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Midwifery leaders' experience of engaging with Appreciative Inquiry to co-create a mentoring program: A qualitative study

Mon, 01 Sep 2025 00:00:00 GMT

Title: Midwifery leaders' experience of engaging with Appreciative Inquiry to co-create a mentoring program: A qualitative study Authors: Lennon, K.; Roddy, E.; Dewar, B.; McLaughlin, K.; Musgrave, L.; Cook, M.; Tierney, O. Abstract: Aim: To understand the experience of midwifery leaders using the Appreciative Inquiry methodology to co-create and implement a Mentoring in Midwifery program in NSW, Australia. Methods: Qualitative data were generated using an appreciative approach in focus group discussions, project planning and implementation discussions with working group members, and program implementation facilitators. The data were analysed using 5th Generation Evaluation. Findings: Twenty midwifery leaders from across NSW Health participated in focus groups or project discussions. The evaluation of these discussions identified three themes: Connection, Learning, and Growth. Each included sub-themes of; Connection: the nature and nurture of connections; Learning: learning lightbulbs; and Growth: the gains and pains of growth. Discussion: The use of Appreciative Inquiry is a valuable change methodology and process that supports the effective design, development and implementation of a project. In addition, involvement in co-creation using Appreciative Inquiry can support and enable leadership development for those involved that is transferable to other initiatives and leadership roles. Conclusion: This paper explores the impact for midwifery leaders in the context of developing and implementing a Statewide mentoring program for midwives within NSW Health. Co-creation and the use of Appreciative Inquiry is an effective process in a midwifery context. This approach enabled midwifery leaders to experience a new way of working, develop a deep sense of connection, learn together and develop new capabilities as leaders that are translated into practice.

Virtually delivered lifestyle interventions for overweight and obese pregnant people: A systematic review

Thu, 01 May 2025 00:00:00 GMT

Title: Virtually delivered lifestyle interventions for overweight and obese pregnant people: A systematic review Authors: Park, T.; Brickwood, S.; Buss, K.; Tran, V.; Parsons, D.; Wisely, K.; Gillett, K.; Lavis, H.; Heaney, S. Abstract: Background: Gestational weight gain (GWG) impacts both foetal and maternal health outcomes, with excessive GWG in overweight and obese people further increasing the risk of complications for this population. Lifestyle changes including consuming a healthy diet and physical activity are core strategies for management. Since 2020 and the emergence of the COVID-19 pandemic, use of telehealth has increased; however, little is known about the effectiveness of virtually delivered strategies for maintaining healthy gestational weight during pregnancy. Objectives: To describe the effect of virtually delivered lifestyle interventions on promoting healthy GWG and reducing maternal and foetal complications associated with excessive GWG, with the view to inform future clinical practice. Design: This systematic review followed preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines and targeted quantitative studies assessing virtually delivered lifestyle interventions for maintaining healthy gestational weight for overweight and obese pregnant individuals aged 18 and older. Data sources and methods: Six databases (MEDLINE, CINHAL, EMBASE, EMCARE, MIDIRS and APA PsycINFO) were searched using a rigorous search strategy. Data extraction investigated mode of telehealth delivery, intervention type and GWG outcomes. Quality appraisal was conducted using the Critical Appraisal Skills Programme tool and risk of bias was assessed using the Risk of Bias assessment (RoB-2). Results: Nine studies met inclusion criteria and within those studies, six different telehealth modalities were identified. Interventions varied and included GWG tracking, step counts, diet and exercise goal setting. Effectiveness of studies was inconsistent, with five studies demonstrating lower GWG. Conclusion: Results suggest that lifestyle interventions delivered via telehealth may be effective at reducing excessive GWG. The development of targeted interventions integrated into obstetric guidelines aimed at reducing excessive GWG via telehealth platforms should be considered as a strategy not only for pandemic situations, but to increase antenatal care and service access. Description: Citation added with permission from Heidi Lavis, Occupational Therapist, Port Macquarie Base Hospital, MNCLHD.

A scoping review of effective health practices for the treatment of birth trauma

Sat, 01 Mar 2025 00:00:00 GMT

Title: A scoping review of effective health practices for the treatment of birth trauma Authors: Jomeen, J.; Guy, F.; Marsden, J.; Clarke, M.; Darby, J.; Landry, A.; Jefford, E. Abstract: Background: There is currently no consensus on the most effective health practices to manage or reduce the effects of birth trauma (BT) and childbirth-related posttraumatic stress disorder (CB-PTSD). Aim: The aim was to map the current literature on effective health practices for BT/CB-PTSD, identify key elements (the what, when and how) important for effective health practices, and highlight gaps in maternity care. Methods: A systematic search was conducted across key nursing, allied, and medical databases (MEDLINE, Scopus, PubMed) for key terms related to (1) birth trauma and (2) intervention. Only peer-reviewed, English-language papers published since 2000 were included to ensure the relevance and timeliness of the findings. Following PRISMA-ScR guidelines, 6,347 articles were identified through databases/registers and citation searching. After removing 1,342 duplicates, 5,005 were screened by title and abstract. A further 4,544 were excluded, leaving 461 for full-text screening. Afterf excluding another 433, 28 papers met inclusion for this review. Findings: The first session delivered early (within the first 72 h of birth) by a clinician (midwife/psychologist/counsellor) significantly reduced BT/CB-PTSD in the short-term. Both trauma-focused and non-trauma-focused were supported at this stage, provided they were structured. If intervention is delayed (weeks to months post-birth), a trauma-focused, multi-session approach is recommended. Discussion: Early, structured interventions should be considered routine care for women with BT/CB-PTSD, with more intensive, structured, trauma-focused approach for persistent symptoms. The potential role of digital mental health tools is promising, particularly for women in low-resource settings, but requires further research to evaluate feasibility, acceptability, and sustainability. Keywords: Birth trauma; Childbirth-related PTSD; Interventions; Review.

Weighing as a stand-alone intervention does not reduce excessive gestational weight gain compared to routine antenatal care: a systematic review and meta-analysis of randomised controlled trials

Sun, 01 Jan 2017 00:00:00 GMT

Title: Weighing as a stand-alone intervention does not reduce excessive gestational weight gain compared to routine antenatal care: a systematic review and meta-analysis of randomised controlled trials Authors: Fealy, S.; Taylor, R. M; Foureur, M.; Attia, J.; Ebert, L.; Bisquera, A.; Hure, A. Abstract: Background: Excessive gestational weight gain is associated with short and long-term adverse maternal and infant health outcomes, independent of pre-pregnancy body mass index. Weighing pregnant women as a stand-alone intervention during antenatal visits is suggested to reduce pregnancy weight gain. In the absence of effective interventions to reduce excessive gestational gain within the real world setting, this study aims to test if routine weighing as a stand-alone intervention can reduce total pregnancy weight gain and, in particular, excessive gestational weight gain. Methods: A systematic review and meta-analysis of randomised controlled trials (RCTs) was conducted between November 2014 and January 2016, and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Seven databases were searched. A priori eligibility criteria were applied to published literature by at least two independent reviewers. Studies considered methodologically rigorous, as per the Academy of Nutrition and Dietetics Quality Criteria Checklist for Primary Research, were included. Meta-analysis was conducted using fixed-effects models. Results: A total of 5223 (non-duplicated) records were screened, resulting in two RCTs that were pooled for meta-analysis (n = 1068 randomised participants; n = 538 intervention, n = 534 control). No difference in total weight gain per week was observed between intervention and control groups (weighted mean difference (WMD) -0.00 kg/week, 95% confidence interval (CI) -0.03 to 0.02). There was also no reduction in excessive gestational weight gain between intervention and control, according to pre-pregnancy body mass index (BMI). However, total weight gain was lower in underweight women (n = 23, BMI <18.5 kg/m2) in the intervention compared to control group (-0.12 kg/week, 95% CI -0.23 to -0.01). No significant differences were observed for other pregnancy, birth and infant outcomes. Conclusion: Weighing as a stand-alone intervention is not worse nor better at reducing excessive gestational weight gain than routine antenatal care.