We assessed the occurrence of 4 safety concerns among labor and delivery teams: dangerous shortcuts, missing competencies, disrespect, and performance problems. A total of 3282 participants completed surveys, and 92% of physicians (906 of 985), 93% of midwives (385 of 414), and 98% of nurses (1846 of 1884) observed at least 1 concern within the preceding year. A majority of respondents said these concerns undermined patient safety, harmed patients, or led them to seriously consider transferring or leaving their positions. Only 9% of physicians, 13% of midwives, and 13% of nurses shared their full concerns with the person involved. Organizational silence is evident within labor-and-delivery teams. Improvement will require multiple strategies, used at the personal, social, and structural levels.
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http://dx.doi.org/10.1016/j.ajog.2013.07.013 | DOI Listing |
BMC Health Serv Res
January 2025
Makerere University School of Public Health/New Mulago Hospital Complex, P.O. Box 7072, Kampala, Uganda.
Background: Retesting for HIV during pregnancy, labor, and postpartum is crucial for identifying new infections and ensuring timely interventions to prevent mother-to-child transmission (PMTCT). Uganda's national guidelines recommend that pregnant women be retested in the 3rd trimester or during labor/delivery. However, limited information exists regarding adherence to these guidelines, which may affect the effectiveness of PMTCT efforts.
View Article and Find Full Text PDFBMC Pregnancy Childbirth
January 2025
Department of Maternal and Child Nursing and Public Health, School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Geburtshilfe Frauenheilkd
January 2025
Department of Obstetrics and Gynaecology, Erlangen University Hospital, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.
Introduction: Preconception obesity is a risk factor for pregnancy and delivery, which is why giving birth in a perinatal center (care levels I and II) is recommended. There are currently no studies which have investigated the birth outcomes of obese patients based on the care level of the maternity hospital. This study aims to assess the effect of a higher body mass index prior to conception on maternal and fetal outcomes in a maternity hospital (care level IV).
View Article and Find Full Text PDFBackground: With the COVID-19 emergency, the provision of healthcare had to be reorganized. Community Health Services for Families of Trieste adopted new methods to ensure continuity of care and the maintenance of the Standards and Good Practices of the Baby Friendly Initiative of UNICEF for the Birth Care Pathway. The aim of the study was to identify the perceived needs of women, couples, caregivers, and health professionals during the COVID-19 pandemic and evaluate new healthcare strategies, identifying weaknesses and strengths, and future developments.
View Article and Find Full Text PDFBMJ Open
December 2024
Community Health and Epidemiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Objectives: The objectives of this study are to determine whether the additional clinical criteria of the Mozambique maternal near miss abstraction tool enhance the effectiveness of the original WHO abstraction tool in identifying maternal near miss cases and also evaluate the impact of sociodemographic factors on maternal near miss identification.
Design: Cross-sectional study.
Setting: Two secondary referral hospitals in Inhambane province, Mozambique from 2021 to 2022.
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