Clients’ psychosocial communication and midwives’ verbal and nonverbal communication during prenatal counseling for anomaly screening

Objectives: This study focuses on facilitation of clients’ psychosocial communication during prenatal counseling for fetal anomaly screening. We assessed how psychosocial communication by clients is related to midwives’ psychosocial and affective communication, client-directed gaze and counseling duration. Methods: During 184 videotaped prenatal counseling consultations with 20 Dutch midwives, verbal psychosocial and affective behavior was measured by the Roter Interaction Analysis System (RIAS). We rated the duration of client-directed gaze. We performed multilevel analyses to assess the relation between clients’ psychosocial communication and midwives’ psychosocial and affective communication, client-directed gaze and counseling duration. Results: Clients’ psychosocial communication was higher if midwives’ asked more psychosocial questions and showed more affective behavior (b = 0.90; CI: 0.45–1.35; p < 0.00 and b = 1.32; CI: 0.18–2.47; p = 0.025, respectively). Clients “psychosocial communication was not related to midwives” clientdirected gaze. Additionally, psychosocial communication by clients was directly, positively related to the counseling duration (b = 0.59; CI: 0.20–099; p = 0.004). Conclusions: In contrast with our expectations, midwives’ client-directed gaze was not related with psychosocial communication of clients. Practice implications: In addition to asking psychosocial questions, our study shows that midwives’ affective behavior and counseling duration is likely to encourage client’s psychosocial communication, known to be especially important for facilitating decision-making

Specific antenatal interventions for Black, Asian and Minority Ethnic (BAME) pregnant women at high risk of poor birth outcomes in the United Kingdom: a scoping review

Background: Disparity exists in maternal and infant birth outcomes of Black and Minority Ethnic (BAME) women giving birth in the United Kingdom (UK) compared to the majority. There is therefore a need to reconsider existing maternity service provision to ensure culturally competent services. The purpose of this scoping review was to ascertain what specific maternity interventions have been implemented in the UK for BAME women (2004–2014) so that increased awareness of the need and scope of specific maternity interventions for BAME women can be identified. Methods: A scoping review was conducted in order to determine the evidence base. It was determined that no prior systematic reviews had been conducted and it was apparent that literature in this field was sparse. Scoping review is an ideal method when literature is likely to be heterogeneous and the research field relatively unexplored. A keyword strategy was used implementing population (P), intervention (I), comparison (C) and outcomes (O). Results: An initial 2188 papers were identified. Following screening and review, only 5 heterogeneous papers remained suitable and were included. The included interventions employed sample sizes of N = 160-1441, examined a range of different outcome measures and were delivered across different parts of the UK with high numbers of BAME residents. Conclusions: There is a lack of rigorous research interventions and practice interventions which are currently documented, of specific maternity interventions which are aimed to address culturally competent maternity services and the sharing of best practice addressing the increased risks of BAME women delivering in the UK

Non-western women in maternity care in the Netherlands: Exploring 'inadequate' use of prenatal care and the experiences of care professionals

Non-western women in the Netherlands are more likely to make inadequate use of prenatal care than native Dutch women. Furthermore, non-western women are diverse in origin which implies diversity in their needs and expectations for maternity care. This thesis examines the factors and reasons explaining non-western women’s inadequate prenatal care utilisation, and the experiences of midwives and maternity care assistants with non-western women. The findings revealed that first and second-generation non-western women’s inadequate prenatal care utilisation could largely be explained by sociocultural factors. For first-generation non-western women socioeconomic, demographic and pregnancy factors also explained a large part of their inadequate prenatal care utilisation. The findings also revealed that midwives and maternity care assistants have adopted among others proactive, flexible and creative approaches to address issues encountered in the provision of care to non-western women

Factors affecting the use of prenatal and postnatal care by women of non-western immigrant origin in industrialized western countries.

Background: In many industrialized western countries immigrants constitute a substantial part of the population, which is also seen in the prenatal and postnatal care client population. Research in several industrialized western countries has shown that women of non-western immigrant origin make inadequate use of prenatal and postnatal care. They do not enter timely and/or do not attend all appointments. Several quantitative and qualitative studies in western industrialized countries have investigated factors affecting the use of prenatal and postnatal care by women of non-western immigrant origin. The quantitative studies focused among others on socioeconomic and cultural factors, and the qualitative studies focused among others on experiences and expectations. By taking both quantitative and qualitative studies into account, this systematic review aims to provide a more in depth understanding of the factors affecting the use of prenatal and postnatal care by women of non-western immigrant origin in industrialized countries. Methods: A systematic review of literature published between 1995 and August 2010 was performed in 11 databases and resulted in 6295 titles. A three stage screening process consisting of title, abstract and full text screening was conducted. Each selected abstract and article was screened independently by two reviewers. Data were synthesized by use of narrative and tabular methods. Results: Preliminary results show that cultural factors such as language, accessibility to services such as making appointments and health beliefs such as considering pregnancy not needing special attention, affected the use of prenatal and postnatal care by women of non-western immigrant origin in industrialized western countries. Conclusion: These preliminary results indicate that different specific types of factors need to be taken into account when developing measures to reduce inadequate use of prenatal and postnatal care by women of non-western immigrant origin in industrialized pwestern countries. (aut. ref.