Bridging Perspectives, Building Resilience: Safety-II Guided Reflexive Dialogues Between Care Professionals and Clients as Part of Developing Integrated Maternity Care.

Background: Limitations of traditional structures and approaches to further enhance patient safety, satisfaction, and systemic sustainability in healthcare, are becoming increasingly visible. Embedding reflexivity is a proposed strategy to promote progress. We aimed to explore the potential of creating reflexive spaces for promoting integration and client-centeredness in maternity care specifically.

Routine third-trimester ultrasonography and child neurodevelopmental outcomes: a follow-up of a pragmatic cluster-randomised controlled trial.

Aims/background: Routine third-trimester ultrasonography is increasingly conducted to screen for foetal growth restriction (FGR) and reduce adverse perinatal and child neurodevelopmental outcomes using timely obstetric management. While it did not reduce adverse perinatal outcomes in previous trials, evidence regarding its association with child neurodevelopmental outcome is absent. We examined whether routine third-trimester ultrasonography is positively associated with child developmental and behavioural/emotional outcomes compared to usual care.

Self-management support from health care providers in Shared Medical Appointments: Didactic techniques, peer learning, group dynamics and motivation.

Objective: We investigated the support of self-management by health care providers (HCP) in prenatal Shared Medical Appointments (SMA).

Methods: on an topic list, semi-structured interviews were conducted. HCP who provided prenatal care in SMA in the last five years were recruited.

Working in smaller teams in community midwifery practices to foster continuity of carer: Midwives' experiences - A qualitative study in the Netherlands.

Background: Midwife-led continuity of carer (MLCC) improves health outcomes and increases pregnant women's satisfaction. Working in smaller teams in community midwifery practices is one of the ways to promote continuity of carer.

Aim: To gain insight into the experiences of Dutch community midwives regarding working in smaller teams, by identifying motivators and barriers.

Unisex and Sex-Specific Prescriptive Fetal Growth Charts for Improved Detection of Small-for-Gestational-Age Babies in a Low-Risk Population: A post hoc Analysis of a Cluster-Randomized Study.

Introduction: Our aim was to develop and evaluate the performance of population-based sex-specific and unisex prescriptive fetal abdominal circumference growth charts in predicting small-for-gestational-age (SGA) birthweight, severe SGA (sSGA) birthweight, and severe adverse perinatal outcomes (SAPO) in a low-risk population.

Methods: This is a post hoc analysis of the Dutch nationwide cluster-randomized IRIS study, encompassing ultrasound data of 7,704 low-risk women. IRIS prescriptive unisex and IRIS sex-specific abdominal circumference (AC) fetal growth charts were derived using quantile regression.

Associations Between Early-Pregnancy Vitamin D Status and Postpartum Depressive and Anxiety Symptoms.

Objective: Maternal postpartum depressive and anxiety symptoms are risk factors for subsequent maternal and child mental health problems. Little is known about the potential role of antepartum vitamin D and C-reactive protein (CRP) in the etiology of maternal postpartum affective symptoms. We investigated associations between antepartum vitamin D status and postpartum depressive and anxiety symptoms and whether antepartum CRP mediated these associations.

Antenatal cardiotocography in primary midwife-led care: a budget impact analysis.

Objectives: In many countries, the healthcare sector is dealing with important challenges such as increased demand for healthcare services, capacity problems in hospitals and rising healthcare costs. Therefore, one of the aims of the Dutch government is to move care from in-hospital to out-of-hospital care settings. An example of an innovation where care is moved from a more specialised setting to a less specialised setting is the performance of an antenatal cardiotocography (aCTG) in primary midwife-led care.

Decline in home births associated with faster increase in trend of postpartum haemorrhage and manual removal of the placenta.

In this study we explored the relationship between home birth rates and increasing rates of postpartum haemorrhage (PPH) and manual removal of the placenta (MROP). Data were used from the Dutch national perinatal registry (2000-2014) of women in midwife-led care. Adjusting for place of birth flattened the increasing trends of PPH and MROP.

Inter- and intraobserver agreement of antenatal cardiotocography assessments by maternity care professionals: A prospective study.

Objective: In the Netherlands, antenatal cardiotocography (aCTG) to assess fetal well-being is performed in obstetrician-led care. An innovative initiative was started to evaluate whether aCTG for specific indications-reduced fetal movements, external cephalic version, or postdate pregnancy-is feasible in non-obstetrician-led care settings by independent primary care midwives. Quality assessment is essential when reorganizing and shifting tasks and responsibilities.

Experienced disrespect & abuse during childbirth and associated birth characteristics: a cross-sectional survey in the Netherlands.

Background: Experiencing upsetting disrespect and abuse (D&A) during labour and birth negatively affects women's birth experiences. Knowing in what circumstances of birth women experience upsetting situations of D&A can create general awareness and help healthcare providers judge the need for extra attention in their care to help reduce these experiences. However, little is known about how different birth characteristics relate to the experience of D&A.

Differences in rates of severe perineal trauma between midwife-led and obstetrician-led care in the Netherlands: A nationwide cohort study.

Objective: To investigate trends and rates of severe perineal trauma (SPT), also known as obstetric anal sphincter injury (OASI), between midwife-led and obstetrician-led care in the Netherlands, and factors associated with SPT.

Methods: This nationwide cohort study included registry data from 2000 to 2019 (n = 2,169,950) of spontaneous vaginal births of term, live, cephalic, single infants, without a (previous) caesarean section or assisted vaginal birth.First, trends of SPT and episiotomy were shown.

Elements of organisation of integrated maternity care and their associations with outcomes: a scoping review protocol.

Introduction: Integrated care is seen as an enabling strategy in organising healthcare to improve quality, finances, personnel and sustainability. Developments in the organisation of maternity care follow this trend. The way care is organised should support the general aims and outcomes of healthcare systems.

(Non-)disclosure of lifetime sexual violence in maternity care: Disclosure rate, associated characteristics and reasons for non-disclosure.

Background: In maternity care, disclosure of a past sexual violence (SV) experience can be helpful to clients to discuss specific intimate care needs. Little evidence is available about the disclosure rates of SV within maternity care and reasons for non-disclosure.

Aim: The aim of this study was to examine (1) the disclosure rate of SV in maternity care, (2) characteristics associated with disclosure of SV and (3) reasons for non-disclosure.

Trends in postpartum hemorrhage and manual removal of the placenta and the association with childbirth interventions: A Dutch nationwide cohort study.

Background: Because the cause of increasing rates of postpartum hemorrhage (PPH) and manual placental removal (MROP) is still unknown, we described trends in PPH, MROP, and childbirth interventions and examined factors associated with changes in rates of PPH and MROP.

Methods: This nationwide cohort study used national perinatal registry data from 2000 to 2014 (n = 2,332,005). We included births of women who gave birth to a term singleton child in obstetrician-led care or midwife-led care.

Antenatal cardiotocography in dutch primary midwife-led care: Maternal and perinatal outcomes and serious adverse events. A prospective observational cohort study.

Problem: It is yet unknown whether shifting antenatal cardiotocography (aCTG) from obstetrician-led to midwife-led care leads to a safe reduction in referrals.

Background: ACTG is used to assess fetal well-being. In the Netherlands, the procedure has until now been performed as part of obstetrician-led care.

Assessing safe and personalised maternity and neonatal care through a pandemic: a case study of outcomes and experiences in two trusts in England using the ASPIRE COVID-19 framework.

Background: The COVID-19 pandemic has resulted in profound and far-reaching impacts on maternal and newborn care and outcomes. As part of the ASPIRE COVID-19 project, we describe processes and outcome measures relating to safe and personalised maternity care in England which we map against a pre-developed ASPIRE framework to establish the potential impact of the COVID-19 pandemic for two UK trusts.

Methods: We undertook a mixed-methods system-wide case study using quantitative routinely collected data and qualitative data from two Trusts and their service users from 2019 to 2021 (start and completion dates varied by available data).

Antenatal cardiotocography in primary midwife-led care: Women's satisfaction.

Background: In the Netherlands, antenatal cardiotocography (aCTG), used to assess fetal well-being, is performed in obstetrician-led care. To improve continuity of care, an innovation project was designed wherein primary care midwives perform aCTGs for specific indications. The aim of this study was to examine the satisfaction and experiences of pregnant women who received an aCTG in primary midwife-led care and explore which factors were associated with high satisfaction.

Consent and refusal of procedures during labour and birth: a survey among 11 418 women in the Netherlands.

Background: Informed consent for medical interventions is ethically and legally required; an important aspect of quality and safety in healthcare; and essential to person-centred care. During labour and birth, respecting consent requirements, including respecting refusal, can contribute to a higher sense of choice and control for labouring women. This study examines (1) to what extent and for which procedures during labour and birth women report that consent requirements were not met and/or inadequate information was provided, (2) how frequently women consider consent requirements not being met upsetting and (3) which personal characteristics are associated with the latter.

The Impact of Mode of Birth, and Episiotomy, on Postpartum Sexual Function in the Medium- and Longer-Term: An Integrative Systematic Review.

(1) Background: Sexual function can be affected up to and beyond 18 months postpartum, with some studies suggesting that spontaneous vaginal birth results in less sexual dysfunction. This review examined the impact of mode of birth on sexual function in the medium- (≥6 months and <12 months postpartum) and longer-term (≥12 months postpartum). (2) Methods: Literature published after January 2000 were identified in PubMed, Embase and CINAHL.

The ethics of consent during labour and birth: episiotomies.

Unconsented episiotomies and other procedures during labour are commonly reported by women in several countries, and often highlighted in birth activism. Yet, forced caesarean sections aside, the ethics of consent during labour has received little attention. Focusing on episiotomies, this paper addresses whether and how consent in labour should be obtained.

The natural pattern of birth timing and gestational age in the U.S. compared to England, and the Netherlands.

Objective: To examine cross-national differences in gestational age over time in the U.S. and across three wealthy countries in 2020 as well as examine patterns of birth timing by hour of the day in home and spontaneous vaginal hospital births in the three countries.

Self-management support by health care providers in prenatal Shared Medical Appointments (CenteringPregnancy©) and prenatal individual appointments.

Objective: This cross-sectional questionnaire study investigates if there a difference in the extent to which health care providers in prenatal Shared Medical Appointments (CenteringPregnancy©) and in prenatal individual appointments support self-management in patient education. It also investigates if there is a difference in the extent to which health care providers in CenteringPregnancy@ and in individual appointments pay attention to the factors of the Integrated Model for Behavioral Change (I-Change) in supporting self-management.

Methods: Dutch health care providers in prenatal care were invited to fill out a questionnaire.

Making maternity and neonatal care personalised in the COVID-19 pandemic: Results from the Babies Born Better survey in the UK and the Netherlands.

Background: The COVID-19 pandemic had a severe impact on women's birth experiences. To date, there are no studies that use both quantitative and qualitative data to compare women's birth experiences before and during the pandemic, across more than one country.

Aim: To examine women's birth experiences during the COVID-19 pandemic and to compare the experiences of women who gave birth in the United Kingdom (UK) or the Netherlands (NL) either before or during the pandemic.