Papers by Christine Furber
Bjog: An International Journal Of Obstetrics And Gynaecology, May 27, 2021
Objectives To explore how childbirth-related blood loss is evaluated and excessive bleeding recog... more Objectives To explore how childbirth-related blood loss is evaluated and excessive bleeding recognised; and to develop and test a theory of postpartum haemorrhage (PPH) diagnosis. Design Two-phase, exploratory, sequential mixed methods design using focus groups, interviews and a pilot, randomised crossover study. Setting Two hospitals in North West England. Sample Women (following vaginal birth with and without PPH), birth partners, midwives and obstetricians. Methods Phase 1 (qualitative): 8 focus groups and 20 one-to-one, semi-structured interviews were conducted with 15 women, 5 birth partners, 11 obstetricians, 1 obstetric anaesthetist and 19 midwives (n = 51). Phase 2 (quantitative): 11 obstetricians and ten midwives (n = 21) completed two simulations of fast and slow blood loss using a high-fidelity childbirth simulator. Results Responses to blood loss were described as automatic, intuitive reactions to the speed, nature and visibility of blood flow. Health professionals reported that quantifying volume was most useful after a PPH diagnosis, to validate intuitive decisions and guide ongoing management. During simulations, PPH treatment was initiated at volumes at or below 200 ml (fast mean blood loss 79.6 ml, SD 41.1; slow mean blood loss 62.6 ml, SD 27.7). All participants treated fast, visible blood loss, but only half treated slow blood loss, despite there being no difference in volumes (difference 18.2 ml, 95% CI À5.6 to 42.2 ml, P = 0.124). Conclusions Experience and intuition, rather than blood loss volume, inform recognition of excessive blood loss after birth. Women and birth partners want more information and open communication about blood loss. Further research exploring clinical decision-making and how to support it is required.
Objective: To identify and critically review the research literature that has examined fathers' i... more Objective: To identify and critically review the research literature that has examined fathers' involvement during labour and birth and their influence on decision making. Design: The review follows the approach of a narrative review. Systematic searches of electronic databases Social Services Abstract, Sociological Abstracts, ASSIA, CINAHL Medline, Cochrane library, AMED, BNI, PsycINFO, Embase, Maternity and Infant care, DH-Data and the Kings Fund Database were combined with manual searches of key journals and reference lists. Studies published between 1992-2013 examining fathers' involvement during intrapartum care were included in the review. Findings: The findings of this review suggest that fathers' level of involvement during labour ranges from being a witness or passive observer of labour and birth to having an active supporting and coaching role. The findings also suggest that there are a number of facilitators and barriers to fathers' involvement during labour and birth. There are a limited number of studies that have examined fathers' involvement in decision making and specifically how fathers' influence decision making during labour and birth. Key conclusions Future research needs to address the gap in the literature regarding fathers' involvement and influence on decision making to help midwives and obstetricians understand the process in order enhance the transition to parenthood for women and men.
British journal of midwifery, Oct 2, 1995
The Health of the Nation Report (Department of Health, 1992) has ensured that smoking has a high ... more The Health of the Nation Report (Department of Health, 1992) has ensured that smoking has a high profile today. This article reviews reasons why women smoke, examines their smoking habits and gives practical suggestions for the midwife to use when encouraging women to quit smoking.
British journal of midwifery, Nov 1, 2010
During pregnancy, the eating behaviour and body of childbearing women can become open to public s... more During pregnancy, the eating behaviour and body of childbearing women can become open to public scrutiny. It is important to gather the views of those who are pregnant and have an eating/weight issue to ensure that maternity services meet their needs and to reduce any stress and discomfort they may endure. However, prompting women to engage in research that would explore these issues in depth can prove difficult. This article outlines the experiences of a team of investigators who have tried to examine the phenomena of pregnancy among women who have an eating disorder or who are classed as obese. It focuses on the obstacles encountered while undertaking two qualitative projects and outlines lessons learnt from this work, which may prove helpful to others wishing to study these areas.
Midwifery, Dec 1, 2000
Objective: to explore midwives' attitudes to health promotion. Design: quantitative study, data c... more Objective: to explore midwives' attitudes to health promotion. Design: quantitative study, data collected using self-completed postal questionnaires in 1996. Setting: the North West of England,UK. Participants: 182 senior midwives who were working in hospital and community settings. Key ¢ndings: the patterns of views towards health promotion approaches were complex as midwives stated that they preferred societal approaches but worked in approaches that focused on the individual. Health promotion methods that centre on the individual were also preferred. Clinical practice base, educational quali¢cations and age were in£uential in midwives'opinions. Implications for practice: there is a need for further clari¢cation of the midwife's understanding of their role as a health promoter. Educators should ensure that health promotion is explained within its practical context and there should be opportunity for midwives to develop skills of lobbying, negotiating, implementing and policy planning. Liaison with other disciplines should be fostered to understand their roles and develop joint health promotion strategies.There is a need for further research exploring midwives' opinions from a qualitative perspective.
Journal of Obstetric, Gynecologic, & Neonatal Nursing, Nov 1, 2012
Objective: To explore the complexities of diaper area cleansing reported by women participating i... more Objective: To explore the complexities of diaper area cleansing reported by women participating in a randomized controlled trial designed to compare optimally formulated baby wipes (Johnson's Baby Skincare fragrance free wipe) with cotton wool and water. Design: A mixed-method design incorporating quantitative and qualitative methods to explore maternal views and experiences of using baby wipes or cotton wool and water to cleanse their newborn's diaper area over an 8-week period. Setting: Participants were recruited from a large regional maternity hospital in Northern England. Participants: Participants included 280 women and their healthy term newborns; 252 provided 4-week data (90.0%) and 237 provided 8-week data (85.0%). Methods: Data from diaries and structured face-to-face interviews at 4 weeks and telephone interviews at 8 weeks were transcribed and thematically analyzed to identify themes. Quantitative data were compared between randomized groups using descriptive statistics and two-group tests, where appropriate. Results: Major themes identified highlighted the practical realities of diaper area cleansing, diaper area cleansing and everyday life, and living with the rhetoric that water is best. Baby wipes were perceived as more convenient efficient at cleansing. Some women using cotton wool and water did not cleanse skin after urination alone. Diaper changing was significantly more frequent in the baby wipes group at 4 weeks, but there was no significant difference between the groups at 8 weeks. Conclusion: Women are faced with a complex environment regarding diaper area cleansing and need clear evidencebased advice and guidance on effective diaper area cleansing.
Journal of Reproductive and Infant Psychology, Jun 23, 2016
Midwifery, Sep 1, 2015
Objective: To identify and critically review the research literature that has examined fathers' i... more Objective: To identify and critically review the research literature that has examined fathers' involvement during labour and birth and their influence on decision making. Design: The review follows the approach of a narrative review. Systematic searches of electronic databases Social Services Abstract, Sociological Abstracts, ASSIA, CINAHL Medline, Cochrane library, AMED, BNI, PsycINFO, Embase, Maternity and Infant care, DH-Data and the Kings Fund Database were combined with manual searches of key journals and reference lists. Studies published between 1992-2013 examining fathers' involvement during intrapartum care were included in the review. Findings: The findings of this review suggest that fathers' level of involvement during labour ranges from being a witness or passive observer of labour and birth to having an active supporting and coaching role. The findings also suggest that there are a number of facilitators and barriers to fathers' involvement during labour and birth. There are a limited number of studies that have examined fathers' involvement in decision making and specifically how fathers' influence decision making during labour and birth. Key conclusions Future research needs to address the gap in the literature regarding fathers' involvement and influence on decision making to help midwives and obstetricians understand the process in order enhance the transition to parenthood for women and men.
In: Manchester Pharmacy Education Conference; 27 Jun 2016-27 Jun 2016; The University of Manchester. The University of Manchester Library; 2016., 2016
BMC Pregnancy and Childbirth, 2016
Background: Worldwide maternal perception of fetal movements has been used for many years to eval... more Background: Worldwide maternal perception of fetal movements has been used for many years to evaluate fetal wellbeing. It is intuitively regarded as an expression of fetal well-being as pregnancies in which women consistently report regular fetal movements have very low morbidity and mortality. Conversely, maternal perception of reduced fetal movements is associated with adverse pregnancy outcomes. We sought to gain insight into pregnant women's and clinicians views and experiences of reduced movements. Method: We performed qualitative semi-structured interviews with pregnant women who experienced reduced fetal movements in their current pregnancy and health professionals who provide maternity care. Our aim was to develop a better understanding of events, facilitators and barriers to presentation with reduced fetal movements. Data analysis was conducted using framework analysis principles. Results: Twenty-one women and 10 clinicians were interviewed. The themes that emerged following the final coding were influences of social network, facilitators and barriers to presentation and the desire for normality. Conclusions: This study aids understanding about why women present with reduced movements and how they reach the decision to attend hospital. This should inform professionals' views and practice, such that appreciating and addressing women's concerns may reduce anxiety and make presentation with further reduced movements more likely, which is desirable as this group is at increased risk of adverse outcome. To address problems with information about normal and abnormal fetal movements, high-quality information is needed that is accessible to women and their families.
In Trends Seminar Series Topics in Research and Education For Nursing Development in Singapore 16 Nov 2012 National University of Singapore 2012, Nov 1, 2012
African Journal of Midwifery and Women's Health, 2013
This study aimed to explore how sociocultural practices and beliefs may influence maternal mortal... more This study aimed to explore how sociocultural practices and beliefs may influence maternal mortality in Nigeria by examining the cultural practices and popular traditional beliefs of the Ibibio and Annang ethnic groups of Akwa Ibom state. The research used semi-structured and unstructured in-depth face-to-face interviews and focus group discussions (FGDs) for data collection. Two sites in Akwa lbom state of Nigeria—Etinan and Oruk Anam—were selected for the study. Thirty women of childbearing age and 10 men were interviewed. Four focus group discussions were held with 5 mothers-in-law, 5 menopausal women and 10 midwives. Thirty five observation sessions were conducted with seven traditional birth attendants (TBAs). Thematic analysis of the data was undertaken. The computer software programme NVivo 8 was used to support management of data. The findings are presented in two themes: Childbearing as an inevitable burden or destiny and pregnancy, mystery, and superstition and the role of...
Independent Nurse, 2012
Pregnancy can have a psychological impact on women who are obese or overweight, write Christine F... more Pregnancy can have a psychological impact on women who are obese or overweight, write Christine Furber and Linda McGowan
Nurse Education in Practice, 2003
This paper describes a multi-professional teaching innovation that took place at The University o... more This paper describes a multi-professional teaching innovation that took place at The University of Manchester during October 2001. Ideas for the project were first established in December 2000 when a multi-professional team of educationalists began exploring ways in which three disparate student groups could be brought together as part of an integrated learning activity (). For this reason, a problem-based learning scenario was developed to encourage nursing, midwifery, and medical students to share their previous knowledge and principles of care. In addition, the students were also asked to identify the type(s) of information they felt should be included in a user guide for new parents regarding the uncomplicated labour and puerperium. In total 10-second year nursing, 17-third year midwifery and 13-fourth year medical students volunteered to take part. These were subsequently divided into five integrated problem-based learning groups each supported by two teachers reflecting similar multi-professional backgrounds. In this paper, the discussion will explore a series of themes identified as being of major import by students and tutors during the qualitative phase of the study namely:
Background Being obese and pregnant is associated with substantial risks for the mother and her c... more Background Being obese and pregnant is associated with substantial risks for the mother and her child. Current weight management guidance for obese pregnant women is limited. The latest recommendations suggest that obese pregnant women should gain between 5.0 and 9.1 kg during the pregnancy period, and weight loss is discouraged. However, observational studies indicate that some obese pregnant women, especially those who are heavier, lose weight during pregnancy. Furthermore, some obese pregnant women may intentionally lose weight. The safety of weight loss when pregnant and obese is not substantiated; some observational studies suggest that risks associated with weight loss such as pre-eclampsia are improved, but others indicate that the incidence of small-for-gestational infants are increased. It is important to evaluate interventions that are designed to reduce weight in obese pregnant women so that the safety of weight loss during this period can be established. Objectives To evaluate the effectiveness of interventions that reduce weight in obese pregnant women. Search methods We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 July 2012) and contacted experts in the field. Selection criteria Randomised controlled trials, 'quasi-random' studies and cluster-randomised trials comparing a weight-loss intervention with routine care or more than one weight loss intervention. Cross-over trials were not eligible for inclusion. Data collection and analysis We identified no studies that met the inclusion criteria for this review. Main results There were no included trials. 1 Antenatal interventions for reducing weight in obese women for improving pregnancy outcome (Review)
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Papers by Christine Furber