'The greatest feeling you get, knowing you have made a big difference': survey findings on the motivation and experiences of trained volunteer doulas in England.

Background: Support from a doula is known to have physical and emotional benefits for mothers, but there is little evidence about the experiences of volunteer doulas. This research aimed to understand the motivation and experiences of volunteer doulas who have been trained to support women during pregnancy, birth and the postnatal period.

Methods: A postal questionnaire survey was sent to volunteer doulas at five volunteer doula projects working in low-income areas in England.

Evaluation of trained volunteer doula services for disadvantaged women in five areas in England: women's experiences.

Disadvantaged childbearing women experience barriers to accessing health and social care services and face greater risk of adverse medical, social and emotional outcomes. Support from doulas (trained lay women) has been identified as a way to improve outcomes; however, in the UK doula support is usually paid-for privately by the individual, limiting access among disadvantaged groups. As part of an independent multi-site evaluation of a volunteer doula service, this study examined women's experiences of one-to-one support from a trained volunteer doula during pregnancy, labour and the post-natal period among women living in five low-income communities in England.

Healthy Start vitamins--a missed opportunity: findings of a multimethod study.

Objective: To evaluate and provide a real-life view of the operation of the Healthy Start vitamins scheme.

Setting: The study took place in primary care and community settings that served rural, urban and ethnically diverse populations, in two sentinel sites: London, and Yorkshire and the Humber. An online consultation and stakeholder workshops elicited views from across England.

A balancing act in an unknown territory: a metasynthesis of first-time mothers' experiences in early labour.

Objective: to integrate findings of individual studies in order to broaden the understanding of first-time mothers' experiences of early labour.

Design: the methodology was metasynthesis which is based on the interpretive meta-ethnography described by Noblit and Hare (1988). Metasynthesis is research on research which synthesises the findings of previous qualitative studies, and the focus is on interpretation and the creation of new knowledge.

Can food vouchers improve nutrition and reduce health inequalities in low-income mothers and young children: a multi-method evaluation of the experiences of beneficiaries and practitioners of the Healthy Start programme in England.

Background: Good nutrition is important during pregnancy, breastfeeding and early life to optimise the health of women and children. It is difficult for low-income families to prioritise spending on healthy food. Healthy Start is a targeted United Kingdom (UK) food subsidy programme that gives vouchers for fruit, vegetables, milk, and vitamins to low-income families.

Midwives' beliefs and concerns about telephone conversations with women in early labour.

Objective: to explore midwives' concerns, experiences and perceptions of the purpose of telephone contacts with women in early labour.

Design: a qualitative design based on interpretive phenomenology.

Setting: two Maternity Units in the Midlands of England.

Integrating women's views into maternity care research and practice.

The purpose of this paper is to consider the role of women's views in maternity care research and practice: what we mean by that, how and when women's views are sought (or not), and what we should do next. It is argued that women's views are not a stand-alone extra, but integral at every stage, including having an impact on clinical outcomes. Attending to "women's views" should not only mean a post hoc assessment of experiences but also needs to consider expectations and values.

Optimising the location of antenatal classes.

Objectives: To combine microsimulation and location-allocation techniques to determine antenatal class locations which minimise the distance travelled from home by potential users.

Design: Microsimulation modeling and location-allocation modeling.

Setting: City of Leeds, UK.

Infant feeding attitudes of women in the United Kingdom during pregnancy and after birth.

Background: To address the recognized low rates of breastfeeding in the United Kingdom (UK), a change in fundamental attitudes toward infant feeding might be required. This paper reports an exploration of women's attitudes toward breastfeeding at different time points in the perinatal period, undertaken as part of a larger breastfeeding evaluation study.

Objectives: To measure women's infant feeding attitudes at 3 stages during the perinatal period to see whether, on average, they differed over time.

Attitudes to prenatal diagnosis and termination of pregnancy for 30 conditions among women in Saudi Arabia and the UK.

Objective: The aim of this research was to compare attitudes between women from different cultural and/or religious backgrounds toward prenatal diagnosis (PND) and termination of pregnancy (TOP) for 30 different conditions.

Methods: A questionnaire examining parents' attitudes toward PND and TOP for 30 different conditions was completed by 100 Saudi, 222 UK-White, and 198 UK-Pakistani women. Comparison of overall attitudes with PND and TOP between groups was carried out, and a total score reflecting attitudes was obtained.

Early labour services: changes, triggers, monitoring and evaluation.

Objectives: to identify the changes to early labour services, their triggers and monitoring.

Design And Setting: a mixed methods approach in two stages, firstly a postal questionnaire survey of Heads of Midwifery (HoM) services in NHS Trusts in England (cover sheet to each HoM and questionnaire for each unit in their jurisdiction) and, secondly, semi-structured telephone interviews with a purposive sample of senior midwives. The interviews sought further information about reasons for change; the impact of changes and explored the unit's particular innovations.

Parents' views on how health professionals should work with them now to get the best for their child in the future.

Background: Pregnancy and the first years of life are important times for future child well-being. Early identification of families and children who might be likely to experience poorer outcomes could enable health professionals and parents to work together to promote each child's well-being. Little is known about the acceptability and feasibility of such an approach to parents.

Converting policy into care: women's satisfaction with the early labour telephone component of the All Wales Clinical Pathway for Normal Labour.

Aims: This article is a report of a study of women's experiences of, and satisfaction with, telephone communications within the All Wales Clinical Pathway for Normal Labour ('the Pathway').

Background: The Pathway was introduced throughout Wales over 2003-2004. Its philosophy emphasizes the desirability of a woman remaining at home until labour is established with assessment by telephone, in contrast to the more common scenario where the phone call is a precursor to admission and face-to-face assessment.

Men and infant feeding: perceptions of embarrassment, sexuality, and social conduct in white low-income British men.

Background: The views of fathers have been shown to be important determinants of infant feeding decisions, but men's perceptions of breastfeeding and formula feeding are rarely explored. Our objectives were to address this gap and examine cultural associations and beliefs concerning infant feeding practices among men.

Methods: Five focus groups were conducted with low-income men (n = 28) living in areas of social deprivation in Leeds, northeast of England, and low-income areas of Glasgow, west of Scotland.

Factors influencing the infant feeding decision for socioeconomically deprived pregnant teenagers: the moral dimension.

Background: The importance of breastfeeding-related health outcomes in reducing inequalities in health has been recognized as a National Health Service target to increase initiation rates especially among disadvantaged groups in England. This study examined the psychosocial factors influencing infant feeding intention among pregnant teenagers expecting their first baby and living in deprived urban areas in England.

Methods: A mixed methods study, using a quantitative questionnaire based on the Theory of Planned Behaviour, was conducted in four English regions with predominantly white and Asian teenagers (n = 71).

The role of attitudes towards the targets of behaviour in predicting and informing prenatal testing choices.

Research considering the role of attitudes in prenatal testing choices has commonly focused on the relationship between the attitude towards undergoing testing and actual testing behaviour. In contrast, this study focused on the relationship between testing behaviour and attitudes towards the targets of the behaviour (in this case people with Down syndrome (DS) and having a baby with DS). A cross-sectional, prospective survey of 197 pregnant women measured attitudes towards the targets of prenatal testing along with intentions to use screening and diagnostic testing, and the termination of an affected pregnancy.

Roundtable discussion: Early labor: what's the problem?

In places where hospital birth is the norm, one of the major contemporary challenges to the organization of intrapartum care is posed by women who are not in established labor. In the United Kingdom, these women have been given a special name, "Category X," and they can account for a substantial percentage of admissions (1). These women are not deemed to be in need of hospital care, but the women themselves may feel otherwise as they struggle to understand the sensations they are experiencing.

Studying the infant feeding intentions of pregnant women experiencing material deprivation: methodology of the Looking at Infant Feeding Today (LIFT) study.

The Looking at Infant Feeding Today (LIFT) study examined the factors underlying the infant feeding choices of first-time mothers in the Leeds and Bradford areas of England experiencing material hardship, with a view to informing interventions aimed at increasing breastfeeding uptake amongst this group. This short report describes the novel methodology used to obtain data from a sample of pregnant women who are traditionally 'hard-to-reach' in deprived areas. This involved the use of trusted individuals such as midwives and multilingual health workers.

Using an extended theory of planned behaviour to inform interventions aimed at increasing breastfeeding uptake in primiparas experiencing material deprivation.

Objectives: The theory of planned behaviour (TPB) was employed to investigate infant feeding intentions and subsequent behaviour in women from selected areas of economic hardship in the UK. Underlying beliefs were examined in order to inform future interventions aimed at increasing breastfeeding uptake among women living in such areas, which is associated with low rates of breastfeeding.

Design: Midwives recruited women from areas meeting study criteria.

Decisions about testing and termination of pregnancy for different fetal conditions: a qualitative study of European White and Pakistani mothers of affected children.

The aim of this study is to explore reasons for and against prenatal testing and termination for a range of conditions in women from two different ethnic backgrounds. A total of 19 Pakistani and European women in West Yorkshire, UK, who either had a child with a genetic condition or had terminated a pregnancy for one, completed a questionnaire about their attitudes regarding prenatal testing and termination for 30 different fetal conditions and were interviewed about their reasons for their responses. There were more similarities than differences between the Pakistani and European white women.

Predicting breastfeeding in women living in areas of economic hardship: Explanatory role of the theory of planned behaviour.

This study employed the theory of planned behaviour (TPB) and additional variables (descriptive norm, moral norm, self-identity) to investigate the factors underlying breastfeeding intention and subsequent breastfeeding at four time points (during hospital stay, at hospital discharge, 10 days postpartum and 6 weeks postpartum) in a sample of women selected from defined areas of economic hardship (N = 248). A model containing the TPB, additional variables and demographic factors provided a good prediction of both intention (R (2) = 0.72; attitude, perceived behavioural control, moral norm and self-identity significant predictors) and behaviour - breastfeeding at birth (88.

Perinatal factors related to negative or positive recall of birth experience in women 3 years postpartum in the Netherlands.

Background: Little research has been conducted to date on women's postnatal emotional well-being and satisfaction with the care received in the Netherlands. The aim of this study was to investigate Dutch women's views of their birth experience 3 years after the event.

Methods: A questionnaire was mailed to all women who had given birth in 2001 and who had at least one prenatal, perinatal, or postnatal visit to the participating midwifery practice.

Have women become more willing to accept obstetric interventions and does this relate to mode of birth? Data from a prospective study.

Background: Concern has increased about rising rates of cesarean section and other obstetric interventions, and it has been suggested that a change in women's attitudes may be partly responsible. Our objectives were, first, to examine changes in women's antenatal willingness to accept obstetric interventions between 1987 and 2000 and, second, to look at the relationship between willingness to accept obstetric interventions and mode of birth.

Methods: Data on willingness to accept obstetric interventions were collected at 35-36 weeks of pregnancy using postal questionnaires, and follow-up of women was conducted 6 weeks postnatally.