It's a breech!

Over the last decades, caesarean section has become the method of choice for breech presentation. This article is a reflection on my personal experience as a midwife and my thoughts in regard to questioning the justifications for performing routine caesarean for all breeches

Offering relaxation techniques, promoting women's choices.

This article is part of the "What about next time? A series of reflections" occasional series of articles. In this article, Mo Tabib reflects on her experience as a midwife introducing relaxation techniques to a woman with a prolonged latent phase of labour. The reflection explores the complexity of the woman's decision-making process, particularly when the element of continuity of carer is absent; and where limited choices have been offered. Considering this complexity, the midwife may face challenges and hesitations with regard to her position in the woman's decision-making process. This reflection uses aspects of MacDonald's reflective model (2014) to provide a framework to reflect, explore and learn from the experience

Service evaluation of relaxation workshops for pregnant women.

This article reports a service evaluation of 'antenatal education on physiology of childbirth and relaxation'. A service evaluation was carried out during group class discussion, immediately after the workshops, and following birth. Identified themes in the collected data were (a) my own relaxation, (b) confident, and not afraid, (c) proud of myself, (d) unexpected and feeling in control, and (e) support. Overall, women creatively customized the learned skills and reported feelings of pride and confidence. They reported feeling able to apply relaxation techniques when unexpected situations arise. Support and encouragement from partners and midwives were also valued by women. The evaluation demonstrates the efficacy of designing antenatal education that includes education on physiology of normal birth and relaxation training

The role of antenatal relaxation practices in enhancing maternal psychological wellbeing and childbirth experiences: an observational study

IntroductionThere is growing qualitative evidence that antenatal education on relaxation practices can enable women to deliberately induce a deep state of emotional calmness. Learning to shift focus from distressing emotions such as anxiety and fear to this altered state of calmness may significantly enhance women's confidence, thereby protecting maternal psychological wellbeing and leading to more positive childbirth experiences. However, the generalisability of these findings remains uncertain. This study aimed to bridge this gap by using quantitative methods to validate and extend the qualitative evidence.MethodsThrough an observational study with a prospective longitudinal cohort design, ninety-one women attending a single antenatal relaxation class at a Scottish NHS maternity service completed online surveys including Childbirth Self-Efficacy Inventory (CBSEI), Warwick Edinburgh Mental Well-Being Scale (WEMWBS), Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ), and Six-item State-Trait Anxiety Inventory (STAI-6) at pre-class, post-class and post-birth.ResultsFindings indicated significant improvements in childbirth self-efficacy expectancy, mental wellbeing, fear of childbirth, and both trait and state anxiety after attending the class, and these improvements remained stable until 4–8 weeks after birth. Women widely reported using relaxation practices, with the majority perceiving a positive influence on their pregnancy and childbirth experiences. The majority also viewed their overall childbirth experiences as positive.DiscussionConsequently, maternity services should consider reforming current antenatal education to align with these findings

From charter to culture: implementing an emotional intelligence programme.

In this oral presentation, the researchers spoke about a programme to provide emotional intelligence training to midwives. This programme was introduced in part to address issues identified in the 2022 Culture Matters survey. The presentation also covers a study undertaken to review the success of the programme

A Different Way of Being: The Influence of a Single Antenatal Relaxation Class on Maternal Psychological Wellbeing and Childbirth Experience An Exploratory Sequential Mix-Method Study

Background: Perinatal mental health problems are prevalent, have a wide range of adverse effects on the mother and her child, and are predictors of negative childbirth experiences. Therefore, improving perinatal mental health is a global public health priority and developing services that could promote it must be a priority for maternity services. There is growing evidence that antenatal education incorporating hypnosis or guided imagery techniques may have the potential to promote perinatal mental health and positive childbirth experiences. However, high-quality research in the field is lacking.Aim and objectives: This study aimed to explore the influence of a single 3- hour Antenatal Relaxation Class (ARC), incorporating theory on childbirth physiology, hypnosis and guided imagery, on maternal psychological wellbeing and childbirth experiences. The objectives of the study were to: a) identify the aspects of maternal psychological wellbeing and childbirth experiences that may be influenced by ARC, b) understand ‘why’ and ‘how’ any influence may occur, c) identify the factors that may mitigate the influence of ARC during labour and birth, and d) test the significance of any influence over time.Methods: The study took an exploratory sequential mixed-method approach. In the initial qualitative phase, a purposive sample of 17 women and 9 birth partners participated in either individual (8 women) or joint (9 women and their birth partners) semi-structured in-depth interviews. The data were analysed using descriptive qualitative and reflexive thematic analysis. The follow up quantitative phase was a prospective longitudinal cohort study that used surveys to further examine childbirth experiences and measure psychological wellbeing in a sample of 91 women at three time points: pre-class, post-class, and post-birth.Findings: Attending ARC was associated with increased childbirth self-efficacy, reduced fear of childbirth and state and trait anxiety, as well as improved mental wellbeing. These changes were significant and lasted over time, until after the birth. Attitudes towards childbirth changed after attendance at ARC, which motivated wide use of relaxation techniques as a self-care behaviour during pregnancy, labour, birth and beyond. Use of relaxation techniques was perceived to positively influence women’s childbirth experiences and choices including a decline in choice of epidural use for labour pain. The efficacy of the learned techniques in the management of labour pain, however, depended on the ‘birth space’ which encompassed the physical environment, interactions with birth attendants and the clinical picture of the experience.Conclusion: Incorporating theory on childbirth physiology, hypnosis and guided imagery in childbirth education can enhance perinatal psychological wellbeing and childbirth experiences. Providing relevant education for birth practitioners may contribute to a salutogenic model of childbirth care in which practitioners can facilitate childbirth education as well as a birth space that is conducive to experiencing an altered state of consciousness as a health promoting state

"Doing" is never enough, if "being" is neglected: exploring midwives' experiences of an emotional intelligence (EI) programme: a qualitative study. [Presentation]

The role of the midwife is emotionally demanding, with many midwives experiencing high levels of stress and burnout, and a great number considering leaving the profession. This has serious implications for the delivery of high-quality, safe maternity care. One of the major factors leading to job dissatisfaction is the conflict between midwives' aspiration of truly 'being' with the woman and the institutional expectations of the role, which focuses on the 'doing' aspects of the job. 'Being' present to a woman's psychological needs, whilst meeting the institutional demands, requires high levels of emotional intelligence (EI) in the midwife. Therefore, enhancing midwives' EI could be beneficial. An EI programme was made available to midwives with the intention to promote their emotional intelligence and enable them to utilise relaxation techniques for those in their care. The aim of this study was to explore midwives' perspectives on the influence of the EI education programme on their emotional wellbeing and experiences of practice. The study took a descriptive qualitative approach. Thirteen midwives participated in focus group interviews. The data were analysed using thematic analysis. The overarching theme of 'The Ripple Effect' included three themes of 'Me and my relationships', 'A different approach to practice', and 'Confidence and empowerment'. The programme was seen to create a positive ripple effect, influencing midwives personally, their approach to practice, and feelings of confidence in their role. Attendance at an EI education programme equipped the midwives in this study with stress management skills which enhanced their emotional wellbeing and experiences of practice

"Doing" is never enough, if "being" is neglected: exploring midwives' perspectives on the influence of an emotional intelligence education programme: a qualitative study. [Article]

The role of the midwife is emotionally demanding, with many midwives experiencing high levels of stress and burnout, and a great number considering leaving the profession. This has serious implications for the delivery of high-quality, safe maternity care. One of the major factors leading to job dissatisfaction is the conflict between midwives' aspiration of truly 'being' with the woman and the institutional expectations of the role, which focuses on the 'doing' aspects of the job. 'Being' present to a woman's psychological needs, whilst meeting the institutional demands, requires high levels of emotional intelligence (EI) in the midwife. Therefore, enhancing midwives' EI could be beneficial. An EI programme was made available to midwives with the intention to promote their emotional intelligence and enable them to utilise relaxation techniques for those in their care. The aim of this study was to explore midwives' perspectives on the influence of the EI education programme on their emotional wellbeing and experiences of practice. The study took a descriptive qualitative approach. Thirteen midwives participated in focus group interviews. The data were analysed using thematic analysis. The overarching theme of 'The Ripple Effect' included three themes of 'Me and my relationships', 'A different approach to practice', and 'Confidence and empowerment'. The programme was seen to create a positive ripple effect, influencing midwives personally, their approach to practice, and feelings of confidence in their role. Attendance at an EI education programme equipped the midwives in this study with stress management skills which enhanced their emotional wellbeing and experiences of practice

Exploring midwives' experiences of an emotional intelligence programme (EIP): a qualitative study.

This poster summarises the results of a study that sought to evaluate an emotional intelligence programme for midwives. This programme aimed to address reported challenges experienced by midwives in terms of a discrepancy between wanting to be emotionally and psychologically supportive of their patients, and task-focused institutional expectations for how the midwife should be spending their time

"Doing" is never enough if "being" is neglected: the influence of an emotional intelligence programme (EIP) on midwives' emotional wellbeing and experiences of practice: a pilot survey study.

This brief report summarises the methodology, findings and conclusion of a study that aimed to evaluate the impact of an emotional intelligence training programme for midwives. The programme aimed to address known issues with high stress and burnout in the midwifery profession