquire this knowledge, and explore their experiences of seeking and receiving menopause-related care. METHODS:A qualitative design was employed using focus group interviews. Data were analysed thematically to identify key patterns. RESULTS:Two overarching themes were identified: (1) Knowledge is Power, which reflected the importance of access to reliable information, the role of peer networks, and how preparedness shaped women's experiences of menopause; and (2) Navigating Menopause Care, which highlighted women's varied experiences with healthcare providers, systemic gaps in care, and the resilience required to seek support. DISCUSSION:Findings demonstrate that some women accessed beneficial treatments and supportive care. However, many had limited prior knowledge while encountering dismissive attitudes, gaps in professional knowledge, and a lack of accessible resources. Supporting women with timely accurate information and improving healthcare provider knowledge are critical to enhancing menopause care in Ireland.
Objective This study aimed to understand the perspectives of community-based doulas in New York State regarding the opportunities and challenges facing the profession. Specifically, it explored their experiences, perceived barriers, and recommendations prior to the implementation of Medicaid reimbursement. Methods Five in-person focus groups were conducted with 22 community-based doulas in four regions of New York State between October and November 2023. Discussions explored participants' pathways into doula work, training experiences, professional practice, collaboration with healthcare providers, and perspectives on Medicaid reimbursement. Data were analyzed using reflexive thematic analysis. Results Five themes were identified: (1) pathways and motivation for doula work, (2) training and certification, (3) role recognition and hospital collaboration, (4) client outreach and recruitment, and (5) Medicaid reimbursement and implementation readiness. Across themes, participants described community-based doulas as providing community-rooted support while facing persistent structural barriers to professional recognition, financial sustainability, and integration within maternal healthcare systems. Participants emphasized the need for stronger professional support, greater public awareness, and more collaborative relationships with healthcare providers. Conclusion Findings suggest that expanding Medicaid reimbursement alone may not be sufficient to support the community-based doula workforce. Sustainable integration of community-based doulas into maternal healthcare systems will also require investments in workforce development, improved public awareness and referral pathways, and stronger collaboration between doulas and healthcare providers.
OBJECTIVE:To describe and compare the sociodemographic and access to care characteristics, specifically travel patterns, funding, and wait times, following the Dobbs decision among people receiving assistance from a practical support abortion fund, and examine factors associated with variation in wait times within each period. METHODS:We used administrative data from a U.S. abortion fund that provides logistical support to people seeking abortions and prioritizes pregnancies of 15 weeks or greater. We included clients that received funding and with abortion appointments between July 2019 and June 2023. Bivariate analyses compared travel patterns, funding, and wait times between pre- and post-Dobbs groups. We used Wilcoxon-Mann-Whitney tests to compare median wait times between periods and Kruskal-Wallis tests to assess within-group differences. RESULTS:Among 3641 clients, 62.9% received support before Dobbs. More than half (56.0%) had pregnancies of 24 weeks or greater at the time of referral to the abortion fund. Compared with pre-Dobbs clients, post-Dobbs clients were more likely to originate from states with restrictive abortion policies (67.8% vs 53.1%) and from the South (69.4% vs 52.6%). Post-Dobbs clients also received more funding on average ($1732 vs $899) and experienced longer wait times (median 9 vs 6 days) for their abortion appointment. CONCLUSIONS:Following Dobbs, clients from a practical support abortion fund were more likely to travel from restrictive states, required more funding, and waited longer for abortion care. These findings highlight increasing barriers to abortion access and the critical role of practical support organizations in helping people obtain care.
OBJECTIVES:Characterize how the rates of induced abortion differ by clinical and social patient characteristics. STUDY DESIGN:Retrospective cohort analysis of pregnancies (2012-2023) in an integrated healthcare delivery system. We present the association of induced abortion by social and clinical factors; we calculated prevalence ratios (PR) from modified log-Poisson models, adjusted for all other covariates considered. RESULTS:The likelihood of abortion was lower among individuals ≥40 years, individuals with obesity, Spanish speakers, and greater neighborhood deprivation; and higher for public insurance, Black race, and multiparous pregnancies. CONCLUSIONS:There are substantial differences in the utilization of abortion services by social and clinical factors.
OBJECTIVE:Preterm infants experience feeding difficulties that may persist beyond infancy and affect both infants and their families. The Neonatal Eating Assessment Tool (NeoEAT) is a parent-reported questionnaire designed to identify feeding difficulties in infants across breastfeeding, bottle-feeding, and mixed-feeding modes. This study aimed to translate and culturally adapt the NeoEAT into Norwegian, evaluate its psychometric properties and explore parent-reported feeding difficulties among Norwegian infants. METHODS:The NeoEAT was translated and culturally adapted according to the ISPOR Principles of Good Practice for Translation and Cultural Adaptation. In a survey study, parents of preterm and term infants completed the Norwegian NeoEAT, which was used to assess internal consistency, test-retest reliability and known-group validity. RESULTS:Fifty parents participated in the survey. Cognitive debriefings supported the face validity of the Norwegian NeoEAT. The questionnaire demonstrated strong internal consistency for the total scales (Cronbach's α = 0.85-0.90) and good test-retest reliability. However, several subscales showed low internal consistency and known-group validity was limited. Parent-reported feeding difficulties were similar in preterm and term infants, although some differences were observed in the breastfeeding version. CONCLUSION:The Norwegian NeoEAT was successfully translated and culturally adapted. The findings support its face validity, internal consistency, and test-retest reliability. However, limitations related to sample size and construct validity indicate that the present study should be regarded as a preliminary psychometric evaluation rather than a full validation. Further studies with larger and more diverse samples are needed to establish reference values and confirm the instrument's psychometric properties.
BACKGROUND:Sexual and reproductive health and rights (SRHR) education is particularly important in wartime Ukraine, where young people face disrupted access to services, persistent socio-cultural taboos, and increased vulnerability related to conflict. However, little is known about how Ukrainian students and future professionals understand and make sense of SRHR. OBJECTIVE:This study explored how SRHR was conceptualised in pre-course written responses and articulated in post-course focus group reflections, and how these framings related to students' future professional readiness in wartime Ukraine. METHODS:A qualitative exploratory design was used. Data comprised pre-course open-ended responses (n = 15) and post-course focus group discussions (three groups; n = 16) from voluntary participants of the same international SRHR course. The two datasets were analysed using framework analysis and treated as complementary qualitative sources rather than as matched individual-level pre-post data. RESULTS:Pre-course written responses showed that students mostly understood SRHR in biomedical and informational terms, focusing on reproductive health, contraception, sexually transmitted infections, and access to medical services. In post-course focus group reflections, SRHR was discussed more broadly, with attention to psychological, social, ethical, institutional, and rights-based dimensions: students reflected on professional responsibility, youth-friendly services, structural barriers, and the importance of SRHR in the context of war. CONCLUSIONS:Transformative learning-based SRHR education provided a useful context for broader reflection on sexual and reproductive health and rights among future professionals. Integrating such courses into higher education may support professional reflection and preparedness for SRHR-related practice during war and post-war recovery in Ukraine.
BACKGROUND:An increasing number of women are seeking a more physiological birth, opting to give birth without epidural analgesia. However, most of them ultimately opt for it. METHODS:A qualitative study using semi-structured interviews was conducted to explore women's final decisions regarding epidural analgesia among those who initially desired a physiological birth. RESULTS:Fourteen women were interviewed. Decision-making regarding epidural analgesia emerged as a dynamic and evolving process occurring throughout labour, shaped by interacting factors including personal motivations, fear-related considerations, previous childbirth experiences, prenatal preparation, pain management strategies, and perceived support. These factors influenced women's capability to maintain or revise their initial birth plan. Positive motivations include the desire for a more intimate and active birth experience while negative motivations were mainly related to fear of immobility or epidural analgesia failure, often driven by stress or anxiety. Some characteristics, such as parity, were described as non-modifiable, whereas perceived support and opportunities for mobility were reported as contextual factors influencing women's experiences and decisions. CONCLUSION:These findings highlight the importance of a personalised, woman-centered approach that recognises childbirth decision-making as an evolving process and supports women's changing needs throughout labour.
OBJECTIVE:Negative childbirth experiences can be detrimental to maternal and child health. To promote health equity, there is a need to understand how different immigrant populations experience childbirth in their host countries. In Canada, there is a growing population of Arab immigrants, however, there are yet to be any studies exploring the childbirth experiences of Arab immigrant and refugee women in Canada. This study aims to explore the childbirth experiences of Arab immigrant and refugee women in the Ontario (Canada) healthcare system and identify communication needs. METHODS:This descriptive qualitative study employed semi-structured interviews with nine Arab immigrant or refugee women who had given birth in Ontario, Canada within the past seven years. Framework analysis was used to analyze the interview data. RESULTS:Five themes were established related to childbirth experiences and communication dynamics. Women interviewed discussed (1) lack of birth preparedness, (2) needing emotional, physical, and language support, (3) uncertainty surrounding the role of maternity care providers, (4) the importance of culturally and religiously sensitive care, and (5) fostering respectful and empowering relationships with Arab women. CONCLUSIONS:Childbirth care for Arab immigrant and refugee women may be improved by encouraging maternity care providers to explicitly explain their professional roles and responsibilities. Cultural and religious sensitivity training would further enhance the quality of care provided during childbirth. Offering tools that empower Arab women to seek childbirth-related information and access justice when professional misconduct occurs can improve their experiences of receiving care.
OBJECTIVE:Heavy menstrual bleeding (HMB) is a common gynaecological condition, yet management practices remain variable, and women report dissatisfaction with care and treatment decision-making. While previous research has explored women's experiences, less is known about how clinicians approach assessment, treatment decisions and shared decision-making in HMB care. This study explored Australian clinicians' perspectives on managing HMB. METHODS:Semi-structured interviews were conducted with Australian clinicians, including general practitioners and gynaecologists with experience in managing HMB. Participants were recruited through professional networks and snowball sampling. Interviews took place between March and July 2025 and explored patient assessment, how patients were involved in treatment discussions and the potential role of decision aids. Transcribed audio recordings were analysed thematically using Framework analysis. RESULTS:15 participants (n = 9 general practitioners and n = 6 gynaecologists) were interviewed. Five main themes were identified. Clinicians varied in how they assessed HMB, commonly relying on proxy indicators rather than formal diagnostic tools. Treatment pathways were shaped by time constraints, clinical setting, and system-level factors, including access to specialist care. Views on hysterectomy differed, with most framing it as a last-line option, while some considered it a valid choice for well-informed women. Limited consultation time was frequently described as a barrier to shared decision-making. CONCLUSION:The findings highlight the need for clearer diagnostic guidance, balanced patient information, and patient decision-support tools that enhance shared decision-making. Supporting patient-centred discussions that balance clinical caution with respect for preferences will be critical to improving the consistency and quality of HMB management.
BACKGROUND:There is limited knowledge about the extent of intrapartum cardiotocography use in low-risk pregnancies and whether practice aligns with international and Danish national guidelines. AIM:To describe the use and the initial indications of intrapartum cardiotocography in low-risk pregnancies. Furthermore, to investigate whether practice of intrapartum fetal monitoring aligns with international and Danish national guidelines. METHODS:A cross-sectional study was conducted among 411 women with low-risk pregnancies at a single hospital in Denmark. Data were retrieved from electronic medical records covering the period 1st January 2023 to 31st December 2023. Descriptive statistics were performed. FINDINGS:A total of 204 (49.6%) women with low-risk pregnancies were monitored with cardiotocography during labour. The most frequent initial indications for cardiotocography application were: fetal heart rate abnormalities (n = 71, 34.8%), epidural analgesia administration (n = 66, 32.4%), and meconium-stained amniotic fluid (n = 34, 16.7%). In total, 35 cases (8.5%) did not align with the international guidelines, with the majority (n = 23, 65.7%) receiving less extensive cardiotocography than recommended. In comparison, 57 cases (13.9%) did not align with the Danish national guidelines; among these, most women (n = 54, 94.7%) received more extensive cardiotocography monitoring than recommended. CONCLUSION:Approximately half of women with low-risk pregnancies were monitored with cardiotocography during labour. In general, intrapartum fetal monitoring practices in low-risk pregnancies showed minimal deviation from international and Danish national guidelines. Most of non-compliant cases were associated with epidural analgesia administration, highlighting an area that warrants increased attention in clinical practice.
OBJECTIVE:Birth plans are commonly promoted to enhance women's autonomy during childbirth, yet evidence of their effectiveness remains inconsistent. The aim of this study was to map and discursively analyse birth plan templates in Swedish public maternity care and online from a gender perspective, focusing on autonomy, decision-making and informed consent. METHODS:We collected birth plan templates from 21 healthcare regions and developed an online search strategy to identify web-based templates and instructions for writing a birth plan. In total, we analysed 64 documents using Critical Frame Analysis. RESULTS:Our analysis revealed five frames with six related discursive struggles. Birth plans could improve care and birth experiences, while women's wishes were both encouraged and dismissed. Birthing women had capacity to express their wishes, yet significant expertise was implied. Birthing women had agency and decision-making power, but birth plans provided no guarantees for fulfilling women's wishes. Midwives and maternity care were accommodating and adaptable, yet midwives lacked time for birth plans and birth plans were sometimes framed as unnecessary. Finally, childbirth was portrayed as both possible to plan for and unpredictable and impossible to control. CONCLUSION:Framings of birth plans navigated between accommodating women's preferences and the need for organisational efficiency. The coexistence of empowering frames and contradictory messages illustrates the ambiguity surrounding birth plans. The wide range and conflicting instructions may increase the gap between birth expectations and birth experiences. Heightened awareness of birth plans and how they relate to birthing women's autonomy is important for Swedish maternity care.
