Background: In high-income countries, hospital length of stay after a normal birth has gradually decreased correspondingly to length of stay in care of other patients. A short stay provides a greater opportunity for autonomy and an increased sense of participation, but it may involve great challenges satisfying parental guidance as well as on the possibility of preventing, discovering, and treating neonatal medical conditions. Aim: This study evaluates postnatal care based on cost calculations, risk assessments, and parents’ satisfaction with care. Methods: Questionnaires were sent to 1 122 new mothers and her partner during 1998-1999. For the summary of utilization of health care services during the first 28 days postdelivery, the participants were linked with registry data from the hospital administration system for mothers and newborns (n= 773). The answers were also used to describe new parents’ experiences with postnatal care (n = 1 479). The costs for five postnatal care models were estimated, including three care options: Maternity Ward, Family Suite, and Early Discharge. Data about neonatal readmissions and death within 28 days was retrieved from the Swedish Medical Birth Register, the Swedish Hospital Discharge Registry, and the Swedish Cause-of-Death Register between 1999 and 2002 (n = 197 898). This data was related to data about postnatal follow-up practices from all 48 Swedish delivery wards. Results: The readmission rate for the mothers was similar among the various care options, and there was no difference in utilization of health care or breastfeeding outcome due to type of maternity care. As a proxy for morbidity, the readmission rate for the newborns was influenced by postdelivery follow-up routines as routine neonatal examination timing. Depending on the proportion of mothers receiving care at the Maternity Ward, the costs differed significantly between the various care models, while parents’ preferences complied with the cost-minimizing option Family Suite. Most mothers and fathers (70%) were satisfied with the overall impression of the postnatal care, but 72% were dissatisfied with at least one particular topic. A main finding was that the parents experienced a close emotional attachment, an affinity that was not always supported by the staff. The father was not treated as a principal character even though the parents wanted the father’s to be involved and recognized. Conclusions: Since the postnatal care options are not always the most cost minimizing and postnatal routines influence neonatal morbidity and parental satisfaction, the postnatal services need to be improved. Without increasing risks or costs, every postnatal care option ought to meet the families’ need for support, security, autonomy, and attachment with each other.

Thesis (PhD)--Macquarie University, Division of Humanities, Department of Modern History, 2003. / Bibliography: p. 417-478. / Introduction: breeding and feeding -- The medical man: sex, science and society -- Confined: women and obstetrics 1880-1899 -- The kindest cut? The caesarean section as turning point -- Reproduction in decline -- Resisting reproduction: women, doctors and abortion -- From obstetrics to paediatrics: the rise of the child -- The breast was best: medicine and maternal breastfeeding -- The deadly bottle and the dangers of the wet nurse: the "artificial" feeding of infants -- Surveillance and the mother -- Mothers and medicine: paradigms of continuity and change. / The late nineteenth and early twentieth centuries saw profound changes in Australian attitudes towards maternity. Imbibed with discourses of pronatalism and eugenics, the production of infants became increasingly important to society and the state. Discourses proliferated on "breeding", and while it appeared maternity was exulted, the child, not the mother, was of ultimate interest. -- This thesis will examine the ways wider discourses of population impacted on childbearing, and very specifically the ways discussions of the nation impacted on medicine. Despite its apparent objectivity, medical science both absorbed and created pronatalism. Within medical ideology, where once the mother had been the point of interest, the primary focus of medical care, increasingly medical science focussed on the life of the infant, who was now all the more precious in the role of new life for the nation. -- While all childbirth and child-rearing advice was formed and mediated by such rhetoric, this thesis will examine certain key issues, including the rise of the caesarean section, the development of paediatrics and the turn to antenatal care. These turning points can be read as signifiers of attitudes towards women and the maternal body, and provide critical material for a reading of the complexities of representations of mothers in medical discourse. / Mode of access: World Wide Web. / 478 p

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 4 uppsatser.

The purpose of this study was to describe the utilisation of maternal and child health (MCH) care services by mothers from four selected health facilities in the Balaka District of Malawi. A non- experimental quantitative descriptive research was conducted to determine the knowledge of mothers with regard to MCH services and to identify factors that impact on the utilisation of the MCH care, based on the Andersen’s behavioral model of health services utilization. A combination of proportionate stratified sampling and convenience sampling was used and data was collected by means of self-administered questionnaires. It was found that mothers know the available services and that a number of factors have an impact on the utilisation of health care services. These relate amongst others to educational level, finances and cultural beliefs. / Health Studies / M.A. (Public Health)

Mozambique is in the process of setting up maternity waiting homes (MWHs) in an attempt to improve access of women living in remote areas. It is expected that MWHs will increase institutional deliveries and consequently, decrease maternal mortality caused by the delay in reaching obstetric care. However, no evidence for this assumption has been found in the literature. The objective of this research was, using Geographical Information Systems (GIS), to assess the impact of MWHs in increasing institutional deliveries coverage. GIS technology is a valuable methodology to analyse access, especially in contexts where official records are weak. An ecological study, using a sample of 28 health facilities, was conducted in six districts in northern Mozambique. The findings suggest that MWHs could contribute to increasing institutional deliveries coverage in a range of 4% to 2 %. However, they do not appear to increase access of women living in remote areas. / M.A. (Public Health)

A descriptive quantitative study was undertaken in the Leribe and Butha-buthe northern districts of Lesotho. Thirty-six trained, twenty-four untrained TBAs and nine nurses involved in training TBAs were recruited. In line with research by Clarke and Lephoto (1989:3) the TBAs were elderly females who had children of their own. In contrast with the MOH (1993: 10) where TBAs were found to be illiterate, most (93%) of the TBAs in this study had at least a primary education. The art of primary midwifery was learned through assisting with a delivery and being taught by mothers or mothers-in-law. The public health nurses conduct formal training ofTBAs in Lesotho over a period of two weeks, where subjects like ante-natal care, delivery of the baby and post- natal care are addressed. The majority (78.8%) provide antenatal care at their homes or the home of the mother. This includes palpation, history taking, and abdominal massage and health education. An important role is identifying women at risk. During labour the progress of labour is monitored and care is given to the mother and baby post-natally. Trained TBAs could identify women at risk more readily than untrained TBAs. Cases referred most frequently were prolonged labour and retained placenta. Trained TBAs practiced hygiene more often and gave less herbs than untrained TBAs. The health care system is providing support to the TBAs through training and supervision, but was found to be inadequate. Community leaders are involved in the selection of TBAs for training. Regular meetings are held with the TB As to discuss problems. Communication is one of the problems the TB As have to face, because of the long distances from health care centres. A lack of infrastructure and supplies is also of concern. It can be concluded that TBAs play an important role in maternal health care in Lesotho and are supported to a lesser degree by the health care system, which causes problems for the TBAs in their practices. It is recommended that the ministry of health becomes more aware of the need for training TBAs and that a programme for training should be more appropriate, taking cultural practices into account. / Advanced Nursing Science / D.Lit. et Phil.

Made available in DSpace on 2015-08-20T17:09:54Z (GMT). No. of bitstreams: 0 Previous issue date: 2015-02-27. Added 1 bitstream(s) on 2015-08-20T17:26:08Z : No. of bitstreams: 1 000840475.pdf: 2606413 bytes, checksum: a17c090283b530b2394c19d28dd32aa2 (MD5) / As taxas de mortalidade infantil configuram-se como indicadores que exprimem as condições de vida e saúde da população, uma vez que são determinados, principalmente, por condições socioeconômicas e pela qualidade da assistência à saúde obtida. A partir da segunda metade da década de 90 do século XX, observou-se que a taxa de mortalidade neonatal, que estava em torno de 20 óbitos/mil nascidos vivos, passou a representar 60% dos óbitos em menores de um ano. Pretendeu-se, com este estudo, a análise do itinerário terapêutico percorrido por mães de crianças que foram a óbito por causas evitáveis no período neonatal, entre janeiro de 2013 a junho de 2014, em município do interior paulista. Esta pesquisa de cunho qualitativo foi desenvolvida com base no referencial do itinerário terapêutico, a partir das experiências de mães de crianças que faleceram no período neonatal. Foram realizadas entrevistas semiestruturadas com nove mulheres. O material coletado foi sistematizado segundo o Método de Análise Temática de Conteúdo, sendo subdividido nas categorias: Atenção Pré-natal, Atenção ao Parto e Atenção Pós-parto à Mãe e ao Neonato. Observou-se que a busca ativa pelas mulheres pelo melhor atendimento profissional foi constante nos três momentos, sendo que a devolutiva do serviço, tanto público quanto privado, frente às necessidades de saúde apresentadas, demonstrou fragilidades, distanciando-se dos princípios e diretrizes estabelecidos pelo SUS. Salienta-se a relevância de investimentos na detecção precoce e nas respectivas condutas frente às intercorrências apresentadas pelas gestantes, parturientes, puérperas e recém-nascidos, valorizando e garantindo o devido atendimento das demandas apresentadas / Infant mortality rates are configured as indicators expressing the living conditions and health of the population, since they are determined mainly by socioeconomic conditions and the quality of the obtained health care. From the second half of the 90s of the twentieth century, it was observed that the neonatal mortality rate, which was around 20 deaths / thousand live births, now accounts for 60% of deaths in children under one year. It was intended, with this study, the analysis of the therapeutic road traveled by mothers of children who died from preventable causes in the neonatal period, from January 2013 to June 2014 at a university hospital in São Paulo. This qualitative nature study was developed based on the framework of therapeutic itinerary, based on the narratives of mothers of children who died in the neonatal period. Semi-structured interviews with nine women were interviewed. The collected material was systematized according to the Content thematic analysis method, being subdivided into categories: Prenatal Care,Childbirth Care and Postpartum Care of the Mother and Newborn. It was observed that the active search for the best care for women was constant in the three times, and the devolutiva service, both public and private, across the health needs presented, demonstrated weaknesses, distancing themselves from the principles and guidelines established by the SUS . We emphasize the importance of investments in early detection and its front conducts the complications presented by pregnant women, pregnant women, mothers and newborns, valuing and ensuring the proper care of the demands presented

Abstract The purpose of this research is to describe fathers' experiences in the context of family life after the birth of a baby. The approach to the topic is phenomenological. The data were collected in two stages from partners or husbands of women who had given birth to a child in a central hospital. First, 30 fathers were interviewed in 1999, three months after the child's birth. Three years later, in the spring and summer of 2002, 15 out of the 30 fathers were selected for a second interview on the basis of their ample talking and subsequent ability to express their experiences best. There were both first-timers and more experienced fathers among the informants. The open, conversational interviews yielded 650 pages of material, which was analyzed by the phenomenological method developed by Amadeo Giorgi and further developed by Juha Perttula in Finland. The study produced 15 individual situational meaning structures concerning the fathers' experiences. These individual meaning structures were used to create a general situational meaning structure concerning the fathers' experiences of family life after the birth of a baby. The family life after the birth of a baby involved the meaning of obtaining and building a home. It produced joy, happiness, but also responsibility and concern. The wife's pregnancy, the delivery and the new child entailed growing as a father and developing as a man. It also called for adjusting to the changed situation. The fathers' experiences of family life after the birth of a baby were influenced by their own childhood experiences and upbringing, by their growth into fatherhood and by their actions as fathers. The atmosphere of the home was based on the relationship between the husband and wife. The fathers appreciated the professionals' way of meeting and caring for the expectant family, but felt that the approach was mother-oriented and ignored the fathers. / Tiivistelmä Tutkimuksessa kuvaillaan isien kokemuksia perheenlisäyksen yhteydessä. Tutkimuksen lähestymistapa on fenomenologinen. Keräsin keskussairaalassa synnyttäneiden äitien avo- tai aviomiehiltä aineiston kahdessa eri vaiheessa: vuonna 1999 haastattelin kolmen kuukauden kuluttua synnytyksestä 30:tä perheenlisäyksen kokenutta isää ja kolmen vuoden kuluttua ensimmäisestä haastattelusta valitsin heidän keskuudestaan 15 isää, jotka puhuivat riittävästi ja ilmaisivat näin kokemuksiaan parhaiten. Nämä isät haastattelin kevään ja kesän 2002 aikana uudelleen. Isät olivat vaihtelevasti joko ensimmäisen lapsen isiä, tai joissakin perheissä oli useita lapsia. Tutkimusaineistona olivat isien avoimet keskustelunomaiset haastattelut, joita kertyi kaikkiaan 650 sivua. Analysoin aineiston Amadeo Giorgin kehittämällä ja Juha Perttulan edelleen kehittämällä analyysimenetelmällä. Tämän tutkimuksen tuloksena muodostui 15 yksilökohtaista situationaalista merkitysrakennetta isien kokemuksista perheenlisäyksen yhteydessä. Niiden avulla tämän tutkimuksen tuloksena muodostettiin yleinen situationaalinen merkitysrakenne isien kokemuksista perheenlisäyksen yhteydessä. Koettu perheenlisäys merkitsi isille kodin rakentumista ja rakentamista. Se tuotti iloa, onnea ja myös vastuuta sekä huolta. Vaimon raskaus, synnytys ja uusi lapsi merkitsivät kasvamista isänä ja kehittymistä miehenä. Perheenlisäys merkitsi sopeutumista uuteen muuttuneeseen tilanteeseen. Isien kokemuksiin perheenlisäyksestä vaikuttivat lapsuuden kokemukset, isäksi kasvaminen, kasvatus ja isänä toimiminen. Miehen ja vaimon välinen parisuhde oli perusta kodin ilmapiirille. Odottavan perheen kohtaaminen ja hoito koettiin äitisuuntautuneeksi ja arvokkaaksi mutta isät ohittavaksi.

Maternal deaths in Ethiopia are mainly due to complications of pregnancy and delivery. The socio-cultural contexts under which these pregnancies and deliveries occur that pave the way for these complications and mortality. In Ethiopia, the maternal mortality ratio had been 353/100,000 live births in 2015. Therefore, the purposes of this study were to examine, and describe the socio-cultural determinants and missed opportunities of maternal health care in Eastern Ethiopia. The study was conducted in selected districts of Grawa, Chelenko and Haramaya Woreda, East Hararghe, Oromia National Regional State, Ethiopia. A community-based survey involving pregnant women in their third trimester and women who gave birth in the last five years, husbands, mothers-in-law, sisters-in-law, health workers, religious and community leaders were conducted between September up to December 2017. A systematic sampling technique was used to get a total of 422 study participants for quantitative and 24 FGD participants to qualitative study were adopted using triangulation of data collection. Pre-tested and structured questionnaire was used to collect relevant data. The main instrument used for quantitative data collection was the structured questionnaire, specifically in-depth interview methods. Bivariate and Multivariate data analysis were performed using SPSS version 25.0 and focus group discussion (FGD) was used to collect qualitative information and the information was analysed using thematic analysis method based on Atlas.ti version 8.2 statistical software packages. The study revealed that among 359 (85%) pregnant women who planned for ANC visit, 16 (4.5%) received ANC four or more times during their last pregnancies, the respondents (81.3%) claimed that they were taken care of by skilled delivery attendant during delivery, 18.5% of them said that they delivered at home and 71.1% of them received medical care after delivery (missed opportunity). Women in the age group 15-24 years [AOR: 1.18, 95%CI: 1.18 (0.37, 3.74)], primary school [AOR: 4.09, 95%CI: 4.09(0.96, 15.50)], women intended their last pregnancy [AOR: 3.1, 95% CI: 0.32(0.11, 0.94)], and women living in urban residences [AOR: 1.2, 95%CI: 0.86(0.25, 2.95)] were significant predictors of unplanned home delivery. For optimal and effective interventions of maternal health services utilization, provisions should be made for better women‘s education, family planning, community-based health insurance, health facilities access, job opportunity and women empowerment; provisions should also be made for creating income generating activities to women. Strengthening village women‘s army wing, refreshing and enabling health extension workers and traditional birth attendants. What is more, optimal measures should be taken to discourage traditional practices such as female genital mutilation, polygamy, violence against women and teenage marriage. Finally, free maternal and child health services should be advocated for so that the gap in maternal healthcare services is bridged. / Health Studies / D. Litt. et Phil. (Health Studies)

Thesis(M. A. (Nursing)) -- University of Limpopo, 2021 / BACKGROUND The quality Kangaroo Mother Care (KMC) continues to be sub-standard as it is not managed properly, despite the maternal and neonatal services provided by the midwives during postpartum and neonatal period, as this can lead to increased neonatal mortality rate and maternal depression at selected hospitals of Limpopo Province, therefore the researcher is interested in developing strategies to enhance quality KMC at selected hospitals of Limpopo Province. KMC has been found to have physiological, behavioural, psychosocial and cognitive developmental benefits, and it enhances motherinfant bonding. The aim of the study was to develop strategies to enhance quality Kangaroo Mother Care in selected hospitals of Limpopo Province. RESEARCH METHOD A quantitative descriptive cross-sectional research method was used to collect numerical data with regard to the factors that hinders the quality Kangaroo Mother Care in selected hospitals of Limpopo Province. Population size was 77, Simple Random Probability Sampling was used in this study with the sample size of 65 midwives. Data were collected using self-administered questionnaires and analysed using Statistical Package for Social Sciences (SPSS) version 24. Quantitative analysis is the numerical representation and manipulation of observations for the purpose of describing and explaining the phenomenon reflected on observations (Babbie & Roberts, 2018). RESULTS The study revealed that the factors that hinders quality of Kangaroo Mother Care are lack of education and training to midwives regarding Kangaroo Mother Care, and other sources suggested that all categories of nurses should also be trained. The midwives are knowledgeable with regard to KMC, however, the problem remains the work overload when they have to monitor both the mother and neonate during feeding. It was further indicated that family members can also assist with regard to KMC. Strategies were developed, as optimal KMC environment, optimal KMC interventions, enhance optimal mother attitude to KMC crate gender sensitive environment. CONCLUSION The study concluded that the quality of KMC should be enhanced through both the promotion of education and training to all midwives, and involvement of families to assist in KMC at selected hospitals of Limpopo Province