Problem Medicalised maternity systems do not address spirituality as an aspect of childbirth and its practices of care. Neglecting the spiritual nature of childbirth may negatively affect psychological, emotional and physical wellbeing.Background While there is growing interest in the spiritual side of childbirth there is a paucity of literature on the topic, and hence a lack of understanding generally about how to attend to women's needs for emotional and spiritual support in childbirth.Aim To collaboratively and through consensus explore ways that spirituality could be honoured in 21 st Century maternity care.Methods An online co-operative inquiry. Starting with a scoping exercise (N=17) nine co-inquirers continued to Phase One using online discussion boards and seven co-inquirers continued to Phase Two and Three. Co-inquirers were involved in international group work and individual reflective and transformational processes throughout.Findings Four reflective themes emerged: 'meaning and sense-making'; 'birth culture'; 'embodied relationships and intuition'; and 'space/place/time'. 'Spiritual midwifing' was an overarching theme.There were eight areas of individual transformation and actions concerning spirituality and birth: 1) disseminating inquiry findings; 2) motivating conversations and new ways of thinking; 3) remembering interconnectedness across time and spaces; 4) transforming relationships; 5) transforming practice; 6) generating reflexivity; 7) inspiring self and others to change, and 8) inspiring creativity. Conclusion Spiritual awareness around birth experience emerges through relationships and isaffected by the spatial environment. Spiritual midwifing is a relational approach to birth care that recognises and honours the existential significance and meaningfulness of childbirth. Problem or IssueNeglecting the spiritual aspects of childbirth may negatively affect psychological, emotional and physical wellbeing. What is Already KnownCultural and spiritual aspects of childbirth have been identified across different disciplines and shown to be integral to childbirth. What this Paper addsWorking in an unprecedented asynchronous manner, this cooperative inquiry engaged participants across several global regions. Spirituality as an aspect of childbirth is foregrounded, gesturing to a quality of being that informs practical ways of being around childbirth named 'spiritual midwifing'.
Background: Treatment of adolescents who stutter is an under-researched area that would benefit from greater attention. Aims: To investigate whether an intensive treatment programme for older teenagers who stutter, aged over 16 years of age, is effective in reducing overt and covert aspects of stuttering. Methods & Procedures:A repeated-measures, single-subject experimental design was replicated across participants. The study consisted of a 5-week baseline phase, 2-week intensive treatment phase, 5-week consolidation phase and 10-month follow-up phase. Participants were asked to make ten video recordings at home during each phase, while completing a reading and a conversation task. Recordings were analysed in terms of the percentage of stuttered syllables using a simplified time-series analysis. Participants completed self-report questionnaires at predetermined times throughout the study. Data are presented for three males aged 17;7, 17;11 and 18;10. Outcomes & Results:One participant completed all required recordings. Difficulties were encountered collecting follow-up data with the other two participants and data are available up to 5 months after the intensive therapy phase. A significant trend of reduced frequency of stuttering was found for all three participants during the intensive therapy phase. This trend continued throughout the consolidation phase and remained significant when available longer-term data were included in the analysis. Participants also reported increased self-efficacy about speaking and reduced overt and covert aspects of stammering. Conclusions & Implications:Findings show that this therapy programme for teenagers had a significant treatment effect for the participants studied in the short-and medium-term, however longer-term data were not available for all participants. Issues in conducting research with this client group are discussed.
The third stage of labour marks the final stage of the transition from woman to mother. For most women or parents this is a particularly precious moment as they meet their baby for the first time. Yet the medical paradigm views this final juncture as the most dangerous stage of labour. While there may be an essence of truth in this approach, in the Western world it could be considered as a historical legacy from childbirth dating back to the 19th century when postpartum haemorrhage was a devastating cause of maternal mortality and morbidity. Medicalization of childbirth was seen to be an attractive innovation without risk at this time. It is questioned whether this legacy has relevance in contemporary maternity care where women's improved nutrition and social conditions have reduced morbidity and mortality from postpartum haemorrhage. This article discusses the current evidence on physiological verses active management of the third stage of labour. However it focuses primarily on how to support women during a physiological third stage of labour and proposes a study designed to further explore the essence of this support.
This study aimed to evaluate the effectiveness of positive systemic practice (PSP) in the context of a controlled trial. PSP is a model of family therapy for adolescent emotional and behavioural problems. A series of thirtyseven consecutive patients assigned to a PSP treatment group and thirtyfive similar patients consecutively assigned to a waiting-list control group completed this trial. They were assessed at baseline (Time 1) and 16 weeks later (Time 2) using the strengths and difficulties questionnaire (SDQ) that evaluates adolescent emotional and behavioural problems, and the systemic clinical outcomes and routine evaluation (SCORE) that evaluates family functioning. The PSP group was also followed up 6 months later (Time 3). For trial completers, the clinical improvement rate on the SDQ in the treatment group (65%) was significantly greater than that of the control group (20%) at Time 2 and the improvement was maintained at Time 3 (60%). The amelioration in adolescent behaviour problems on the SDQ was correlated with improvement in family adjustment on the SCORE. Treatment completers reported a high level of treatment satisfaction with this model of family therapy.Practitioner points • PSP is a promising model of family therapy for adolescent emotional and behavioural problems. • A distinctive feature of the model is the provision, by a co-therapy team, of conjoint family sessions and parallel series of sessions to adolescents and parents. • The model is described in a treatment manual.
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