BackgroundMaternal smoking can cause health complications in pregnancy. Particulate matter (PM2.5) metrics applied to second hand smoke (SHS) concentrations provide indoor air quality (IAQ) measurements and have been used to promote smoking behaviour change among parents of young children. Here, we present the qualitative results from a study designed to use IAQ measurements to help pregnant women who smoke to quit smoking.MethodsWe used IAQ measurements in two centres (Aberdeen and Coventry) using two interventions: 1. In Aberdeen, women made IAQ measurements in their homes following routine ultrasound scan; 2. In Coventry, IAQ measurements were added to a home-based Stop Smoking in Pregnancy Service. All women were invited to give a qualitative interview to explore acceptability and feasibility of IAQ measurements to help with smoking cessation. A case study approach using grounded theory was applied to develop a typology of pregnant women who smoke.ResultsThere were 39 women recruited (18 in Aberdeen and 21 in Coventry) and qualitative interviews were undertaken with nine of those women. Diverse accounts of smoking behaviours and experiences of participation were given. Many women reported changes to their smoking behaviours during pregnancy. Most women wanted to make further changes to their own behaviour, but could not commit or felt constrained by living with a partner or family members who smoked. Others could not envisage quitting. Using themes emerging from the interviews, we constructed a typology where women were classified as follows: ‘champions for change’; ‘keen, but not committed’; and ‘can’t quit, won’t quit’. Three women reported quitting smoking alongside participation in our study.ConclusionsPregnant women who smoke remain hard to engage,. Although providing IAQ measurements does not obviously improve quit rates, it can support changes in smoking behaviour in/around the home for some individuals. Our typology might offer a useful assessment tool for midwives.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-016-1062-1) contains supplementary material, which is available to authorized users.
This article reports a service evaluation of “antenatal education on physiology of childbirth and relaxation.” A service evaluation was carried out during group class discussion, immediately after the workshops, and following birth. Identified themes in the collected data were (a) my own relaxation, (b) confident, and not afraid, (c) proud of myself, (d) unexpected and feeling in control, and (e) support. Overall, women creatively customized the learned skills and reported feelings of pride and confidence. They reported feeling able to apply relaxation techniques when unexpected situations arise. Support and encouragement from partners and midwives were also valued by women. The evaluation demonstrates the efficacy of designing antenatal education that includes education on physiology of normal birth and relaxation training.
We have worked together as midwifery practitioners, educators, and researchers for nearly 15 years. Our interest in 'relaxation' and its use in childbirth stemmed from our growing focus on women's experiences and a recognition of the increased incidence of anxiety and fearfulness of the birthing process. Having sought training in meditation and hypnosis, we incorporated many of the principals into our own practice. The results were astounding, with most women embracing this approach and many using no pharmaceutical or regional anaesthesia during childbirth. We also observed that their labour was often quicker than the average for their parity. We went onto work with a colleague to establish a dedicated service to women who had a fear of childbirth and were seeking to avoid a vaginal birth to overcome this. The content of the service focused on the principals of relaxation to make it more accessible and useful for childbirth. Women and clinicians were so positive about this service that it demanded an expansion of the provision and also warranted the training of more midwives. This service has now been accessible to any women in this particular Health Board in Scotland for the last eight years. During this time thousands of women and many partners have attended and most completed an evaluation. This has provided us with rich insights into their experiences of the service and how this has impacted their birth experience. We are now exploring this further in primary research and disseminating this widely. As midwifery educators and researchers, we recognised that we also needed to prepare midwives to support women using these techniques and have incorporated this into undergraduate, pre-registration curricula for student midwives. This has also been rolled out into continuous professional development for midwives building capacity and acceptability in the workforce. This chapter will examine the influence that meditation 2 and relaxation, may have on childbirth experiences. We will draw on the existing literature and reflect on our experience of embedding the knowledge and skills of meditation and relaxation within the context of antenatal education and midwifery practice in NHS maternity services in the UK. By describing the processes of development, service delivery and sharing research and evaluation, we will bring new insights to this important area of childbirth practice.
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