How are the Dietary Needs of Pregnant Incarcerated Women Being Met? A Scoping Review and Thematic Analysis.

INTRODUCTION: The number of incarcerated pregnant women is increasing globally. With many having complex health and social backgrounds, incarceration provides opportunities for health interventions, including the chance to have their nutritional needs met. Despite the additional nutritional requirements of pregnancy being well documented, how these are being met within the correctional setting is currently poorly understood. METHODS: A scoping review of the literature was conducted to identify the literature published between January 2010 and April 2023 related to the provision of nutrition for pregnant women in the international prison systems. Sixteen papers met the criteria for inclusion in the review. The relevant key findings were charted and thematically analysed. RESULTS: Two themes were identified: 'the inconsistent reality of food provision' and 'choice, autonomy and food'. There is a clear disparity in the way in which diet is prioritised and provided to pregnant incarcerated women across several countries. DISCUSSION: The findings highlight the need for a consistent approach to diet on a macro, global level to ensure the health of women and their infants in context.

Social media influencers' impact during pregnancy and parenting: A qualitative descriptive study.

Pregnant people and parents engage with social media networking sites seeking support and information that is shared in a relatable way. Engaging with social media influencers (SMIs) and their followers, however, may have both affirming and harmful effects. SMIs can facilitate information-sharing, discussion, and supportive behaviors, but engaging with SMIs can lead to negative experiences and exposure to misinformation. To date, little is known about the impacts of following influencers during pregnancy and early parenthood. The aim of this study was to explore how engaging with SMIs impacts pregnant people and parents of children aged 5 or under in Australia. A qualitative descriptive approach was taken. Qualitative data from 85 anonymously completed online written surveys were thematically analyzed using Braun & Clarke's six-step process. Five overarching themes and two subthemes were identified. The first theme, "Comparisons of self," held two subthemes: "Unfavorable comparisons of self to SMIs" and "Favorable comparisons of self to SMIs." Additional themes were "A virtual community of inspiration and togetherness," "Sharing of information, opinions & experiences," "Gatekeeping self-efficacy," and "Credibility." The findings of the study indicated that discordance between influencer-mediated expectations of parenthood and a person's actual experience may affect well-being and perceptions of parental self-efficacy. Information sought from influencers may substitute for face-to-face education by clinicians. Health professionals who are also influencers may possess the ability to provide evidence-based information. This content, however, is not without risk for bias or incompleteness.

How do new midwives' early workforce experiences influence their career plans? An integrative review of the literature.

AIM: To explore how the early workforce experiences of new midwives influence their career plans. BACKGROUND: Each year, thousands of new midwives graduate from entry-to-practice midwifery courses, gain professional registration, and enter the workforce. Despite this, the world continues to face a shortage of midwives. The first five years of clinical practice, commonly referred to as the early career period, can be highly stressful for new midwives, contributing to early attrition from the profession. Supporting the transition from midwifery student to registered midwife is vital if we are to grow the workforce. Whilst the early career experiences of new midwives have been more broadly explored; little is currently understood about how these can influence their career plans. METHODS: Following Whittemore and Knafl's (2005) five-stage process, an integrative review was conducted. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Nineteen studies met the criteria for inclusion. Thematic analysis was undertaken to organise and present the findings. FINDINGS: Thematic analysis, guided by the review question led to the identification of three overarching themes: 'the need for support', 'sustaining health and wellbeing', and 'being able to provide safe and effective midwifery care'. CONCLUSION: Very little research to date has specifically explored how the early career experiences of new midwives influence their career plans, particularly within the Australian context. Further research is required to better understand how the early workforce experiences of new midwives can either strengthen their commitment to the profession or contribute to the decision to leave midwifery prematurely. This knowledge would provide a basis for the development of appropriate strategies to minimise early attrition from the midwifery profession and promote career longevity.

The impact of social media influencers on pregnancy, birth, and early parenting experiences: A systematic review.

BACKGROUND: Pregnant and new parents are increasingly engaging with social media. The impacts of engaging with social media 'influencers' and 'bloggers' during a time of heightened vulnerability to influence, in particular, merits exploration. AIM: To systematically review the literature to identify what is known about how following social media 'influencers' and 'bloggers' impacts pregnant and new parents' experiences and decision-making. METHODS: A search of CINAHL, World of Science, Medline, EMBASE and Google Scholar databases was undertaken in January 2023 to identify the literature focusing on the impacts of engaging with influencers or bloggers as pregnant or new parents. The reference lists of the included papers were hand-searched. Data were extracted from each paper, tabulated, and thematically analysed. The review was reported using the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. FINDINGS: Seventeen papers met the inclusion criteria and were included in the final synthesis. Thematic analysis revealed four overarching themes, which were 'sharing information', 'support', 'identity', and 'monetisation'. DISCUSSION: Social media influencers provide a network of peers amongst whom discussions, supportive behaviours, and information sharing take place. However, concern arises around the potential for combative interactions, the risk for transmission of misinformation, and the potential impacts of following influencers who are also qualified health professionals. CONCLUSION: Existing research suggests that engaging with social media influencers can be both beneficial and harmful for pregnant and new parents. At the current time, it is unclear how exposure to the benefits or harm impacts personal experiences and decision-making.

How is cultural safety understood and translated into midwifery practice? A scoping review and thematic analysis.

AIM: To identify and understand the scope of the literature published since January 2008 that explored Australian midwives understanding of cultural safety and how this is translated into their practice when caring for First Nations women and families. BACKGROUND: Recognition and understanding of First Nations peoples history and culture and the impact this has on the health and wellbeing of women and their families is essential if the midwife is to promote culturally safe and respectful maternity care. The role and responsibilities of the midwife in ensuring that their practice is culturally safe are now reflected in the Australian professional midwifery codes and standards. Whilst midwifery academics' awareness of cultural safety and how it is taught within midwifery education programs have previously been explored, at present, little is known about midwives' understanding of cultural safety, and how this translates into their clinical practice. METHODS: A Scoping Review was undertaken following Arksey and O'Malley's five step process. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta Analyses - Scoping Review extension checklist. Twelve studies met the criteria for inclusion. Thematic analysis was used to analyse the data and organise the results. RESULTS: Thematic analysis, guided by two predetermined review questions led to the identification of six overarching themes: 'Awareness of deficiencies', 'The importance of meeting women's diverse needs', 'Understanding relationships as a foundation for culturally safe care', 'Working in partnership with others', 'Providing individualised care' and 'Fostering effective relationships and communication'. One sub-theme of the first theme was identified, this was named 'Seeking an understanding of culture'. CONCLUSION: Australian midwives' level of understanding of cultural safety and how it is translated into their midwifery practice when caring for First Nations women and their families differ widely. Midwives across Australia require increased and equitable access to appropriate opportunities to improve their knowledge and understanding of cultural safety. Whilst theoretical learning on cultural safety has a place in all midwives annual mandatory training requirements, this should ideally be supplemented, where possible, with opportunities for immersive practice in communities. Immersion was considered the optimal way to gain rich knowledge and understanding to strengthen culturally safe midwifery practice. Continuity models of midwifery care which incorporate the principles of cultural safety should be consistently implemented across Australia. These models enable midwives, women, families, communities, and Aboriginal Support Workers to work in collaboration towards achieving optimal outcomes for mothers and babies. STUDY REGISTRATION: N/A.

Workplace violence in the Australian and New Zealand midwifery workforce: A scoping review.

AIM: The aim of the study is to identify and map what is known about workplace violence involving midwives in Australia and New Zealand. BACKGROUND: Research from the United Kingdom demonstrates that workplace violence within maternity services is a pervasive issue with significant and wide-ranging clinical, individual and organisational consequences. To date, little is known about this issue within Australian and New Zealand maternity services. EVALUATION: A scoping review, guided by Arksey and O'Malley's framework, was conducted. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. Just one identified study aimed to explore midwives' experiences of workplace violence. A further nine arrived at related results or themes. KEY ISSUES: Workplace violence is present in a variety of forms across maternity services in Australia and New Zealand. Its prevalence is, however, yet to be understood. Workplace violence causes physical and mental health issues for midwives, premature workforce attrition, and jeopardizes the quality and safety of maternity care. CONCLUSIONS: Workplace violence has been acknowledged as one of the key contributing factors towards premature attrition from the midwifery profession, with new graduate midwives most likely to leave. With the midwifery workforce ageing and evidence of serious clinical implications emerging, workplace violence needs urgent research and organisational attention. IMPLICATIONS FOR NURSING MANAGEMENT: Workplace violence is a key contributing factor towards recruitment and retention challenges for managers. To help tackle this, managers have a key role to play in identifying and effectively addressing workplace violence by acting as positive role models, taking a zero-tolerance approach and fostering collegial relationships. Managers, holding key clinical leadership positions, are pivotal to ensuring all complaints raised are handled with transparency and consistency regardless of one's position within the clinical hierarchy and organisational structure.

The parents are watching: Midwifery students' perceptions of how workplace bullying impacts mothers and babies.

PROBLEM: Bullying in the midwifery profession has been documented and the problem is now known to extend to the poor treatment of midwifery students. In nursing, research has shown that bullying in the clinical workplace can adversely impact on quality of care. To date, no research has explored whether the bullying of midwifery students has secondary impacts on the experiences and care of mothers, babies, and their support persons. AIM: To examine how midwifery students, who self-identify as having been bullied, perceive the repercussions on women and their families. METHODS: This qualitative descriptive study explored 120 Australian and United Kingdom (UK) based midwifery students. Data were collected using an anonymous online qualitative survey and were thematically analysed. FINDINGS: The findings suggest that the bullying of midwifery students impacts women and their families in a number of ways. Midwifery students perceive that mothers and babies are frequently implicated either directly or indirectly in the enactment of bullying. This can impact their safety, fractures relationships, and impairs the women's confidence in the student and the profession. Students additionally reported that women and/or their support persons can feel compelled to step in to defend and protect the student. CONCLUSIONS: The bullying of midwifery students is perceived to place women at risk, in uncomfortable situations, damage rapport and undermines their confidence in students and the profession. This also impacts adversely on the student's ability to provide women centred care as they lose confidence in front of the woman and her family when they are bullied by registered midwives.

Midwifery students' perceptions of the modifiable organisational factors that foster bullying behaviours whilst on clinical placement. A qualitative descriptive study.

PROBLEM: An increasing body of research suggests midwifery students experience bullying and harassment whilst on clinical placement. Little is known, however, about factors that foster bullying within this context and how they may be addressed. AIM: To explore and describe midwifery students' perceptions of what modifiable organisational factors foster bullying behaviours and to map the identified factors against the students' perceptions of a solution. METHODS: A qualitative descriptive design was used. A total of 120 midwifery students from the United Kingdom and Australia participated in this study. Participants completed an online qualitative survey and data was thematically analysed. FINDINGS: The midwifery students in this study perceive that several organisational factors exist that help foster bullying behaviours towards them whilst undertaking clinical placement. Three overarching themes were identified relating to ineffective midwifery mentorship, the high stress environment of the maternity unit, and challenges faced with transparency and whistleblowing. Students identified a range of potential structural responses to bullying. CONCLUSIONS: Recommendations are made that midwifery managers and academics acknowledge how students perceive several potentially modifiable organisational factors which either lead to or exacerbate the likelihood of them being the target of bullying whilst on clinical placement. Consideration should be given to solutions that from the student's perspective may help tackle bullying and subsequently lead to fewer students leaving midwifery education and further depleting the future workforce.