Major Survey Findings of Listening to Mothers<sup>SM</sup> III: New Mothers Speak Out

Declercq, Eugene; Sakala, Carol; Corry, Maureen P.; Applebaum, Sandra; Herrlich, Ariel

doi:10.1891/1058-1243.23.1.17

Cited by 155 publications

(153 citation statements)

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“…It is important to educate parents on how to share a bed safely, as parents have stated they would appreciate this advice 42 and because bedsharing is widespread. 10,[44][45][46] Public health efforts must address the reality that tired parents must feed their infants at night somewhere and that sofas are highly risky places for parents to fall asleep with their infants, especially if parents are smokers or under the influence of alcohol or drugs. Safe sleep messages must also recognize that breastfeeding infants and formula-feeding infants do not sleep the same way and do not share the same risks when bedsharing.…”

Section: Future Directionsmentioning

confidence: 99%

Speaking Out on Safe Sleep: Evidence-Based Infant Sleep Recommendations

Bartick

Smith

2014

Breastfeeding Medicine

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The American Academy of Pediatrics (AAP) issued recommendations in 2005 and 2011 to reduce sleep-related infant death, which advise against all bedsharing for sleep. These recommendations overemphasize the risks of bedsharing, and this overemphasis has serious unintended consequences. It may result in increased deaths on sofas as tired parents try to avoid feeding their infants in bed. Current evidence shows that other risks are far more potent, such as smoking, shared sleep on sofas, sleeping next to impaired caregivers, and formula feeding. The emphasis on separate sleep is diverting resources away from addressing these critical risk factors. Recommendations to avoid bedsharing may also interfere with breastfeeding. We examine both the evidence behind the AAP recommendations and the evidence omitted from those recommendations. We conclude that the only evidence-based universal advice to date is that sofas are hazardous places for adults to sleep with infants; that exposure to smoke, both prenatal and postnatal, increases the risk of death; and that sleeping next to an impaired caregiver increases the risk of death. No sleep environment is completely safe. Public health efforts must address the reality that tired parents must feed their infants at night somewhere and that sofas are highly risky places for parents to fall asleep with their infants, especially if parents are smokers or under the influence of alcohol or drugs. All messaging must be crafted and reevaluated to avoid unintended negative consequences, including impact on breastfeeding rates, or falling asleep in more dangerous situations than parental beds. We must realign our resources to focus on the greater risk factors, and that may include greater investment in smoking cessation and doing away with aggressive formula marketing. This includes eliminating conflicts of interest between formula marketing companies and organizations dedicated to the health of children.

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Section: Future Directionsmentioning

confidence: 99%

Speaking Out on Safe Sleep: Evidence-Based Infant Sleep Recommendations

Bartick

Smith

2014

Breastfeeding Medicine

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“…1 However, when compared with IAFHR, EFM does not reduce the overall risk of perinatal death (relative risk [RR] = 0.85; 95%; confidence interval [CI], 0.59-1.23) or cerebral palsy (RR = 1.74; 95% CI, 0.97-3.11). Electronic fetal monitoring was associated with reduction in the rate of neonatal seizures by half (RR = 0.50; 95% CI, 0.31-0.80); however, this reduction was not ultimately associated with differences in long-term neonatal neurologic status.…”

Section: Introductionmentioning

confidence: 99%

“…27 The Internet is an even more common source of information, and 97% of mothers reported that they used the Internet for this purpose. 1 Nurses and other maternity care providers should be aware of the content of Web sites and books on childbirth to assist women in their care to make informed decisions. We evaluated evidence-based information available to consumers in 3 different types of Web sites: popular maternity sites; maternity provider sites; and childbirth education sites and popular maternity books.…”

Section: Introductionmentioning

confidence: 99%

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Consumer Information on Fetal Heart Rate Monitoring During Labor

Torres

Vries

Low

2014

Journal of Perinatal &Amp; Neonatal Nursing

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Electronic fetal monitoring (EFM) is used for the majority of births that occur in the United States. While there are indications for use of EFM for women with high-risk pregnancies, its use in low-risk pregnancies is less evidence-based. In low-risk women, the use of EFM is associated with an increased risk for cesarean birth compared with the use of intermittent auscultation of the fetal heart rate. The purpose of this investigation was to evaluate the existence of evidence-based information on fetal heart rate monitoring in popular consumer-focused maternity books and Web sites. Content analysis of information in consumer-oriented Web sites and books was completed using the NVivo software (QRSinternational, Melbourne, Australia). Themes identified included lack of clear terminology when discussing fetal monitoring, use of broad categories such as low risk and high risk, limited presentation of information about intermittent auscultation, and presentation of EFM as the standard of care, particularly upon admission into the labor unit. More than one-third of the sources did not mention auscultation, and conflicting information about monitoring methods was presented. The availability of accurate, publically accessible information offers consumers the opportunity to translate knowledge into the power to seek evidence-based care practices during their maternity care experience.

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“…Changes in maternal demographics and risk factors such as increased maternal age during the first pregnancy have been proposed as potential causal mechanisms to explain high CB utilization, but research has now shown that these are not root causes [3] . Alternately, more recently CB has been linked to the increased use of commonly used clinical interventions for labor management such as continuous electronic fetal monitoring (CEFM), epidural analgesia, and oxytocin for induction or augmentation of labor.…”

Section: Introductionmentioning

confidence: 99%

Place, provider and timing: Factors influencing the overuse of cesarean in low-risk primigravid women

Regan

McElroy

Chung

et al. 2014

JNEP

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The purpose of this study was to examine the relationship between the type and timing of commonly used intrapartum clinical factors and their relationship to birth outcomes. The factors included in the analysis were type of provider (midwife or obstetrician), place of birth (home or hospital), cervical dilation on admission, and commonly used labor interventions, namely use of continuous electronic fetal monitoring, epidural anesthesia and oxytocin on the type of birth (cesarean or vaginal birth). The research question guiding the analysis was: what factors increase the likelihood of cesarean birth (CB)? The findings reported here are parts of a larger mixed methods study that used three data collection methods: a projective test, a focus group, and a semi-structured postpartum interview. The study took place in an urban area in the mid-Atlantic United States and the sample was comprised of 49 low-risk primigravid women recruited between 28-36 weeks gestation. The analysis reported here only used data from the postpartum interview. During the interview, each woman reported the events of their labor and birth that were then mapped along a timeline. The findings show that admission to hospital early in labor played a key role in increasing the number of interventions used and was associated with increased risk of CB. The small, homogenous sample limited the ability to conduct more comprehensive statistical analysis and to generalize to more diverse groups, however, the proportional differences are highly suggestive and warrant further investigation.

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Major Survey Findings of Listening to Mothers^SM III: New Mothers Speak Out

Cited by 155 publications

References 0 publications

Speaking Out on Safe Sleep: Evidence-Based Infant Sleep Recommendations

Speaking Out on Safe Sleep: Evidence-Based Infant Sleep Recommendations

Consumer Information on Fetal Heart Rate Monitoring During Labor

Place, provider and timing: Factors influencing the overuse of cesarean in low-risk primigravid women

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Major Survey Findings of Listening to MothersSM III: New Mothers Speak Out

Cited by 155 publications

References 0 publications

Speaking Out on Safe Sleep: Evidence-Based Infant Sleep Recommendations

Speaking Out on Safe Sleep: Evidence-Based Infant Sleep Recommendations

Consumer Information on Fetal Heart Rate Monitoring During Labor

Place, provider and timing: Factors influencing the overuse of cesarean in low-risk primigravid women

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Product

Resources

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Major Survey Findings of Listening to Mothers^SM III: New Mothers Speak Out