In early December the Maternal & Child Health Journal accepted our latest research paper on maternity care based in Nepal . The first author, Amrit Banstola, is based in Nepal and this exciting paper is co-authored with several Nepal-based collaborators as well as BU Visiting Faculty Prof. Padam Simkhada. Prof. Simkhada recently moved from Liverpool John Moores University to the University of Huddersfield. The target journal Maternal & Child Health Journal has an Impact Factor of 1.736.
The Government of Nepal is trying to expand and improve the quality of maternal and neonatal health service delivery in more remote areas of the country. However, relatively little is known about the preparedness of maternity care facilities to providing Emergency Obstetric Care (EmOC) in remote and rural areas. In order to achieve improvement maternal health services in one remote district to help achieve the sustainable development goals (SDGs). Our study assesses what birthing centres exist and how ready these are to provide EmOC services in Taplejung District.
Prof. Edwin van Teijlingen
Centre for Midwifery, Maternal & Perinatal Health
- Banstola, A., Simkhada, S., van Teijlingen, E., Bhatta, S., Lama, S., Adhikari, A, Banstola A., The availability of emergency obstetric care in birthing centres in rural Nepal: A cross-sectional survey, Maternal & Child Health Journal. (accepted).
A new publication by Dr. Luisa Cescutti-Butler (FHSS) and her co-authors (Professor A Hemingway & Dr. J. Hewitt-Taylor) which explores women’s experiences of caring for a late preterm baby using feminism as a research methodology has just been published in the Australian Women and Birth Journal (October 2019). Her research found that women who become mothers’ of late preterm babies have a complex journey. It begins with separation, with babies being cared for in unfamiliar and highly technical environments where the perceived experts are healthcare professionals. Women’s needs are side-lined, and they are required to care for their babies within parameters determined by others. Institutional and professional barriers to mothering/caring are numerous. For example: some of the women who were separated from their babies immediately after birth had difficulties conceiving themselves as mothers, and others faced restrictions when trying to access their babies. Women described care that was centred on their babies. They were allowed and expected to care for their babies, but only with ‘powerless responsibility’. Many women appeared to be excluded from decisions and were not always provided with full information about their babies. The research concludes by recommending that women whose babies are born late preterm would benefit from greater consideration in relation to their needs, rather than the focus being almost exclusively on their babies.
Luisa is Senior Lecturer in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH) and Lead for Examination of the Newborn in the Faculty of Health & Social Sciences. If you would like any further information please email Luisa on firstname.lastname@example.org
Cescutti-Butler, L.D. Hewitt-Taylor, J. and Hemingway, A., 2019. Powerless responsibility: A feminist study of women’s experiences of caring for their late preterm babies. Women and Birth, DOI: https://doi.org/10.1016/j.wombi.2019.08.006
Cescutti-Butler, L.D., Hemingway, A., and Hewitt-Taylor, J., 2018. “His tummy’s only tiny” – Scientific feeding advice versus women’s knowledge. Women’s experiences of feeding their late preterm babies. Midwifery, DOI: https://doi.org/10.1016/j.midw.2018.11.001
This autumn the Dutch journal for midwives Tijdschrift voor Verloskundigen published a paper on the risk associated with thinking in terms of risks . Dr. Marianne J Nieuwenhuijze is the lead author of this paper written in Dutch. Marianne is associated with the Research Centre Midwifery Science at the Academie Verloskunde Maastricht (the Netherlands). Her co-authors are BU Professor Edwin van Teijlingen in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH) and Dr. Helen Bryers who is Honorary Public Health Specialist (Midwife) at NHS Highland. The paper builds on earlier work around the concept of the social/medical model in pregnancy and childbirth [2-7].
- Nieuwenhuijze, M., van Teijlingen, E., Mackenzie-Bryers, H. (2019) In risiko’s denken is niety zonder risiko (In Dutch: Thinking in terms of risk, it not with its risk). Tijdschrift voor Verloskundigen (in Dutch: Journal for Midwives), 43 (4): 6-9.
- Brailey, S., Luyben, A., Firth, L., van Teijlingen, E. (2017) Women, midwives and a medical model of maternity care in Switzerland, Int J Childbirth 7(3): 117-125.
- van Teijlingen, E. (2017) The medical and social model of childbirth, Kontakt 19 (2): e73-e74
- MacKenzie Bryers H., van Teijlingen, E. (2010) Risk, Theory, Social & Medical Models: critical analysis of the concept of risk in maternity care, Midwifery 26(5): 488-496.
- Ireland, J., van Teijlingen, E. (2013) Normal birth: social-medical model, Practising Midwife 16 (11): 17-20.
- van Teijlingen E. (2005) A critical analysis of the medical model as used in the study of pregnancy and childbirth, Sociol Res Online, 10 (2) Web address: http://www.socresonline.org.uk/10/2/teijlingen.html
- Luce, A., Cash, M., Hundley, V., Cheyne, H., van Teijlingen, E., Angell, C. (2016) “Is it realistic?” the portrayal of pregnancy and childbirth in the media BMC Pregnancy & Childbirth 16: 40 http://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-016-0827-x
Congratulations to Dr. Rachel Arnold in the Centre for Midwifery, Maternal & Perinatal Health who had her first paper accepted since she started working at BU two months ago. Her paper ‘Villains or victims? An ethnography of Afghan maternity staff and the challenge of high quality respectful care’ is co-authored with her former PhD supervisors Professor Kath Ryan (BU Visiting Faculy), Professor Emerita Immy Holloway and CMMPH’s Professor Edwin van Teijlingen . The paper is Open Access funded by Bournemouth University’s Open Access Fund which will help promote the visibility of the paper before REF 2021.
I was tempted to head this blog ‘Dr. Arnold only two months at BU and first paper published’, but I decide this would perhaps send the wrong message to other new BU staff. Rachel completed her PhD in CMMPH and this is paper is the third publication from her thesis. The other academic publications by Dr. Arnold on Afghanistan have been in BJOG and Social Science & Medicine [2-3].
- Arnold, R., van Teijlingen, E., Ryan, K., Holloway, I. (2019) Villains or victims? An ethnography of Afghan maternity staff and the challenge of high quality respectful care , BMC Pregnancy and Childbirth (accepted).
- Arnold R., van Teijlingen E, Ryan K., Holloway I. (2015) Understanding Afghan health care providers: Qualitative study of culture of care in Kabul maternity hospital, BJOG 122: 260-267.
- Arnold, R., van Teijlingen, E., Ryan, K., Holloway, I. (2018) Parallel worlds: an ethnography of care in an Afghan maternity hospital, Social Science & Medicine 126:33-40.
The month saw the publication of the latest collaborative paper between FHSS academics, BU Visiting Faculty and NHS clinicians. Our paper ‘Design errors in vital sign charts used in consultant-led maternity units in the United Kingdom’  is available for a free download from Elsevier until August 28, 2019. Till then no sign up, registration or fees are required, click here.
The authors, as part of the Modified Obstetric Warning Score (MObs) Research Group, lead by BU Visiting Faculty Richard Isaac, argue that obstetric observation charts in the UK contain poor design features. These charts have common errors such as an inappropriate use of colour, poor alignment and axes labelling. Consequently, these design errors render charts difficult to use and could compromise patient safety. The article calls for an evidence-based, standardised obstetric observation chart, which should integrate ‘human factors’ and user experience.
This research team, earlier published ‘Vital signs and other observations used to detect deterioration in pregnant women: Analysis of vital sign charts in consultant-led maternity units’. 
- Isaacs, R., Smith, G., Gale-Andrews, L., Wee, M., van Teijlingen, E., Bick, D.E., Hundley, V. on behalf of the Modified Obstetric Warning Score (MObs) Research Group. (2019) Design errors in vital sign charts used in consultant-led maternity units in the United Kingdom, International Journal of Obstetric Anesthesia 39:60-67.
- Smith, G., Isaacs, R., Gale-Andrews, L., Wee, M., van Teijlingen, E., Bick, D., Hundley, V. (2017) Vital signs and other observations used to detect deterioration in pregnant women: Analysis of vital sign charts in consultant-led maternity units. International Journal of Obstetric Anesthesia 30: 44-51.
Congratulations to Prof. Vanora Hundley of FHSS on the publication of her ‘Editorial midwifery special issue on education: A call to all the world’s midwife educators!’ in Midwifery (Elsevier). This editorial is co-authored by midwives Franka Cadée of the International Confederation of Midwives (ICM) and Mervi Jokinen of European Midwives Association (EMA). The editorial was written to accompany a Special Issue of the journal focussing on midwifery education. The Midwifery Special Issue addresses a wide range of topics from across the globe. Whilst the editorial explores the challenges for midwifery educators from three diﬀerent midwifery perspectives: (1) political; (2) academic ; and (3) professional association.
Congratulations to all three authors!
Prof. Edwin van Teijlingen
Centre for Midwifery, Maternal & Perinatal Health (CMMPH)
- Hundley, V., Cadée, F., Jokinen, M. (2018) Editorial midwifery special issue on education: A call to all the world’s midwife educators!, Midwifery 64: 122-123
In the first week of July Bournemouth University ran its second international midwifery education conference in the Executive Business Centre. This year’s conference was called ‘What works in midwifery education? A conference run by midwifery educators for midwifery educators.’ CMMPH (Centre for Midwifery, Maternal & Perinatal Health) brought together nearly 100 delegates on Thursday and Friday (July 5-6). There were presentations and posters from midwifery educators based in in all four countries of the UK, Germany, Belgium, Switzerland and Australia, resulting in lively stimulating debates.
The conference organisers has teamed up with the leading scientific journal in the field Midwifery (published by Elsevier). To coincide with BU’s conference Midwifery published this month its special issue on Midwifery Education. This special issue was introduced at the conference by Dutch midwife Dr. Ans Luyben, one of the special issue’s editors.
The conference awarded two prizes for the best poster. One prize was for the best academic poster and one voted by the conference audience. The former prize was won by a poster from NHS Education for Scotland. The public’s poster prize was won by a poster from the University of Bradford jointly produced by film students and student midwives.
The main conference organisers Dr. Catherine Angell and Dr. Sue Way from CMMPH said afterwards that the success of the conference means that CMMPH will organise a third midwifery education conference run for and by educators in three years’ time.
Today BMC Pregnancy & Childbirth published the latest paper by a PhD student at Bournemouth University. Our congratulations go to Alice Ladur in the Centre for Midwifery, Maternal & Perinatal Health (CMMPH), who published `Whose Shoes?’ Testing an educational board game with men of African descent living in the United Kingdom . This paper is based on her PhD research and co-authored with her supervisors.
The paper addresses issues around men’s involvement in programmes or interventions aimed at the improvement of maternal health. One such innovative intervention is an educational board game which offers a unique approach to present health information where learning is reinforced through group discussions supporting peer-to-peer interactions. The authors would like to thank Gill Phillips for permission to use the Whose Shoes? board game and all participants for their participation in the PhD study.
Alice PhD is focused on Uganda and this particular paper reports a qualitative study with men from Uganda who live in the UK on their views of an educational board game. This pilot study explored perceptions on whether a board game was relevant as a health promotional tool in maternal health prior to implementation in Uganda.
- Ladur, A.N., van Teijlingen, E., Hundley, V. (2018) `Whose Shoes?’ Testing an educational board game with men of African descent living in the United Kingdom, BMC Pregnancy & Childbirth 18:81. http://rdcu.be/JXs0
Since late 2015 the world strives to achieve towards the Sustainable Development Goals (SDG). The SDGs bring together the social, economic and environmental aspects of development. There are 17 SDGs sub-divided into 169 targets. One of these 17 goals focuses specifically on health, namely to “ensure healthy lives and promote wellbeing for all at all age”. SDG devotes 13 health-related targets to diverse population health and wellbeing issues including maternal and child health, communicable disease including HIV, non-communicable diseases, substance use, traffic accidents, universal access to sexual and reproductive health, and sanitation.
Nepal is one of the many countries that have signed up to the SDGs. This week BU researchers Dr. Pramod Regmi, Prof. Vanora Hundley, Prof. Edwin van Teijlingen, FHSS, PhD students Sheetal Sharma and Preeti Mahato, and BU Visiting Faculty Prof. Padam Simkhada (Liverpool John Moores University) published an editorial under the title ‘Sustainable Development Goals: relevance to maternal & child health in Nepal’ . This editorial written by health researchers working in Nepal highlights some of the weaknesses in the country’s health care system. These key problems include the persistence of inequalities in health and the limited access to health services and the low uptake of care in many poorer populations especially in the more remote rural regions. For instance, only about one in nine of the poorest women deliver their babies with the aid of a skilled birth attendant (SBA), whilst 81.5% for the richest women benefit form a SBA. Therefore, this editorial stresses the need for a continuum of health care services to be available across the country and for all sections of the society. Moreover, we can only assess whether a country has reached all or any of the SDGs if there is systematic monitoring and regular review of interventions at all levels. Hence, Nepal should develop measureable and time-bond indicators to track its progress towards the SDGs. The country will need support from development partners in both its attempts to achieve the SDGs as well when it tries to collect and analysis data to assess its progress.
Prof. Edwin van Teijlingn
- Regmi, P., van Teijlingen, E., Hundley, V., Simkhada, P., Sharma, S., Mahato, P. (2016) Sustainable Development Goals: relevance to maternal & child health in Nepal. Health Prospect 15(1):9-10. healthprospect.org/archives/15/1/3.pdf
Student midwives spend approximately 50% of their three year undergraduate programme in the clinical area. Going to a new placement is often a stressful time for them as they consider ‘will they fit in’, ‘will they know enough’, ‘have they the right skills’, ‘what will they be able to learn whilst there to meet their practice assessments’ and so on. Other concerns relate to being away from home, what hours they are expected to do and how they cope with ‘difficult’ mentors. If students are unfamiliar with healthcare environments it takes time for them to adjust and become used to the environment. It was these thoughts that began fermenting in my head back in 2010 and following a positive response from students whose views on a book on placements were informally sought, I pitched the idea to a commissioning editor at Wiley Blackwell. In addition wider research had revealed that no such book existed within the published midwifery arena. Finally, in 2012 a contract was agreed between myself, and Margaret Fisher, Associate Professor in Midwifery at Plymouth University to co-edit nine chapters for submission in November 2014. The book is now due for publication on the 11th December 2015.
Professor Paul Lewis wrote the forward and chapter contributions from Bournemouth University lecturers, Dr. Sue Way, Stella Rawnson and myself, prepare prospective and current students for midwifery practice and the profession, caseloading and the elective period. Jo Coggins and Henrietta Otley, both midwives practising in North Wiltshire were co-opted to write chapters on ‘Preparing for practice’ and ‘Low-risk midwifery placements’. Other chapters were written by Margaret Fisher and Faye Doris at Plymouth University.
The final published edition is small enough to fit into a uniform pocket and contains many vignettes from students currently or previously studying at Bournemouth and Plymouth University. Their stories reflect ‘real life’ clinical experience and ‘Top Tips’ provide overall advice. Three original cartoons illustrating the vagaries of placement were devised by Clare Shirley (formerly a BU student, now a newly qualified midwife) and Hugo Beaumont (4th year medical student at Plymouth University). Students and women have provided photographs. Both Margaret and I hope students far and wide will enjoy the book which aims to provide a realistic perspective on clinical placement, by offering hints and tips and encouragement along their student journey.