Fatherhood as Taking the Child to Oneself: A Phenomenological Observation Study after Caesarean Birth

This paper describes the meaning of a father’s presence with a full-term healthy child delivered by caesarean section, as observed during the routine post-operative separation of mother and child. Videotaped observations recorded at a maternity clinic located in the metropolitan area of Stockholm, Sweden formed the basis for the study, in which fifteen fathers with their infants participated within two hours of elective caesarean delivery in the 37th - 40th week of pregnancy. A phenomenological analysis based on Giorgi’s method was conducted on the data. The description of the new father’s experiences that emerged pointed to a process of being and becoming in taking the child to himself. Fatherhood developed gradually as a result of recurrent experiences of the child’s expressions. There was an ebb and flow between taking on the role of being a father and physical withdrawal from the role. The findings of this study not only confirm previous accounts of new fathers’ experiences, but go further in revealing an ebb and flow variation in the fathers’ involvement. What this indicates is that the process of transition to fatherhood requires not only presence but time. The period required for this process thus must not be disturbed, but supported, trusting in the father’s ability to assume his role as a father. It is suggested that, in addition to their relevance in guiding the attitudes and expectations of those professionally involved in postnatal care and community health, these findings could be useful in antenatal courses for parents, and especially in instances when caesarean birth is planned, to highlight the meaning of the role of fathers as caregivers. Indo-Pacific Journal of Phenomenology, Volume 6, Edition 2 August 200

Building a new generation of midwifery faculty members in Bangladesh

This paper presents an initiative to build a new generation of midwifery faculty in Bangladesh, with the ultimate objective of providing insight into how to build capacity in the midwifery faculty to best utilize the existing academic, health care and policy environment. The initiative focuses on a promising approach that starts with a new generation of midwifery faculty who can lead a chain of change when separating midwifery teaching from nursing. The initiative identified four different interdependent components of equal importance, namely the initiation of master’s and bachelor’s degrees, development of accreditation guidelines and tools, and a mentorship programme. Building a new generation of midwifery faculty has the potential, despite challenges, to enhance retention, foster greater commitment for the institutions, increase research and contribute to the attainment of national goals

The Historical Development of the Midwifery Profession in Bangladesh

Sexual and reproductive health and rights have been identified as the core areas of practice, theory and research for the midwifery profession. The midwifery profession, as defined by the International Confederation of Midwives Global Standards, is new in Bangladesh. This paper aims to give an overview of the historical process that has taken place in the past decades to develop the midwifery profession in Bangladesh. The professional development of midwives is the result of many years of collaboration and relationship building among stakeholders such as the government, non-government organizations, academia, professional associations, United Nations agencies, and donors. All are working toward achieving the common goal of preventing/ reducing maternal and child mortality through education, the development of supportive laws, policies and guidelines, and the deployment of midwives. Lessons learnt from the Bangladesh experience can provide useful guidance for other countries in Asia that are currently establishing midwifery as a profession that aims to provide safe and high quality sexual, reproductive, maternal and newborn care

Knowledge and Perceptions regarding Sexual and Reproductive Health among high school students in Kathmandu, Nepal

Background: Nepal recently began teaching sexual education in the school system and has established youth friendly services in order to meet the need of increased sexual and reproductive knowledge among the youth. Objective: To examine the sexual and reproductive knowledge and perceptions among young people attending schools in Kathmandu. Method: A written questionnaire was distributed to 160 students, in a classroom environment, in four schools in Kathmandu. Results: Two thirds of the females and nearly 60% of the males knew that it was possible to get sexually transmitted infection (STI) during one sexual encounter and more than half of the students knew when in the menstrual cycle conception was more likely to occur . One third of the participants did not know that it was possible to become pregnant after having intercourse once. The males demonstrated less knowledge than the females regarding every aspect of sex and reproduction, with the exception of pregnancy prevention. Conclusion and clinical implications: For the youths in this study, it was more important to prevent unwanted pregnancies than to protect oneself from STIs. Establishment of a hotline on the internet, where personalized and confidential counselling can be offered may complement the comprehensive sexual education in schools

To Achieve Safe and Respectful Maternity Care in Tertiary Level Hospitals in Nepal, Relatives are a Valued Addition to the Provision of Maternity Care

Introduction The White Ribbon Alliance for safe motherhood believes respectful maternity care is the universal right of every childbearing woman. Methods NHRC in 2012 approved an inquiry of respectful care at facility-based childbirth. Individual-, focus group interviews and content analysis was used for gathering and analysis of data. Findings The participating women and the SBAs shared similar views, and this was that together the SBAs and relatives ensured the women remained within the comfort and safety zone when giving birth in a tertiary level maternity unit. Conclusion The SBAs strategy of having relatives provides basic care alongside the provision of medical care by the SBAs is a strategy that Nepal could use to improve the quality of its maternity care without any additional costs. Clinical implication Prenatal classes might contribute to preparing relatives. Further Research Further research could evaluate such a strategy in order to determine its effectiveness in reduction of morbidity and mortality

A Commentary: Bangladesh to take over the training of midwifery educators

While Bangladesh has made gains in maternal health provisions, there are still gaps and unmet need for services. Bangladesh has trained over 7 000 midwives, and many more midwifery educators are needed to serve the country’s population of 140 million with midwifery services. In April 2016 the first nursing faculty teaching midwifery students at nursing institutes across Bangladesh were enrolled in a blended online and onsite master’s programme with the Dalarna University, Sweden. The programme content focused the subject sexual, reproductive and perinatal health and was the first of its kind in Asia. The graduating faculty members were expected to be in a position to deliver higher quality education to the midwifery students (1, 2). To date, the team of teachers from Dalarna University has trained 150 midwifery educators (3). The current proposal from the University is that an equivalent to the Swedish Master\u27s programme should be established in Bangladesh. While Bangladesh has made gains in education of midwives, there are still gaps and unmet need for educators with skills and knowledge in the subject of midwifery. During a period of transition, open seminars will be held at Dalarna University for all alumni who want to attend, with the hope on the part of the team of Dalarna university teachers being that they provide inspiration for high-quality midwifery education in Bangladesh

Perceptions of the role of the man in family planning, during pregnancy and childbirth: A qualitative study with fifteen Nepali men

Introduction: In Nepal, by tradition, family life and marriage are generally controlled by patriarchal norms, sanctions, values and gender differences. Women in Nepal have limited possibilities to make decisions regarding their sexual and reproductive health, as the husbands and other elders in the family make most of the decisions regarding family planning, pregnancy and childbirth. Aim: To describe the perceptions of Nepali men regarding the role of the man with respect to family planning, pregnancy and childbirth. Methods: A qualitative study was conducted with 15 Nepali men in both urban and rural areas. The material was analyzed through inductive content analysis. Findings: One main category and two generic categories were identified. One generic category contained six subcategories and the other five subcategories. The main category was labeled: “He leads – She follows” and the generic categories were labeled: “Supporting women in family planning, during pregnancy and childbirth” and “Withdrawal from supporting women in family planning, during pregnancy and childbirth”. Conclusion: The role of the Nepali men with respect to family planning, pregnancy and childbirth, was identified as a conflicted approach. This study highlights the importance of understanding the influence of culture and tradition when developing strategies for promoting sexual and reproductive health during family planning, pregnancy and childbirth among families in Nepal

Addressing violence against women within the midwifery curriculum in Bangladesh: A focus group discussion inquiry

Background: Violence against women is a significant problem affecting public health and human rights worldwide. The midwife profession is identified as a key profession in identifying violence against women and to provide first line support. In Bangladesh, there is a national plan aiming for a society free from violence against women and children by 2025. Midwifery is relatively new to Bangladesh and it is central to investigate how the topic is addressed within midwifery education. Objective: To examine how violence against women is addressed in midwifery education in Bangladesh and identify potential needs for improvement, from the perspective of midwifery educators and clinical midwives. Methods: Five focus group discussions were conducted with 29 midwifery educators and clinical midwives from different parts of the country, with a topic guide based on the WHO clinical and policy guidelines for response to intimate partner violence and sexual violence against women. The data were analysed by qualitative content analysis. 15 Results: The need to linking theory and practice was highlighted. A broad base of theoretical knowledge and possibilities for clinical practice will enable future midwives to identify, communicate and support women subjected to violence, and to link with available services. An improved curriculum, aligned to the needs of the women among whom future midwives will work is essential, as are knowledgeable midwifery educators, in relation to the topic and to varied pedagogics. Conclusions: Educators need to be innovative when finding ways for midwifery students to link theory about violence against women to practice. To highlight the unique contribution midwifery can make to the field, networking with local and community authorities is central. If space was provided for midwifery educators to improve the content related to violence against women in the midwifery curriculum the confidence of both midwifery educators and future midwives would be strengthened