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  • 1
    Electronic Resource
    Electronic Resource
    Changing childbirth, I and II (1994)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 101 (1994), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1994.tb11966.x
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  • 2
    Electronic Resource
    Electronic Resource
    Immersion in Water During First Stage of Labor (2002)
    Malden, USA : Blackwell Publishing, Inc.
    Birth 29 (2002), S. 0 
    Details
    ISSN: 1523-536X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1523-536X.2002.0163d.x
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  • 3
    Electronic Resource
    Electronic Resource
    Strategies to Address Global Cesarean Section Rates: A Review of the Evidence (2002)
    Malden, USA : Blackwell Publishing, Inc.
    Birth 29 (2002), S. 0 
    Details
    ISSN: 1523-536X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: The steadily increasing global rates of cesarean section has become one of the most debated topics in maternity care. This paper reviews and reports on the success of strategies that have been developed in response to this continuing challenge. Methods: A literature search identified studies conducted between 1985 and 2001 from the Cochrane Database of Systematic Reviews, Medline, Sociofile, Current Contents, Psyclit, Cinahl, and EconLit databases. An additional search of electronic databases for Level 1 evidence (systematic reviews), Level 2 (randomized controlled trials), Level 3 (quasi-experimental studies), or Level 4 (observational studies) was performed. Selection criteria used to identify studies for review included types of study participant, intervention, outcome measure, and study. Results: Interventions that have been used in an attempt to reduce cesarean section rates were identified; they are categorized as psychosocial, clinical, and structural strategies. Two clinical interventions, (external cephalic version, vaginal birth after a previous cesarean) and one psychosocial intervention (one-to-one trained support during labor) demonstrated Level 1 evidence for reducing cesarean section rates. Conclusions: Although the evidence for one-to-one care and external cephalic version came from both developed and developing settings, the systematic review for vaginal birth after a cesarean was restricted to studies conducted in the United States. The effective implementation of the preceding strategies to reduce cesarean rates may depend on the social and cultural milieu and on associated beliefs and practices. (BIRTH 29:1 March 2002)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1523-536X.2002.00153.x
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  • 4
    Electronic Resource
    Electronic Resource
    Increasing Cesarean Section Rates: Exploring the Role of Culture in an Australian Community (2004)
    Oxford, UK; Malden, USA : Blackwell Science Inc
    Birth 31 (2004), S. 0 
    Details
    ISSN: 1523-536X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Abstract:  Background: The proportion of births by cesarean section in Australia has recently increased by 35 percent, rising from 17 percent in 1990 to 23 percent in 2000. Unlike previous research, which has focused on women's role in increasing rates of cesarean section, this study aimed to explore the existence of wider cultural norms of acceptance of cesarean section in the Australian community, and the implications these might have for rising rates. Methods: A postal self-completion questionnaire was sent to a consecutive sample of 148 women who delivered 7 weeks earlier at the Women's and Children's Hospital, a tertiary-referral public maternity hospital in metropolitan Adelaide, South Australia. These women were recruited at 18 weeks’ gestation, and had been involved in a wider study. The questionnaire included three sections, one section on agreement with statements pertaining to cultural acceptance of cesarean section, a second on personal consideration of cesarean section in early pregnancy, and a third including sociodemographic questions. Results: Of the total sample, 92 women responded to the questionnaire (response rate 62%). Of 6 items relating to community acceptance of cesarean section, responses ranged from 71.4 percent agreement (“common for people to think that cesarean section offers an easier way of giving birth”) to 23.1 percent agreement (“the media seems to portray cesarean section as a better option than vaginal delivery”). The option of having a cesarean section was considered by almost 15 percent (10/68) of women early in their pregnancy. For the vast majority (8/10) this consideration was clinically based. Conclusions: This investigation demonstrated that these Australian women, independent of sociodemographic variables such as age and education level, agreed that cesarean section was perceived as an easy, convenient way of giving birth.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.0730-7659.2004.00289.x
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  • 5
    Electronic Resource
    Electronic Resource
    A systematic review comparing continuity of midwifery care with standard maternity services (1998)
    Oxford, UK : Blackwell Publishing Ltd
    BJOG 105 (1998), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective To review randomised controlled trials of alternative maternity services characterised by continuity of midwifery care.Methods A systematic review of randomised controlled trials, analysed on an intention to treat basis, in which the study intervention was characterised by a midwife or small group of midwives providing care from early pregnancy to the postnatal period (defined as that provided on the postnatal ward); and the controls by standard maternity care as practised in the place where the trial was conducted. The seven trials identified included 9148 women. Main outcome measures were interventions during labour, maternal outcomes and infant outcomes.Results The alternative models with continuity of midwifery care were associated with less use of obstetric interventions during labour (eg, induction, augmentation of labour, electronic fetal monitoring, obstetric analgesia, instrumental vaginal delivery and episiotomy). However, the caesarean section rate did not differ statistically between the trial groups (OR 0.91; 95% CI 0.78 to 1.05). The lower episiotomy rate in the alternative models of care (OR 0.69; 95% CI 0.61 to 0.77) was associated with a significantly higher rate of perineal tears in the pooled alternative groups (OR 1.15; 95% CI 1.05 to 1.26). The percentage of intact perineums was very similar for the two groups (OR 1.11; 95% CI 1.00 to 1.24). There was no maternal death, and rates of maternal complications based on unpooled estimates did not show any statistically significant differences. The proportion of babies with an Apgar score 〈 7 at five minutes after the birth was approximately the same in the pooled alternative groups as in the control groups (OR 1.13 95% CI 0.69 to 1.84). Admission to intensive care or special care baby unit was similar (OR 0.86; 95% CI 0.71 to 1.04). The difference in perinatal deaths was bordering on statistical significance (OR 1.60; 95% CI 0.99 to 2.59).Conclusion Continuity of midwifery care is associated with lower intervention rates than standard maternity care. No statistically significant differences were observed in maternal and infant outcomes. However, more research is necessary to make definite conclusions about safety, for the infant as well as for the mother. This review illustrates the variation in the different models of alternative and standard maternity care, and thus the problems associated with pooling data from different trials.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.1998.tb09969.x
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  • 6
    Electronic Resource
    Electronic Resource
    The development and process evaluation of an information-based intervention for pregnant women aimed at addressing rates of caesarean section (2005)
    Oxford, UK and Malden, USA : Blackwell Science Ltd
    BJOG 112 (2005), S. 0 
    Details
    ISSN: 1471-0528
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Objective  Few strategies aimed at addressing rising rates of caesarean section have explicitly involved information-based approaches for pregnant women. This study describes the development and evaluation of such an intervention for pregnant women, encompassing pamphlets and a peer support network (PSN).Design  Process evaluation.Setting  The study was undertaken at a metropolitan teaching hospital in Adelaide, South Australia.Population  A consecutive sample of pregnant women attending the ultrasound clinic over a two-month period, recruited at 18 weeks of gestation.Methods  Participants received two pamphlets at 18 weeks of gestation and information on a PSN at around 28 weeks of gestation. A questionnaire was sent to women at seven weeks postnatal, asking them to evaluate the intervention.Main outcome measures  The extent to which the intervention resources were used and participants were satisfied with the resources they received.Results  Ninety-two women returned questionnaires (response rate of 62%). Women generally resisted engaging with the informational resources, citing irrelevance to their situation, for example, 53% (49/92) read all of the pamphlets. None of the women used the PSN. Women who had experienced childbirth previously and those of higher education were significantly more likely to read the pamphlets. While generally satisfied with pamphlet content, one in five women reported feeling distressed by some of the information.Conclusions  This exploratory study casts doubt on the notion of information provision for pregnant women as a panacea for addressing rising rates of caesarean section.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1471-0528.2005.00753.x
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  • 7
    Electronic Resource
    Electronic Resource
    Immersion in Water in the First Stage of Labor: A Randomized Controlled Trial (2001)
    Oxford, UK : Blackwell Science Inc
    Birth 28 (2001), S. 0 
    Details
    ISSN: 1523-536X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: Current forms of analgesia often have significant side effects for women in labor. Bathing in warm water during labor has been reported to increase a woman's comfort level and cause a reduction in painful contractions. The objective of this trial was to compare immersion in warm water during labor with traditional pain management for a range of clinical and psychological outcomes. Methods: A prospective randomized controlled trial of 274 pregnant women, who were free from medical and obstetric complications and expecting a singleton pregnancy at term, was conducted at the Women's and Children's Hospital, a maternity tertiary referral center in Adelaide, South Australia. Women in labor were randomized to an experimental group who received immersion in a bath or to a nonbath group who received routine care. Pharmacological pain relief was the primary outcome that was measured, and secondary outcomes included maternal and neonatal clinical outcomes, factors relating to maternal and neonatal infectious morbidity, psychological outcomes, and satisfaction with care. Results: The use of pharmacological analgesia was similar for both the experimental and control groups; 85 and 77 percent, respectively, used major analgesia. No statistical differences were observed in the proportion of women requiring induction and augmentation of labor or in rates of perineal trauma, length of labor, mode of delivery, or frequency of cardiotocographic trace abnormalities. Neonatal outcomes (birthweight, Apgar score, nursery care, meconium-stained liquor, cord pH estimations) revealed no statistically significant differences. Infants of bath group women required significantly more resuscitation than routine group women. Routine group women rated their overall experience of childbirth more positively than bath group women. Psychological outcomes, such as satisfaction with care or postnatal distress, were the same for both groups. Conclusion: Bathing in labor confers no clear benefits for the laboring woman but may contribute to adverse effects in the neonate.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1523-536X.2001.00084.x
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  • 8
    Electronic Resource
    Electronic Resource
    Nearshore fish habitat utilization and species associations in Lake Opinicon (Ontario, Canada) (1978)
    Springer
    Environmental biology of fishes 3 (1978), S. 173-184 
    Details
    ISSN: 1573-5133
    Keywords: Ecosystem ; Populations ; Habitat utilization ; Biomass ; Fish habitat ; Lake fish ; Seasonal movements ; Centrarchids ; Cyprinids ; Yellow perch
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology
    Notes: Synopsis The bulk of Lake Opinicon fish biomass is concentrated in the physically diverse inshore areas. Quantitative analysis of the community compositions of the various inshore habitat types (weedy inlets, sandy shallows, rock shelf, gravel, etc.) showed that each supported a characteristic assemblage of fishes with a relatively constant species and year class composition. This was maintained throughout the season despite a drop in fish biomass in late summer when there was a progressive movement into the offshore waters. Weedbed areas supported the highest biomass, and greatest species and year class diversity. Thereafter, in declining order of richness, were rocky and sandy areas. A few fish species were restricted to single habitat types, e.g.Notropis heterodon to inshore weedbeds.Lepomis macrochirus, the commonest species in the lake was, by contrast, versatile and occurred in all inshore habitats. Commonly the numbers of a species in a habitat differed between day and night. Significant diel movements between habitats characterized two nocturnal feedersPomoxis nigromaculatus andIctalurus nebulosus.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00691941
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