Aims and objectives To explore the experiences of parents with babies born between 28–32 weeks’ gestation during transition through the neonatal intensive care unit and discharge to home. Background Following birth of a preterm baby, parents undergo a momentous journey through the neonatal intensive care unit prior to their arrival home. The complexity of the journey varies on the degree of prematurity and problems faced by each baby. The neonatal intensive care unit environment has many stressors and facilitating education to assist parents to feel ready for discharge can be challenging for all health professionals. Design Qualitative descriptive design. Methods The project included two phases, pre‐ and postdischarge, to capture the experiences of 20 couples (40 parents), whilst their baby was a neonatal intensive care unit inpatient and then after discharge. Face‐to‐face interviews, an online survey and telephone interviews were employed to gather parent's experiences. Constant comparative analysis was used to identify commonalities between experiences. Recruitment and data collection occurred from October 2014–February 2015. Results/Findings Overlapping themes from both phases revealed three overarching concepts: effective parent staff communication; feeling informed and involved; and being prepared to go home. Conclusion Our findings can be used to develop strategies to improve the neonatal intensive care unit stay and discharge experience for parents. Proposed strategies would be to improve information transfer, promote parental contact with the multidisciplinary team, encourage input from fathers to identify their needs and facilitate parental involvement according to individual needs within families. Relevance to clinical practice Providing information to parents during their time in hospital, in a consistent and timely manner is an essential component of their preparation when transitioning to home.

Background: Assessment of childbirth fear, in advance of pregnancy, and early identification of modifiable factors contributing to fear can inform public health initiatives and/or school-based educational programming for the next generation of maternity care consumers. We developed and evaluated a short fear of birth scale that incorporates the most common dimensions of fear reported by men and women prior to pregnancy, fear of: labour pain, being out of control and unable to cope with labour and birth, complications, and irreversible physical damage.Methods: University students in six countries (Australia, Canada, England, Germany, Iceland, and the United States, n=2240) participated in an online survey to assess their fears and attitudes about birth. We report internal consistency reliability, corrected-itemto-total correlations, factor loadings and convergent and discriminant validity of the new scale. Results:The Childbirth Fear -Prior to Pregnancy (CFPP) scale showed high internal consistency across samples (α >0.86). All corrected-item-to total correlations exceeded 0.45, supporting the uni-dimensionality of the scale. Construct validity of the CFPP was supported by a high correlation between the new scale and a two-item visual analog scale that measures fear of birth (r >0.6 across samples). Weak correlations of the CFPP with 2 scores on measures that assess related psychological states (anxiety, depression and stress) support the discriminant validity of the scale. Conclusion:The CFPP is a short, reliable and valid measure of childbirth fear among young women and men in six countries who plan to have children. Highlights• Fear of childbirth can precede pregnancy and is associated with preferences for cesarean section among young men and women who plan to have children in the future.• Assessing fear of birth and associated factors for young adults in different countries is an important first step in understanding why some young women and men are afraid of childbirth and how this issue might be addressed.• We developed a 10-item fear of birth scale that incorporates the main dimensions of fear reported by young adults in the literature, including fear of: labour pain, bodily damage, and complications.• The Childbirth Fear -Prior to Pregnancy (CFPP) scale had high internal consistency reliability across samples, measured one underlying construct, was highly correlated with another measure of childbirth fear, and was weakly correlated with measures of depression, anxiety and stress.

The majority of behavioral sleep interventions for young children involve extinction procedures where parents must ignore their child's cries for a period. Many parents have difficulties with this, contributing to attrition, non-compliance, and treatment avoidance. Yet why these methods are difficult to implement has rarely been addressed in the literature. This paper discusses seven potential reasons why parents may find extinction sleep interventions difficult: enduring crying, practical considerations, fear of repercussions, misinformation, incongruence with personal beliefs, different cultural practices, and parent wellness. These reasons are discussed in relation to the current literature. Practicing health professionals and sleep researchers could benefit from an awareness of these issues when suggesting extinction interventions and offering alternatives which may be more appropriate for family circumstances and facilitate parental informed choice.

Background: Qualitative evidence has provided rich descriptions around reasons for planning a homebirth with a midwife. Reasons and the importance, confidence and support around this option have not been examined by parity with a larger cohort. Aim: examine women's characteristics, reasons and perceptions of the importance, confidence and support around choosing homebirth based upon parity. Methods: a mixed method approach was undertaken within a prospective cohort study in Western Australia where women planning a homebirth have the option of a publicly funded model or care from privately practising midwives. At recruitment a questionnaire collected demographic data, perceived importance, confidence and support plus reasons for choosing homebirth. A qualitative component included an open ended question that encouraged sharing of opinions providing textual data explored by content analysis. Findings: Reasons noted by 211 pregnant women for choosing homebirth were: avoidance of unnecessary intervention (58.8%), comfort and familiarity of home (34.1%), freedom of making own choices (25.6%), and having more continuity of care (24.2%). Reasons for planning homebirth were similar by parity, except for comfort of home being more important (44.0% vs 28.7%, p=0.025) and continuity of care (13.3% vs 30.1%, p=0.006) being less important to primigravid women. Themes revealed common beliefs around childbirth, appreciation for access to homebirth and a desire for greater awareness and less negativity around homebirth. Conclusion: Regardless of parity, homebirth was believed to be safe and supported by partners. Reasons identified from qualitative research to avoid intervention, the comfort of home, choice and continuity of care were supported.

In this study, Malawian midwives' perceptions of occupational risk of human immunodefiency virus (HIV) infection are described. Knowledge of perceptions of HIV risk in developing countries and consequences on patient care is limited. A qualitative approach using purposive sampling was undertaken with 7 midwives. Participants considered their occupational risk to be high, encompassing these four themes: exposure to body fluids, availability of resources, hand washing practices, and support from management. Additional themes related to the impact of high risk on clinical practice: working in a climate of fear, refraining from touch, loss of interest in midwifery, and improvising care practices.

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Insight into the unique integrated experiences during a birth centre intrapartum transfer can inform midwives, empowering them to better support parents through antenatal education before and by offering discussion about the birth and transfer after. Translation of findings to practice also reinforces how midwives can support their colleagues by recognising the accompanying midwife's role and knowledge of the woman.

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