Marie Berg

There is limited knowledge regarding childbirth outcomes among women with pregnancies resulting from rape. At Panzi Hospital, a tertiary hospital in eastern Democratic Republic of Congo (DRC), a holistic care programme is provided for survivors of sexual violence. Explore childbirth outcomes among women classified as Robson Group 1 who received care in a birthing room designed to promote person-centredness, comparing those with rape-related pregnancies to other women. This study was conducted between March 2021 and July 2022, with consecutive collection of childbirth data from nulliparous women at term with a single foetus in cephalic presentation and spontaneous onset of labour, i.e. Robson Group 1. All participants received care in a new birthing room designed to promote person-centredness. Childbirth outcomes were compared between women with rape-related pregnancies (n = 159) and those without (n = 302). No statistically significant differences in childbirth outcomes were observed. Among women with rape-related pregnancies, 81.8% had vaginal births, compared to 83.4% in the comparison group. Caesarean section rates were 18.2% and 16.6%, respectively. The childbirth experience was rated positively by 80.5% of women in the rape-related pregnancy group and 84.8% in the comparison group with scores of 8-10 on the modified Visual Analogue Scale for Overall Childbirth Experience (VAS-OCE, 0-10). Childbirth outcomes among women with rape-related pregnancies receiving care within a holistic programme were comparable to those of other pregnant women, when care was provided in a birthing room designed to promote person-centred care.

Investing in midwives educated according to international standards is crucial for achieving Sustainable Development Goals in maternal and newborn health. Applying a person-centred care approach and using simulation-based learning to improve the learning experience for midwifery students may enhance the quality of childbirth care. This protocol describes a study evaluating the implementation of person-centred approach and simulation-based learning in childbirth as part of a midwifery education programme at the Evangelical University in Africa, DRC. The research will be exploratory and guided by an implementation research framework. Ethical approval has been obtained. Facilitators working at the programme’s five clinical practice sites will be trained in: 1) Introducing person-centred childbirth care using a training programme called‘Mutual Meetings’; and 2) integrating simulation-based learning, specifically by using the three courses: Essential Care of Labor, Bleeding after Birth, and Vacuum Extraction. Data will include interviews with midwifery students, facilitators and clinical preceptors, and maternal and neonatal outcomes from birth registers. By integrating a validated and culturally adapted person-centred care training programme and simulation-based learning into a midwifery education programme and clinical practice sites, the findings from the study anticipate an improvement in the quality of childbirth care. Training facilitators in these methodologies aim to effectively mitigate maternal and neonatal adverse outcomes. The findings are expected to provide valuable recommendations for governments, policymakers, and healthcare providers in the DRC and beyond, contributing to significant improvements in midwifery education and aligning with global health priorities, including the Sustainable Development Goals. The study was registered retrospectively with the ISRCTN registry on the 23rd of February 2024. The registration number is: ISRCTN10049855.

Introduction: Theoretical models for midwifery have been developed in different countries, but few have been evaluated. This study evaluated the implementation of a midwifery model of woman-centered care (MiMo) in practice. Methods: A mixed method study based on an implementation of MiMo was...

Numerous quality-improvement projects including healthcare professional training are conducted globally every year, but there is a gap between the knowledge obtained in the training and its impleme...

Background: Maternal and neonatal mortality and morbidity in the Democratic Republic of Congo (DRC) are among the highest worldwide. As part of a quality improvement programme in a health zone in the DRC aimed at contributing to reduced maternal and neonatal mortality and morbidity, a three-pillar training intervention around childbirth was developed and implemented in collaboration between Swedish and Congolese researchers and healthcare professionals. The aim of this study is to explore contextual factors influencing this intervention. Methods: A qualitative research design was used, with data collected through focus group discussions (n = 7) with healthcare professionals involved in the intervention before and at the end (n = 9). Transcribed discussions were inductively analysed using content analysis. Results: Three generic categories describe the contextual factors influencing the intervention: i) Incentives motivated participants’ efforts to begin a training programme; ii) Involving the local health authorities was important; and (iii) Having physical space, electricity, and equipment in place was crucial. Conclusions: This study and similar ones highlight that incentives of various types are crucial contextual factors that influence training interventions, and have to be considered already in the planning of such interventions. One such factor is expectations of monetary incentives. To meet this in a small research project like ours would require a reduction of the scale and thus limit the implementation of new evidence-based knowledge into practice aimed at reducing maternal mortality and morbidity.