Yes / Perineal trauma is associated with short- and long-term maternal morbidity. Research has found that maternal position at birth can influence perineal trauma. However, there is a dearth of evidence examining specific maternal positions, including waterbirth, and how these can influence incidence and degree of perineal trauma. Such evidence is important to help reduce trauma rates and improve information for women and midwives. To address this gap in reliable evidence, a systematic review was conducted. Seven studies met the inclusion criteria. Compared to land birth, waterbirth was found to cause an increase in perineal trauma. Kneeling and all-fours positions were most protective of an intact perineum. Allowing for different variables, sitting, squatting and using a birth-stool caused the greatest incidence of trauma. The findings of this review demonstrate that further research is required around perineal guarding in alternative birth positions and how parity affects trauma rates with waterbirth, so that women may be advised appropriately. It also suggests findings that midwives can use when discussing alternative birth positions with women.

Thesis (M.A.)--Texas State University-San Marcos, 2007. / Vita. Appendix: leaves 34-35. Includes bibliographical references (leaves 36-38).

Thesis (M.A.)--Texas State University-San Marcos, 2007. / Vita. Appendix: leaves 34-35. Includes bibliographical references (leaves 36-38).

There is low use of health facilities for childbirth in South Sudan despite the majority of households reporting access to a health facility. South Sudan has a high maternal mortality ratio with 789 maternal deaths for every 100,000 live births. The absence of a midwife during labor and delays in reaching health facilities for childbirth remain the leading contributing factors to the high maternal mortality. Little is known, however, about factors influencing use and non-use of health facilities for delivery in the country. This phenomenological study, therefore, seeks to build a body of evidence by describing the experiences of women using health facilities for childbirth. Applying the health belief model, structured interviews were conducted confidentially with 20 women between the ages of 18 and 45 who delivered at the Juba Teaching Hospital. Interviews were voice recorded, transcribed, and analyzed by hand-coding and through NVivo computer software. A review of copied data, comparison with field notes, and member checking were done to ensure data quality. Five broad themes emerged based on the research questions and linked these to the theoretical model. Findings revealed that women received support and assistance during their childbirth experience at the hospital from their husbands, mothers-in-law, health workers, and neighbors. Women reported negative factors such as hunger and positive factors such as care provided by midwives as affecting their childbirth experiences. This research could contribute to improving health outcomes for women and newborns. This study has implications for positive social change by transforming the provision of maternity services in South Sudan.

This thesis is based on a study that was conducted in the Manicaland Province of Zimbabwe during the period 1996-1997. The main objective of the study was to identify factors in traditional midwifery that facilitate the vulnerability of both the birthing woman and the traditional birth attendant (TBA) to risks in childbirth. Traditional birth attendants in Zimbabwe, though for a long time a shunned and ridiculed cadre, have always been the custodians of maternal health in the rural areas. TBAs have traditionally relied on intuition and hands-on-experience in their day-to-day practice. With the government's adoption of the upgrading programme for TBAs as a Primary Health Care initiative to reduce infant and maternal mortality, TBAs in Zimbabwe have since incorporated some of the modern obstetric methods into their own traditional practices. There is yet another group of TBAs, who regardless of the training programme, have continued dependence on their experiential and intuitive knowledge for delivery of health. Traditional Birth Attendants, as well as the rural women with whom they share an explanatory model of birthing, were consulted in this study in order to get an emic understanding of risk construction, which in turn would inform intervention strategies. It was hoped that the fusion of these conceptual categories (indigenous with biomedical), would contribute to a body of knowledge which would be a foundation for culturally compelling interventions to reduce risks in traditional birthing practices. As this study unfolded, it became apparent that not only was the women's preference for the TBA determined by cultural forces, but that there were a myriad of additional, contextual forces at play. Macro-processes affecting TBA practices are noted, and issues analyzed from the broader perspective of critical medical anthropology (CMA). / Thesis / Master of Arts (MA)

published_or_final_version / abstract / Sociology / Master / Master of Philosophy

No description available.

No description available.

No description available.

The aim of the thesis is to explore pregnant women's decision-making and major influences on their preferences for a place of delivery. The study was prompted by the UK government's policy of a woman centred maternity service (Department of Health 1993b), and the observation that studies had concentrated on professionals' rather than women's views about the place of delivery. Two factors were considered to have potential influence in decision making, one being the individual woman's risk perception related to the process of childbirth, and the other, knowledge about available options for place of birth. First, a systematic review was conducted, looking at available studies on women's views about the place of delivery. Only 9 studies were found, suggesting a need for more studies. Secondly, a primary study was conducted using in-depth interviews with 20 women planning a hospital birth, and 13 planning a home birth to explore factors that led to their respective choices. Results from the primary study indicate that women were not offered information about the availability of home birth. Consequently, 90% of those planning a hospital birth did not give thought to where they were going to have their babies, but assumed they were going to go to hospital. On the other hand, those planning a home birth found information privately and discussed the options with their husbands before making a decision. Additionally, results exposed differences in perception of safety concerning childbirth for subsequent deliveries according to planned place of delivery. Control of the birth process and environment was also found to be important for women planning a home birth. Risk perception and information about available options were found to influence decision-making about the place of birth, thus supporting the hypotheses of the thesis.