This research investigated a new community-based model of continuity of care provided collaboratively by a small team of midwives and obstetricians (St George Outreach Maternity Project or STOMP). The study considered whether STOMP improved maternal and neonatal clinical outcomes, resulted in a better experience for women and could be implemented within the current resources of a public teaching hospital in Sydney, Australia. A randomised controlled trial using a Zelen design was used to compare the STOMP model with standard care. One thousand and eighty-nine women were randomly allocated to either the STOMP model or standard hospital-based care. The Zelen design was used to increase the participation of women from non-English speaking backgrounds and to reduce disappointment bias in women allocated to the control group. The results suggest that the model of community-based continuity of care is associated with a lower caesarean section rate, more positive experiences for women and costs less than standard care. There were no differences in the number of medical complications experienced in either group, but more women in the control group were admitted to hospital during the antenatal period. There were four perinatal deaths in each group. Women in the STOMP group reported a higher quality of antenatal care compared with the control group. Women in the STOMP group also reported that the community-based service was accessible and convenient with reduced waiting times for appointments. Women in the STOMP group were more likely to have received adequate information about labour, birth and the postnatal period and felt more 'in control' during labour compared with the control group. Women from both groups reported problems with postnatal care, particularly when provided in the hospital. The study also examined the impact of the STOMP model on women from Chinese and Arabic-speaking backgrounds. The STOMP model appeared to reduce the rate of elective and emergency caesarean section in Chinese-speaking women compared with English-speaking women. Small numbers precluded statistical analysis on these data so the results must be interpreted with caution. Women from Chinese-speaking backgrounds reported receiving insufficient information. The STOMP model improved the provision of information, however Chinese-speaking women still reported inferior experiences. There were also differences in the method of infant feeding. The results indicate that the model provides effective, cost efficient and satisfying maternity care. New models of maternity care can be implemented within current resources when organisations have a strong commitment to change.

Thesis (M.S.)--University of Nevada, Reno, 2006. / "December 2006." Includes bibliographical references (leaves 31-34). Online version available on the World Wide Web.

Thesis (Ph. D.)--University of Texas at Austin, 1998. / Vita. Includes bibliographical references (leaves 202-211). Available also in a digital version from Dissertation Abstracts.

Thesis (M.S.)--Brigham Young University. Dept. of Sociology, 2008. / Includes bibliographical references (p. 29-35).

Thesis (M.S.)--Boston University

No description available.

Purpose: The purpose of this study was to inform nursing practice and clinical interventions that support breastfeeding among mothers <24 years of age who resided in a maternity shelter. Methods: Nine young mothers aged 17 to 24, who had initiated breastfeeding, and resided at a maternity shelter, participated in individual semi-structured interviews. This qualitative study was conducted using interpretive description methodology and inductive content analysis. Findings: These young mothers took ownership of their choice to breastfeed and found empowerment in this choice and practice. The institutional and social environments that young mothers experienced were critical to their breastfeeding success. Hospital postpartum nurses had a critical role in the establishment of early breastfeeding by providing a combination of practical hands-on and emotional support to the multifaceted needs of these mothers. Ongoing, accessible, and non-judgemental peer, family, and community support were important to breastfeeding initiation and duration. Conclusion: A combination of emotional and practical supports from multifaceted trusted sources, including professional and peer supports on an ongoing basis are crucial to young at-risk mothers reaching their breastfeeding goals. Implications for clinical practice: Nurses need to focus dually on the practical aspects of breastfeeding while establishing strong therapeutic relationships with this population to successfully provide breastfeeding supports. A combination of accessible and trusted long term professional and peer supports is a key element to designing future breastfeeding support and promotion programs for this population.

Despite popular and professional concerns with childbirth and prenatal care there are few empirical studies of behavior in hospitals where these events typically occur. The problem set for the study reported here was to observe behavior in the maternity department of a hospital and to provide a theoretical description of what was observed in terms relevant to sociologists' interest in the social organization of work routines of professional staff members serving a lay client population. The thesis is thus a description of medical staff members' work routines, with an analytic interest in how that relates to features of work routines of service occupations in general. Specifically, the study reports upon the ways lay patients may differ from professional medical staff members in their perspectives on prenatal care and childbirth and how staff members see these divergences as often resulting in organizational problems when they try to provide care which is "complete, " efficient and expeditious. Further, the study describes how staff members develop interactional (and other) methods for managing patients, especially those who adhere to these nonmedical perspectives, so as to cope with such practical pressures as the need to schedule patients and their demands, provide a visibly competent performance for superiors, peers and patients, and prepare the patient for efficient and expeditious processing at subsequent organizational stages. It is asserted that these practical pressures (termed demand characteristics) are features commonly found in work routines of service occupations in general. Finally, it is argued that an ethnographic study of work routines of professional staff members of service institutions, e_. g., hospitals, may be necessary to explain adequately features of apparently natural or biological events, such as childbirth, that occur within them. / Arts, Faculty of / Anthropology, Department of / Graduate

Tsui Ka Chun, Jamie. / "Architecture Department, Chinese University of Hong Kong, Master of Architecture Programme 2010-2011, design report." / Includes bibliographical references (p. 88). / Chapter 00 --- Thesis Statement / Chapter 01 --- Inspirations / Chapter 02 --- Categorization of Infill Structure / Chapter 03 --- Study from 'Flexible Housing' / Chapter 04 --- Strategy - from Structure to Spatial Flexibility / Chapter 05 --- Program & Site Selection / Chapter 06 --- Development of Structural Strategy / Chapter 07 --- Design Exploration / Chapter 08 --- Design Outcome / Chapter 09 --- Special Study / Chapter 10 --- Essay & Conclusion / Chapter 11 --- Reference/Bibliography / Chapter 12 --- Appendix

Yes / Asylum-seeking and refugee (AS&R) women living in the UK often have complex health and social care needs, with poor underlying mental and physical health and an increased risk of negative pregnancy outcomes. Despite this, AS&R women are less likely to attend for timely maternity care and when they do, care may be poor, with staff not understanding their specific needs and displaying poor attitudes. This article discusses the Maternity Stream of the City of Sanctuary and how this charity aims to work with statutory and voluntary sector maternity-related services and groups to develop services that are inclusive for AS&R women and meet their specific needs. Volunteer AS&R women are central to the activities of the Maternity Stream and this article discusses how they engage with midwives and other maternity workers to facilitate the development of services that may ultimately improve pregnancy outcomes for AS&R women.