Barriers preventing Australian midwives from providing antenatal asthma management
International guidelines indicate that management of asthma during pregnancy should be multidisciplinary; however, the role of midwives has not been researched.
A qualitative descriptive study exploring Australian midwives' current knowledge about asthma in pregnancy and their perceived role in antenatal asthma management was conducted, involving individual semi-structured in-depth interviews with 13 midwives in a tertiary referral hospital. Data were analysed using Morse and Field's four-stage process.
Midwives identified barriers preventing them from providing antenatal asthma management, including: lack of knowledge about asthma in pregnancy; time constraints; women's knowledge about asthma in pregnancy; lack of a clear referral pathway; and lack of accessible asthma management equipment. Barriers were influenced by the institutional context in which the midwives worked.
While participants identified barriers preventing them from providing recommended antenatal asthma management, they also suggested that improving their knowledge about asthma in pregnancy and developing a clear referral pathway may be beneficial.
Asthma is one of the most common potentially serious conditions that complicates pregnancy, with approximately 3–14% of pregnant women affected by asthma worldwide; 12.7% of pregnant women in Australia and 8.3–10.9% in the UK (Sawicki et al, 2011; Charlton et al, 2013). Evidence emerging in the literature demonstrates that if asthma is well-managed throughout pregnancy, adverse maternal and fetal outcomes such as maternal hypertension, preterm birth and low infant birth weight can be reduced (Schatz et al, 1995; Murphy et al, 2006; Murphy et al, 2011). The clinical course of asthma during pregnancy is unpredictable, making management challenging (Kircher et al, 2002). The goal of effective asthma management during pregnancy is the prevention of exacerbations, which can cause hypoxic episodes in the mother and reduce oxygen to the baby.
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