摘要:

ABSTRACT:Through a mail survey in 1991, we compared the opinions of 597 physicians practicing obstetrics, 723 maternity care nurses, and 70 midwives from the province of Quebec, Canada, about selected maternity care issues, including the practice of midwifery. Results showed that divergent points of view existed between and within the three groups on many maternity care issues. Physicians were more divided over the routine use of obstetric intervention than the approach to care or their opinion about midwives. Midwives held more client‐centered and less interventionist attitudes than nurses or physicians. Nurses were much more open to midwives than physicians, but 20 to 30 percent of physicians saw some advantages in legalizing the practice of midwifery. Physicians and nurses generally considered midwives as a greater professional threat to the other group than to themselves. The fact that many physicians were critical of current maternity care is difjcult to reconcile with their general opposition to midwives. How and to what extent physicians will respond to women's desire for more humanized and less interventionist care remains an open question. Given the problems facing maternity care in North America, expanding midwifery services is an alternative to examine seriously. (BIRTH 21:2, June 199

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1994.tb00237.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

ABSTRACT:We examined medical obstetric conditions predating pregnancy and current symptoms as predictors of the timing of the start of prenatal care among low‐income women in Snohomish County, Washington. The investigation was a cross‐sectional survey with retrospective record review. Subjects were 473 women who sought care through the community health center network, which was the only provider of prenatal care for low‐income women in the county at the time of the study. Women with a history of two or more medical or obstetric conditions were more likely than those without such histories to seek prenatal care early in pregnancy. Women who, in the current pregnancy, had few physical symptoms were more likely to delay seeking prenatal care than symptomatic women. Among this relatively homogeneous group, sociodemographic characteristics were not associated with the timing of entry into prenatal care. The Jindings help to explain the patterns of prenatal care use of certain groups, and suggest avenues for intervention to improve use among low‐income women. (BIRTH 21:2, Ju

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1994.tb00238.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

ABSTRACT:In recent years it has become possible to use eggs from one woman to bring about a pregnancy in another. This led to new dejinitions of who can be considered the mother of a child. Despite much speculation about the problems that may ensue from this situation, it is not at all clear that the women who have made the active decision to involve themselves in egg donation or gestational surrogacy will share these concerns. This paper reports on the interpretive frameworks used by 13 women who experienced either egg donation or gestational surrogacy, to defne their relationships to any children (actual or potential) conceived as a result of their actions. (BIRTH 21:2, June 1994)

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1994.tb00239.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

ABSTRACT:The effects of pregnancy on the maternal cardiorespiratory system include increases in oxygen consumption, cardiac output, heart rate, stroke volume, and plasma volume. The increase in oxygen reserve seen in early pregnancy is reduced later, suggesting that maternal exercise may present a greater physiologic stress in the third trimester. Evidence suggests that weight‐bearing exercise produces a greater decrease in oxygen reserve than nonweight‐bearing exercise. Furthermore, to maintain a heart rate below 140 beats per minute during pregnancy, the intensity of weight‐bearing exercise must be reduced. Nonweight‐bearing, water‐based exercise results in smaller fetal heart rate changes and a lower maternal heart rate than the same exercise performed on land. Exercising in the supine position in late pregnancy has raised concerns because cardiac output in the supine position is lower than in the lateral position at rest, presumably because the gravid uterus partially obstructs the inferior vena cava. Sustained exercise produces a training effect on the mother, although reported associations between this effect and the experience of labor are not consistent. Short‐term changes in fetal heart rate provide circumstantial evidence that physical activity can influence the fetus. Acute effects of exercise that can potentially affect the fetus include hyperthermia, changes in uteroplacental flow, reduced levels of maternal glucose, and increased uterine contractions. Moderate to high levels of sustained maternal exercise have been associated with reduced birthweight. Much research remains to be done on the effects of specexercise regimens during pregnancy, the effects on previously sedentary women, and the long‐term health consequences to the offspring of women who perform vigorous exercise during pregnancy. (BIRTH 21

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1994.tb00240.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

摘要:

ABSTRACT:This case report describes a primipara who successfully breastfed 35‐week‐gestation twins for over six months. Positive interactions, research‐based management strategies, and innovative problem solving helped her avoid the individual, interpersonal, and system factors that can injuence lactation failure. (BIRTH 21:2, June

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1994.tb00241.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1994.tb00242.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1994.tb00243.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1994.tb00244.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1994.tb00245.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY

ISSN:0730-7659    

DOI:10.1111/j.1523-536X.1994.tb00246.x

出版商:Blackwell Publishing Ltd    

年代:1994

数据来源: WILEY