/library/oar/handle/123456789/109176 2026-05-27T11:25:18Z /library/oar/handle/123456789/109495 Title: Mothers’ lived experiences of antenatal care in Malta Abstract: The purpose of antenatal care is to prevent, identify and treat conditions that may threaten the health of the mother and her baby, and ensure a positive birth experience through person-centred care (WHO, 2016). This study aimed to explore how mothers experience antenatal care in the local setting. Objectives were set to understand and elicit the meaning of the lived experiences of mothers’ antenatal care provided at the local public hospital, the primary health care centres and the private clinics. An Interpretative Phenomenological Analysis (IPA) study was conducted using a purposive sample of ten mothers recruited from the local public hospital, post-natal wards in the immediate post-partum period. Data was collected through one-time, face-to-face, semi-structured interviews with each participant. The ‘Quality Maternal and Newborn care Framework’ (Renfrew et al., 2014) guided this study. Data was analysed using IPA analysis described by Smith, Flowers and Larkin (2009). Three super-ordinate themes emerged from the data; ‘A Sense of Being Cared For’, ‘What Matters’ and ‘Addressing the Unknown’. Results showed that antenatal care during pregnancy was essential to mothers as it provided them with guidance, reassurance, encouragement, peace of mind and support during a crucial time in their life. Mothers felt that antenatal care should be woman-centred and tailored to their individual needs. Furthermore, mothers seeking antenatal care in the private sector felt that antenatal care should be offered in clinics solely for pregnant women and not other patients seeking alternative health care. Mothers identified the midwife as a fundamental part of antenatal care as her role goes beyond the mother’s physical, aspects of care but extends to a spiritual, emotional, and cultural level. Recommendations for midwifery practice, education and research are proposed, namely providing fully functioning antenatal care clinics in the community to avoid referrals to other clinics/hospital, creating workshops on cultural and religious diversity and how it impacts antenatal care, and conducting a similar study, however exploring both mothers’ and fathers’ experiences of antenatal care. Description: M.Sc.(Melit.) 2022-01-01T00:00:00Z /library/oar/handle/123456789/109493 Title: Newly qualified midwives’ lived experiences of caring for women during labour and birth Abstract: Once student midwives successfully complete their midwifery training, they become newly qualified midwives [NQMs] and their professional midwifery career commences. As they embark on this journey, one of the maternity settings where they get to provide midwifery care is the birthing unit. This study focuses on the lived experiences of NQMs while working at the birthing unit. The study addressed this scenario and aimed to elicit and understand the meaning of NQMs’ lived experiences of caring for women during labour and birth. The objectives of this study revolved around capturing NQMs’ experiences of caring for women during labour and birth, uncovering the meaning of these experiences and elicit any supportive measures which NQMs identify as helpful when caring for women during labour and birth in such initial phase of their career. A Heideggerian hermeneutic phenomenological research approach was adopted and a purposive sampling technique was used to recruit ten participants. One-time, one-to-one, semi-structured, in-depth interviews were conducted with each of the ten participants in this study. These included NQMs employed at the main local hospital who had worked at the Central Delivery Suite [CDS] as part of their rotation period in the last two years post qualification. The research process and analysis of the data were guided by van Manen’s (1990) six-step approach. Hermeneutic philosophical notions and the William Bridges transition theory (1991) guided the study and the interpretation of the findings. Two themes and their corresponding subthemes emerged from the data. The theme Baptism of Fire captures all the challenges, hurdles and impediments that NQMs faced once they started their placement at the CDS. In the theme Containing the Fire, findings revealed that after some time, things started to fall into place and NQMs started to better cope with challenges and address obstacles they faced. The main outcome of this study reveals that NQMs' experiences at the CDS were impacted by the outcome of their placement at the birthing unit when they were still student midwives, as well as the support and guidance they found from their colleagues once they started their rotation period and became part of the team as qualified midwives. Findings were congruent with the current literature however, there were a number of unique findings that emerged from this study. These include that working at the CDS and assisting a woman in labour and birth gives NQMs a sense of fulfilment. Moreover, they viewed their experience at the CDS as the essence of midwifery and a steppingstone in the growth of their career, as they felt that they had become true midwives. Based on the findings of this study, several recommendations were highlighted, mainly for further research and implications for practice, policy and education to better assist NQMs as they embark on their journey of caring for women during labour and birth. The main recommendation, based on the participants' narratives, is for NQMs to be assigned to a senior midwife when on the birthing unit, so they have someone to refer to for guidance and support. Description: M.Sc.(Melit.) 2022-01-01T00:00:00Z /library/oar/handle/123456789/109491 Title: Pregnant women’s expectations for the early postpartum period after their first childbirth Abstract: The aim of this study was to explore pregnant women’s expectations for the early postpartum period after their first childbirth. The objectives were to explore women's’ expectations for their physical and emotional state in the early postpartum period, to inquire into women’s expectations for caregiving during this period, to identify sources of influence on maternal expectations, and to consider the perceived adequacy of information received about the early postpartum period. A qualitative approach was adopted, with semi-structed interviews used to generate data from a purposive sample of seven expectant mothers in the third trimester of their first pregnancy. A response rate of 100% was attained. The interviews conducted were audio-recorded and transcribed to collect the actual verbatim responses of the participants and facilitate content analysis. The data collected was then analysed using Braun and Clarke's (2006) thematic analysis. While some women had established expectations for the early period following childbirth, the focus of others was on the pregnancy and birth, and they were unable to clearly visualise the period beyond that. The mother’s physical state in the early postpartum and her ability to independently care for the neonate was viewed as somewhat unpredictable, being that it would be heavily influenced by the mode of delivery. Most of the women reported feeling unprepared for the postpartum period, with some questioning their own mothering abilities. Expectant mothers predicted that the assistance provided by a compassionate midwife, as well as by their family, and particularly their partners, would be invaluable to their adjustment in the early postpartum period. Antenatal educational classes were not felt to offer sufficient information about the puerperium, and women were unsure whether listening to the stories of other mothers provided an accurate picture of what their own experience would be like. The study concluded that many women perceive the early postpartum as a somewhat unknown and, to a certain extent, unknowable period for which they were largely ill equipped. Based on the findings, a number of recommendations for practice, education, and future research are proposed, including the necessity for large-scale quantitative research to provide better insight into maternal knowledge and expectations regarding the postnatal period prior to childbirth. This would allow improvments to both prenatal education and postnatal care in accordance with women’s needs. Description: B.Sc. (Hons)(Melit.) 2022-01-01T00:00:00Z /library/oar/handle/123456789/109490 Title: Midwives' views on vaginal birth after a previous caesarean section Abstract: A vaginal birth after Caesarean section refers to a vaginal delivery following a previous delivery by Caesarean section. The aim of this study was to explore midwives’ perceptions on vaginal birth after Caesarean section. The objectives were; to enquire into how midwives perceive vaginal birth after a previous Caesarean section, to explore their thoughts about maternal choice in determining their preferred birth method, and to explore the physical and psychological intrapartum care provided to women attempting a vaginal birth after a Caesarean section. A qualitative approach was adopted, using semi-structured, one-to-one interviews, conducted with a purposive sample of six midwives working at the Central Delivery Suite at Malta’s main general hospital. A 100% response rate was achieved. The interviews were audio-recorded, and then transcribed verbatim. Data was analysed using thematic analysis. The findings revealed that midwives had a positive attitude towards vaginal birth after Caesarean section, and encouraged eligible women to opt for this alternative. However, they also believed in promoting informed decision making, and respecting women’s choices. Midwives felt that women were primarily influenced by the advice of obstetricians, as well as by their own previous experiences of birth and postpartum recovery. The opinions of other women within their close social network, were also found to have an impact on maternal decision. Participants claimed that effective communication and psychological support were needed throughout the experience, especially if women required an emergency Caesarean section, following an unsuccessful trial of labour, which often left women feeling downhearted. The study concluded that choosing the optimal mode of birth after a previous operative delivery is often a complex decision for expectant mothers. The study suggests the need for all eligible expectant mothers to receive unbiased information about vaginal birth after Caesarean section. The main recommendations of the study entail the need for further research exploring obstetricians’ attitudes towards vaginal birth after Caesarean section. This would provide a deeper insight into how these professionals may be influencing women in their decisions. This study also recommends training for all healthcare professionals providing intrapartum care, to continuously keep them informed regarding updated evidence-based guidelines on vaginal birth after Caesarean section. Description: B.Sc. (Hons)(Melit.) 2022-01-01T00:00:00Z