Background: Not being breastfed is internationally considered to have a lifelong impact on morbidity and mortality. In the UK and other developed nations, adolescent mothers are among those least likely to breastfeed and require additional support to do so due to their unique developmental position. Evidence indicates that many young mothers who intend to breastfeed never initiate breastfeeding or stop soon after giving birth, and there may be factors in the UK health system or wider society preventing the success of breastfeeding support interventions. These considerations led to a two-phase investigation which aimed to study the context of breastfeeding support and evaluate a targeted breastfeeding support intervention for young women. Methods: A realist evaluation framework was used. 83 UK health professionals responded to an e-questionnaire. Focus groups and interviews were conducted with 15 young mothers (aged 16-20) in Oxford, England. A breastfeeding support package was then developed and implemented on a UK postnatal ward for six months. A concurrent mixed methods evaluation was carried out. Each component of the investigation was analysed thematically using inductive content analysis. Ethical approval was received. Findings: Young women appear motivated to breastfeed to show that they are good mothers. However, breastfeeding can alienate them from their families at a time when they need to be accepted in their new mothering role. Young mothers can feel disempowered after birth and like ‘fish out of water’ on the postnatal ward. A need was identified for proactive breastfeeding support from health professionals focusing on relational care, particularly as some maternity professionals displayed negative attitudes to teenage mothers and breastfeeding. Despite staff training developing a more positive and enabling attitude towards young women, much of the proposed support package proved impossible to implement in a busy, task-orientated medical environment where time, convenience, control, and individual staff beliefs were used as yardsticks to determine the acceptability of different aspects of care. Conclusion: This study highlights the importance of proactive, relational breastfeeding support for young mothers. Such support requires a facilitative environment in order to be implemented successfully. It is suggested that such an environment could be created on the postnatal ward if midwives and MSWs created workplace communities and claimed ownership of their time and space. Action Learning may facilitate this process.

In South Africa and worldwide high rates of teenage pregnancy and motherhood remains a concern. According to Mkhwanazi (2010:349) most of teenage pregnancy occurs among poor black and coloured communities. The majority of these pregnancies are unwanted and unplanned resulting teenage mother experiencing problems with motherhood. The relationship in family peers and communities are adversely affected. Teenage motherhood seen as to be socially economically and physically delirious for the teenage mother and her baby. Teenage motherhood became a burden not only on the teenage mother but also to the family and the State. Cultural issues aggravated the situation in which the teenage mother finds herself in which is the lack of support from the communities in which they live. This results to the teenage mother having a feeling being alienated. The researcher as a midwife working in labour ward observed that the teenagers of younger ages are frequently admitted in labour wards in one of the hospitals in Nelson Mandela Metropolitan Municipality. The researcher became interested to conduct a study on mother hood experiences of teenage mothers: A Xhosa Pespective. The first objective of the study was to explore and describe the motherhood experiences of Xhosa teenagers. The second objective was to make recommendations to assist the midwives to help teenage mothers cope with motherhood. These recommendations could be used by health professionals to address the research findings. A qualitative, explorative descriptive and contextual research design was used to reach the objectives of the study. The research population consisted of Xhosa speaking teenage mothers who were residing at Kwazakhele Township and whose age was between 12 -16 years. Teenage mothers who gave birth to live babies during the last 6-12 months. Ethical considerations were maintained throughout the research study .Semi- structured interviews were conducted before data saturation was reached. The data collected during the interviews were transcribed and analyzed using Tech’s model of data analysis. The aspect of trustworthiness according to Guba’s model was implemented in the research study and included credibility, applicability, consistency and neutrality.

Patients often exhibit premonitory abnormalities in vital signs before an adverse clinical outcome. Patient survival may depend on the decisions of nurses to call for assistance. There is a paucity of published early warning scores (EWS) literature for general ward use from South Africa. In a public hospital in South Africa, the study aimed to develop, validate and test the impact of implementation of a modified early warning scoring (MEWS) system vital signs chart and training programme designed to improve hospital nurses’ performance in early identification of postoperative clinical and physiological deterioration in adult patients.

No description available.

Civil unrest has become a feature of South African society and has resulted in varying degrees of social disruption. Health services, particularly those located in residential areas, have been affected. As nurses constitute the largest group of health care professionals in South Africa, and often live in the communities in which they work, they serve as useful indicators both of community dynamics and the health services. This study describes the effect of civil unrest on nursing personnel and determines the short term and long term effects on health and nursing services. A self-administered questionnaire was distributed to all community based nurses working in two major health services in the Cape Peninsula in 1986. In addition, routinely available health data directly related to nursing services were collected on a monthly basis for the period 1984-1988 (inclusive). For purpose of analysis the Cape Peninsula was classified into areas of high, medium and low impact violence evident in 1986. The nursing questionnaire had a response rate of 76.9%. Problems associated with civil violence that were identified were the need for nurses to ensure the safety of their own children; transportation to and from work; identification as nurses; security; curtailment of nursing services (particularly home visits); disruption of ancillary services; employer attitudes; political and police activity. Health data relating directly to nursing services revealed disrupted antenatal dinics, an increase in the number of women booking antenatally following a time of disrupted booking clinics, an increase in deliveries associated with interrupted family planning clinics, a decrease in treatment of ophthalmia neonatorum and umbilical sepsis associated with curtailed home visits. The study indicated that nurses wer:a not adequately equipped to cope with the changing demands mad1:1 upon them during periods of political instability; that civil unrest negatively affects nursing personnel and nursing services; and further, that disruption of a service impacted other services. It is recommended that in areas of violence it is essential to have a single management team co-ordinating all health services; education and in-service training must address the needs of nurses.and health care in situations of civil violence; nurses must strive to be accepted as universal carers and be committed to justice and peace; and the professional association must be proactive in providing guidelines to nurses who are affected by civil unrest.

Thesis (M.A.)--York University, 2006. Graduate Programme in Interdisciplinary Studies. / Typescript. Includes bibliographical references (leaves 257-265). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:MR29590

Thesis (Ph. D.)--University of Washington, 2006. / Vita. Includes bibliographical references (p. 255-295).

Thesis (M.S.)--University of Michigan, 1998. / Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 1998. / Includes bibliographical references.

The general aim of this study was to provide an in-depth exploration of the experiences of a group of 30 women who planned home births. This was to expand on the small amount of qualitative research in the field and suggest avenues for further research. With this general aim, I analysed the women's experiences in relation to the contexts in which they planned home births in order to provide a useful account for the women in the study, those who may plan home births in the future, as well as clinicians, managers and policy-makers involved in maternity services. I considered some of the wider political, social and historical discourses, which underpin the present situation in Scotland regarding home births. While I acknowledged that these are unstable reference points, they were useful in gaining insights into the current situation. This was particularly the case when looking at home birth as part of a complex interplay between dominant and subordinate ideologies, which were partially played out through gender relations symbolised by the male doctor and the female midwife. A postmodern reading of feminisms provided the conceptual tools to examine diverse belief systems around birth in relation to women's narratives. Suspending "truth" enabled diverse knowledges to become more visible. This validated women's experiential knowledge which could then be placed alongside other knowledge systems, and examined in terms of dominant and marginalised ideologies. The project became one of conflicts and silences, searching out and listening to, and making visible "other" voices. This raised issues of power, control, autonomy and resistance. In most cases I interviewed each woman twice before her baby's birth and twice following the birth. Interviews were usually 1 Y2 to 2 hours in length, taped and transcribed. A qualitative software program, NUD*IST was used to assist with analysis, but the conceptual framework for the analysis remained rooted in a postmodern feminist approach using a relational voice methodology. The main findings were that National Health Service (NHS) community midwifery services were based on an attenuated technocratic model of birth. This imposed a philosophy and structure of care that prevented women and midwives from developing alternative ideologies based on their own knowledges. It prevented women and midwives from forming trusting, supportive relationships, which stand at the core of holistic philosophies of birth. Women and midwives were often obliged to draw on subversive techniques to use their knowledge and skills in order to make the best of a system which by definition could not be woman-centred or holistic. The main conclusion was that birth requires to be socialised rather than medicalised, so that technology and medical practices can be developed and used to support women and babies, and midwifery practices when necessary, rather than birth being technocratised and social practices used to humanise an essentially inhumane system of care.