References

Healthy pregnancy for women with asthma—an information paper for health professionals.St Leonards: Asthma Foundation NSW; 2006

Australian Institute of Health and Welfare: Australian Centre for Asthma Monitoring. Monitoring asthma in pregnancy: a discussion paper. 2013. http://www.aihw.gov.au/publication-detail/?id=60129544570 (accessed 8 January 2015)

Bondarianzadeh D1, Yeatman H, Condon-Paoloni D A qualitative study of the australian midwives' approach to listeria education as a food-related risk during pregnancy. Midwifery. 2011; 27:(2)221-8 https://doi.org/10.1016/j.midw.2009.06.002

Charlton RA, Hutchison A, Davis KJ, de Vries CS Asthma management in pregnancy. PLOS One. 2013; 8:(4) https://doi.org/10.1371/journal.pone.0060247

Brodie P Addressing the barriers to midwifery – australian midwives speaking out. Aust J Midwifery. 2006; 15:(3)5-14

George A, Johnson M, Duff M, Blinkhorn A, Ajwani S, Bhole S, Ellis S Maintaining oral health during pregnancy: perceptions of midwives in southwest Sydney. Collegian. 2011; 18:(2)71-9

Gharaibeh H, Oweis A, Hamad KH Nurses' and midwives' knowledge and perceptions of their role in genetic teaching. Int Nurs Rev. 2010; 57:(4)435-42 https://doi.org/10.1111/j.1466-7657.2010.00814.x

Kircher S, Schatz M, Long L Variables affecting asthma course during pregnancy. Ann Allergy Asthma Immunol. 2002; 89:(5)463-6

Lim A, Stewart K, Abramson MJ, Walker SP, George J Multidisciplinary approach to management of maternal asthma (MAMMA [copyright]): the PROTOCOL for a randomized controlled trial. Chest. 2014; 145:(5)1046-54 https://doi.org/10.1378/chest.13-2276

McLeod D, Benn C, Pullon S, Viccars A, White S, Cookson T, Dowell A The midwife's role in facilitating smoking behaviour change during pregnancy. Midwifery. 2003; 19:(4)285-97

Morse J, Field P Nursing Research: The Application, 2nd edn. London: Chapman & Hall; 1996

Murphy VE, Clifton VL, Gibson PG Asthma exacerbations during pregnancy: incidence and association with adverse pregnancy outcomes. Thorax. 2006; 61:(2)169-76

Murphy VE, Namazy JA, Powell H, Schatz M, Chambers C, Attia J, Gibson PG A meta-analysis of adverse perinatal outcomes in women with asthma. BJOG. 2011; 118:(11)1314-23 https://doi.org/10.1111/j.1471-0528.2011.03055.x

Asthma management handbook 2014.South Melbourne: NAC; 2014

National Heart Lung and Blood Institute. National asthma education and prevention program expert panel report 3: guidelines for the diagnosis and management of asthma. 2007. http://www.nhlbi.nih.gov/files/docs/guidelines/asthsumm.pdf (accessed 8 January 2015)

Neergaard MA, Olesen F, Andersen RS, Sondergaard J Qualitative description – the poor cousin of health research?. BMC Med Res Methodol. 2009; 9:(52)52-6

Rogers C, Bloomfield L, Townsend J A qualitative study exploring midwives' perceptions and views of extending their role to the examination of the newborn baby. Midwifery. 2003; 19:(1)55-62

Ross-Davie M, Elliott S, Sarker A, Green L A public health role in perinatal mental health: are midwives ready?. British Journal of Midwifery. 2006; 14:(6)330-4

Sandelowski M Whatever happened to qualitative description?. Res Nurs Health. 2000; 23:(4)334-40

Sawicki E, Stewart K, Wong S, Paul E, Leung L, George J Management of asthma by pregnant women attending an australian maternity hospital. Aust N Z J Obstet Gynaecol. 2011; 52:(2)183-8 https://doi.org/10.1111/j.1479-828X.2011.01385.x

Schatz M, Zeiger RS, Hoffman CP, Harden K, Forsythe A, Chilingar L Perinatal outcomes in the pregnancies of asthmatic women: a prospective controlled analysis. Am J Respir Crit Care Med. 1995; 151:(4)1170-4

Barriers preventing Australian midwives from providing antenatal asthma management

02 February 2015
13 min read
Volume 23 · Issue 2

Abstract

International guidelines indicate that management of asthma during pregnancy should be multidisciplinary; however, the role of midwives has not been researched.

Method:

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.

Findings:

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.

Conclusion:

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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