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The aim of this study was to explore and synthesize the experience of maternity care by female asylum seekers and refugees. The approach was a longitudinal exploratory multiple case study that used a series of interviews, photographs taken by the women, field notes and observational methods to contextualize data obtained during 2002 and 2003. Data was collected in the women's home and a hospital trust. Four women agreed to participate, three women were asylum seekers and one woman was a refugee. Three key themes were generated: the perception of ‘self’ understanding in practice, and the influence of social policy. The women perceived ‘self’ as a response to social interaction. At times, ‘taken for granted’ communication in practice created a barrier to understanding for the women. Social policy related to seeking asylum, dispersement, housing and health directly affecting the lives and subsequent maternity experiences of the women. The theory of symbolic interactionism and transformational educational theory was applied to the findings, highlighting that self-awareness is of paramount importance in care delivery. The strength and resilience of migrating women is acknowledged and should be used as a starting point to develop partnerships in care and to build the woman's self-esteem during their maternity experiences.

Aim To report an analysis of the concept of vulnerability associated with pregnancy, birth and the postnatal period. Background The concept of vulnerability during childbirth is complex and the term, ‘to be vulnerable’ frequently attains a vague application. Analysis about vulnerability is needed to guide policy, practice, education and research. Clarity around the concept has the potential to improve outcomes for women. Design Concept analysis. Data sources Searches were conducted in CINAHL, EMBASE, PubMed, Psychinfo, MEDLINE, MIDIRS and ASSIA and limited to between January 2000 – June 2014. Data were collected over 12 months during 2014. Methods This concept analysis drew on Morse's qualitative methods. Results Vulnerability during pregnancy, birth and the postnatal period can be defined by three main attributes: (a) Threat; (b) Barrier; and (c) Repair. Key attributes have the potential to influence outcome for women. Inseparable sub‐attributes such as mother and baby attachment, the woman's free will and choice added a level of complexity about the concept. Conclusion This concept analysis has clarified how the term vulnerability is currently understood and used in relation to pregnancy, birth and the postnatal period. Vulnerability should be viewed as a complex phenomenon rather than a singular concept. A ‘vulnerability journey plan’ has the potential to identify how reparative interventions may develop the woman's capacity for resilience and influence the degree of vulnerability experienced. Methodology based around complex theory should be explored in future work about vulnerability.

Background: Previous studies have suggested that transcutaneous bilirubinometry (TcB) may provide a useful method for screening for significant jaundice, thereby reducing unnecessary blood tests. These studies have not allowed an estimation of the magnitude of such a benefit. Objectives: To evaluate the accuracy of TcB as a method of determining the need for serum bilirubin (SBR) measurements in full term babies and to quantify the magnitude of any benefit. Subjects: Babies born at more than 34 weeks gestation who had not previously been exposed to phototherapy and were requiring blood sampling in the first week of life. Method: TcB measurements were made at the same time as blood sampling. SBR was measured in all blood samples. For jaundiced babies, the ability of TcB to detect significant jaundice (SBR > 249 µmol/l) was evaluated.Results: There was a correlation between SBR and TcB measurements (n = 303, r = 0.76, p < 0.0001), but the 95% prediction interval for SBR from TcB was wide (± 88.3 µmol/l). For the 285 jaundiced babies, the area under the receiver operator characteristic curve was 0.89. A TcB value of 18 detected significant jaundice with a sensitivity of 100% and a specificity (95% confidence interval) of 45% (39% to 51%). If blood samples had only been taken from babies with a TcB value greater than 18, the number of samples taken would have been reduced by 34%. Conclusions: SBR cannot be measured accurately by TcB. However, TcB measurements can be used to determine the need for blood sampling in jaundiced babies and will reduce the number of blood samples taken. Recent improvements in TcB may improve the performance of this method.