Medications and Breastfeeding

The aim of this chapter is to provide the reader with an understanding of the impact of the administration of medication to breast-feeding women and the key points related to this. The management and administration of medication is an essential skill for midwives. Equally, promoting breast feeding and supporting women’s infant feeding choices are essential skills for midwives. It is important that midwives and student midwives have knowledge around the use of medication during the lactating period in order to provide safe and effective care for breast-feeding women. This chapter will focus on the role of the midwife and student midwife in administration of medication to breast-feeding women and the key points related to this. As part of this process, it is necessary that midwives and student midwives understand the transfer of medication into breast milk and use the most up-to-date knowledge about medicines management and breast feeding. This is essential in order to provide accurate and evidence-based information to women, enabling them to make an informed choice (Nursing and Midwifery Council (NMC), 2018). This chapter will also explore some safe medication that can be used during the lactation period and common challenges arising while women breast feed and how these can be managed with and without the use of medicine

Construct and content validity of the Greek version of the Birth Satisfaction Scale (G-BSS)

Background: ‘Birth Satisfaction’ is a term that encompasses a woman’s evaluation of her birth experience. The term includes factors such as her appraisal of the quality of care she received, a personal assessment of how she coped, and her reconstructions of what happened on that particular day. Her accounts may be accurate or skewed, yet correspond with her reality of how events unfolded. Objective: To evaluate properties of an instrument designed to measure birth satisfaction in a Greek population of postnatal women. Study design: We assessed factor structure, internal consistency, divergent validity and known-groups discriminant validity of the 30-item Greek Birth Satisfaction Scale – Long Form (30-item G-BSS-LF) and its revised version the 10-item Greek-BSS-Revised (10-item-G-BSS-R), using survey data collected in Athens. Participants: A convenience sample of healthy Greek postnatal women (n = 162) aged 22–46 years who had delivered between 34 and 42 weeks’ gestation. Results: The 30-item-G-BSS-LF performed poorly in terms of factor structure. The short-form 10-item-G-BSS-R performed well in terms of measurement replication of the English equivalent version as a multidimensional instrument. The short-form 10-item-G-BSS-R comprises three subscales which measure distinct but correlated domains of: (1) quality of care provision (4 items), (2) women’s personal attributes (2 items), and (3) stress experienced during labour (4 items). Key conclusions: The 10-item-G-BSS-R is a valid and reliable multidimensional psychometric instrument for measuring birth satisfaction in Greek postnatal women

Measurement equivalence of the Birth Satisfaction Scale-Revised (BSS-R): further evidence of construct validity

Objective and background The 10-item Birth Satisfaction Scale-Revised (BSS-R) is being increasingly used internationally, including the development of translated versions of the tool. However, to date, a direct comparison between the original version of the tool and a non-English language translated version has yet to be conducted. Recognising that measurement equivalence is critical in order to be able to meaningfully compare scores on the measure between different versions, the current study sought to evaluate the measurement invariance characteristics of the BSS-R within this context. Methods: A secondary analysis of two data sets. The study used a measurement invariance testing approach to determine the relative equivalence between the original UK English-language version and the Greek-translated version of the BSS-R. Participants were a convenience sample of UK (n = 228) and Greek (n = 162) postnatal women. Results: The BSS-R was found to offer an excellent model fit with pooled data, a robust configural model and metric-level invariance between English- and Greek-language versions. The BSS-R was also found to demonstrate partial scalar invariance, with 80% of item intercepts non-invariant between both versions. Two non-invariant items at the scalar level are likely to represent real differences between participant groups in terms of birth satisfaction as an artefact of service delivery type and relative difference in delivery mode. Conclusion: The BSS-R is both conceptually and statistically comparable between different versions of the tool suggesting the utility of the measure for international comparative studies

Measurement equivalence of the Birth Satisfaction Scale-Revised (BSS-R): further evidence of construct validity

Objective and background: The 10-item Birth Satisfaction Scale-Revised (BSS-R) is being increasingly used internationally, including the development of translated versions of the tool. However, to date, a direct comparison between the original version of the tool and a non-English language translated version has yet to be conducted. Recognising that measurement equivalence is critical in order to be able to meaningfully compare scores on the measure between different versions, the current sought to evaluate the measurement invariance characteristics of the BSS-R within this context. Methods: A secondary analysis of two datasets. The study used a measurement invariance testing approach to determine the relative equivalence between the original UK English-language version (Hollins Martin and Martin, 2014) and the Greek-translated version (Vardavaki et al., 2015) of the BSS-R. Participants were a convenience sample of UK (n=228) and Greek (n=162) postnatal women (n=162).Results: The BSS-R was found to offer an excellent model fit with pooled data, a robust configural model and metric level invariance between English and Greek-language versions. The BSS-R was also found to demonstrate partial scalar invariance, with 80% of item intercepts non-invariant between both versions. Two non-invariant items at the scalar level are likely to represent real differences between participant groups in terms of birth satisfaction as an artefact of service delivery type and relative difference in delivery mode. Conclusion: The BSS-R is both conceptually and statistically comparable between different versions of the tool suggesting the utility of the measure for International comparative studies

Domestic Violence and the role of the midwife

Domestic Violence (DV) is a serious public health problem that can endanger the health of the mother and the fetus. It is estimated that DV frequency worldwide varies. The average incidence of emotional abuse is 28.4%, of physical abuse 13.8% and of sexual abuse is 8%, statistics which appear to be valid in Greece as well. It is reported that 25% of DV cases begin during pregnancy and childbirth. DV during the perinatal period is associated with adverse effects on the physical health of the mother and child. It also affects their mental health and the way women interact and bond with their babies. The approach of structured questions from midwives and health care professionals to all women during pregnancy, as a 'window of opportunity' and screening type application, has shown to increase the rate of DV reporting. The midwives must, and they also want to ask these questions. However, this is a difficult and sensitive topic to discuss, and due to lack of resources and training, fear of uncertainty about what they might discover, and what to do with this information makes this difficult to ask. Solutions include continued continuity of care, empathetic communication, a clearer framework for action and understanding of the legal framework, and access to professional support for midwives and health care professionals are discussed

Construct and content validity of the Greek version of the Birth Satisfaction Scale (G-BSS)

Background: ‘Birth Satisfaction’ is a term that encompasses a woman’s evaluation of her birth experience. The term includes factors such as her appraisal of the quality of care she received, a personal assessment of how she coped, and her reconstructions of what happened on that particular day. Her accounts may be accurate or skewed, yet correspond with her reality of how events unfolded. Objective: To evaluate properties of an instrument designed to measure birth satisfaction in a Greek population of postnatal women. Study design: We assessed factor structure, internal consistency, divergent validity and known-groups discriminant validity of the 30-item Greek Birth Satisfaction Scale – Long Form (30-item G-BSS-LF) and its revised version the 10-item Greek-BSS-Revised (10-item-G-BSS-R), using survey data collected in Athens. Participants: A convenience sample of healthy Greek postnatal women (n = 162) aged 22–46 years who had delivered between 34 and 42 weeks’ gestation. Results: The 30-item-G-BSS-LF performed poorly in terms of factor structure. The short-form 10-item-G-BSS-R performed well in terms of measurement replication of the English equivalent version as a multidimensional instrument. The short-form 10-item-G-BSS-R comprises three subscales which measure distinct but correlated domains of: (1) quality of care provision (4 items), (2) women’s personal attributes (2 items), and (3) stress experienced during labour (4 items). Key conclusions: The 10-item-G-BSS-R is a valid and reliable multidimensional psychometric instrument for measuring birth satisfaction in Greek postnatal women