The characteristics of compassionate care during childbirth according to midwives: a qualitative descriptive inquiry.

BACKGROUND: Although compassion is considered to be of prime importance in nursing and midwifery, there is no clear understanding of what compassionate care in childbirth entails, and how midwives perceive compassionate care is largely unknown. This study accordingly seeks to describe the characteristics, of compassionate care during childbirth as perceived by midwives. METHODS: A qualitative descriptive inquiry was undertaken with a voluntary online survey, where participants were recruited via snowball sampling on the social networking site, Facebook. The participants were midwives, and the unit of analysis was the received responses. Participants reported on instances of compassionate care during childbirth. The data was thematically analysed using Tesch's eight steps to identify common themes. RESULTS: Ninety-eight responses were analysed and three themes with eight sub-themes emerged as dominant characteristics. Themes and sub-themes were as follows: making meaningful connections with women (displaying good interpersonal skills, conduct based on dignity and respect, establishing trust); initiating individualised understanding of each woman (showing empathy, permitting maternal choice) and action through care and support (providing emotional support, assistance through instrumental care, continuous informational support). CONCLUSIONS: In seeking to determine what characterises compassionate care in childbirth, the findings reveal a process of making meaningful connections with women through recognising their needs, initiating individualised understanding of each woman's needs and desiring to ease it, which is subsequently manifested in action through emotional, instrumental and informational care and support. A better understanding of how midwives perceive compassionate care could potentially improve the quality of care midwives offer during childbirth.

Ancient Maya wetland fields revealed under tropical forest canopy from laser scanning and multiproxy evidence.

We report on a large area of ancient Maya wetland field systems in Belize, Central America, based on airborne lidar survey coupled with multiple proxies and radiocarbon dates that reveal ancient field uses and chronology. The lidar survey indicated four main areas of wetland complexes, including the Birds of Paradise wetland field complex that is five times larger than earlier remote and ground survey had indicated, and revealed a previously unknown wetland field complex that is even larger. The field systems date mainly to the Maya Late and Terminal Classic (∼1,400-1,000 y ago), but with evidence from as early as the Late Preclassic (∼1,800 y ago) and as late as the Early Postclassic (∼900 y ago). Previous study showed that these were polycultural systems that grew typical ancient Maya crops including maize, arrowroot, squash, avocado, and other fruits and harvested fauna. The wetland fields were active at a time of population expansion, landscape alteration, and droughts and could have been adaptations to all of these major shifts in Maya civilization. These wetland-farming systems add to the evidence for early and extensive human impacts on the global tropics. Broader evidence suggests a wide distribution of wetland agroecosystems across the Maya Lowlands and Americas, and we hypothesize the increase of atmospheric carbon dioxide and methane from burning, preparing, and maintaining these field systems contributed to the Early Anthropocene.