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Health Awareness Week

International Day of the Midwife

5th of May 2023

This year's IDM theme, 'Together again: from evidence to reality' is a nod to the upcoming 33rd ICM Triennial Congress, where the global midwife community will come together for the first time in more than five years. It is also honours the efforts of midwives and their associations to action critical evidence like the State of the World’s Midwifery (SoWMy) 2021 towards meaningful change for our profession and the women and families we care for.  International Confederation of Midwives


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Midwifery practice





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Support for healthy breastfeeding mothers with healthy term babies
When 'breastfeeding only' support is offered to women, the duration and in particular, the exclusivity of breastfeeding is likely to be increased. Support may also be more effective in reducing the number of women stopping breastfeeding at three to four months compared to later time points.  For 'breastfeeding plus' interventions the evidence is less certain. Support may be offered either by professional or lay/peer supporters, or a combination of both. Support can also be offered face‐to‐face, via telephone or digital technologies, or a combination and may be more effective when delivered on a schedule of four to eight visits. Further work is needed to identify components of the effective interventions and to deliver interventions on a larger scale. Cochrane Database of Systematic Reviews – Intervention 22 October 2022

Interventions for preventing mastitis after childbirth
There is some evidence that acupoint massage is probably better than routine care, probiotics may be better than placebo, and breast massage and low frequency pulse treatment may be better than routine care for preventing mastitis. Cochrane Database of Systematic Reviews – Intervention 29 September 2020

Treatments for breast engorgement during lactation
Although some interventions may be promising for the treatment of breast engorgement, such as cabbage leaves, cold gel packs, herbal compresses, and massage, the certainty of evidence is low and we cannot draw robust conclusions about their true effects. Future trials should aim to include larger sample sizes, using women ‐ not individual breasts ‐ as units of analysis. Cochrane Database of Systematic Reviews – Intervention 20 September 2020

Oral galactagogues (natural therapies or drugs) for increasing breast milk production in mothers of non‐hospitalised term infants
Due to extremely limited, very low certainty evidence, we do not know whether galactagogues have any effect on proportion of mothers who continued breastfeeding at 3, 4 and 6 months. There is low‐certainty evidence that pharmacological galactagogues may increase milk volume. There is some evidence from subgroup analyses that natural galactagogues may benefit infant weight and milk volume in mothers with healthy, term infants, but due to substantial heterogeneity of the studies, imprecision of measurements and incomplete reporting, we are very uncertain about the magnitude of the effect. The authors are also uncertain if one galactagogue performs better than another. With limited data on adverse effects, they are uncertain if there are any concerning adverse effects with any particular galactagogue; those reported were minor complaints. Cochrane Database of Systematic Reviews – Intervention 18 May 2020

Schedules for home visits in the early postpartum period
The evidence is very uncertain about the effect of home visits on maternal and neonatal mortality. Individualised care as part of a package of home visits probably improves depression scores at four months and increasing the frequency of home visits may improve exclusive breastfeeding rates and infant healthcare utilisation. Maternal satisfaction may also be better with home visits compared to hospital check‐ups. Overall, the certainty of evidence was found to be low and findings were not consistent among studies and comparisons. Further well designed RCTs evaluating this complex intervention will be required to formulate the optimal package. Cochrane Database of Systematic Reviews – Intervention 21 July 2022

Local cooling for relieving pain from perineal trauma sustained during childbirth
There is limited very low‐certainty evidence that may support the use of cooling treatments, in the form or ice packs or cold gel pads, for the relief of perineal pain in the first two days following childbirth. It is likely that concurrent use of several treatments is required to adequately address this issue, including prescription and non‐prescription analgesia. Studies included in this review involved the use of cooling treatments for 10 to 20 minutes, and although no adverse effects were noted, these findings came from studies of relatively small numbers of women, or were not reported at all. The continued lack of high‐certainty evidence of the benefits of cooling treatments should be viewed with caution, and further well‐designed trials should be conducted. Cochrane Database of Systematic Reviews – Intervention 9 October 2020




Factors that influence women's engagement with breastfeeding support: A qualitative evidence synthesis
Key messages:

  • Supporting women to initiate and continue to breastfeed is a complex process.
  • The current models of breastfeeding support are dependent on a variety of contextual factors encouraging and supporting women to initiate and continue breastfeeding.
  • Practitioners and service developers need to be aware that throughout the whole continuum of maternity care, women's breastfeeding support needs are dynamic, and it is unpredictable when challenges and needs arise.
  • The emotional and physical difficulties sometimes associated with breastfeeding may require diverse forms of support, also in combination, to counteract challenges.

Maternal and child nutrition 22 August 2022

Causes of perception of insufficient milk supply in Western Australian mothers
Key messages

  • In this study in Western Australia, 44% of the mothers had a perception of insufficient milk supply within 3 weeks of birth.
  • The most common reason for this perception was that their infant was not satisfied after breastfeeds.
  • Supplementary infant formula was used by 66% of the mothers before their first visit to a lactation consultant.
  • Maternal perception of insufficient milk supply improved after targeted advice from a lactation consultant.

Maternal and child nutrition 20 September 2020

The significance of early breastfeeding experiences on breastfeeding self-efficacy one week postpartum
Key messages

  • Breastfeeding self-efficacy is an important determinant for breastfeeding duration, and breastfeeding experiences influence breastfeeding self-efficacy. However, sparse knowledge exists on prevalence and factors associated with early breastfeeding experiences and self-efficacy.
  • Compared with positive experiences, negative breastfeeding experiences 1 week postpartum increase odds for low breastfeeding self-efficacy by nine times and a drop in breastfeeding self-efficacy by three times.
  • The association between negative breastfeeding experience and low breastfeeding self-efficacy is stronger among primiparous than multiparous women.
  • Epidural analgesia and interrupted skin-to-skin contact following birth increase odds for negative breastfeeding experiences one week postpartum. First-time mothers, mothers with high body mass index, and mothers with no social support are at risk of negative breastfeeding experiences
  • This study provides new insights into early negative breastfeeding experiences and general breastfeeding self-efficacy and emphasizes the importance of offering evidence-based breastfeeding support postpartum to prevent early negative breastfeeding experiences

Maternal and child nutrition 5 March 2020

Vulnerable mothers' experiences breastfeeding with an enhanced community lactation support program
Key messages

  • Vulnerable mothers who participated in one program delivered under the Canada Prenatal Nutrition Program reported planning and attempting to breastfeed but were unprepared for the challenges. Three main challenges were identified by participants: physical (e.g., pain and low milk supply), practical (e.g., cost of breastfeeding support and time pressures), and breastfeeding self-efficacy (e.g., milk supply concerns and conflicting information).
  • Mothers identified in-home skilled help provided in a non-judgmental manner as key elements of the community lactation support.
  • Mothers perceived in-home lactation consultant services and double-electric breast pumps helped mitigate various breastfeeding challenges.

Maternal and child nutrition 26 January 2020

Breastfeeding Aversion Response (BAR): A descriptive study
This study contributes new information about the experience of BAR, including when it commonly happens and who may be at greater risk. More support is needed for women who want to breastfeed while experiencing BAR. New public health policies which promote breastfeeding are needed to help women achieve satisfying breastfeeding experiences and meet their own breastfeeding goals. Journal of midwifery and women’s health 17 April 2023 


Midwifery practice

The role and scope of contemporary midwifery practice in Australia: A scoping review of the literature
There is a mismatch between the operational parameters for midwifery practice in Australia and the evidence-based models of continuity of midwifery carer that are associated with optimal outcomes for childbearing women and babies and the midwives themselves. Women and birth 9 January 2023

Skills and knowledge of midwives at free-standing birth centres and home birth: A meta-ethnography
The findings highlight that midwives integrated their sensorial experiences with their clinical knowledge of anatomy and physiology to care for women at home birth and in free-standing birth centres. The interactive relationship between midwives and women is at the core of creating an environment that supports physiological birth while integrating the lived experience of labouring women. Further research is needed to elicit how midwives develop these proficiencies. Women and birth 8 April 2023

Reducing disparities in postpartum care utilization: Development of a clinical risk assessment tool
An easy to implement clinical decision support tool can help identify FQHC patients at risk for postpartum nonattendance. Future interventions to improve adequacy of prenatal care can encourage early entry into prenatal care and sufficient prenatal visits. These efforts may improve postpartum care attendance and maternal health. Journal of midwifery and women’s health 24 December 2022

Experiences, beliefs, and values influencing midwives’ attitudes toward the use of childbirth interventions
Midwives with a wait and see attitude seem to have a more restricted approach toward interventions compared with midwives with a check and control attitude. Midwives need to be aware how their experiences, beliefs, and values shape their attitudes toward use of interventions. This awareness could be a first step toward the reduction of unwarranted interventions. Journal of midwifery and women’s health 2 August 2022

Pregnancy and weight monitoring: A feasibility study of weight charts and midwife support
Key messages

  • Brief MI training for midwives is insufficient to result in incorporation of discussions of maternal weight into antenatal care.
  • Weight charts are acceptable to women but currently lack evidence as an effective method of supporting women achieve a healthy gestational weight gain.
  • More complex interventions aimed at supporting pregnant women maintain a healthy weight are required, including interventions appropriate for women who have obesity and pregnant women who gain more weight than recommended.

Maternal and child nutrition 28 March 2020

Home-based postnatal midwifery care facilitated a smooth succession into motherhood: A Swedish interview study
Mothers valued the well-structured home-based postnatal midwifery care. Important for mothers was to receive health checks, adequate information, and that midwives have a kind and individual approach to the families. Midwives play an important role for mothers in the early days after the birth of their baby. European journal of midwifery 8 April 2023

Use of pregnancy personalised follow-up in case of maternal social vulnerability to reduce prematurity and neonatal morbidity
This work suggests that personalized pregnancy follow-up (PPFU)  improves pregnancy outcomes and emphasizes that the detection of social vulnerability during pregnancy is a major health issue. BMC pregnancy and childbirth  26 April 2023



Midwife led randomised controlled trials in Australia and New Zealand: A scoping review
Additional support for midwives to design and conduct trials and publish findings is required. Further support is needed to translate registration of trial protocols into peer reviewed publications.  These findings will inform the Australasian Nursing and Midwifery Clinical Trials Network plans to promote quality midwife led trials. Women and birth 7 March 2023

UK midwives’ perceptions and experiences of using Facebook to provide perinatal support: Results of an exploratory online survey
Seeking support from Facebook groups during pregnancy is now widespread and social media has been widely used by the United Kingdom National Health Service (NHS) maternity services to communicate with service users during the COVID-19 pandemic. Despite this, little is currently known about midwives’ attitudes towards, and experiences of social media in practice. Research is needed to understand barriers and solutions to meeting mothers’ expectations of online support and to improve services. This study explored midwife involvement in Facebook groups, exploring experiences and perceptions of its use to communicate with and support mothers. Plos digital health 17 April 2023

Factors that promote a positive childbearing experience: A qualitative study
Although women often sought out care that promoted physiologic birth, they emphasized that the way they were cared for was more important than fulfilling specific birth aspirations. Quality maternity care has the capacity to support a woman's confidence in her own abilities and promote a positive, and sometimes transformative, childbearing experience. Journal of midwifery and women’s health 9 September 2022

“Never let a good crisis go to waste”: Positives from disrupted maternity care in Australia during COVID-19

  • Women who gave birth during the COVID-19 pandemic reported a range of positives despite disrupted services.
  • Positives were related to mandated care changes, including having decreased visitors in the hospital during the postnatal period, increased access to telehealth and partners working at home. Midwifery continuity of care was highly valued.
  • Strong agreement was found between the perspectives of pregnant and postnatal women and midwives regarding the positives.

Midwifery 17 April 2022

The use of continuous foetal monitoring technologies that enable mobility in labour for women with complex pregnancies: A survey of Australian and New Zealand hospitals

  • This is the first survey of the use of continuous foetal monitoring technologies in Australian and New Zealand hospitals
  • Wireless technology was seen to increase women's mobility and a sense of choice and control in labour
  • Most Australian and New Zealand facilities have wireless machines, however barriers to women's access persist
  • Reasons for barriers to access are unclear, further research is required

Midwifery 19 November 2020

Comprehensiveness of infant formula and bottle feeding resources: A review of information from Australian healthcare organisations
Key messages

  • Insufficient formula-feeding support from health services can lead to parents relying on formula packaging or other commercial information.
  • Most formula-feeding resources from Australian healthcare organisations focus on preparing infant formula and using infant formula. However, comprehensiveness of information varies—on average, information on preparing infant formula was more comprehensive than that on using infant formula.
  • Many resources do not address responsive bottle-feeding practices, which impacts risk of infant overweight and obesity.
  • The Australian government infant feeding guidelines should be revised to include more comprehensive best-practice formula-feeding recommendations; subsequently, this should be reflected in formula-feeding information from health organisations.

Maternal and child nutrition 15 December 2021

Linking student in nursing/student in midwifery employment to Australian professional standards: A cross-sectional study
The results of this study affirm the important integrative relationship between this work and student learning, whilst also demonstrating links to the achievement of professional standards, a requirement for all nursing and midwifery graduates. The absence of collaboration and connection between the university and clinical settings is of major concern given the long-standing attempts to reduce the intransigent ‘theory-practice gap’. It is axiomatic that the work undertaken by nursing and midwifery undergraduates in dedicated clinical employment roles in NQ contributes in significant ways to student learning and professional development. Collegian 19 April 2023



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