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The #QualWorld2017 Virtual international conference, hosted by the International Institute for Qualitative Methodology (@theIIQM)

The virtual international conference, hosted by the International Institute for Qualitative Methodology (IIQM)  is the first online conference focused on the subject of qualitative research. I gravitated towards this as something new, exciting and inclusive. Plus, as my new daughter has just been born….a virtual online conference seemed to be the perfect way to share my latest work and breastfeed at the same time.

The poster I presented was:

Exploring the perceptions of new mother’s in relation to psychological distress and workplace support in midwifery. A Patient and Public Involvement study

I was representing The Centre for Innovative Research Across the Life Course at Coventry University. This work was formed in partnership with Dr. Gemma Pearce and Dr. Elizabeth Bailey, also from Coventry University.

Qual-World Interactive Virtual Conference

The conference theme was: Qualitative Research Across Boundaries

Keynote Speakers:

Prof. Amanda Kenny, La Trobe University, Australia
Prof. Trish Greenhalgh, University of Oxford, UK
Prof. Martyn Hammersley, The Open University, UK
Prof. Babette Babich, Fordham University, The Jesuit University of New York City

Here are a few snapshots of the keynote speeches…

As an early career researcher (post-doc) I really appreciated the insights shared in relation to progressing an academic career and thriving in a research centre. The idea that collaborations and publications can be planned to achieve maximum impact really appeals to me…. a few hints and tips in the right direction were very welcome.

I have yet to use or explore storytelling and narratives in my research career thus far in any great depth. As such, it was really inspiring to see how these have been used in other qualitative work. Ethnography is also an area fairly new to me, and so being introduced to new topics in this way really helped me to digest and think about new directions for my own research.

Then, to  fall in love with philosophy again was wonderful…looking at what makes science….science….within the terminology of the postmodern? Lot’s to think about here. And certainly lot’s to discuss. The online chat room was on the go throughout the conference, and on Twitter. The conversations really made me think about my own future directions in research and how it may be grounded.

Yet the best thing about this conference for me was the fact that it has been so accessible for me. Having just had a new baby girl, this conference gave me the chance to share new findings from our PPI study from the comfort of home. This meant that I could care for my baby and breastfeed whilst not missing out on the career I love. Thank you to the conference organizers for making this possible. …and thank you to the Centre for Innovative Research Across the Life Course for funding my place.

As you can see, this tweet of my experience was the most popular one of the conference… I think that these accessible conferences are really making history and showing the way for future conferences of this type.

In conclusion…I would like to reiterate the following tweet:

If you would like to follow the progress of my work going forward..

Follow me via @SallyPezaroThe Academic MidwifeThis blog

Until next time…Look after yourselves and each other 💚💙💜❤

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Developing your literature search strategy in 5 easy steps

OK, so you have a research problem that you want to solve or answer using evidence based in the literature. You need to find the right literature and capture it by spreading your net wide, and in the right places. You need a strategy for searching the literature….a search strategy if you will. I hope that these 5 steps will get you to where you want to be.

search strategy

What is a search strategy?

1.A structured organisation of terms used to search a database

2.A document that shows how terms combine to retrieve the best results

3.Something that must be adapted for each database you use

4.Something which is tailored to the question you are trying to answer

5.A good search strategy is something that takes time to refine

Different ways to search the literature

1.Electronically

2.Manually

3.Snowballing of the literature (going from reference list to reference list to find what you  need.

4.We can do a rapid review of the literature or an exhaustive one

5.We can see what other published literature reviews have done and how they have found their literature for ideas.

6.Ask! (Librarians, authors etc.)… authors of great papers often know of other papers you may be looking for…why not ask them?

Step one: Define your research question or ‘problem’.

First…we will use this as an example: Does hand washing among midwives reduce postnatal infections? 

  Example:
P (Problem or Patient or Population) postnatal infections
I (intervention/indicator) hand washing
C (comparison) no hand washing; other solution; masks
O (outcome of interest) reduced infection

 

Whilst PICO can sometimes be seen as the go to tool for formulating your question..don’t be limited by it. Here are a few other tools to help your formulate your perfect research question…

Methodology  e.g. questionnaires

Issues e.g. ethical decision-making

Participants e.g. midwives or patients

—————————————————

Setting – Where? What is the context?

Perspective – For who?

Intervention (Subject of Interest)– What?

Comparison – What else?

Evaluation – What results?

————————————————————

Sample

P I Phenomenon of Interest

Design

Evaluation

Research type

————————————————————

Client – who is the service aimed at?

Location – where?

Improvement – what do you want to find out?

Professional – who is involved in providing/improving the service?

——————————————–

Context

Intervention

Mechanism

Outcome

———————————————-

Expectation—What do you want the information for?

Client Group.

Location.

Impact— What change are you looking for? How is this being measured?

Professionals.

Service—For example, community services, birth centres or accident and emergency.

Step two: choose which databases you will search

Different search databases should be searched separately as they each have their own dictionaries of terms and keywords. Each database is tailored toward a particular topic of interest. The following set of databases relate to healthcare topics.

1.Web of Science (strong coverage which goes back to 1990 and most of its journals written in English)

2.Scopus (Covers a superior number of journals but with lower impact and limited to recent articles)

3.CINHAL (Prime source of nursing and allied health literature)

4.Pubmed & MEDLINE (Great starting point for any health or medical literature search.)

5.Cochrane (The source of systematic reviews)

6.NHS Evidence & The TRIP database (Search a limited number of high quality sources)

7.PsychINFO (Prime source for psychology and psychiatry literature.)

8.AMED (Allied and Complementary Medicine Database)

9.HMIC (Health Information Management Consortium – great information from DoH and Kings Fund)

There are no strict rules as to how many databases you should search. That would depend on how thorough you are trying to be. Also, many databases will pick up duplicates for you…which you will later need to delete.

Step three: Identify and map your key concepts

A concept map is a visual representation of concepts within your research question or ‘problem’ and their relationships to each other.

To create a concept map:

  • Write down the main concepts which relate to your research question and circle them on a blank page.
  • Write down other words/concepts and ideas which relate to each of your concepts in groups. Draw lines between concepts to show how they are related.

concept map

Step four: Identify your key words

Some of these you may already have found in your concept mapping work, however, you really need to grab every keyword you can to get the best results…sometimes your databases will already have predefined keywords for you to use….helpful 🙂

To identify your own keywords, you will need to break down your own research question. I will go back to using our example.

Does Hand washing among midwives reduce Postnatal infections
‘OR’ ‘AND’ ‘OR’ ‘AND’ ‘OR’
Hand hygiene Midwifery staff Postpartum infections
‘OR’ Clean hands ‘OR’ Midwif* ‘OR’ After birth
‘OR’ Washed hands

 

 

Step five: Build your concepts and keywords into a search strategy

Sounds easy right? Well let me show you how to do this using an example from one of my published systematic literature reviews.

The questions relating to this review were…

1) What interventions have been developed to support midwives and/or student midwives in work-related psychological distress? and 2) What are the outcomes and experiences associated with the use of these interventions?

Key concepts have been underlined.

Below is a search strategy I built to answer these research questions. This was used to search one database only.

search strategy

As you can see, the search starts right from the bottom with the first concept ‘midwives’… the ‘population’. Each concept moving forward is grouped together with keywords combined with the boolean operator ‘OR’. When I need to combine concepts nearer the top, I combine them using the boolean operator ‘AND’. See below…

Image result for boolean operators

This search strategy also uses truncations, where I have entered the root of the word and then a (*) at the end. When you do this, the database will then return any ending of the root word. Another example of this would be ….child* = child, childs, children, childrens, childhood.

If a word you want to find is spelled in different ways, wildcards can also be used to substitute a symbol for one letter of a word. Examples of how you might use this may be

wom!n = woman, women
colo?r = color, colour

(Credits to https://libraries.mit.edu/experts/)

Click this link for a great example paper, where the authors have mapped their key concepts and search terms to their research questions and databases.

Image result for searching

I hope you find this ‘How to’ guide useful. I now look forward to you all going forth to develop and share your own search strategies with me. I can’t wait to see what problems you will solve 🙂

If you would like to follow the progress of my work going forward..

Follow me via @SallyPezaroThe Academic MidwifeThis blog

Until next time…Look after yourselves and each other 💚💙💜❤

 

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Top tips for #FreshersWeek #freshers2017 #Uni #StudentLife from an academic midwife

Tis that time of year again when students from all over the world descend upon university campuses to embark upon a fun filled journey of learning, adventure and growth.

Having been in education now for a number of years, I think this must be close to my tenth freshers week! Every year I get the same buzzy feeling of excitement as the freshers week commences…

(Unless that is the same feeling of excitement you get when Santa is coming…oh come on…Autumn…I am already thinking about the festive season!)

The streets are full of vibrant things to do and get involved in…people are making friends and connections and everyone is ready to take on a new challenge in life!

The sad thing is…whether I wear my student ID badge, or my staff ID badge..I am seemingly passed by when the invites for the foam parties and other nights out are being dished out…(grump)!…hmm…I wonder why? 🤔🎓 Maybe it will be different this year…and if you do see me on campus…I would love to hear about your plans!

I will be involved in the #CovHLSFreshers Twitter takeover this year..Ooh..snazzy!

 

As well as other survival guides out there, I wanted to share some of my own hints and tips for freshers.

Tip One:

No matter how scared or excited you are during freshers week….I think there are a few quotes that you should memorize and repeat to yourself in times of need….

Image result for a little nonsense now and then quote

Image result for everything will be alright in the end

 

Image result for be who you are and say what you feel

Related image

Related image

Tip Two:

Remember that there is no need to justify your course choice to anyone but yourself. This is your journey, your life now….trust yourself to make your own life choices. You got this!

Tip Three:

Find your tribe….Not necessarily those who look and talk like you…but those who will hear your voice, sing with you and lift you up. This could be your relevant student society or Twitter community..it could even be those you meet through doing what you love….hold on tight to these people for the ride…and make sure to lift each other up!

Tip Four:

Document your journey and take time to reflect. This experience will be over all too quickly and it’s going to be amazing! reflecting will help you to be mindful about your own situation and recognize your own achievements as your hard work pays off. Be grateful for 1 thing every day…however big or small…and celebrate the achievements of yourself and others every chance you get.

Tip Five:

Look after yourself. Self care can make your university experience a million times better. Take breaks, help yourself before you help others…and as for romance……

Image result for put your own oxygen mask on first quote

See->

10 Tips for Success & Self-Care for Academics

Category Archives: Student Tips 🎓

❤Welcome all!❤

See you on campus!

If you would like to follow the progress of my work going forward..

Follow me via @SallyPezaroThe Academic MidwifeThis blog

Until next time…Look after yourselves and each other 💚💙💜❤

 

 

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Five Myths about Internationalization in higher education

Freshers week is almost upon us again this year at Coventry University and I am learning to teach!…So I wanted to reflect on and celebrate the diversity of students coming to study.

 

I have always enjoyed the vibrancy and wealth of knowledge that international students bring to universities…and when you are indulging in a new topic of interest, international students can bring a wealth of new and insightful knowledge to the table…from around the world! But there are a few myths about internationalization that I wanted to reflect on with the help of Jane Knight. These myths apply to all higher academic institutions, and of course there are always exceptions to every rule.

MYTH ONE: FOREIGN STUDENTS AS INTERNATIONALIZATION AGENTS

“A long-standing myth is that more foreign students on campus will produce
more internationalized institutional culture and curriculum. “

In fact, unless there are bespoke programmes targeted towards international students, divisions and factions will often provide a more secular experience on campus. The rationale for internationalizing a university campus is often well intended, but new strategies will be required to turn this vision into practice. To reflect on this, there may be some scope to include international students in blended learning sessions prior to their arrival on campus. Perhaps a buddying system with domestic students may also enhance the learning experience, as international students will also be adapting to a new life outside of the classroom at first.

MYTH TWO: INTERNATIONAL REPUTATION AS A PROXY FOR QUALITY

Internationalization does not always translate into improved quality or high standards. This means that we, as teachers may need to find new ways to evaluate the quality of our outputs with a view to making real world improvements. This means acting on student feedback at a personal level to understand what is happening on the shop floor. Improvements will not appear automatically, but rather than just hoping for the best….PDSA cycles may be of use when making such improvements.

 

Image result for pdsa cycle nhs

 

MYTH THREE: INTERNATIONAL INSTITUTIONAL AGREEMENTS

It is often believed that the greater number of international agreements or
network memberships a university has the more prestigious and attractive it is to
other institutions and students

To maintain active and fruitful relationships, major investments are required in human and financial resources from individual faculty members, departments, and international university offices. This is not always feasible to maintain. Therefore, it will be key to develop a few deep and meaningful international relationships or partnerships rather than create many paper based partnerships which may not always best serve our students, staff and/or institutions.

MYTH FOUR: INTERNATIONAL ACCREDITATION

The premise is that, the more international accreditation stars
an institution has, the more internationalized it is and ergo the better it is. But a foreign recognition of quality does not necessarily speak to the scope, scale, or value of international activities related to teaching/learning, research. Again, it will only be via the creation of deep and meaningful real-world relationships that meaningful connections can be made between quality and reaping the rewards of international partnerships.

MYTH FIVE: GLOBAL BRANDING

It is a myth that an international marketing scheme is the equivalent of an internationalization plan.

An international marketing campaign is a promotion and branding exercise…an internationalization plan is a strategy to integrate an international, intercultural, and global dimension into the goals and teaching, research, and service functions of a university. In teaching international students, it may be more important to focus on the internationalization plan, as this is what may result in the better student and staff experience within the university. Then again, of course it depends on what university policies and strategies set out to achieve.

Personally, I would like to spend my time in higher education creating small numbers of really meaningful international relationships rather than collaborate with large numbers of international students and institutions. Whilst large numbers may look better on paper, superficial relationships will not translate into value, quality or high standards in academia.

People work better when they are connected through things that matter, and in order to reap the rewards of an international student community, we must all make connections that matter. It is focusing on the few important relationships that will enable us to listen, plan, do and act better in higher education.

Image result for international students

Further reading:

Knight, Jane. “Five myths about internationalization.” International Higher Education 62 (2015).

Beine, Michel, Romain Noël, and Lionel Ragot. “Determinants of the international mobility of students.” Economics of Education review 41 (2014): 40-54.

Soria, Krista M., and Jordan Troisi. “Internationalization at home alternatives to study abroad: Implications for students’ development of global, international, and intercultural competencies.” Journal of Studies in International Education 18.3 (2014): 261-280.

Sin, Sei-Ching Joanna, and Kyung-Sun Kim. “International students’ everyday life information seeking: The informational value of social networking sites.” Library & Information Science Research 35.2 (2013): 107-116.

If you would like to follow the progress of my work going forward..

Follow me via @SallyPezaroThe Academic MidwifeThis blog

Until next time…Look after yourselves and each other 💚💙💜❤

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5 reasons why you should be blogging

I started this blog at the start of my PhD. To begin with, it was a way of telling my thoughts, documenting my diary and sharing what I was learning with others along the way. Now it is also a way of sharing my work and enjoying thought provoking conversations with others. Here are 5 reasons why I believe that you should be blogging too.

Image result for blogging

1. You have a brain, a voice, and something to say…why keep your amazing thoughts in your head?…By writing them on a blog, you can start conversations with some of the other great brains in the world…what an opportunity! You could literally reach millions on the internet. Once people start to read your work, you can also become established in your field…don’t hold it all in!

2. Have you been to a good conference or seminar lately? Why not share your learnings via your very own blog?….not only will this help you to organise your thoughts and reflect on your own learning, but it will also help your peers and readers to learn from your own experiences…That’s a good thing…right?

3. Stand out as someone who creates new content online. Not only will this help you to stand out as an expert in your own field, but perspective employers, funders and collaborators will also see that you are not just another online spectator. You will fast become known as an online innovator. Think that you aren’t anything special?…By blogging, you are already doing what most people are not!

4. Blogging is free, yet it could be an invaluable tool in helping you improve your writing and your confidence. It could also help you to become more mindful, a reflective practitioner and an inspiration to others.

5. Blogging enables you to join an online community, grow your followers and develop positive and reciprocal relationships online. One way you can do this is by guest blogging (as I did recently). You can also interact with other blogs and offer constructive comments to the conversation. If you would like to practise by guest blogging here on this blog…feel free to drop me a message and I will be glad to help 🙂

Go on…see these benefits for yourself!

Image result for blog

If you would like to follow the progress of my work going forward..

Follow me via @SallyPezaroThe Academic MidwifeThis blog

Until next time…Look after yourselves and each other 💚💙💜❤

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Exploring ‘obstetric violence’ and ‘birth rape’

trauma hiding.jpg

Recently, the wonderful Ibone Olza (Perinatal Psychiatrist and Childbirth Activist from Childbirth is Ours, Spain) contacted me about her work on obstetric violence, birth rape and professional trauma. After reading her papers and watching her present her work, I was compelled to document and reflect upon some of the issues raised, here.

The following points are made within the paper: Fernández, Ibone Olza. “PTSD and obstetric violence.” Midwifery today with international midwife 105 (2013): 48-9.

Birth trauma has been defined as “Actual or threatened injury or death to the mother or her baby” (Beck 2008). Yet such trauma lies in the eye of the beholder, therefore, any trauma experienced by either the mother, newborn or the birth attendant may be due to a subjective experience of stress which does not need to fit any particular criteria necessarily. This means that some traumatic events may be subjective in their nature, and as such, we cannot judge what may or may not cause another person trauma. It is a personal interpretation or perception.

A meta-ethnographic analysis of studies about women’s perceptions and experiences of a traumatic birth reported that women are often traumatized as a result of the actions or inactions of midwifery staff (Elmir et al. 2010). Whatever, such inactions or actions may be…women often use words such as ‘barbaric’, ‘intrusive’, ‘horrific’ and ‘degrading’ to describe their mistreatment (Thomson and Downe 2008).

For Hodges, drugging or cutting a pregnant woman with no medical indication is an act of violence, even when performed by a medical professional in a hospital. Inappropriate medical treatment is also clearly abusive, although few women are aware that this is deliberate mistreatment (Hodges 2009).

The term ‘birth rape’ has been used by women who feel that their bodies have been violated. Kitzinger highlighted that many women who have experienced a traumatic birth display similar symptoms to rape survivors (Kitzinger 2006). The video below explores these issues in greater detail, as we can hear the lovely  Ibone Olza  sharing this work.

 

One of the things I was most encouraged about, was that  Ibone Olza  considers the wellbeing of the midwifery staff in her work. Birth attendants are often also traumatized by these acts, and may feel powerless to intervene. In a recent study by Beck, 26% of obstetric nurses met all the diagnostic criteria for screening positive for PTSD due to exposure to their patients who were traumatized (Beck and Gable 2012). Being present at  abusive deliveries can magnify staffs’ exposure to birth trauma.

staff use phrases such as…

“the physician violated her”

“a perfect delivery turned violent”

“unnecessary roughness with her perineum”

“felt like an accomplice to a crime”

“I felt like I was watching a rape.”

….to describe the guilt that ensued when they felt like they had failed women or they did not speak up and challenge/question…

Article 51 establishes that: The following acts implemented by health personnel are considered acts of obstetric violence:

  1. Untimely and ineffective attention of obstetric emergencies
  2. Forcing the woman to give birth in a supine position, with legs raised, when the necessary means to perform a vertical delivery are available
  3. Impeding the early attachment of the child with his/her mother without a medical cause thus preventing the early attachment and blocking the possibility of holding, nursing or breastfeeding immediately after birth
  4. Altering the natural process of low-risk delivery by using acceleration
    techniques, without obtaining voluntary, expressed and informed consent of the woman
  5. Performing delivery via cesarean section, when natural childbirth is possible, without obtaining voluntary, expressed, and informed consent from the woman

(D’Gregorio 2010)

trauma

Yet whilst people do bad things, it is important to remember that they are not necessarily bad people…

This work explains how professionals may exert obstetric violence due to:

  • Lack of technical skills to deal with emotional and sexual aspects of childbirth.
  • Unsolved trauma. The medicalization of childbirth produces more severe iatrogenic
    complications (Johanson, Newburn and Macfarlane 2002; Belghiti et al. 2011). If the
    professionals do not have a supportive space to reflect or to deal with this aspect of iatrogenic care, they may fall into a spiral of continuously increased medicalization as a defensive strategy. Childbirth is then perceived as a very dangerous event, “a bomb ready to explode,” without realizing that interventions cause more unnecessary interventions and pain.
  • Professional burnout in birth attendants will lead to increased dehumanized care and therefore never-ending figures of women experiencing childbirth as very traumatic.

..and so the challenge will be to identify and address these root causes to ensure that maternity staff are able to provide excellence in midwifery care. My work explores how we might support the psychological wellbeing of health care staff may increase levels of humanity and compassion in care. I hope to keep in touch with Ibone Olza and many others around the world who share the same passion for this work. Together we may collectively work towards a time where maternity workers are psychologically safer, and therefore better able to provide the excellence in care they strive to give.

If you would like to follow the progress of my work going forward..

Follow me via @SallyPezaroThe Academic MidwifeThis blog

Until next time…Look after yourselves and each other 💚💙💜❤

References and further reading

  • Soet JE, Brack GA, DiIorio C. Prevalence and predictors of women’s experience of psychological trauma during childbirth. Birth 2003 Mar;30(1):36-46.
  • Creedy DK, Shochet IM, Horsfall J. Childbirth and the development of acute trauma symptoms: incidence and contributing factors. Birth 2000 Jun;27(2):104-111.
  • Ayers S, Pickering AD. Do women get post traumatic stress disorder as a result of childbirth? A prospective study of incidence. Birth 2001 Jun;28(2):111-118.
  • Beck CT, Gable RK, Sakala C, Declercq ER. Post traumatic stress disorder in new mothers: results from a two stage U.S. national survey. Birth 2011 Sep;38(3):216-227.
  • Allen S. A qualitative analysis of the process, mediating variables and impact of traumatic childbirth. Journal of Reproductive and Infant Psychology 1998;16(2-3):107-131.
  • Beck CT, Watson S. Impact of birth trauma on breast-feeding: a tale of two pathways. Nurs Res 2008 Jul-Aug;57(4):228-236.
  • Beck CT. Post-traumatic stress disorder due to childbirth: the aftermath. Nurs Res 2004 Jul-Aug;53(4):216-224.
  • Beck CT. Birth trauma: in the eye of the beholder. Nurs Res 2004 Jan-Feb;53(1):28-35.
  • Ayers S. Delivery as a traumatic event: prevalence, risk factors, and treatment for postnatal posttraumatic stress disorder. Clin Obstet Gynecol 2004 Sep;47(3):552-567.
  • Olde E, van der Hart O, Kleber R, van Son M. Posttraumatic stress following childbirth: a review. Clin Psychol Rev 2006 Jan;26(1):1-16.
  • Elmir R, Schmied V, Wilkes L, Jackson D. Women’s perceptions and experiences of a traumatic birth: a meta-ethnography. J Adv Nurs 2010 Oct;66(10):2142-2153.
  • Nicholls K, Ayers S. Childbirth-related post-traumatic stress disorder in couples: a qualitative study. Br J Health Psychol 2007 Nov;12(Pt 4):491-509.
  • Ayers S. Thoughts and emotions during traumatic birth: a qualitative study. Birth 2007 Sep;34(3):253-263.
  • Thomson G, Downe S. Widening the trauma discourse: the link between childbirth and experiences of abuse. J Psychosom Obstet Gynaecol 2008 Dec;29(4):268-273.
  • Goldbort JG. Women’s lived experience of their unexpected birthing process. MCN Am J Matern Child Nurs 2009 Jan-Feb;34(1):57-62.
  • Sawyer A, Ayers S. Post-traumatic growth in women after childbirth. Psychol Health 2009 Apr;24(4):457-471.
  • Hodges S. Abuse in hospital-based birth settings? J Perinat Educ 2009 Fall;18(4):8-11.
  • Kitzinger S. Birth as rape: There must be an end to ‘just in case’ obstetrics. British Journal of Midwifery 2006;14(9):544-545.
  • Beck CT. The anniversary of birth trauma: failure to rescue. Nurs Res 2006 Nov-Dec;55(6):381-390.
  • Beck CT, Gable RK. A Mixed Methods Study of Secondary Traumatic Stress in Labor and Delivery Nurses. J Obstet Gynecol Neonatal Nurs 2012 Jul 12.
  • Perez D’Gregorio R. Obstetric violence: a new legal term introduced in Venezuela. Int J Gynaecol Obstet 2010 Dec;111(3):201-202.
  • Callister LC. Making meaning: women’s birth narratives. J Obstet Gynecol Neonatal Nurs 2004 Jul-Aug;33(4):508-518.
  • Johanson R, Newburn M, Macfarlane A. Has the medicalisation of childbirth gone too far? BMJ 2002 Apr 13;324(7342):892-895.
  • Belghiti J, Kayem G, Dupont C, Rudigoz RC, Bouvier-Colle MH, Deneux-Tharaux C. Oxytocin during labour and risk of severe postpartum haemorrhage: a population-based, cohort-nested case-control study. BMJ Open 2011 Dec 21;1(2):e000514.