This practice initiative aimed (a) to implement strategies encouraging midwives to improve father involvement, (b) to describe its perceived impact, and (c) to gather recommendations for broader implementation. Two communities of practice were formed to exchange insights on father involvement strategies. Midwives implemented various changes and reflected on their impact. Successful strategies comprised simple changes (e.g., addressing both fathers and mothers) and larger organizational changes (e.g., applying work/care distribution discussions). To implement this on a broader scale, midwives formulated recommendations aiming at midwives (e.g., increasing awareness; providing courses) and policy makers (e.g., providing financial compensation for midwives to involve fathers). We demonstrated that (a) minor and major changes can be made to enhance father involvement in midwifery care, (b) a community of practice can enhance awareness on an underrepresented issue, and (c) changes are needed within midwifery and policy to increase awareness and enable father involvement.
The peanut ball (PB) is a nonpharmacological, cost-effective tool used during labor to improve outcomes. This narrative review explores the current literature and clinical findings on using PB in nulliparous women following epidural anesthesia. A randomized clinical trial at four labor and birth units confirmed the literature. Evidence supports that PB use may reduce the first stage of labor, reduce the time from epidural to full dilation, and enhance maternal satisfaction. Proper PB positioning is essential to optimize pelvic diameters during labor, and educating nurses on PB use is critical to improving outcomes. PB use is a promising strategy to support physiologic labor and potentially reduce cesarean birth rates in nulliparous women.
Postpartum is often described as the fourth trimester of pregnancy, yet health-care support typically tapers off around 6 weeks after birth. In the United States, once individuals are discharged from obstetrics and gynecology care, the continuity and consistency of postpartum guidance can become uncertain. Many new parents may enter the postpartum period with limited preparation for the physical, emotional, and social changes that arise after birth, highlighting the importance of strengthening the delivery of postpartum education and support. As health-care providers, we need effective tools to educate our patients beyond a brief 15-minute visit. The problem lies in the persistent barriers to accessing adequate postpartum health education. The World Health Organization recommends postpartum assessments at 24 hours, day 3, week 2, and week 6, emphasizing the value of ongoing support during the postpartum period. However, opportunities remain to strengthen postpartum education, as many women would benefit from clearer guidance on basic postpartum care and more consistent, standardized discharge education from providers.
In this column, the editor of The Journal of Perinatal Education discusses how policy can support safer birth. The editor also describes the contents of this issue, which offer a broad range of resources, research, and inspiration for childbirth educators in their efforts to promote, support, and protect natural, safe, and healthy birth and postpartum.
Leveraging the innate neonatal instinct for autonomous milk-seeking, breast crawl facilitates a more natural initiation of breastfeeding. This phenomenon entails the newborn’s self-directed crawling toward the maternal breast, culminating in spontaneous nipple location and self-attachment during the first feeding. This process occurs through uninterrupted skin-to-skin contact between the mother and the infant without external intervention. To elucidate the lived experiences of primiparous mothers engaging in breast crawl, this qualitative study explored factors influencing neonatal breast crawl implementation. The objectives were to identify facilitators and barriers, thereby informing clinical adoption and evidence-based strategies for optimizing the initial breastfeeding experience. A descriptive qualitative design was employed. Using purposive sampling, 12 postpartum women who experienced breast crawl at Jiaxing University Affiliated Women and Children’s Hospital between March and May 2024 were recruited as participants. Semistructured interviews were conducted, and data were analyzed using Colaizzi’s phenomenological analysis method. Two overarching themes emerged: facilitators and barriers to neonatal breast crawl. Facilitators comprised four subthemes: (a) neonatal milk-seeking drive, (b) maternal perseverance, (c) doula assistance, and (d) familial support. Barriers encompassed four subthemes: (a) maternal factors (e.g., knowledge deficits and labor fatigue), (b) neonatal factors (e.g., birth weight, Apgar scores, and safety risks including suffocation and falls), (c) support system factors (e.g., privacy concerns and familial interference), and (d) medical factors (e.g., birth mode and disruptions from clinical procedures). Obstetric clinicians should prioritize implementing neonatal breast crawl in clinical practice. Efforts must enhance health-care provider’s and maternal comprehension of its benefits, establish robust mother–infant support systems, develop standardized education protocols, and formulate evidence-based implementation frameworks. These measures will generate compelling evidence regarding the safety and efficacy of neonatal breast crawl. Registration: ChiCTR1800018195 (2018-09-04).
Perinatal loss is a profound experience that can lead to lasting emotional distress, including anxiety, depression, and posttraumatic stress disorder. Women with a history of perinatal loss often require increased medical attention and emotional support during subsequent pregnancies. Limited resources were available for these women at a West Texas hospital. Our aim was to implement and evaluate a structured prenatal class tailored to their needs, incorporating education, mental health support, and staff training. The class was offered virtually and face-to-face. Although participation was limited, qualitative feedback suggested the women valued the emotional and informational support. The findings suggest that ongoing support and education focused on addressing the stressful challenges following a maternal experience of perinatal loss are essential.
The sexual nature of birth has been well established through scientific research over decades. The frame of mind, bodily state, hormonal mix, and circumstances that allow for an enjoyable sexual experience can also allow for an easier birth experience, even to the point of orgasmic birth. The path to an orgasmic birth is not easy or intuitive. Ending up anywhere on that path can increase the chances of a positive birth experience for many people. Engaging in sexual actions like kissing, nipple stimulation, and clitoral stimulation can make birth easier and prevent medical interventions. Birthing people can benefit from sex-related actions and the accompanying state of mind, but they need to be informed about what they are and why or how to use them. It is difficult to incorporate this information into childbirth classes and there are few examples. This information is not yet a standard part of patient-centered childbirth education curriculums. To remedy this deficiency, this article outlines seven educational objectives that should be met in all childbirth education programs and patient-centered educational materials about birth. As a childbirth educator for several decades, I have reviewed many current and past childbirth education resources. The sexual nature of birth was not addressed when I was taught to be a childbirth educator. I just completed an advanced childbirth educator certification program where these objectives were not met. One of the most popular slide presentations on the market for childbirth education used by many hospitals and childbirth educators does not meet these objectives. I have found that many maternity care professionals are uncomfortable even discussing the sexual aspects of birth. In my certification program, I brought up midwife Ina May Gaskin’s assertion that she has never seen a birthing person experience a tear or episiotomy if they were using clitoral stimulation during pushing. I was criticized by the doula, who was the instructor, for even bringing this up, and she shut down discussion of this immediately. I have had two midwives and a doula say that they are uncomfortable even bringing up the sexual nature of birth in a childbirth class. I spoke with a midwife who had just completed her midwifery program at a major institution, and she said that the sexual nature of birth was not part of her education. She said she had never heard of or seen any care provider recommend that someone engage in sexual actions to make birth easier. Even books or films with the words “orgasmic birth” in the title do not make clear the path to that birth experience. To fill this gap, and to help those who do not know how to explain this or feel uncomfortable doing so, I am proposing these seven objectives and techniques for incorporating this information into childbirth classes and resources in a way that has resonated with my childbirth class participants for years.
Childbirth education has the potential to enhance self-efficacy and reduce fear of birth. During pregnancy, women are highly receptive to suggestions and are more likely to respond in a nonvolitional way. Effective communication is key to optimizing the birth experience, yet strategies to teach communication skills are lacking. An understanding of language structures such as GREAT (Greeting, Rapport, Expectations, Addressing concerns, Tacit agreement) and LAURS (Listening, Acceptance, Utilization, Reframing, Suggestion) provides a systematic approach to communication. This framework raises awareness of subconscious processes that can adversely affect perceptions and behaviors. Childbirth educators are ideally placed to adapt their communication and educate parents in ways that reduce anxiety and empower parents to make informed, confident decisions that optimize the birth experience.
This systematic review analyzes European Union (EU) prenatal education programs over the last 24 years from a pedagogical perspective, examining their content, methods, and outcomes, and provides recommendations for future program design. A qualitative content analysis of 27 studies on prenatal education programs published between 1999 and 2023 in EU member countries was conducted. There was a notable lack of consensus on the content of prenatal education programs. Almost all the programs focused on the field of health. Pedagogy could thus contribute to a broader and more complex awareness of future challenges, in addition to complementing and enhancing future prenatal education programs, in order to move toward a unified evidence-based approach.
Breastfeeding is the clinical gold standard of nutrition for newborns due to its health benefits to the mother and newborn. Successful initiation of breastfeeding is multifactorial and includes nursing support and interventions, especially during the Golden Hour. Implementation of a structured postvaginal birth newborn flowchart was explored in an effort to improve breastfeeding initiation and nursing staff confidence to provide breastfeeding support. Results indicate that the implementation of a flowchart along with related nursing education can positively affect Golden Hour breastfeeding practices and nurse confidence to support breastfeeding.
Birth perceptions of nursing students may influence their future professional practice. Art-based research offers a means to explore subconscious thoughts and emotions. The aim of this study was to explore nursing students’ perceptions of childbirth through birth art. A descriptive qualitative design with an art-based approach was employed. Forty-three third-year nursing students enrolled in an obstetrics and gynecology nursing course created drawings depicting childbirth as a landscape and reflected on their artwork using guiding questions. Written reflections were analyzed through content analysis and metaphor analysis. A complex emotional profile emerged, encompassing both positive (happiness, love) and negative (pain, sadness, confusion) emotions. Birth was frequently associated with distressing factors such as pain, anxiety, fear, and loneliness, yet students also emphasized the importance of holistic and supportive care. Birth art facilitated access to students’ subconscious perceptions, enhancing emotional awareness. These findings suggest that art-based methods may be valuable tools in nursing education to foster empathy and prepare students to provide respectful, supportive care during childbirth.
This case report aimed to evaluate the effects of childbirth preparation education and telecare provided to couples experiencing fear of childbirth, based on the Watson Human Caring Model, on partners’ readiness for birth, maternal and paternal attachment, and to explore the applicability of the model in perinatal nursing care. The Fear of Childbirth Scale was administered to 16 couples who responded to a social media announcement, and the couple scoring highest was selected for the intervention after providing verbal and written informed consent. A care plan was developed according to the Watson Human Caring Model. A total of six video calls were conducted with the couple via WhatsApp—once weekly from the 32nd gestational week and twice weekly from the 36th week—amounting to 18 hours of childbirth preparation education and telecare. Data were collected using the Couples’ Introductory Information Form, Prenatal Self-Assessment Scale (Readiness for Birth and Fear of Birth Subscale), Prenatal Maternity Expectations Scale, Prenatal Attachment Inventory, Fathers’ Fear of Birth Scale, Prenatal Paternity Expectations Scale, and Prenatal Paternal Attachment Scale. In the study, it was observed that the birth preparation education provided using the Watson Human Care Model, which incorporates a holistic approach, and home telecare were quite helpful. The care given according to the model resulted in positive improvements in the spouses’ readiness for birth and maternal–paternal attachment. It was observed that birth preparation education and home care telecare services were beneficial. That care could also be provided through telehealth services, as outlined in the Watson Care Model, for spouses with a fear of childbirth. It was concluded that the birth preparation education and home care telecare service provided positive improvements in the spouses’ readiness for birth and maternal–paternal attachment and that the spouses experienced a healthy and happy birth process by going through it together.
Antenatal care is essential for ensuring a healthy pregnancy, especially in first-time mothers (primigravida) who may experience greater uncertainty and risks. The present study aimed to evaluate the effect of a perinatal education program on maternal outcomes among primigravida mothers. A total of 144 primigravida mothers attending the antenatal outpatient department at a tertiary care hospital were enrolled. The intervention group ( n = 72) received perinatal education covering antenatal care (diet, hygiene, exercise, and relaxation), intranatal guidance (back massage, breathing techniques, and labor expectations), and postnatal education (breastfeeding, newborn care, maternal health, and family planning) in seven sessions. The control group ( n = 72) received routine care. Maternal outcomes were assessed throughout pregnancy, during labor, and postpartum, and data were analyzed using appropriate parametric and nonparametric statistical tests. The posttest knowledge scores were significantly higher ( t = 20.59, p < .001) in the intervention group (33.9 ± 2.5) than the control group (21.2 ± 4.6). The intervention group had lower stress scores and a higher rate of normal vaginal births compared with the control group. The intervention group showed a significantly shorter duration of labor in the second and third stages, increased placental weights, and lower blood loss during birth ( p < .001 for all). The perinatal education program significantly improved maternal knowledge and outcomes in primigravida mothers, including higher rates of normal vaginal birth, shorter labor duration, reduced blood loss, and fewer complications. These findings support integrating structured perinatal education into routine antenatal care to enhance maternal knowledge and clinical parameters and improve overall pregnancy outcomes.
Kangaroo mother care (KMC), which encompasses skin-to-skin contact between the mother and her baby, exclusive breastfeeding, and early hospital discharge, has been instrumental in saving numerous premature and low-birth weight newborns worldwide. We aimed to compare the impact of the duration of KMC on the short-term clinical parameters of very preterm neonates. We did an ambispective analysis of 69 very preterm neonate–mother dyads admitted to a Level III Neonatal Intensive Care Unit (NICU) of a tertiary care hospital in Eastern India between January 2021 and December 2022. KMC was initiated in all eligible babies at the earliest opportunity, irrespective of their respiratory status and birth weight. The clinical parameters were compared between Group A with extended KMC duration (>5 hours) and Group B with short KMC duration (≤4 hours). Baseline characteristics were analyzed using descriptive statistics. The baseline characteristics were comparable in both groups. The mean (± standard deviation [ SD ]) gestational age was 29.5 ± 1.9 weeks, and the mean birth weight (± SD ) was 1,106 ± 289 g. Out of 71 babies, 33 were female. Thirty-nine percent of the neonates were small for gestational age (SGA). When compared with the short KMC group, the babies who received extended-duration KMC during their hospital stay had significantly better weight gain by 7.1 g/kg/day ( p = .03), length gain by 0.7 cm/week ( p = .003), and head circumference gain by 0.23 cm/week ( p = .006). The duration of hospitalization was also shorter and trending toward significance in the group with extended duration KMC (49.2 vs. 41 days, p = .13). Longer duration of KMC hours is associated with significant improvement in anthropometric parameters and shorter duration of hospitalization. Hence, all mothers (or caregivers) must be encouraged to provide a longer duration of KMC hours.
The postpartum period is pivotal for both maternal and infant well-being, yet factors influencing postpartum readiness remain underexplored. This study investigates these factors with an emphasis on the impact of perinatal educators on optimizing readiness. We conducted a cross-sectional survey using a modified "Perceived Readiness for Discharge After Birth Scale" among patients up to 6 weeks postpartum. Our analysis, through multivariable regression, indicated that multiparous individuals felt more prepared for the postpartum period compared with primiparous individuals. Factors such as age, race, ethnicity, education, and other demographic variables did not significantly affect perceived readiness. The findings suggest that tailored postpartum education is essential, particularly for first-time parents, and that demographic factors alone should not dictate preparedness assessments.
Maternal health-care provider burnout is prevalent, resulting in increased absenteeism, depersonalization, and reduced sense of efficacy. Compassion may mitigate the adverse effects of burnout for health-care providers, but the experience of compassion for birth doulas has not been examined. Using constructivist grounded theory methods, we addressed the research question: How do certified birth doulas experience compassion in hospital-based births? We interviewed a purposive sample of 18 certified birth doulas. Data analysis revealed that doulas experience compassion in three developmental domains: intrapersonal, professional, and interpersonal. Doulas self-identify as compassionate individuals. Self-reflection and professional experience enhance a sense of humanness for providers, clients, and families. Compassion sustains birth doulas, increasing their sense of efficacy and mitigating burnout.
Perinatal education is delivered by maternity services to improve health literacy, health, and experience outcomes. The needs of parents when designing and implementing perinatal programs have been understudied. This study's aim was to understand the needs of expectant and new parents in relation to perinatal education and to apply these findings to guide the development and implementation of a new program. Following interviews with parents from a Queensland maternity hospital, thematic analysis revealed themes that were mapped to implementation science frameworks to inform implementation strategies. One metatheme, "navigating the journey," four primary themes, and eight subthemes were identified. This study identified factors that can be leveraged to support implementation success and highlights strategies to enhance implementation efficacy.
A lack of access to timely and appropriate support is associated with early breastfeeding cessation, and programs that house lactation support in tandem with primary care have improved feeding outcomes. The purpose of this clinical project was the integration of lactation services and primary care within a federally qualified health center, providing insights into implementation challenges and innovations. Utilizing a lactation consultant alongside a clinician during primary care visits required administrative and logistical support, as well as early clinician champions. This program demonstrated a financially stable and efficacious collaboration with a family medicine residency program.
Childbirth is a critical and transformative experience in a woman's life; however, it is often accompanied by fear and perceived as a highly stressful event. Fear of childbirth may adversely affect a woman's confidence in her ability to give birth and her perceived competence regarding the birthing process. This study aimed to investigate the effect of motivational interviewing on childbirth self-efficacy and birth satisfaction among pregnant women. The study sample consisted of 85 pregnant women who were randomly assigned to either an intervention or a control group. Participants in the intervention group attended motivational interviewing sessions conducted over a 4-week period. Mode of birth and birth satisfaction were evaluated during the postpartum period. Among women in the intervention group, nearly 70% had a vaginal birth, and approximately 63% reported being satisfied with their childbirth experience. A statistically significant difference was observed between the groups in total childbirth self-efficacy scores following the intervention. The findings indicate that motivational interviewing can enhance childbirth self-efficacy and decrease the preference for cesarean birth.Trial registration: Registered in the ClinicalTrials.gov (NCT06082895).
The aim of this study was to investigate the role of psychological capital (PsyCap) and coping behaviors that promote well-being among a sample of pregnant individuals experiencing socioeconomic disadvantage. Within our sample (N = 182), optimism, self-efficacy, and hope were positively associated with well-being (β ranges from .18 to .28, p < .01). Optimism was associated with a greater number of adaptive coping behaviors (β = .25, standard error = 0.00, p < .01). Latent class analyses revealed three classes in the data set based on patterns of coping behaviors: (a) social copers (29%), (b) minimal copers (14%), and (c) solitary copers (57%) and well-being scores were different between classes (p < .01). Training for perinatal educators on strategies that foster PsyCap and social coping behaviors may help mitigate perinatal health disparities.
