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Oliver, Jacob B. "Birthing Attila." Thesis, Aberystwyth University, 2015. http://hdl.handle.net/2160/3a37bc8b-6a4a-470d-ba90-452dfb823617.
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I have termed Birthing Attila a creative-critical project since it is not only a collection of poems, or a critical compendium of methodologies and theories, but an alignment of the two in a mutually illuminating process. My creative work informs my critical, and, reflexively, my critical informs my creative. The Birthing Attila project engages with orthodox narratives of history and ideology, critiquing them, working against linear expectation, and identifying and dramatizing margins of society that are often subordinated or neglected in such discourses. By engaging with New Historicist theory as a creative impetus (see Chapter Three) and exploring other theoretical debates chiefly within feminism and post-colonialism, my poetry is drawn into line with a critical praxis. This critical-creative contact locates Birthing Attila at the confluence of recent work on the 'interfrictions' between theorized inquiry and creative practice. The poems themselves seek to encourage today's readers to look internally and at the world around them, all viewed through a 'time-slipped universe' that adopts three 'worlds' inextricably intertwined - the fall of Rome, the 1980s, and contemporary society. Through the use of a time-slipped space in the creative pieces, fault lines, fractures, and permutations of perception across and embedded within history are explored within poems as well as between them. Birthing Attila fuses time together where clean distinctions between periods and events, and the ability to identify a clear chronology beyond the characters' narrative arcs, are, as with the separation of critical and creative practice in the construction of the project, rendered impossible. Chapter One (Reflections and Influences) explores the range of literary influences on the project and the genesis of the idea of a time-slipped space as a means of critique, focusing principally on the four most central literary figures to the poems' generation: Bret Easton Ellis, Tiffany Atkinson, Charles Bukowski, and Wallace Stevens. Chapter Two (Negotiating Borders and Boundaries) introduces cultural cartography and the ways in which the delineation of borders, boundaries, and 'the other' shape notions of identity, and how, consequently, these often artificial distinctions may be misappropriated for use in nationalist and imperialist dogma in the dominant discourse, particularly as it pertains to the West. Chapter Three (New Historicism and Creative-Critical Practice) seeks to firmly situate the Birthing Attila project along a creative-critical axis and expounds on the reflexive exercise of creative-critical writing. This chapter also explains the decision to employ Marjorie Levinson's New Historicism as a creative springboard, as opposed to viewing New Historicism through a purely critical lens. Chapter Four (Gender and Space) expands on the mapping of the body politic, engages with post-colonial and feminist theory, and investigates notions of time, space, and linearity. Perhaps most crucially, this chapter also explains the role of women in the collection and the choice to consciously exclude them from the poems as a means of critique.
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Geffinger, Lesley. "Process in progress : birthing a character." Thesis, The University of Iowa, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=1592554.
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The following paper is a summary of my personal process as an actor. My process, as any process is in a constant state of flux. I discuss my current approach to a role from the callback portion of an audition to performance.
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Burns, Ethel. "Intrapartum birthing pool use in the UK." Thesis, Oxford Brookes University, 2014. https://radar.brookes.ac.uk/radar/items/5d0136b3-f1fa-4956-9e11-3d39261a279a/1/.
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Over past centuries, childbirth has become increasingly medicalised, with a shift to hospital births and an overuse of interventions for women at low risk of childbirth complication. In response, there has been a move towards normalising birth which has grown in strength over recent years. In this thesis, I describe a programme of research which aimed to examine whether intrapartum birthing pool use could make an important contribution to normalising childbirth for low risk women. Maternity stakeholders differ in their views of intrapartum birthing pool use, with some emphasising its potential to reduce interventions and increase spontaneous birth and others raising concerns that birthing pool use, particularly waterbirth, predisposes women and their newborn to an increased risk of adverse events and outcomes The focus of my programme of research was therefore on examining the efficacy and safety of intrapartum birthing pool use, and its potential contribution to normalising childbirth for healthy women. In the first stage of my research programme, I analysed prospectively collected data for 8,924 nulliparous and multiparous women who used a birthing pool during labour in their planned place of birth. In the second stage ̧ I explored the possibility of comparing intrapartum interventions and outcomes for women who used a birthing pool and women who could have, but chose not to use a birthing pool in one obstetric unit. Having found the unit was not representative of other obstetric units, in the third stage I used a bespoke dataset comprising routinely collected maternity data collated by Hospital Episode Statistics (HES) as a comparator for the birthing pool data. This research found that, for the birthing pool sample, adverse maternal and newborn outcomes were rare, and there were no differences in interventions and outcomes between care settings for multiparae or newborn. Comparisons with HES data showed significantly more birthing pool women had a spontaneous birth. This allays concerns over safety and supports the conclusion that intrapartum birthing pool use can make an important contribution to normalising birth.
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Bowers, Toni L. "Maternal and perinatal outcomes in alternative birthing methods." Honors in the Major Thesis, University of Central Florida, 2001. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/265.
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This item is only available in print in the UCF Libraries. If this is your Honors Thesis, you can help us make it available online for use by researchers around the world by following the instructions on the distribution consent form at http://library.ucf.edu/Systems/DigitalInitiatives/DigitalCollections/InternetDistributionConsentAgreementForm.pdf You may also contact the project coordinator, Kerri Bottorff, at kerri.bottorff@ucf.edu for more information.Bachelors
Health and Public Affairs
Nursing
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Ervita, Sumardjono Iljas Baker M. Phil. "Birthing experiences of internally displaced mothers in Aceh /." Abstract, 2006. http://mulinet3.li.mahidol.ac.th/thesis/2549/cd388/4737920.pdf.
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Miller, Janneli. "Birthing practices of the Raramuri of Northern Mexico." Diss., The University of Arizona, 2003. http://hdl.handle.net/10150/289917.
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This dissertation provides an ethnographic account of birthing practices among Raramuri women in Northern Mexico. The Raramuri practice of kin assisted birth is consonant with core cultural norms and social practices. Raramuri curers diagnose and treat illness, but they typically do not assist at birth, which is a deemed a normal part of the life course. Health is maintained by adhering to community norms of thinking well and acting well, through such behavioral ideals as non violence, generosity, reciprocity, and modesty. Pregnant women minimize risk at birth by conforming to these ideals. The Raramuri, an indigenous population of northern Mexico, number about 100,000. They live in remote canyon regions of the Western Sierra Madre, engaging in subsistence horticulture and pastoralism. In recent years, increasing numbers of Raramuri are migrating to urban areas, due to the effects of logging, drought, and drug growing, all of which contribute to loss of arable land. As a result, Raramuri are entering urban areas in unprecedented numbers. This dissertation draws upon reproductive histories, birth narratives, and participant observation in two sites: Chihuahua city and a remote rancho. The Mexican government provides health services to Raramuri in both localities, and Raramuri women have their most sustained and frequent interaction with mestizos when they seek health care. Reproductive health interactions are fraught with miscommunication, which Raramuri experience as a loss of autonomy and control, leading to their reluctance to utilize services. High infant and maternal mortality rates among the Raramuri are typically blamed on non utilization of existing services. I provide an in depth and nuanced analysis, which addresses poverty and malnutrition, mistrust of state health and family planning agendas, and forms of institutional racism. I argue that the structural violence the Raramuri experience is glossed over by reports which deflect responsibility and blame the victim. Raramuri birthing practices are an expression of women's sense of agency, a form of resistance to a state apparatus they do not trust, and an important site of social reproduction where key values are transmitted and reaffirmed within families, extended kin groups, and Raramuri society as a whole.
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Kildea, Sue. "Birthing business in the bush : it's time to listen /." Electronic version, 2005. http://adt.lib.uts.edu.au/public/adt-NTSM20051006.180714/index.html.
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Edwards, Nadine Pilley. "Women's experiences of planning home births in Scotland : birthing autonomy." Thesis, University of Sheffield, 2001. http://etheses.whiterose.ac.uk/12829/.
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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.
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Callaghan, Helen M. "Birth dirt: relations of power in childbirth." University of Technology, Sydney. Faculty of Nursing, Midwifery and Health, 2002. http://hdl.handle.net/2100/400.
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This thesis presents the findings of a doctoral study which analysed video tapes of labouring Australian women at the end of the 20th century, historical data from midwifery and medical textbooks, consumer material, and personal experience as a midwifery student in 1970- 1971. The data analysis was achieved using discourse analysis, but was influenced by Michel Foucault together with anthropological and sociological approaches, particularly as these can be applied to visual material. ‘Dirt’ is a commonly accepted term, but it becomes difficult to define as it is so dependant on the context. Since the discovery of the germ theory in the 19th century, however, it is difficult for western health professionals to conceive of dirt as being anything but unaesthetic, unhygienic and pathogenic. When analysing the data from this study, it became evident that birth and dirt have a close association. The changes that have occurred in childbirth have revolved around who and what is perceived as clean, and who and what is perceived as dirty. This thesis argues that ‘birth dirt’ exists, but, its form will vary depending on the time, the place, and the culture, although it is always centred around the physical reality of birth. Video tapes of the birthing process indicate that midwives, in their ritualised behaviours of containing, controlling and cleaning up the ‘dirt’ associated with birth, create a barrier between themselves and the women. ‘Dirt’ in this instance is the ‘contaminating’ body fluids and substances derived from the woman and her baby. The dirt relationship is a power relationship and the midwife is an essential part of its structure. The midwife is the dirty worker who maintains the cleanliness of the environment and controls the ‘dirt’ during birth. There is considerable rhetoric about midwives as being ‘with woman’, but the reality is that the midwives are more often ‘with dirt’.
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Fannin, Maria. "Midwifery as mediation : birthing subjects and the politics of self-determination /." Thesis, Connect to this title online; UW restricted, 2006. http://hdl.handle.net/1773/5619.
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Creedy, Debra Kay, and D. Creedy@mailbox gu edu au. "Birthing and the development of trauma symptoms: Incidence and contributing factors." Griffith University. School of Applied Psychology, 1999. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20030102.101015.
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Background: Little is known about the relationship between women's birthing experiences and the development of trauma symptoms. This study aimed to determine the incidence of acute trauma symptoms and posttraumatic stress disorder (PTSD) in women as a result of their labor and delivery experiences, and identify factors that contributed to the women's psychological distress. Method: Using a prospective, longitudinal design, women in their last trimester of pregnancy were recruited from four public hospital antenatal clinics. Four to six weeks postpartum, telephone interviews were conducted with participants (n = 499) and explored the medical and midwifery management of the birth, perceptions of intrapartum care, and the presence of trauma symptoms. Results: One in three women (33%) identified a traumatic birthing event and reported the presence of at least three trauma symptoms. Twenty-eight women (5.6%) met DSM-IV criteria for acute posttraumatic stress disorder. Antenatal variables were not found to contribute to the development of acute or chronic trauma symptoms. The level of obstetric intervention experienced during childbirth (beta = .351, p <.0001) and the perception of inadequate intrapartum care (beta = .319, p <.0001) during labor were consistently associated with the development of acute trauma symptoms. Conclusions: Posttraumatic stress disorder following childbirth is an under-recognized phenomenon. Women who experienced both a high level of obstetric intervention and were dissatisfied with their intrapartum care were more likely to develop trauma symptoms than women who received a high level of obstetric intervention or women who perceived their care to be inadequate. Such findings should prompt a serious review of intrusive obstetric intervention during labor and delivery, and the psychological care provided to birthing women.
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Beechey, Desley. "Eureka! Women and birthing on the Ballarat goldfields in the 1850s." Thesis, Australian Catholic University, 2003. https://acuresearchbank.acu.edu.au/download/c6d1aee19568b440dda2bda267dc14a0d8f67e9d66d5d51268ec4822289f479f/1799994/Beechy_2003_Eureka_women_and_birthing_on_the.pdf.
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The Ballarat goldfields were a raucous, noisy, exhilarating place that was a tent home for thousands of men, women and children in the 1850s. The Ballarat goldrush and the Eureka Rebellion are among the most significant events in the history of Australia. They set the scene for this study titled Eureka! Women and birthing on the Ballarat goldfields in the 1850s. This qualitative study utilised and historical research method informed by a feminist perspective.
This account reveals the story of women’s lives and their birthing at this time as found in historical documents. These documents revealed that the women birthed in their tents with a female friend, relative or lay midwife present. Trained midwives were rare and doctors were too expensive for the majority of poor diggers with no guarantee they were genuine. While most women birthed safely the appalling conditions, infection and birth complications all contributed to high rates of maternal and neonatal mortality and morbidity.
This study has implications for both women and midwives. Hearing voices through this story of their lives and birthing will expand the understanding of issues specific to women. The sharing of the story of birthing in the 1850s will raise awareness of the connections between midwifery history and the twenty-first century giving midwives an appreciation of the past along with different perspectives and greater understanding of women and birthing so their midwifery practice in the future will be enhanced.
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FitzHarris, Heidi Sue Blycker. "Celebrating the Natural Cycle of Life: A Birthing and Hospice Center." Thesis, Virginia Tech, 2006. http://hdl.handle.net/10919/35758.
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When the special moments of life and death are imminent, where do you want to be?
My thesis seeks to create an eco-sensitive, sustainable building that celebrates the time and place of two of life s most amazing events: birth and death. Rather than a conventional singular center, my thesis proposes a combined program for a new architectural project type: a Birthing and Hospice Center. Although the concept may be surprising, once people fully understand that we live in a closed system and embrace the cyclical nature of life, it is an appropriate program that represents another aspect of sustainability. The project site is located in an urban area of Old Town Alexandria, Virginia along the Potomac River.
The Birthing and Hospice Center integrates both the human life cycle and the material life cycle of the building s materials, water, and site for a holistic experience and celebration. It explores how to heighten our environmental experience of place, light, air, water, and time. My thesis seeks to create a beautiful place where people can celebrate their own special event, while at the same time, understand and celebrate the larger realm of the natural life cycle.Master of Architecture
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Bruggeman, Seth C. "Birthing Washington: Objects, memory, and the creation of a national monument." W&M ScholarWorks, 2006. https://scholarworks.wm.edu/etd/1539623499.
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The National Park Service's (NPS) George Washington Birthplace National Monument has commemorated Washington and his life for over seventy-five years. For much of that time, the NPS worked closely with the memorial's progenitors, the 'ladies' of the Wakefield National Memorial Association (WNMA). Although equally committed to the preservation of Washington's legacy, these two groups clashed over questions of authenticity, historical authority, and proper commemorative strategy. This dissertation explores their relationship for what it reveals about the rise of public history in this country and Federal involvement therein.;We witness at Washington's birthplace a collision between old-order Colonial Revivalists (led for a time by renowned preservationist Louise DuPont Crowninshield) and a new generation of male museum professionals under NPS Director Horace Albright. The WNMA erected a 'replica' Memorial House atop a site marked in 1815 by George Washington Parke Custis. The NPS determined the Memorial House was neither properly located nor an authentic replica. Still, the WNMA defended the building's veracity. "Birthing Washington" argues that the two groups defined authenticity differently and that those definitions reflected not only gendered difference and political motivation, but also new ways of constituting historical knowledge available during the first half of the twentieth century.;What began as a confused argument about authenticity manifested publicly in decisions made about what kind of objects to display at Washington's birthplace and how to display them. The WNMA preferred charming interiors to the NPS's stark historical realism. Both methods created considerable interpretive possibilities and limitations. Buoyed by national trends, historical realism prevailed at Washington's birthplace. But 'living history' only created new interpretive dilemmas by failing to grapple with old questions about authenticity perpetuated by the Memorial House's ongoing presence. I conclude that sites of public memory cannot help but reify the historical currents of their formative moments and, for that reason, the NPS must challenge itself to interpret the history of commemoration at sites like Washington's birthplace.
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Smith, Genevieve Elizabeth. "Birthing Again with a History of Postpartum Depression: A Case Study." Thesis, The University of Arizona, 2014. http://hdl.handle.net/10150/321960.
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Phillips, Maureen Patricia. "Birthing a third gender : the discourse of women in the American military /." Thesis, Connect to this title online; UW restricted, 2006. http://hdl.handle.net/1773/9514.
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Bharj, Kuldip Kaur. "Pakistani Muslim women birthing in Northern England : exploration of experiences and context." Thesis, Sheffield Hallam University, 2007. http://shura.shu.ac.uk/20627/.
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This study examines Pakistani Muslim women's experiences of labour and maternity services against a backdrop of the National Health Service and the history of Black people in Britain. It sets out to develop an understanding of how Pakistani women see their relationships with midwives and to address the paucity of available research about their intrapartum experiences. The study also aims to contribute to the development of responsive and sensitive midwifery care, and midwifery knowledge and theory. An interpretive ethnographic approach was adopted to obtain narratives from twenty-seven participants: thirteen primigravidae Pakistani Muslim women, nine interpreters and five midwives. The primary method of data collection was conversational qualitative interviews, although a small number of participant observations of women's labours were conducted. Content analysis was utilised for data analysis. The findings of this study reveal that many Pakistani Muslim women generally reported a positive experience of their encounters with maternity services. They valued western obstetric and midwifery services, believing that the midwives and doctors know best; they were grateful for the care they received. The study revealed that adequate and timely information, constructive relationships with the midwives, and support during labour were some of the key factors that shaped women's experiences of labour. Whilst some women expressed satisfaction in these areas, others voiced concern about the variable levels of availability of information, and consequently women laboured without, knowledge of the available methods of pain relief and processes of care during labour. The findings show that Pakistani women value emotional support in labour. A minority of these women were supported by their husbands or female relatives, and some received support from midwives. However for many, when support from midwives was not forthcoming, 'Allah' was the only available source of support. Other key factors highlighted were communication and linguistic barriers, and the role of perceived stereotypes and discrimination, which shaped the context in which women birthed as well as underpinning women's experience of maternity services. The study highlighted that whilst women's ability to speak English played a role in developing relationships with midwives, a lot depended on the attitudes and behaviours of the midwives, and the way they responded to the women. Resources such as interpreters, which may have assisted in overcoming some of the communication barriers, were found to be lacking. The study showed that midwives were the orchestrators of women's labouring experiences, manifesting 'power' in terms of influencing or controlling women, birthing events, processes and resources. Many women appeared to be passive recipients of care; they did not exercise choice and control over the care they received, and the majority did not perceive that they were able to work in partnership with the midwives. These findings are discussed in the context of the way in which service delivery is organised. In addition, the findings are very timely in view of the NHS Plan and the NSF's commitment to women having informed choice and individualised care.
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McIntyre, Mary Cortney. "Birthing centers as ritual spaces : the embodiment of compliance and resistance under one roof : a case study /." Connect to title online (Scholars' Bank), 2008. http://hdl.handle.net/1794/8691.
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Huang, Fei. "A method for evaluating the design of websites for birthing hospitals in Shanghai." [Ames, Iowa : Iowa State University], 2009. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:1468094.
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James-Chetelat, Lois (Lois June) Carleton University Dissertation Sociology. "Reclaiming the birthing experience: an analysis of midwifery in Canada from 1788 to 1987." Ottawa, 1989.
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Latham, Leah M. "Birthing Positions: Is There a Connection Between Acutal Nursing Experience and Evidence-Based Research?" Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/honors/228.
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The objectives of this study were to determine whether there was an association between clinical nursing knowledge of four birthing positions and current evidence-based research of those same positions and also to identify possible areas where nursing knowledge of those birthing positions was inadequate. This pilot study used convenience sampling to survey registered nurses (RNs) and licensed practical nurses (LPNs) on labor and delivery units. The survey was distributed to three hospitals in the southeastern United States, and twenty-four RNs and LPNs participated. Participants’ knowledge did not reflect current clinical evidence in two key areas, (1) the best position to minimize blood loss and (2) the best position to decrease the likelihood anal sphincter tears. Respectively, only 13% and 27.3% of participants selected the correct position. Continuing education for maternity nurses regarding current evidence-based practice concerning various birthing positions remains a need, and incorporating this could include more frequent opportunities for education classes and unit inservices. Results from this study should not be generalized, and more research is needed in this area to validate these findings.
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Lin, Wennifer. "Birth art and the art of birthing creation and procreation on the 'Äina of Tütü Pele /." Diss., Restricted to subscribing institutions, 2008. http://proquest.umi.com/pqdweb?did=1675789081&sid=1&Fmt=2&clientId=1564&RQT=309&VName=PQD.
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Fandrich, David John. "The birthing process select anthems of Samuel Sebastian Wesley and the nineteenth-century English musical renaissance /." 24-page ProQuest preview, 2008. http://proquest.umi.com/pqdweb?did=1507552661&sid=1&Fmt=2&clientId=10355&RQT=309&VName=PQD.
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Martinez, Julia. "Reproducing Injustice: The Unusual Case for Latinx Birthing Parent Mortality and Its Sociological Factors: Literature Review." Scholarship @ Claremont, 2019. https://scholarship.claremont.edu/scripps_theses/1340.
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For birthing parents, the quality of care falls flat in the United States relative to other developed countries as rates of pregnancy-related deaths (PRD) continue to rise. California has in recent years made extraordinary progress in decreasing birthing parent mortality across the board. Yet, health disparities remain between race/ethnicities as Black birthing parents die at three to four times the rate of white birthing parents. In comparison to white Americans marginalized ethnic/racial groups in the United States have less access to quality care, experience and receive lower quality of health care and have less access to quality care, with few exceptions. Intersecting factors such as education, socioeconomic status and acculturation are investigated. Implicit bias, or racism is often overlooked within the medical professions that has real implications on the above-mentioned sociological factors and in turn birthing mortality rates. Institutional and grassroot methods to bring attention to these factors should be referenced for a more intentional approach to solving this social problem historically engrained in our medical institutions.
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Wanske, Barbara Wonneken. "Giving Birth and/to the New Science of Obstetrics: Fin-De-Siecle German Women Writers' Perceptions of the Birthing Experience." The Ohio State University, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=osu1437424709.
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Boyer, Michelle Nicole. "Indigenous Representations of Birthing and Mothering in The Painted Drum, Faces in the Moon, The Way We Make Sense, The Marriage of Saints, and Once Were Warriors." Thesis, The University of Arizona, 2015. http://hdl.handle.net/10150/577488.
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This study examines the traditional views surrounding Indigenous birthing and mothering, as well as the mother-child relationship cycle in contemporary Indigenous literature, and compares the traditional past to the contemporary present. Five contemporary Indigenous novels from four different American Indian and Indigenous Nations are included: Louise Erdrich's The Painted Drum (Ojibwe), Betty Louise Bell's Faces in the Moon (Cherokee), Dawn Karima Pettigrew's The Way We Make Sense and The Marriage of Saints (Creek), and Alan Duff's Once Were Warriors (Maori). Themes in the novels are studied individually and collectively, through the frameworks for literary analysis that Arnold Krupat terms nationalism, indigenism, and cosmopolitanism. Each novel will be analyzed first using Arnold Krupat's theory of literary nationalism, which suggests that in order to fully comprehend an Indigenous text, it must be explored using only a culturally-specific framework that focuses specifically on the Nation depicted within the novel. However, on a broader scope Krupat's literary theory of indigenism will addressed throughout this study, examining ways in which similar parallels within each selected text and Nation overlap to create common areas of study. Lastly, aspects of the mother-child relationship will be assessed using Krupat's theory of literary cosmopolitanism, which suggests that even though there are very unique aspects of Indigenous literature that must be viewed from a tribally-specific vantage point, there are also cosmopolitan, or common, elements within the human experience that link all individuals together like the act of birthing and mothering.
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Valentin, Dominique. "Reducing Maternal and Child Morbidity and Mortality Through Project Recommendations." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2588.
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Haiti is a Caribbean island with a humanitarian medical center providing healthcare services to 90,000 residents. Pregnant women visiting the medical clinic for prenatal care often do not return for delivery; instead, they return home to deliver alone or with the assistance of a traditional matron. Home-birth practices increase maternal-child health morbidity and mortality in an already fragile country. The purpose of this project was to gain a deeper understanding of Haitian pregnant women's preferences to deliver at home or at the healthcare clinic. The transtheoretical model for behavior change and the Johns Hopkins nursing evidence-based practice model guided the project. Two focus groups of 10 pregnant women total were recruited in the community of Delmas 32, Haiti. Group 1 was comprised of 5 women who delivered at home with matrons and Group 2 was comprised of 5 women who delivered at the clinic. Structured questions were asked to identify themes related to delivery location preferences. Focus group transcripts were analyzed guided by the Krueger and Casey strategy model. The thematic analysis was aligned with the peer-reviewed literature. Findings revealed that lack of access to care, lack of education and sensitization, and the attitude of healthcare personnel impacted women's preference for delivery at the clinic. Findings also supported a need to educate staff and the community in the best options for maternal-child care. A workshop was developed, based on the project findings, to share the recommendations with the clinic staff. The clinical leadership have indicated that they will implement the project recommendations. This project has the potential to support social change by reducing maternal-child deaths in Delmas 32 and across the Caribbean.
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Harman, Josephine. "What are antenatal anxieties & how can containing them affect the birthing outcome in terms of complications?" Thesis, University of Essex, 2014. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.635913.
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AIMS: The aims of this research are to explore the effects of brief antenatal psychotherapy on the reduction of the number interventions and complications of childbirth. Also, the exploration of the in-depth understanding of antenatal anxiety, the tracking of psychic change in pregnancy and finally, the identification of service dimensions to be improved, when working with women with antenatal anxiety.
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Dagustun, Johanne. "Learning to birth, mastering the social practice of birth : conceptualising birthing women as skilful and knowledgeable agents." Thesis, University of Leeds, 2017. http://etheses.whiterose.ac.uk/18031/.
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In this thesis, I draw inspiration from Bourdieu’s theory of practice to inform a conceptualisation of birthing women as skilful and knowledgeable agents. The study contributes to geographical knowledge about spaces of birth and about how these represent key sites of learning. Empirical data were collected in 2011/12 through in-depth semi-structured interviews with 26 women living in North-West England (involving 68 childbirth experiences). Two key themes emerged from the women’s narratives: the prevalence of trouble (and how this is accepted as ‘just the way things are’) and routine (and non-medically indicated) diversions from an undisturbed physiological birth process. This thesis argues that rather than representing a space in which women might learn to protect the physiological process of birth, successive experiences of birth seem to represent a space in which many women learn to shut down that possibility. Rather, they prioritise defensive action to protect themselves against emotional and physical harm, with some women learning that a physiological approach to birth is unnecessary, abnormal and dangerous. Whilst there is evidence that some women learn to birth physiologically over their childbearing careers by drawing on their experiential knowledge, the main finding is that being skilful and knowledgeable as a birthing woman frequently works in the opposite direction. The study thus offers new understandings of birthing women as skilful and knowledgeable agents and explores the diversity of women’s learning about birth by drawing a distinction between how women come to master the social practice of birth and how they learn to birth physiologically over their childbearing careers. For the wider academy, this study brings a renewed emphasis on the key role of childbearing women in the social practice of birth.
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Russell, Kim. "Changing the culture on labour ward to increase midwives promotion of birthing pools : an action research study." Thesis, University of Nottingham, 2016. http://eprints.nottingham.ac.uk/35457/.
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Waterbirth practice has the potential to support a midwifery model of care and yet little is known about how the organisation of care can be changed to improve the use of birthing pools. This action research study focused on a group of midwives working on a labour ward in an English obstetric led maternity unit with 3,800 births and 25 recorded waterbirths per year. Interviews and focus groups with labour ward midwives and managers were employed to identify barriers to birthing pool use and inform the change process. Three problem-solving workshops with labour ward coordinators were organised with the aim of influencing other midwives’ use of birthing pools. Data from a newly developed waterbirth questionnaire and maternity records were used to evaluate change in levels of personal knowledge, waterbirth self-efficacy and social support. Foucauldian discourse analysis and One-Way ANOVA with Tukey post hoc tests were used to analyse qualitative and quantitative data. Fourteen midwives took part in focus groups and seventeen in interviews over four research phases. Interventions, developed by workshop attendees, included improvements to the recording and dissemination of waterbirth and water immersion data, target setting and the appointment of a waterbirth champion. By the end of the study the numbers of waterbirth practitioners, recorded waterbirths and social support increased significantly. Discourse analysis revealed the presence of dominant biomedical and subjugated ‘being with woman’ midwifery discourses. The study is the first to describe midwives’ attitudes to waterbirth practice and attempt to improve the use of hospital birthing pools. The findings illustrate that, by co-opting rather than replacing dominant discourses, it is possible to support the delivery of a midwifery model of care in a medicalised environment. As such this study offers a pragmatic approach to organisational change.
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McIntyre, Mary Cortney 1982. "Birthing Centers as Ritual Spaces: The Embodiment of Compliance and Resistance Under One Roof: A Case Study." Thesis, University of Oregon, 2008. http://hdl.handle.net/1794/8691.
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x, 156 p. A print copy of this thesis is available through the UO Libraries. Search the library catalog for the location and call number.A somewhat unknown option for pregnant women receiving prenatal, birth, and postpartum care is that of a birthing center, where midwifery and medical practices come together in varying forms. After conducting feminist-based, participant-observation research at a particular birthing center in the northwestern United States run by a licensed, certified professional midwife, I use ritual and rites of passage analysis to display both the benefits and downfalls of the mainstreaming of midwifery as found in a birthing center. I discuss how the birthing center is a ritual space. Within this ritual space, elaborated rituals act as both compliance with and resistance to established iv medical paradigms of birthing. These rituals serve as active negotiated appropriation and display the ways in which midwives knowledgeably balance trust in natural birth and medical practice, which both play important roles in pregnancy and birth.
Adviser: Lisa Gilman
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Dawson-Black, Patricia A. (Patricia Ann). "Childbirth and Locus of Control: The Role of Perceived Control in the Choice and Utilization of Birthing Alternatives." Thesis, North Texas State University, 1985. https://digital.library.unt.edu/ark:/67531/metadc331471/.
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The purpose of this study was to determine whether the wives' perceptions of personal control over the process of childbirth were related to couples' choices and utilization of three birthing alternatives (home birth, unmedicated hospital birth, and medicated hospital birth). The wives' perceived control over the childbirth process was expected to vary inversely with the level of medical intervention in the birthing alternative chosen. The home birth mothers were expected to perceive themselves as having more control over childbirth than were the unmedicated hospital group mothers, and the unmedicated hospital group mothers more than the medicated hospital group mothers. The husbands' perception of their wives' perceived control in childbirth and their participation was also measured.
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Preller, Cindy. "When birthing makes the news : the depiction of women as a newsworthy item in Die Burger (Oos-Kaap)." Thesis, Rhodes University, 2010. http://hdl.handle.net/10962/d1002935.
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The thesis “When birthing makes the news: the depiction of women as a newsworthy item in Die Burger (Oos-Kaap)” analyses a common, yet complex news topic in the South African print media due to the sensitive, often sensationalised, nature of the topic. The private experience of birthing is featured more and more in the public domain of newspapers because of widespread service delivery problems within the South African health department. Focussing on the Eastern Cape, I examine the representation of birthing in Die Burger (Oos-Kaap) in texts printed between 2005 and 2007, and scrutinise the media’s monitorial role of a self-appointed public hero acting on behalf of the women, to expose the poor conditions at government hospitals, specifically in the Nelson Mandela Bay region. How the women and their bodies are reported on, creates a discursive tension between the negative portrayals of the birthing women and the monitorial role of the media. The news values of sensationalism and profit are achieved with visceral representations of the reproductive functions of the birthing women. A poststructuralist feminist theoretical framework reveals discourses that perpetuate race, class and gender inequalities in the apparently socially-concerned sample of texts. A Critical discourse analysis (CDA) provides an approach and method to inform a close textual analysis of both the lexical and visual elements of the texts. The discourses in the sample differed from text to text. Despite these differences, the monitorial role of the media is still achieved. My research argues that acting in the public interest with sensationalist copy is still acting in the public interest. I conclude that it is not easy for newspapers to separate sensationalism from accountability. Media practitioners should be aware of their role in constructing women’s identities and be particularly thoughtful when reporting on birthing. In doing so, this research aims to improve the manner in which women and their bodies are reported on within the news industry.
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Simmonds, Donna. "Ngaanyatjarra tjukurrpa minyma piriku = Ngaanyatjarra stories for all the ladies : Antenatal and birthing issues for the women of Warburton /." [St. Lucia, Qld.], 2002. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe16735.pdf.
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Gottvall, Karin. "Birth centre care : reproduction and infant health /." Stockholm, 2004. http://diss.kib.ki.se/2004/91-7349-825-4/.
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Ross-Leitenberger, Kimberly A. "Aboriginal midwifery and traditional birthing systems revisited and revitalized, interviews with First Nations elders in the Northwest region of British Columbia." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp03/MQ62495.pdf.
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Saravanan, Sheela. "Training of traditional birth attendants : an examination of the influence of biomedical frameworks of knowledge on local birthing practices in India." Thesis, Queensland University of Technology, 2008. https://eprints.qut.edu.au/19234/1/Sheela_Saravanan_Thesis.pdf.
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Pregnancy and childbirth complications are a leading cause of death and disability among women of reproductive age in developing countries. Worldwide data shows that, by choice or out of necessity, 60 percent of births in the developing world occur outside a health institution and 47 percent are assisted by Traditional Birth Attendants (TBAs), family members, or without any assistance at all. This thesis argues that TBAs in India have the capacity to disseminate knowledge of beneficial maternal practices to the community. Since the 1970s the training of TBAs has been one of the primary single interventions encouraged by World Health Organisation (WHO) to address maternal mortality. However, since the 1990s international funding for TBAs has been reduced and the emphasis has shifted to providing skilled birth attendants for all births due to evidence that the maternal mortality rate (MMR) in developing countries had not reduced. Researchers have observed that the shift in policy has taken place without adequate evidence of training (in)effectiveness and without an alternative policy in place. This thesis argues further that two main types of birthing knowledge co-exist in India; western biomedicine and traditional knowledge. Feminist, anthropological, and midwifery theorists contend that when two knowledge paradigms exist, western knowledge tends to dominate and claim authority over local ways of knowing. The thesis used such theories, and quantitative and qualitative methods, to assess whether the local TBA training programmes in Ahmednagar District in India have been successful in disseminating biomedical knowledge in relation to the birthing practices of local TBAs and in incorporating local knowledge into the training. The data revealed that some biomedical knowledge had been successfully disseminated and that some traditional practices continue to be practiced in the community. There is a top-down, one-sided imposition of biomedical knowledge on TBAs in the training programme but, at the local level, TBAs and mothers sometimes follow the training instructions and sometime do not, preferring to adapt to the local perceptions and preferences of their community. The thesis reveals the significance of TBA training in the district but queries the effectiveness of not including local TBA practices into the training programmes, arguing this demonstrates the hierarchical authority of biomedicine over local traditional practices. The thesis highlights the significance of community awareness that accompanies TBA training and makes recommendations in order to enhance training outcomes.
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Saravanan, Sheela. "Training of traditional birth attendants : an examination of the influence of biomedical frameworks of knowledge on local birthing practices in India." Queensland University of Technology, 2008. http://eprints.qut.edu.au/19234/.
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Pregnancy and childbirth complications are a leading cause of death and disability among women of reproductive age in developing countries. Worldwide data shows that, by choice or out of necessity, 60 percent of births in the developing world occur outside a health institution and 47 percent are assisted by Traditional Birth Attendants (TBAs), family members, or without any assistance at all. This thesis argues that TBAs in India have the capacity to disseminate knowledge of beneficial maternal practices to the community. Since the 1970s the training of TBAs has been one of the primary single interventions encouraged by World Health Organisation (WHO) to address maternal mortality. However, since the 1990s international funding for TBAs has been reduced and the emphasis has shifted to providing skilled birth attendants for all births due to evidence that the maternal mortality rate (MMR) in developing countries had not reduced. Researchers have observed that the shift in policy has taken place without adequate evidence of training (in)effectiveness and without an alternative policy in place. This thesis argues further that two main types of birthing knowledge co-exist in India; western biomedicine and traditional knowledge. Feminist, anthropological, and midwifery theorists contend that when two knowledge paradigms exist, western knowledge tends to dominate and claim authority over local ways of knowing. The thesis used such theories, and quantitative and qualitative methods, to assess whether the local TBA training programmes in Ahmednagar District in India have been successful in disseminating biomedical knowledge in relation to the birthing practices of local TBAs and in incorporating local knowledge into the training. The data revealed that some biomedical knowledge had been successfully disseminated and that some traditional practices continue to be practiced in the community. There is a top-down, one-sided imposition of biomedical knowledge on TBAs in the training programme but, at the local level, TBAs and mothers sometimes follow the training instructions and sometime do not, preferring to adapt to the local perceptions and preferences of their community. The thesis reveals the significance of TBA training in the district but queries the effectiveness of not including local TBA practices into the training programmes, arguing this demonstrates the hierarchical authority of biomedicine over local traditional practices. The thesis highlights the significance of community awareness that accompanies TBA training and makes recommendations in order to enhance training outcomes.
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Mistretta, Amy Caroline. "Examination of Tdap Vaccination Rates by Post-Partum Women in Georgia; Understanding How Birthing Hospitals Play a Role in the Prevention of Pertussis." Digital Archive @ GSU, 2009. http://digitalarchive.gsu.edu/iph_theses/105.
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Background: Pertussis, also known as whooping cough, is an infectious disease of the respiratory tract caused by the bacterium bordatella pertussis. In 2008, the Centers for Disease Control and Prevention (CDC) recommended that all post-partum women not previously vaccinated receive the Tdap (tetanus, diphtheria and acellular pertussis) vaccine in the immediate post-partum period in an effort to protect their newborns from this serious infection. In response, some birthing units in the state of Georgia have introduced programs to administer the Tdap vaccination to their post-partum patients. The purpose of this study is to examine the availability, design and effectiveness of these programs. Methodology: Surveys were sent to 72 birthing units in the state of Georgia. The survey was designed to illicit insight into each birthing unit’s policies and procedures regarding the administration and dissemination of the vaccine to post-partum women. In addition, the data collection instrument provided information on which centers offer the vaccination to their post-partum patients, how successful their program has been in reaching the target population and what barriers may need to be addressed to increase vaccination compliance to this particular population. Results: The results of this study suggest that Tdap programs in Georgia birthing centers can be successful in reaching the intended population and educating patients and hospital staff members on the importance of this vaccination. The majority of birthing centers in middle and southern Georgia do not have Tdap programs. In addition, barriers to Tdap vaccination programs have been identified such as lack of funding, lack of available education resources for both patient and hospital staff and absence of available staff members to administer vaccination. Conclusion: The examination of Tdap vaccination programs in Georgia birthing units can assist policy makers and public health agencies understand how to best allocate resources in an effort to increase vaccination compliance. Further research needs to be conducted to better understand how to improve program quality and availability state-wide and to correlate birthing center Tdap programs with increased vaccination compliance in postpartum women.
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Sprague, Annie G., and res cand@acu edu au. "An Investigation into the Use of Water Immersion upon the Outcomes and Experience of Giving Birth." Australian Catholic University. School of Nursing, 2004. http://dlibrary.acu.edu.au/digitaltheses/public/adt-acuvp56.29082005.
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The use of deep-water immersion during labour and birth is commonplace in many countries including Australia, yet there has been little contemporary Australian data from which to form policies regarding its use during childbirth, or which have included women’s experiences using water immersion. The literature reviewed for this study was positive with regard to the effect of water immersion during childbirth and was associated with decreased rates of perineal trauma, low episiotomy rates, low rates of analgesic use, lower operative deliveries coupled with increased maternal satisfaction of the experience of childbirth when compared with births where water immersion was not involved. The purpose of this research was to investigate the influence of deep-water immersion upon maternal and neonatal outcomes and women's experiences of giving birth in Australia. This study used a mixed method in an attempt to fulfil this purpose: the first phase was a Quasi-experimental design and the second phase was based upon a Hermeneutic Phenomenological approach. Data were collected via a Random Chart Audit, from a random sample of fifty nulliparous women who used deepwater immersion during labour and childbirth and six women were selected to participate in a semi-structured interview. Data from each phase of this study revealed positive birth outcomes and these findings were supported by the literature. The women's stories were positive and comprised elements of four lifeworld themes. • Water’s Embrace • Warped Time • Naked but Clothed • The Shape of Water. Each of these themes encapsulated different aspects of the women's experiences, which when considered together, increased the understanding of the phenomenon of deep-water immersion upon the experience of giving birth.
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Seloka, Kelebogile Cynthia. "Delayed cord clamping for the reduction of intraventricular haemorrhage in low birth weight infants : a systematic review." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/19984.
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Thesis (MCurr)--Stellenbosch University, 2012.ENGLISH ABSTRACT: Intraventricular haemorrhage is associated with neurological morbidity and mortality in low birth weight infants. In spite of improvements in treatment to reduce the incidence of the haemorrhage, the condition continues to remain a major cause of long term morbidity in low birth weight infants. The evidence from the literature has shown that low birth weight infants might benefit from delayed cord clamping particularly in reducing the risk of intraventricular haemorrhage and its neurological consequences. The primary objective of this review was to assess the effects of delayed versus early cord clamping on intraventricular haemorrhage amongst low birth weight infants. The secondary objectives were to evaluate the effects of delayed versus early cord clamping on the Apgar scores, hyperbilirubinaemia and polycythaemia in infants. The following electronic databases were searched: CINAHL, MEDLINE (searched via PubMed) and Cochrane Central Register of Controlled Trials (CENTRAL). Other information was gathered from the reference lists of retrieved articles and relevant experts. The selection criteria entailed all randomised controlled trials comparing delayed versus early cord clamping following birth in infants with low birth weight. Two reviewers independently extracted the data and assessed the quality of the trials. Disagreements on studies for inclusion were resolved by discussion with the third reviewer. The review included five randomised controlled trials with 215 participants. The risk of intraventricular haemorrhage was significantly reduced in the delayed compared with early cord clamping (RR0.52, 95% CI 0.33 to 0.82, P=0.005). No statistically significant difference was shown between delayed versus early cord clamping for the risk of hyperbilirubinaemia (RR O.48, 95% CI -0.43 to 1.39, P=0.30). There was no data available for other comparisons: Polycythaemia and Apgar scores. There is growing evidence that delayed cord clamping might benefit low birth weight infants. In the included studies, delayed cord clamping for at least 30 seconds appear to have a potential in reducing the risk of intraventricular haemorrhage. The results of this review should however be interpreted with caution due to a limited number of studies with the absence of clinically important secondary outcomes in the included trials. Further research is required on large scale randomised controlled trials.
AFRIKAANSE OPSOMMING: Intraventrikulêre bloeding word geassosieer met neurologiese morbiditeit en mortaliteit in suigelinge met ’n lae geboortegewig. Ten spyte van die verbetering in die behandeling om die gevalle van bloeding te verminder, duur die toestand voort as ’n belangrike oorsaak van langtermyn morbiditeit in lae gewig geboortes. Bewyse uit die literatuur toon dat suigelinge met ’n lae geboortegewig voordeel mag trek uit vertraagde afklemming, veral deur die vermindering van die risiko van intraventrikulêre bloeding en die neurologiese gevolge daarvan. Die primêre doelwit van hierdie navorsing was om die effek van vertraagde, versus vroeë afklemming op intraventrikulêre bloeding onder suigelinge met ’n lae geboortegewig te bepaal. Die sekondêre doelwit is om die effekte van vertraagde, versus vroeë afklemming op die Apgar uitslae, hiperbilirubinaemia en polisitaemia by suigelinge te evalueer. Die volgende elektroniese databasisse is nagegaan: CINAHL, MEDLINE (soektog via PubMed); Cochrane Central Register of Controlled Trials (CENTRAL). Ander inligting is verkry uit die bronnelyste van nagevorsde artikels en van relevante deskundiges. Die seleksie kriteria behels alle ewekansige beheerde toetsing, insluitende toekomstige studies wat vertraagde, versus vroeë afklemming vergelyk by suigelinge met ’n lae geboortegewig. Twee resensente het onafhanklik data geneem en die kwalititeit van die toetse bepaal. Verskille oor insluiting van navorsing, is met ’n derde resensent deur middel van bespreking opgelos. Die navorsing het vyf ewekansige beheerde steekproewe met 215 deelnemers ingesluit. Die risiko van intraventrikulêre bloeding is beduidend verminder in die vertraagde gevalle, in teenstelling met vroeë afklemming (RR0.52, 95% CI 0.33 tot 0.82, P=0.005). Geen statistiese beduidende verskil is bewys tussen vertraagde teenoor vroeë afklemming ten opsigte van hiperbilirubinaemia nie (RR 0.48, 95% CI – 0.43 tot 1.39, P=0.30). Daar was geen data beskikbaar vir ander vergelykings nie: Polisytaemia en Apgar uitslae. Daar is groeiende bewyse dat vertraagde afklemming lae geboortegewig suigelinge mag beïnvloed. Dit wil in die ingeslote studies voor kom dat vertraagde afklemming van ten minste 30 sekondes die potensiaal het om die risiko van intraventrikulêre bloeding te verminder. Die uitslae van hierdie beskouing sal nietemin met omsigtigheid geïnterpreteer moet word, weens die beperkte aantal studies met die afwesigheid van klinies belangrike sekondêre uitkomste in die ingeslote proewe. Verdere navorsing word benodig op grootskaalse ewekansige beheerde proewe.
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Reeser, Lindsay E. "The relationship between a woman's personal birth preference and her perceptions of new mothers with different birthing methods : a test of cognitive dissonance theory." Honors in the Major Thesis, University of Central Florida, 2008. http://digital.library.ucf.edu/cdm/ref/collection/ETH/id/1132.
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This item is only available in print in the UCF Libraries. If this is your Honors Thesis, you can help us make it available online for use by researchers around the world by following the instructions on the distribution consent form at http://library.ucf.edu/Systems/DigitalInitiatives/DigitalCollections/InternetDistributionConsentAgreementForm.pdf You may also contact the project coordinator, Kerri Bottorff, at kerri.bottorff@ucf.edu for more information.Bachelors
Sciences
Psychology
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Granello, Carmella A. "The use of the birthing bed versus the delivery table and the relationship to mother's blood loss, perineal trauma, and the infant's neurobehavioral response /." Staten Island, N.Y. : [s.n.], 1989. http://library.wagner.edu/theses/nursing/1989/thesis_nur_1989_grane_use.pdf.
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Desseauve, David. "Pour une meilleure compréhension du rôle des positions d'accouchement en mécanique obstétricale : analyse biomécanique des postures segmentaires." Thesis, Poitiers, 2018. http://www.theses.fr/2018POIT2253/document.
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Lorsque l'on s'intéresse aux positions d'accouchement, les avis sont très partagés. D'après la littérature, les positions dites verticales parmi lesquelles figure la position accroupie semblent aboutir à des issues materno-fœtales plus favorables que les positions horizontales qui comprennent la position gynécologique. Seulement, l'origine de ces bénéfices notamment du point de vue de la mécanique obstétricale reste incertaine. Il apparait que ce manque de clarté provient avant tout d'un manque de définition des postures segmentaires retrouvées lors de ces positions d'accouchement. L'objectif premier de ce travail était donc de définir les postures segmentaires au cours de différentes positions d'accouchement et de préciser en particulier le rôle de la posture des cuisses sur des éléments jugés importants en mécanique obstétricale à savoir l'orientation du plan du détroit supérieur et la courbure lombaire. En premier lieu, une enquête épidémiologique régionale a été effectuée afin d'attester les positions d'accouchement les plus fréquemment adoptées et d'identifier les facteurs associés à leur adoption. Par une méthode dérivée entre autres des méthodes d'analyse du mouvement par système optoélectronique, l'influence de la posture des cuisses (flexion et abduction) sur la posture du plan du détroit supérieur et du rachis lombaire a été analysée tout d'abord en position gynécologique puis en position accroupie. Enfin, l'importance de la posture initiale des cuisses sur les mouvements segmentaires a été évaluée au cours d'une manœuvre obstétricale (Mac Roberts), manœuvre couramment utilisée en cas de dystocie des épaules.Ce travail a permis de mettre en évidence l'importance de la caractérisation des postures segmentaires pour la compréhension des bénéfices d'une position d'accouchement sur une autreWhen looking at birthing positions, opinions are strongly divided. According to the literature, the so-called vertical positions, which include the squatting position, seem to lead to more favorable maternal-fetal outcomes than the horizontal positions which include the gynecological position. In fact, the origin of these benefits, particularly from the point of view of obstetric mechanics, remains uncertain. It appears that this lack of clarity comes primarily from a lack of definition of segmental postures found in these delivery positions.The primary objective of this work was therefore to define the segmental postures during different birthing positions and to specify in particular the role of the thigh posture on elements considered as important in obstetric mechanics namely, the orientation of the pelvic inlet and the lumbar curvature.Firstly, a regional epidemiological survey was carried out to document the most frequently adopted childbirth positions and to identify the factors associated with their adoption.Using a method derived inter alia from movement analysis methods based on optoelectronic system, the influence of thigh posture (flexion and abduction) on the posture of the pelvic inlet and the lumbar spine was analyzed firstly during gynecological position and then during squatting position. Finally, the importance of initial thigh posture on segmental movements was evaluated during an obstetric maneuver (Mac Roberts), a maneuver commonly used in cases of shoulder dystocia.This work has highlighted the importance of the characterization of segmental postures for understanding the benefits of one delivery position on another
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Lobo, Sheila Fagundes. "Caracterização da assistência ao parto e nascimento em um centro de parto normal do município de São Paulo." Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/7/7132/tde-22062009-110528/.
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A proposta de locais alternativos para assistência ao parto e nascimento, em nosso país, faz parte da abordagem deste evento como processos familiares e fisiológicos. Dentre esses locais destacam-se os Centros de Parto Normal, instituídos como uma política do Ministério da Saúde, desde 1999. Os objetivos deste estudo foram descrever as características sociodemográficas, as condições obstétricas na admissão, a prevalência das práticas obstétricas utilizadas no trabalho de parto e parto, as condições maternas e neonatais no parto e a prevalência das práticas utilizadas nos recém-nascidos, em um centro de parto peri-hospitalar do Município de São Paulo. Trata-se de um estudo transversal com coleta retrospectiva de dados, entre 2003 e 2006, com amostra probabilística de 991 prontuários. A coleta dos dados foi realizada no período de junho a outubro de 2007, pela pesquisadora e duas enfermeiras obstétricas. Os dados foram armazenados em um banco de dados com auxílio do programa Epi-info versão 2.000, sendo realizada análise descritiva. Este estudo foi aprovado pelo Comitê de Ética em Pesquisa do Hospital Geral do Itaim Paulista. Os resultados demonstram as seguintes características sociodemográficas: média de idade de 23,6 anos, com desvio-padrão de 5,6 anos e maioria de oito ou mais anos de estudo (76,6% das mulheres). Na admissão, 46,3% eram nulíparas e 77,8% estavam com membranas íntegras, 53,0%, com 5 a 9 cm de dilatação cervical e 4,3% foram internadas no período expulsivo. As práticas mais utilizadas no parto foram: banho de aspersão (71%), amniotomia (62,6%) e episiotomia (25,7%). Condições maternas no parto foram: períneo íntegro em 42,1%, laceração de primeiro grau em 22,4%; 92,2% tiveram acompanhante, sendo, mais frequentemente, o companheiro. O peso médio do neonato foi 3.221,4 gramas, com desvio-padrão de 392,9 gramas; 7,9% apresentaram mecônio no período expulsivo e 98,6% tiveram índice de Apgar 7 no primeiro minuto. Conclui-se que o modelo de assistência praticado no Centro de Parto Normal apresenta resultados maternos e perinatais esperados para mulheres com baixo risco obstétrico, sendo alternativa segura e um modelo menos intervencionista que pode auxiliar no resgate da fisiologia do parto e nascimentoThe proposed alternative places for the delivery and childbirth care, in Brazil, is a part of the approach of these events as family and physiological processes. Among these services there are the Normal Birth Centers, instituted as a policy of the Ministry of Health, since 1999. This study aimed to describe the sociodemographic characteristics, obstetric conditions at admission, the prevalence of obstetric practices used in labor and delivery, maternal and neonatal conditions in labor and prevalence of practices used in newborns, in an alongside Normal Birth Center in São Paulo. It is a cross-sectional study with retrospective data collection, between 2003 and 2006 with random sample of 991 records. Data collection was conducted during June-October 2007, by the researcher and two obstetric nurses. The data were stored in a database using Epi-Info 2000 version, with descriptive analysis. This study was approved by the Research Ethics Committee of the General Hospital of Itaim Paulista. The results show the following sociodemographic characteristics: average age of 23.6 years, with a standard deviation of 5.6 years and majority of eight or more years of study (76.6% women). On admission, 46.3% were nulliparous and 77.8% were with intact membranes, 53.0% with 5 to 9 cm of cervical dilation and 4.3% were hospitalized during expulsion period. The most widely practices used during the labor were: shower bath (71%), artificial rupture of the membranes (62.6%) and episiotomy (25.7%). Maternal conditions during delivery were 42.1% with intact perineum, first-degree lacerations in 22.4%, 92.2% had birthing partner, most often the stable companion. The average weight of newborns was 3221.4 grams, with standard deviation of 392.9 g, 7.9% had meconium during expulsion period and 98.6% had Apgar index of 7 in the first minute. The conclusion was that the model of care practiced at the Normal Birth Center presents maternal and perinatal outcomes expected for women with obstetric low risk, it is a safe alternative and a less interventionist model that can help in the ransom of the physiology of labor and birth
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Muthige, Noluthando. "Role of midwives in facilitating the choice of delivery mode for labouring women in public sector birthing units in the Nelson Mandela Bay Municipality and Sarah Baartman District." Thesis, Nelson Mandela Metropolitan University, 2017. http://hdl.handle.net/10948/19375.
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The World Health Organization (WHO) recommends that of all the live births per year no more than 10-15% of these should be delivered by caesarean section. Despite this recommendation there has been a global increase in the percentage of caesarean section deliveries over the past few decades. In South Africa the percentage is as high as 70% in certain health care institutions which is of concern to midwives. Caesarean section deliveries are needed when the life of the baby, mother or both are at stake. However, this method of delivery bears more disadvantages than advantages to the baby and mother. Despite these disadvantages, some women request a caesarean section in their birth plans while others are influenced by health professionals to request a caesarean section. Therefore, there is a need for labouring women to be guided where possible to have vaginal birth because of its many advantages. This study sought to explore and describe the perceptions of the midwives regarding their role in facilitating the choice of delivery mode for labouring women in public hospitals and midwifery obstetric units (MOUs) of the Nelson Mandela Bay and Sarah Baartman districts. Based on the results of the study, guidelines for midwives in this role were developed. Maputle’sWoman-Centred Childbirth Model (2010) was used as the theoretical lens through which this study was viewed. The researcher selected a quantitative survey design using an explorative, descriptive and contextual research approach. The population consisted of midwives who were working in labour wards at public hospitals and midwife-led MOUs. A non-probability convenience sample was used to collect data using a structured, self-administered questionnaire. The reliability and validity of the data collection instrument were ensured by using various means including a pre-test and an expert panel. Altogether, 300 questionnaires were distributed and 288 were returned. This number excluded the pilot study. Data was collected over a period of three months using the assistance of two fieldworkers. Data was captured and analysed under the supervision of the statistician and supervisors. Analysis was done by means of descriptive analyses that involved the production of frequencies and presented using charts, figures and tables. The major findings of the study are: -The midwives perceived themselves as the main facilitators of a suitable decision by the labouring woman for a safe delivery method - The midwives emphasised the importance of the delivery position preferred by the labouring woman -The midwives indicated that a collaboration between doctors, senior midwives, midwives and midwives in management positions could assist with a decision for a suitable delivery mode option. -The midwives agreed that the culture of the labouring woman should be considered when deciding on a delivery mode and therefore midwifery curriculum should include lessons about cultural diversity. Three principal guidelines were developed, namely: 1. Create an environment that promotes acceptance of a woman’s choice of a delivery mode. 2. Create an environment promoting a collaborative health care relationship 3. Create an environment that is sensitive to cultural needs in the maternity unit Ethical considerations in this study were upheld by maintaining the principles of beneficence, maleficence, autonomy and justice.
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Schneck, Camilla Alexsandra. "Estudo comparativo dos resultados maternos e perinatais em centro de parto normal peri-hospitalar e hospital - São Paulo (SP)." Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/7/7141/tde-11012010-122831/.
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O modelo de assistência ao parto em ambientes extra ou peri-hospitalares foi implantado no Brasil há dez anos. Conduzido por enfermeiras obstétricas e obstetrizes, constitui uma política do Ministério da Saúde direcionada a mulheres com gestação de baixo risco. Os estudos mostram que este modelo pode promover o parto fisiológico e reduzir o uso de intervenções desnecessárias, com bons resultados maternos e perinatais. O objetivo deste estudo foi comparar os resultados maternos e perinatais em mulheres de baixo risco atendidas em um centro de parto normal peri-hospitalar e hospital, considerando: 1. características sociodemográficas e obstétricas das mulheres; 2. utilização de intervenções durante o parto e nascimento entre mulheres e recém-nascidos; 3. condições maternas e perinatais no parto e no pós-parto. Trata-se de um estudo comparativo, observacional, analítico, de tipo transversal, sobre os resultados maternos e perinatais de mulheres de baixo risco, realizado no Centro de Parto Normal Casa de Maria (CPN-CM) e no Hospital Geral do Itaim Paulista (HGIP), na cidade de São Paulo. A população do estudo foi composta pelas 18.488 mulheres atendidas por estes serviços, entre 2003 e 2006. O cálculo do tamanho da amostra foi realizado com a intenção de se detectar uma diferença de, no mínimo, 10% na taxa de mulheres com episiotomia entre o HGIP (35%) e CPNCM (25%) com =0,05 e poder do teste de 90%. Foram incluídas na amostra 991 mulheres que tiveram o parto no CPN-CM e 325 que deram à luz no HGIP e que atendiam aos mesmos critérios estabelecidos para o parto no CPN-CM. As fontes de dados foram os registros dos prontuários das mulheres e seus respectivos recém-nascidos. A análise inferencial foi realizada pelos testes t-Student, Qui-quadrado e exato de Fisher, sendo considerados estatisticamente significantes os valores de p<0,05. Os dados indicaram que 45,4% eram nulíparas e 54,6% tinham um ou mais partos anteriores, sem diferença estatisticamente significante entre os locais de parto. Não houve caso de morte materna ou perinatal. Os resultados mostraram diferença estatisticamente significante entre as características sociodemográficas situação conjugal e realização de consulta de pré-natal e entre as condições na admissão dilatação cervical, estado das membranas e realização de monitorização eletrônica fetal. Quanto às intervenções obstétricas, as mulheres do hospital receberam mais restrição de dieta, amniotomia e ocitocina durante o primeiro período do parto e mais ergometrina e analgésico no pós-parto. Os resultados relacionados com os recém-nascidos mostraram diferenças estatisticamente significantes nas seguintes variáveis: Apgar no primeiro minuto, bossa serossanguínea; fratura de clavícula; desconforto respiratório; aspiração de vias aéreas superiores e gástrica; lavagem gástrica; administração de oxigênio nasal e com pressão positiva; entubação orotraqueal; internação em unidade neonatal. Os resultados maternos e neonatais da assistência no CPN são seguros em comparação com os do hospital. A assistência no CPN foi realizada com menos intervenções e com resultados maternos e neonatais semelhantes aos do hospital. Estes resultados podem subsidiar a ampliação deste modelo com a finalidade de melhorar os índices de morbidade materna e perinatal, além de promover o parto fisiológicoThe model of childbirth care in free-standing and alongside birth centres was implemented in Brazil ten years ago. Led by obstetric nurse-midwives and midwives, it is a policy of the Ministry of Health proposed to assist low-risk pregnant women. Studies show that this model promotes natural birth, reducing the use of unnecessary interventions, and that maternal and perinatal outcomes are favourable. The objective of this study was to compare maternal and perinatal outcomes among low-risk women attended to at an alongside birth centre versus a hospital maternity ward, considering: 1. the sociodemographic and obstetric characteristics of the women; 2. the use of interventions during labour and birth in women and in their newborns; 3. the maternal and perinatal conditions during labour and postpartum. This is a comparative, observational, analytical cross-sectional study of maternal and perinatal outcomes for low-risk women, which was conducted at the Casa de Maria alongside Birth Centre (CPN-CM) and at the Itaim Paulista General Hospital (HGIP), in the city of Sao Paulo. The study population was composed of 18,488 women who were assisted in these services during childbirth between 2003 and 2006. The sample size was calculated with the intent to detect at least a 10% difference in the rate of women with episiotomy among the HGIP (35%) and the CPN-CM (25%) with an =0.05 and test power=90%. The sampling included 991 women who had given birth at the CPN-CM, and 325 who had given birth at the HGIP and who met the same labour criteria as the CPN-CM. The data source was the collection of the womens and their respective newborns medical records. Students t-test, chi-square test and Fishers exact test were used for the inferential analysis, with the threshold p-value for statistical significance being p<0.05. The data showed that 45.4% were nulliparous and 54.6% had had one or more previous births, without any statistically significant difference between the birth places. There were no cases of maternal or perinatal death. In terms of the women, the sociodemographic outcomes that presented statistically significant differences were marital status and number of pre-natal medical appointments; while the outcomes related to conditions at the time of hospital entry statistically significant were: cervical dilation; status of ovular membrane; electronic foetal monitoring (EFM). In terms of obstetric interventions, women in the hospital received a more restricted diet, performance of amniotomy and administration of oxytocin during the first stage of labour; and administration of higher doses of ergometrine and pain relievers postpartum. In terms of the newborn, the outcomes that presented statistically significant differences were: Apgar score at the first minute; caput succedaneum; clavicle fracture; respiratory discomfort; airways and gastric aspiration; gastric lavage; administering supplemental oxygen through a nasal cannula with pressure transducer; orotracheal intubation; admittance to the neonatal care. Maternal and neonatal outcomes in CPN-CM demonstrate safety when compared to those of the hospital. Care provided in CPN-CM entailed fewer interventions and demonstrated similar maternal and neonatal outcomes to those in the hospital. These outcomes support expansion of this model in order to lower maternal and perinatal morbidity rates and to promote natural birth
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Coppen, Regina. "Collaborating 'with women' on their choice of birthing positions : a decision-making approach to apply focussed information as a strategy to enhance knowledge and reduce decision conflict in pregnancy and childbirth." Thesis, University of Surrey, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.395570.
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Davis, James O. "A model for a full-time evangelistic preaching ministry a step-by-step manual for birthing, building, and broadening a full-time evangelistic preaching ministry in local Assemblies of God churches /." Theological Research Exchange Network (TREN), 1997. http://www.tren.com.
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Faria, Denise Gonzalez Stellutti de. "“EMBRIÃO” de centro de parto normal fundamentado na experiência de formação de enfermeiros obstetras." Faculdade de Medicina de São José do Rio Preto, 2015. http://hdl.handle.net/tede/274.
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Introduction: The obstetric care model in Brazil has been the subject of much discussion and research. Attention has centered on the need to consider women’s autonomy during the delivery process and the inclusion of midwives and obstetric nurses in the conduct of low-risk labor and birth. In-hospital normal birth centers (IHNBC) constitute an appropriate model for the care of women in labor and for the incorporation of practices recommended by the World Health Organization (WHO). Objective: To present a proposal of implementation and development of an IHNBC. Methods: This study is divided into chapters and includes a comprehensive review of the literature on the following topics: the Brazilian obstetric care process and the identification of ways to decrease the extremely high rates of cesarean sections in the country; Obstetric Violence; Childbirth Humanization; training and performance of midwives and obstetric nurses; and Normal Birth Centers and Birth Houses. This review supported the creation and implementation of the proposed IHNBC. The hospital that served as a research field is located in the state of São Paulo and offers obstetric care to women who use the Unified Health System (SUS). It also serves as a traineeship field for undergraduate medical and nursing students, medical residents and obstetric nursing specialization students. Results: We present environmental, social and programmatic characteristics (protocols) of the proposed IHNBC, according to the recommendations of the WHO and Ministry of Health. Additionally, we discuss the strengths, difficulties, expectations and perspectives of the development process, in order to comply with the “Stork Network” prerogatives (rede Cegonha, in Portuguese). Conclusion: In the specific context of this research, we expect that the proposed IHNBC implemented in the analyzed obstetric unit continues to be valued by managers and receives greater medical involvement. Moreover, we hope that this proposal is effectively implemented in the assessment phase according to the standards of the Stork Network, with the effective participation of midwives and obstetric nurses, and that this resut in the humanization of obstetric care, the assignment of greater value and recognitition to obstetric nursing and increased normal delivery rates.
Introdução: O modelo de assistência obstétrica no Brasil tem sido tema de muitas discussões e pesquisas que considerem a autonomia da mulher no processo de parturição e a inserção de obstetrizes e enfermeiros obstetras na condução do trabalho de parto e parto de baixo risco. Os Centros de parto normal intra-hospitalares- CPNIH constituem modelo de assistência apropriada à parturiente e da incorporação das práticas recomendadas pela Organização Mundial da Saúde (OMS). Objetivo: apresentar a proposta de implantação e a trajetória de desenvolvimento de um CPNIH. Método: Faz-se ampla revisão da literatura, apresentada em Capítulos, sobre o processo de assistência obstétrica no Brasil que permita diminuir os índices extremos de cesarianas no país, sobre Violência Obstétrica, Humanização do Nascimento, formação e atuação de obstetrizes e enfermeiros obstetras e sobre Centros de Parto Normal e Casas de Parto, que subsidiaram a organização e implantação do CPN proposto. O hospital campo da pesquisa é localizado no interior do estado de São Paulo, atende em Obstetrícia mulheres usuárias do SUS e constitui-se em campo de estágio curricular de alunos de graduação em medicina e enfermagem e para residentes médicos e alunos de especialização em enfermagem obstétrica. Resultados: são apresentadas as características ambientais, sociais e programáticas (protocolos) do CPNIH proposto, segundo as recomendações da OMS e MS, as facilidades, dificuldades, expectativas e perspectivas no desenvolvimento, que possa culminar com atendimento às prerrogativas da rede Cegonha. Conclusão: No aspecto específico desta pesquisa, esperamos que o CPNIH proposto na unidade obstétrica estudada continue a ter a valorização dos gestores, maior participação médica, implantação efetivada na avaliação segundo as normas da Rede Cegonha, efetiva atuação de obstetrizes e enfermeiros obstetras, que se reflitam na humanização do atendimento obstétrico, na valorização da enfermagem obstétrica e aumento dos índices de partos normais.