Valerie E M Fleming | Search PubMed

PubMed2005

Women's needs from antenatal care in three European countries.

OBJECTIVE: To determine the important aspects of antenatal care from a woman's perspective in order to develop a woman-constructed conceptual model of antenatal care. DESIGN: Grounded theory. SETTING: Three European countries: Scotland, Switzerland and The Netherlands. PARTICIPANTS: 23 women using routine antenatal care in the three countries were interviewed: seven women in Scotland, seven in Switzerland and nine in The Netherlands. MEASUREMENTS AND FINDINGS: Three main categories emerged: 'responsibility', 'establishing a sharing trust relationship' and 'support me to be responsible'. The category of 'responsibility', which incorporated the sub-categories 'feeling confident' and 'feeling autonomous', is reported. Despite the many aspects that the women had in common, a divergence of the categories in each of the countries was clearly observed. The main cross-cultural differences were within the sub-category of 'feeling autonomous'. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Responsibility is the main reason why women seek antenatal care. Feelings of confidence and autonomy are substantial attributes of this responsibility. The cultural background of the women seems to cause the differences within the categories. These findings have implications for both the provision and the evaluation of antenatal care.

Adult↗

PubMed2003

Does perineal suturing make a difference? The SUNS trial.

OBJECTIVE: To examine differences in outcome between primiparous women who do and who do not have suturing to first or second degree perineal lacerations sustained during spontaneous vaginal births after 37 weeks of gestation. DESIGN: Parallel group randomised controlled trial. SETTING: Bellshill Maternity Hospital, Lanarkshire, and St John's Hospital, Livingston. POPULATION: Primigravidae with perineal lacerations following spontaneous birth. METHODS: One thousand and three hundred fourteen women were recruited to the trial antenatally from whom 74 were randomised either to be sutured or not sutured immediately after giving birth. Randomisation was stratified by degree of tear. MAIN OUTCOME MEASURES: Using standardised measures, perineal pain and healing were measured at 1 and 10 days and 6 weeks postpartum. In addition, postnatal depression was assessed at 10 days and 6 weeks postpartum. RESULTS: Findings indicated that there were no significant differences between the groups with regard to pain or depression but there were differences with regard to healing. At six weeks, there remained a significant difference in wound closure between the groups, with women who had not been sutured having poorer wound approximation. CONCLUSIONS: While acknowledging the small sample size, the results are nonetheless important, showing persistent evidence of poorer wound approximation in those women who had not been sutured. Practitioners need to review the present practices of not suturing perineal lacerations until research examining the longer term implications is undertaken.

Depression, Postpartum↗