Interpregnancy interval planning after caesarean section.

Canty, A. M., Keedle, H., Makris, A., & Dahlen, H. G. (2025). Interpregnancy interval planning after caesarean section: A national survey. Midwifery,149, 104575. doi:10.1016/j.midw.2025.104575

Abstract

Aim: Explore women’s experience and decision making around interpregnancy interval after caesarean section.

Methods: A sequential mixed methods approach was used to identify themes from qualitative interviews conducted across Australia. 332 women consented to participate in the survey.

Conclusion: Interpregnancy interval continues to be poorly understood potentially impacting on choices women make in their next pregnancy. Given the value placed on online support for women who have had a caesarean birth maternity service providers should address this by providing appropriate resources. This is particularly relevant as this group of women report high rates of trauma.

Full abstract and article available – https://www.sciencedirect.com/science/article/pii/S0266613825002931?via%3Dihub

Prenatal paracetamol exposure and child neurodevelopment: a systematic review and meta-analysis.

D’Antonio, F. Flacco, M. E., Della Valle, L., Prasad, S., Manzoli, L., Samara, A., & Khalil, A. (2026). Prenatal paracetamol exposure and child neurodevelopment: a systematic review and meta-analysis. The Lancet Obstetrics, Gynaecology, & Women’s Health, 0(0), https://doi.org/10.1016/S3050-5038(25)00211-0

Background: Concerns have emerged about the impact of paracetamol use in pregnancy on child neurodevelopment, particularly in relation to autism spectrum disorder. We aimed to synthesise available evidence to investigate associations between prenatal paracetamol exposure and autism spectrum disorder, attention-deficit hyperactivity disorder (ADHD), and intellectual disability.

Findings: 43 studies were included in the systematic review, and 17 studies in the meta-analysis. When considering sibling comparison studies, paracetamol exposure during pregnancy was not associated with the risk of autism spectrum disorder (OR 0·98, 95% CI 0·93–1·03; p=0·45), ADHD (0·95, 0·86–1·05; p=0·31), or intellectual disability (0·93, 0·69–1·24; p=0·63). There was also no association between paracetamol intake during pregnancy and autism spectrum disorder (OR 1·03, 95% CI 0·86–1·23; p=0·78), ADHD (0·97, 0·89–1·05; p=0·49), or intellectual disability (1·11, 0·92–1·34; p=0·28) when considering only studies at low risk of bias according to QUIPS. This absence of association persisted when considering all studies with adjusted estimates and those with more than 5 years of follow-up.

Interpretation: Current evidence does not indicate a clinically important increase in the likelihood of autism spectrum disorder, ADHD, or intellectual disability in children of pregnant individuals who use paracetamol as directed, supporting existing recommendations on its safety.

Full abstract and article available – https://www.thelancet.com/journals/lanogw/article/PIIS3050-5038(25)00211-0/fulltext

What it takes to develop self-confidence and competence in midwifery students for midwifery practice.

Adnani, Q. E. S., Okinarum, G. Y., Sari, A. Z. C., Khaerani, I. N., Gumilang, L., Susanti, A. I., Martini, N., & Sweet, L. (2026). What it takes to develop self-confidence and competence in midwifery students for midwifery practice. Nurse Education Today, 144, 106397, ISSN 0260-6917. https://doi.org/10.1016/j.nedt.2024.106397.

Highlights

• The development of competence and self-confidence is crucial for students pursuing a career in midwifery.
• The cultivation of knowledge and acquisition of essential competencies among midwifery students are facilitated by engagement in research activities, practical training in laboratory and hospital settings, active participation in seminars and workshops, classroom instruction, and individual learning.
• Our findings support several strategies, including acquiring scientific knowledge, engaging in active discourse and organization.

Background: Midwifery practice is multidimensional and complex in supporting women’s reproductive health. Midwives provide care through pregnancy, birth, and the puerperium and may extend to sexual and reproductive health. Midwifery education must develop self-confidence and competence within each midwifery student. This must be learned before registering as a midwife and entering midwifery practice. Little is known about how educational experiences influence midwifery students’ confidence.

Aim: The aim of this study was to understand the educational experiences that influence self-confidence and competence development among midwifery students.

Conclusion: Midwifery students described how the increase in self-confidence can lead to an increase in competence, enabling the provision of high-quality midwifery services.

Full abstract, introduction and article snippets available – https://www.sciencedirect.com/science/article/abs/pii/S0260691724003071

Midwives’ opinions and engagement with midwifery research

Kaur, M., Kerr, D., McCormick, M., & Sweet, L. (2026). Midwives’ opinions and engagement with midwifery research: A cross-sectional study. Women and Birth, 38(3), 101909, ISSN 1871-5192. https://doi.org/10.1016/j.wombi.2025.101909.

Abstract

Background: Midwives’ engagement in research is vital for advancing evidence-based practice and enhancing quality care. Despite the expectation that midwives incorporate evidence into their practice, the profession has historically been underrepresented in research.

Aim: To investigate midwives’ opinions about midwifery research and assess their level of engagement in midwifery-led research.

Methods: A cross-sectional design and a convenience-based sampling approach at one metropolitan hospital were used. Data were collected using an online survey with a combination of closed, multichoice and open-ended questions. Data were analysed using SPSS for descriptive and univariate statistics. Content analysis was used for free-text responses.

Findings: Sixty midwives participated, with a response rate of 16 % (60/380). Most participants expressed positive attitudes toward research,. Less positive attitudes were obtained for confidence and access to resources. A small proportion reported they had authored or co-authored a peer-reviewed journal article (6.7 %), and presented at a conference (8.3 %) or within their healthcare organisation (18.3 %). Midwives reported significant barriers to engagement in research, particularly related to lack of time, low-confidence, and minimal research education.

Discussion

The findings illustrate the recognition by midwives of the essential role that clinical experience, scientific knowledge, and research play in the practice and advancement of midwifery. However, midwives perceive there are barriers to their involvement in research.

Conclusion

Larger studies are needed to develop, implement and evaluate targeted interventions to promote midwifery-led research. Strategies are needed to increase midwives’ engagement in research, including the provision of adequate time, involvement in research activities, and access to resources.

Full abstract and article available – https://www.sciencedirect.com/science/article/pii/S1871519225000435 Midwifery Care: An Evolutionary Concept Analysis

Midwifery Care: An Evolutionary Concept Analysis.

Barbieri, M., Moro, A., Catania, G., Carnevale, F. A., Aleo, G., Zanini, M., Sasso, L., & Bagnasco, A. (2026). Midwifery Care: An Evolutionary Concept Analysis. Nursing Open, 12(11), e70354.

Abstract

Aim: To build an evidence-based definition of midwifery care and its fundamental and distinctive features.

Design: Rodgers and Knafl’s evolutionary concept analysis.

Results: Key findings include five antecedent categories: philosophy, personal features, regulatory features, care context and professional team. Attributes include relationship and family-centredness. Consequences encompass safety, empowerment and professional outcomes. Related concepts and surrogate terms reflect the broader scope and the fragmented perception of ‘midwifery care’.

Discussion: Midwifery care is often limited by obstetric-led models that prioritise risk management over holistic care. This disparity leads to discrimination and professional dissatisfaction, impacting on the quality of care and midwives’ well-being.

Implications for the Profession: Through the conceptualisation of midwifery care, research, education, clinical practice and governance can be oriented toward professional priorities, enhancing coherence, awareness and relevance in relation to the ontological nature of the profession and its systemic value within healthcare and society. In this context, it is crucial for policymakers to maximise the development and implementation of policies that support the establishment of care models based on the principles of midwifery care, ensuring a more comprehensive and effective healthcare system.

Full abstract and article available – https://onlinelibrary.wiley.com/doi/full/10.1002/nop2.70354

A comparison of physiologic third-stage care, expectant management, and oxytocin prophylaxis in the prevention of postpartum hemorrhage.

Hebert, V., Santesso, N., Oltean, I. I., Muraca, G. M., & Darling, E. K. (2026). A Comparison of Physiologic Third-Stage Care, Expectant Management, and Oxytocin Prophylaxis in the Prevention of Postpartum Hemorrhage Following Physiologic Labor and Birth: A Systematic Review. J Midwifery Women’s Health, doi: 10.1111/jmwh.70077. Epub ahead of print. PMID: 41531396.

Abstract

Introduction: This systematic review compared the effects of physiologic care or expectant management during the third stage of labor with oxytocin prophylaxis in preventing postpartum hemorrhage following physiologic birth.

Methods: We searched MEDLINE, Embase, CINAHL, Web of Science, and Cochrane Central Register of Controlled Trials (to December 15, 2023), ClinicalTrials.gov (to July 8, 2024), and reference lists of eligible studies. We included randomized and nonrandomized studies of individuals who experienced physiologic birth or received minimal obstetric interventions. Two reviewers independently assessed eligibility and risk of bias. Random-effects meta-analyses were performed, and evidence certainty was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria.

Results: Three randomized controlled trials and 4 nonrandomized studies (N = 7; 7091 participants) were included, with 3 studies contributing data to the quantitative analyses. For individuals with physiologic birth, low-certainty evidence from one nonrandomized study (3436 participants) suggests that physiologic third-stage care results in a large reduction in the risk of blood loss greater than 1000 mL compared with oxytocin (relative risk [RR], 0.29; 95% CI, 0.09-0.92; 18 fewer per 1000; 95% CI, 22 fewer to 2 fewer). In contrast, evidence from one randomized controlled trial (1686 participants) indicates that expectant management likely results in a large increase in the risk of excessive blood loss greater than 1000 mL (RR, 1.87; 95% CI, 1.36-2.57; 21 more per 1000; 95% CI, 9 more to 39 more; moderate certainty) compared with oxytocin but may not increase the risk of transfusion (low certainty) and results in little to no difference in well-being or breastfeeding (high certainty).

Discussion: Compared with oxytocin, physiologic third-stage care may result in a large reduction in the risk of excessive blood loss, whereas expectant management likely results in a large increase. Further research is needed to improve evidence certainty, focus on patient-important outcomes, and enhance generalizability.

Full abstract and article available https://pubmed.ncbi.nlm.nih.gov/41531396/

https://www.midwife.org.nz/wp-content/uploads/2026/02/J-Midwife-Womens-Health-2026-Hebert-A-Comparison-of-Physiologic-Third‐Stage-Care-Expectant-Management-and-Oxytocin.pdf

Breastfeeding, bonding, and olfaction: unlocking the potential of mother-infant odour exchange.

Roberts, S. C., Damon, F., Durand, K., Havlicek, J., Kourtis, D., Langford, B., Sorokowska, A., Sorokoski, P., Swanson, V., Williams, J., Arnoldi-Meadows, A., Brimaud, D., Dlouha, D., Jelinkova, L., Kankova, S., Kapicova, L., Poirier, A. C., Roberts, K., Sander, J. C, …& Schaal, B. (2026). Breastfeeding, bonding, and olfaction: unlocking the potential of mother-infant odour exchange. eBioMedicine, 123(106086), https://doi.org/10. 1016/j.ebiom.2025. 106086

Summary

Breastfeeding is crucial for infant survival, growth, and health, and it enhances maternal-infant bonding and well-being. However, breastfeeding rates typically fall below international targets, partly due to a high prevalence of latching difficulties, intermittent sucking, refusing the breast, or poor milk supply. Here, we propose that such uniquely human difficulties might be ameliorated by recognising, understanding, and facilitating the olfactory mechanisms that, in other mammals, regulate breastfeeding initiation and maternal–infant relationships in the first weeks of life. We briefly review evidence that odour mediates nipple-searching and suckling behaviour in other species, summarise the comparable evidence in humans, and outline pathways that could potentially reap hitherto unrealised benefits of olfactory communication between human mothers and neonates. We argue that enhanced awareness of such odour exchange could inform and enable changes in both policy and practice that might improve breastfeeding success and maternal-infant bonding, ultimately contributing to reduced infant mortality worldwide.

Full article available – https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(25)00536-5/fulltext

Prenatal Exposure to Migraine Medications, and Neurodevelopmental Outcomes

Camanni, M., van Gelder, M.M.H.J, Cantarutti, A., Nordeng, H., & Lupattelli, A. (2025). Association of Prenatal Exposure to Triptans, Alone or Combined With Other Migraine Medications, and Neurodevelopmental Outcomes in Offspring. Neurology,104(12),e213678. doi: 10.1212/WNL.0000000000213678.

Abstract

Background and objectives: The long-term reproductive safety of migraine medications remains uncertain. This study sought to examine the effect of different intensities and durations of prenatal exposure to triptans, alone and combined with other preventive migraine medications, on neurodevelopmental disorders (NDDs) in children.

Methods: This nationwide health registry study in Norway included pregnancies of women with migraine before pregnancy and followed up their children up to 14 years of age.

Results: We included 26,210 pregnancies of women with migraine; 4,929 and 21,281 were, respectively, nonmedicated and medicated with triptans in the year of prepregnancy. In the latter group, we identified 4 group-based trajectories of triptans alone and combined with preventive medications: discontinuers before (low use) (41.5%, 47.0%), early discontinuers (short-term low use) (31.3%, 28.8%), late discontinuers (moderate use) (21.3%, 9.1%), and late discontinuers (high use) (5.9%, 15.2%). Overall, 1,140 children (4.3%) had a NDD (mean follow-up time: 8 years). Children born to women with any triptan trajectory had a slightly higher risk of NDD compared with children of nonmedicated women (magnitude range of the weighted hazard ratio [wHR]: 1.05-1.16). These risks decreased to the null when discontinuers before (low use) acted as a comparator (magnitude of wHR: 0.94-1.01) or when analyzing speech/language disorders or ADHD (magnitude of wHR: 0.82-1.14). There was a slightly elevated risk of autism disorders with both triptan late discontinuation trajectories (wHR 1.24, 95% CI [0.78-1.97]; wHR 1.30, 95% CI [0.66-2.56]), but the 95% CI crossed the null and the weighted risk difference remained low.

Discussion: Our findings indicate that prenatal exposure to triptans, alone or combined with other migraine medications, does not substantially increase the risk of a broad range of neurodevelopmental outcomes in children up to adolescence.

Full abstract available – https://pubmed.ncbi.nlm.nih.gov/40397854/

Testing for Neonatal Hypoglycaemia in Aotearoa, New Zealand – current Practice survey

Ulyatt, C.M., Harding, J.E., Clapham, V., Alsweiler, J.M., & Lin L. A. (2025). Survey of the Current Practice for Testing for Neonatal Hypoglycaemia in Aotearoa, New Zealand. J Paediatr Child Health, 61(8),1235-1240. doi: 10.1111/jpc.70097.

Abstract

Aims: Neonatal hypoglycaemia is the most common metabolic disturbance in newborns and can lead to brain injury. However, the feasibility of implementing a national recommendation to use accurate testing methods to avoid under- and over-diagnosis depends on current practise, preferences, and resources. We therefore sought to identify current testing practises for neonatal hypoglycaemia to inform recommendations for testing, including devices and timing.

Methods: An online survey was sent to relevant clinical unit leaders across the 19 health regions of New Zealand, and to members of the New Zealand College of Midwives who provide home birth services. These individuals were asked to complete the survey themselves or identify the appropriate practitioner in their unit to complete it.

Results: From 28th August to 12th December 2023, we obtained 71 responses, which came from more than one profession from all but one health region. The most commonly used devices for measuring glucose concentrations in capillary blood samples were blood gas analysers (20/65, 31%) and i-STAT (12/65, 18%). Devices used did not differ among professions, but the use of blood gas analysers was not reported in primary units. i-STAT (22/80, 28%) and blood gas analyser (19/80, 24%) were also the most preferred testing devices. The timing of blood sampling was reported to be similar for > 70% of respondents.

Conclusions: Most healthcare professionals use and prefer accurate blood sampling devices, suggesting implementing a recommendation to use these is likely feasible. However, guidance on the timing of testing is needed.

Full article available – https://pmc.ncbi.nlm.nih.gov/articles/PMC12397843/

Impact of midwife continuity of carer on stillbirth rate and first feed in England. 

Roebuck, C., Sandall, J., West, R. et al. (2025). Impact of midwife continuity of carer on stillbirth rate and first feed in England. Commun Med, 5(339), https://www.nature.com/articles/s43856-025-01025-z

Background

In 2017 NHS England started rolling out a model where women have continuity of carer with the same midwifery team throughout the perinatal period. This study uses national data to test whether women of different groups receiving midwife continuity of carer had lower stillbirth rates and higher rates of a first feed of breast milk than women receiving standard care.

Methods: We compared the two outcomes for women placed on the midwife continuity of carer pathway by 24 weeks and women receiving standard care in England, with logistic regression standardising between groups. We used the Maternity Services Dataset covering 922,149 women conceiving between 2020 and 2022.

Results: Combining all demographic groups, women on a midwife continuity of carer pathway have a higher first feed of breast milk rate (p < 0.001), but do not show a difference in stillbirth rate, compared to women receiving standard care. However, Black women on this pathway have lower stillbirth rates (p = 0.047) compared to Black women receiving standard care, the only demographic group showing a difference.

Women with no antenatal appointment at all by 24 weeks have much higher stillbirth rates than those with an appointment (p < 0.001).

Conclusions: The findings that midwifery continuity of carer increases the first feed of breast milk uptake, which has health benefits. It may decrease stillbirth rates for Black women. Both findings inform future policy development and research. Further investigation and outreach around women not coming forward for timely antenatal care may also be beneficial.

Full article available – https://www.nature.com/articles/s43856-025-01025-z

Breast Milk from Different Lactation Stages and in VitroWound Healing

Aydin Acar, C., Pehlivanoglu, S., Yesilot, S., & Tasdemir, H. I. (2024). The Effect of Breast Milk from Different Lactation Stages on in Vitro Wound Healing. Breastfeed Med,19(9),698-706. doi: 10.1089/bfm.2024.0099.

Abstract

Objective: Wound healing is a complex and dynamic process essential for restoring tissue integrity and homeostasis. It is thought that breast milk contributes positively to the wound healing process, thanks to the components it contains. The aim of this study is to compare the effects of breast milk on the wound healing process at different lactation stages and to evaluate the underlying mechanism(s). Materials and Methods: The effects of breast milk from different lactation stages (colostrum, transitional, and mature milk) on wound healing were determined by in vitro scratch assay in L929 fibroblast cells. 2,2-Diphenyl-1-picrylhydrazyl (DPPH), total oxidant, and antioxidant capacity were used to confirm antioxidant effects. The effect of breast milk on netrin-1 levels in L929 cells was elucidated by ELISA.

Results: Breast milk at different lactation stages promoted wound healing. While the wound closure percentage was determined as 48.7% in the control group, this rate was determined to be the highest at 81.6% in the mature milk group (p:0.0002). The free radical scavenging capacity of colostrum, transitional, and mature milk with DPPH was determined as 49.69%, 60.64%, and 80.85%, respectively, depending on the lactation stages. Netrin-1 levels detected by ELISA were determined as 490.1 ± 6.5 pg/mL in the control group, while the lowest level was determined as 376.6 ± 4.5 pg/mL in mature milk (p:0.0003).

Conclusions: Breast milk, especially mature milk, promoted wound healing on L929 cells by suppressing netrin-1 levels and scavenging free radicals.

Full abstract available – The Effect of Breast Milk from Different Lactation Stages on in Vitro Wound Healing | Breastfeeding Medicine

Topical Breast Milk and Episiotomy Wound Healing:  Literature overview

Sadat Hossaini, K., Nahid Jahani, S., Shariatmoghani, S., Akhlaghi, F., Reza Mazlom, S., & Soleimanpour, S. (2024). Effects of Topical Breast Milk in Promoting Episiotomy Wound Healing: An Overview of Literature. Health Providers, 4(2),109-116.

Abstract

Background: Postpartum perineal wounds, which often result from episiotomies or tears during childbirth, can lead to significant discomfort and complications. This study reviews the therapeutic potential of breast milk as a topical treatment that may enhance wound healing and alleviate pain in postpartum women, based on existing literature.

Results: Four related studies were included in this overview. Research indicates that the topical application of breast milk can significantly enhance the healing of episiotomy wounds in postpartum women, demonstrating reductions in REEDA (Redness, Edema, Ecchymosis, Discharge, and Approximation) scale scores compared to standard care. Many women reported effective healing, and breast milk may outperform traditional antiseptics while alleviating pain. However, there are risks to consider, including the non-sterility of breast milk, which can introduce bacteria into wounds, as well as the potential for adherence to dressings, leading to trauma during dressing changes. Individual responses may also vary, with some women experiencing allergic reactions. Therefore, while breast milk shows promise for wound healing, its risks should be carefully weighed against the benefits, and a professional medical evaluation is recommended for serious wounds.

Conclusion: Topical application of breast milk can significantly enhance the healing of episiotomy wounds in postpartum women, often outperforming standard care. While many women experience effective healing, potential risks, such as non-sterility and dressing adherence, must be considered. Thus, the benefits of using breast milk for wound healing should be carefully weighed against its risks.

Full article available – https://www.health-providers.ir/article_211060_25f56bb8500eae5e05b0422ab1c8caf8.pdf

Women’s experiences of declining recommended or routine maternity care

Mohamed Hussain, I., Buchanan, K., Sweet, L., Sara Bayes, S. (2025). Women’s experiences of declining recommended or routine maternity care: A systematic review. Women and Birth, 38(6),102123, ISSN 1871-5192.

Abstract

Background: Women have the right to decline recommended or routine maternity care. While informed choice is increasingly emphasised in maternity care, the experiences of women who decline recommended or routine care remain underexplored.

Aims: To synthesise evidence on women’s experiences of declining recommended or routine aspects of maternity care.

Methods: A systematic review was conducted using a structured approach informed by Joanna Briggs Institute (JBI) principles for qualitative synthesis. Eight studies were appraised using the Critical Appraisal Skills Programme (CASP) checklist. Data were analysed through a narrative synthesis process, developing categories and dimensions that were synthesised into overarching themes.

Results: Through narrative synthesis, two overarching categories were developed to answer the review question: ‘Women’s Characteristics’ supported by two subcategories: 1) Women’s birth philosophy, autonomy, and trust in the birth process and 2) Informed and values-based decisions to decline care. The second category, ‘Maternity Care Professionals’ Influence’, is supported by subcategories 1) paternalism and the erosion of trust, and 2) risk-averse culture and defensive practice.

Conclusions: This review synthesised literature on why women decline recommended or routine maternity care. Findings indicate that women who decline care demonstrate values-driven, informed decision-making and have a desire for autonomy and respectful care. Maternity care can be improved by recognising women’s rights to decline care, supporting informed choice through advocacy, and providing individualised woman-centred care.

Full article available – https://www.sciencedirect.com/science/article/pii/S1871519225002574?via%3Dihub

Autism – Experiences during pregnancy and early parenthood

Love, A, M. A., Cai, R. Y., Rideout, B., Hollenberg, L., Clapham, H., McKeown, G., Edwards, C., Robinson, A., Benzie, C., & Gibbs, V. (2025). Stories of Competence, Challenges, and Coping: The Experiences of Australian Autistic People During Pregnancy and Early Parenthood. Autism in Adulthood, https://www.liebertpub.com/doi/10.1177/25739581251359894

Abstract

Background: Autistic people often face significant challenges in navigating health care systems, particularly during the vulnerable perinatal period. Many report inadequate care, feeling misunderstood, and being unsupported in addressing their health needs. We explored the pregnancy and early parenthood experiences of Autistic individuals in Australia, addressing the unique health care barriers they may face.

Results: We constructed four key themes from the data. The first theme, “Pregnancy was good for me,” reflected feelings of body positivity and empowerment during pregnancy. Theme 2, “Hyperfocus as an understatement,” illustrated participants’ intense desire to gather information on every aspect of pregnancy and parenthood, which both facilitated and hindered their well-being. The third theme, “Lost in the system,” described the social drain caused by unpredictable health care interactions. The final theme, “Making things work for me,” detailed the coping mechanisms and strategies participants used to manage the demands of pregnancy and early parenthood.

Conclusions: Our findings amplify the stories of competence and empowerment among Autistic parents, highlighting their experiences of resilience and agency in navigating these life transitions. It acknowledges the positive aspects of Autistic parenthood, which are often overlooked in research, and seeks to enhance the evidence base to inform health care practices that better meet the needs of Autistic parents. Importantly, these findings have broader implications for improving health care in other areas where Autistic people face similar challenges. By focusing on the localized experiences within Australia’s health infrastructure, this research provides insights that contribute to more effective inclusive health care interventions, ensuring that Autistic individuals receive the support they need during these critical life stages.

Abstract only available https://www.liebertpub.com/doi/abs/10.1177/25739581251359894

Barriers and facilitators to the implementation of a midwifery-led care model: a qualitative systematic review

 Goncalves, A. S., Pestano-Santos, M., McCourt, C., & Prata, A. P. (2025). Barriers and facilitators to the implementation of a midwifery-led care model: a qualitative systematic review. Midwifery, 158, https://doi.org/10.1016/j.midw.2025.104514.

Abstract

Problem Despite the overwhelming benefits of midwifery-led care models, in many countries, for several reasons, there is a resistance to their implementation.

Background These care models provide both short-term and long-term advantages for mothers and newborn, demonstrate sustainability, and offer economic benefits.

Aim This qualitative systematic review explores and synthesises evidence on stakeholders’ perceptions of the barriers and facilitators to implementing a shift from doctor-led or shared-care models to midwifery-led models of care.

Conclusion Context-specific strategies informed by implementation science must be developed to support the sustainable integration of midwifery-led care models, with a particular emphasis on policy development and stakeholder engagement.

Open access – https://www.sciencedirect.com/science/article/pii/S0266613825002323

The international confederation of midwives essential competencies for midwifery practice: A revision process – 2024

Embo, M., Levy, M., & Pairman, S. (2025). The international confederation of midwives essential competencies for midwifery practice: A revision process – 2024. Midwifery, 149, https://doi.org/10.1016/j.midw.2025.104525.

Abstract

Objective To achieve global expert consensus on the revision of Essential Competencies for Midwifery Practice 2019.

Methods A team worked closely with ICM and key stakeholders to systematically revise the ICM Essential Competencies for Midwifery Practice 2019 framework, documenting quantitative and qualitative data. The framework was updated through a literature review (phase 1), two-round validation (phase 2), translation (phase 3), Board approval (phase 4), face-validity assessment (phase 5), and final adjustments before dissemination (phase 6).

Findings The review included midwifery experts from all ICM regions and related organizations. While ICM initially aimed for a minor revision, the framework expanded from 4 to 5 categories, 31 to 37 competencies, 130 to 250 knowledge indicators, and 182 to 296 skills and behaviours indicators resulting in a major revision. The key change was adding a new category (two) on sexual and reproductive health and rights, focused on contraception, comprehensive abortion care, and gender-based violence and abuse. Four new competencies were added to category one, focusing on technology, interdisciplinary care, prescribing medications and human disasters. Minor adjustments in categories three, four and five focused on normal/physiological birth, midwifery models of care and emergency care.

Conclusion The 2024 revision and update of the ICM Essential Competencies for Midwifery practice (2019) integrates current evidence, global guidance documents and expert input to reflect current midwifery practice globally.

Open access – https://www.sciencedirect.com/science/article/pii/S0266613825002438

The effect of early mother-infant skin-to-skin contact on pain and anxiety during episiotomy repair

Baradwan, D., Hefedh, B., Khadawardi, K., Alanazi, A., et al. (2025). The effect of early skin-to-skin contact on pain and anxiety during episiotomy repair: A systematic review and meta-analysis of randomized controlled trials. Midwifery, 148, https://doi.org/10.1016/j.midw.2025.104460.

Highlights

• Episiotomy pain contributes to mothers’ apprehension about normal vaginal birth.
• Early and continuous skin-to-skin contact (SSC) promotes maternal-infant bonding, regulates neonatal temperature, and supports breastfeeding.
• We studied SSC effectiveness in pain and anxiety relief during episiotomy repair.
• SCC is effective in alleviating pain and anxiety during episiotomy repair.

Full abstract https://www.sciencedirect.com/science/article/abs/pii/S0266613825001780

Prolactin modulation of thermoregulatory circuits provides resilience to thermal challenge of pregnancy

Ladyman, S. R., Georgescu, T. R., Stewart, A. M., Cheong, I., Grattan, D. R., & Brown, R. S. E. (2025). Prolactin modulation of thermoregulatory circuits provides resilience to thermal challenge of pregnancy. Cell Reports, 44(4),115567.

This work demonstrates that prolactin is an important regulator of the thermoregulatory neural circuits in the hypothalamus during reproduction. The hormone-induced changes anticipate the additional metabolic load of late pregnancy and provide thermal resilience against elevated environmental temperatures.

Open access – https://www.cell.com/cell-reports/fulltext/S2211-1247(25)00338-9

How does the first index mode of birth in public or private hospitals predict subsequent births? A 16-year Australian population-based linked data study

Peters, L., De Jonge, A., de Boer, M., Downe, S., & Dahlen, H. G. (2025). How does the first index mode of birth in public or private hospitals predict subsequent births? A 16-year Australian population-based linked data study. BMJ Open, 15(1), e086212.doi: 10.1136/bmjopen-2024-086212.

Abstract

Objectives In this descriptive study, we aimed to assess how the index mode of birth and subsequent birth modes vary over time for public and private hospital maternity care funding models. The second aim was to determine to what extent the index mode of birth predicts subsequent birth modes in general and whether this differs in public versus private hospital maternity care funding models. With our aim, we have an innovative approach, specifically the women’s life course approach, which is hypothesis-generating and can be assessed in future studies.

Design, setting and participants New South Wales population-linked data of low-risk women were analysed (2001–2016). Demographics and public/private care were recorded. Modes of the index birth and subsequent modes of second and third births (ie, spontaneous vaginal, instrumental vaginal elective/emergency caesarean birth) were registered. For those with 2 births and 3 births, 16 and 64 subsequent births patterns were created.

Primary and secondary outcome measures Trend of index modes of birth and subsequent modes of birth over time and the prediction of subsequent birth modes based on the index birth. These outcomes were stratified for the initial maternity care funding model.

Results In total, 172 041 low-risk nulliparous women were included in the initial cohort, 54.1% had a spontaneous index vaginal birth and 71% had their index birth in public hospitals. During the study period, 131 675 women had 2 births and 44 677 of these women had 3 births, respectively. Among women birthing in public hospitals, higher proportions of index and subsequent vaginal births were observed than in private hospitals, with fewer instrumental vaginal births and caesarean sections. Large differences were observed for birth patterns: vaginal-vaginal (public 55.8% vs private 36.8%) and vaginal-vaginal-vaginal (public 57.2% vs private 38.8%). Women with an index spontaneous vaginal birth showed a high probability (91.3%) of subsequent spontaneous vaginal births. When stratified by maternity care funding model, the probabilities were similar: 91.6% in public hospitals and 90.2% in private hospitals.

Conclusions Our study of low-risk Australian women (2001–2011) found that those giving birth in public hospitals had higher proportions of spontaneous vaginal births compared with private hospitals, where caesarean sections were more common. Women with an index spontaneous vaginal birth had a very high probability to have subsequent vaginal births. These findings suggest that index mode of birth may be a predictor for subsequent modes of birth.

Full article available https://pmc.ncbi.nlm.nih.gov/articles/PMC11781108/

A content analysis of women’s experiences of debriefing following childbirth: The birth experience study (BESt)

Bannister, L., Hammond, A., Dahlen, H. G., Keedle, H. (2025). A content analysis of women’s experiences of debriefing following childbirth: The birth experience study (BESt). Midwifery,146, 104421, https://doi.org/10.1016/j.midw.2025.104421

Abstract

Background The early postpartum period is highly vulnerable, with the World Health Organization estimating that 13 % of women globally experience postnatal mental health disorders. Postnatal care often lacks the resources allocated to antenatal and intrapartum care, leading to maternal psychological needs being overlooked. Understanding women’s lived experiences of debriefing is crucial as it provides insights into the practical and emotional aspects of debriefing that effectiveness studies alone cannot capture. Debriefing, a psychological intervention, can help prevent postnatal mental health issues, though the most effective approaches are still debated.

Aim To explore Australian women’s views on the role of debriefing in postnatal care, including its benefits and suggestions for implementation.

Methods The Birth Experience Study (BESt) was a national online survey conducted in 2021 which focused on the experiences of Australian women who had given birth at any time in the preceding five years. The survey included questions about their debriefing experiences, who they debriefed with, and their suggestions for optimal timing of debriefing. Qualitative content analysis was applied to 2154 open-ended responses discussing postnatal debriefing experiences.

Findings Of 2514 responses, two main categories were found that focused on the debriefing experience and suggestions for optimal timing for debriefing following birth. Women highlighted the importance of being heard compared to being dismissed and not being able to validate their feelings.

Conclusion Women value debriefing, and its effective implementation depends on individual experiences and needs. The findings suggest that debriefing should become standard practice, with maternity clinicians trained to provide this crucial aspect of postnatal care.

Full article available https://www.sciencedirect.com/science/article/pii/S0266613825001391

Social media influencers in the space of pregnancy and parenting: a scoping review protocol

Hives, L., Bray, E. P., Nowland, R., & Thomson, G. (2024). Social media influencers in the space of pregnancy and parenting: a scoping review protocol. BMJ Open, 14(10), e087200 DOI:10.1136/bmjopen-2024-087200

Abstract

Introduction Social media influencers (SMIs) are popular sources of online information on various topics, including many aspects of health. Recently, there has been an upsurge in SMIs creating content about pregnancy and parenting, including from midwives, pregnant women and parents. Despite its popularity, SMI content on pregnancy and parenting is not currently regulated, which allows for misinformation and potential harm to women and their children. Research has also found that most women do not discuss the information they access online with their healthcare providers.

This is the first scoping review to map the existing evidence on SMIs in the context of pregnancy and early parenting.

Methods and analysis The scoping review will be conducted from May to December 2024 and reported using guidance from Arksey and O’Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. 10 academic databases will be searched for relevant studies, using keywords and subject headings for the concepts of “social media”, “influencers”, “pregnancy” and “parenting.” All primary and secondary research studies of pregnancy and early parenting SMIs will be included. Two authors will screen the identified studies for eligibility. The risk of bias of the included studies will not be assessed. Extracted data will be presented in tables and will be described narratively.

Ethics and dissemination Ethical approval was not needed for this scoping review. Results will be published in a peer-reviewed journal, presented at conferences, posted on social media and presented to relevant groups.

Full article available https://bmjopen.bmj.com/content/14/10/e087200

Reconsidering “inclusive language:” Consequences for healthcare and equitableness of a growing linguistic movement to address gender identity with a path forward.

Bartick, M., Dahlen, H., Gamble, J., Walker, S., Mathisen, R., & Gribble, K. (2025). Reconsidering “inclusive language:” Consequences for healthcare and equitableness of a growing linguistic movement to address gender identity with a path forward. Sexual and Reproductive Healthcare, 44, 101088, 1877-5756.

Abstract

Increasingly, the language of female reproduction is changing, so terms directly referencing people’s sex are replaced with terms obscuring sex, a language form commonly called “inclusive language” but more accurately is “desexed language.” Desexed language is promoted as assisting individuals experiencing an inner sense of themselves (a gender identity) in conflict with their sex, a state described as being transgender or gender-diverse. It seemingly assumes no harm to the general population. However, the scant existing research suggests it may not be well accepted or understood. There are a variety of types of desexed language, including globalizing language (e.g. replacing “women” with “people”), biology-based language (e.g. “lactating individuals,” “menstruators”), neologisms (“chestfeeding”), appropriation of terms with other meanings (“sex assigned at birth”), and additive language (e.g. “women and birthing people”). Second- and third-person language (e.g. “if you are sexually active,” “those who are pregnant”) can be a type of desexed language depending on context. Desexed language is likely to have an adverse impact on people with low health literacy and language skills, risk alienation, and cause confusion, especially in non-Western countries and cultures. It may even cause harm to transgender and gender-diverse people who also need clear health communications as well as specialized healthcare. Widespread use of desexed language is contrary to the usual practice of implementing targeted tailored communications for those with specialized needs while using the most effective language for most people for general communications. Comprehensive research on the impact of desexed language is urgently needed.

Full article available https://www.sciencedirect.com/science/article/pii/S1877575625000266

Human milk bank services and Islamic milk kinship: pathways and processes for ensuring respect for religious law and tradition in the provision of donor human milk for small vulnerable newborns

https://internationalbreastfeedingjournal.biomedcentral.com/articles/10.1186/s13006-025-00704-w

Gribble, K.D., Zambrano, P., Omer-Salim, A. et al. (2025). Human milk bank services and Islamic milk kinship: pathways and processes for ensuring respect for religious law and tradition in the provision of donor human milk for small vulnerable newborns. Int Breastfeed J, 20(31), 1877-5756.

Abstract

Islam provides strong support for infants to be breastfed, including for wet nursing where mothers are unable to breastfeed. Amongst those infants who may be in need of breastmilk from another woman are small vulnerable newborns. These infants can benefit from donor human milk from a human milk bank (HMB). However, in Islamic contexts, HMBs must be both medically and religiously safe and take account of the religious principle of milk kinship whereby the consumption of breastmilk can create a family relationship between the donor mother and the infant. This paper explores the variety of circumstances under which milk kinship may be created and highlights the two main pathways followed by HMBs to ensure religious safety. It presents the case of the KK HMB in Singapore as an example demonstrating how close collaboration between medical and religious authorities can enable HMBs to provide donor human milk to small vulnerable newborns. Finally, key processes for HMB establishment in the context of Islamic milk kinship are outlined including partnering with key religious leaders, knowing and working with local understandings of milk kinship, ensuring clear communication, proactively addressing community concerns and designing and adapting HMB processes to ensure religious requirements can be maintained.

Full article available https://internationalbreastfeedingjournal.biomedcentral.com/articles/10.1186/s13006-025-00704-w