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Reducing labour pain using non-pharmacological methods
KOPKOVÁ, Iva
This bachelor thesis monitors non-pharmacological methods during labour, evaluates their efficiency on the visual analogue scale, and finds how women view them after childbirth. The theoretical part describes phases of delivery seen by a woman in labour and a midwife, and the matter of pain and specifically the labour pain. The last section of the theoretical part characterizes the non-pharmacological methods of easing labour pain. The empirical part contents qualitative observational research and a semi-structured interview. During labour, midwives observed women fighting the pain without any help of non-pharmacological methods and then with them. They wrote all findings into a record sheet. To be a part of this research, women in labour must not have used any pharmacological methods. Women, while being recorded, answered twelve questions in the interview no more than three days after their childbirth. The research from May 2021 shows which non-pharmacological methods women in the delivery room in the hospital in České Budějovice and Český Krumlov chose to use to ease their pain. The bachelor thesis refers to the importance of non-pharmacological methods in labour, although they cannot be equal to the efficiency of pharmacological approaches. The midwives and doctors may speak about the conclusion of this thesis at professional conferences or antenatal classes.
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Women's views on caesarean section
PUMPROVÁ, Karolína
This bachelor's thesis is dealing with women's opinions about Caesarean section. The thesis consists of two parts - theoretical and practical part. The theoretical part is describing the course of vaginal delivery. We also focused on the description of the caesarean section. The next chapter deals with the midwife's care for a woman before and after caesarean section. We also processed the care of the scar after a caesarean section. Finally, we focused on the complications and consequences of a caesarean section. The practical part describes the research investigation. The aim of this bachelor thesis was to map the opinion of women on caesarean section. Two hypotheses were established. H1: Women prefer vaginal delivery rather than caesarean section. H2: Women think that caesarean section does not affect the health of the child. To achieve set goal, we chose a quantitative research survey using a questionnaire. 19 questions were used in the questionnaire - closed questions and 1 open question. 209 respondents participated and completed the survey. These were women active on social media. The questionnaire was designed for all women, regardless of age. Women who had experience with pregnancy and childbirth or even those who did not have this experience could respond. The study involved women who were or were not pregnant. Most respondents, 92 (44%), were aged 18-25. The most frequent response to completed education was a high school with a high school diploma. The questionnaires were evaluated using the chi square test. The significance level was determined to be 5%. In the research survey, 87.6% of women said that they would prefer vaginal delivery to caesarean section. According to a statistical survey, the p-value was less than 0.05, thus confirming hypothesis 1 "Women prefer vaginal delivery rather than caesarean section". Furthermore, hypothesis 2 was tested using the questions. 64.5% of women answered that they do not think that children after a caesarean section have worse immunity than children after a vaginal birth. Furthermore, 82.5% of women do not think that these children suffer from more allergies. 60.4% of women believe that caesarean section has no effect on breastfeeding. 53.5% stated that separation after a caesarean section does not affect the child's mental health. According to a statistical survey, the p-value was less than 0.05, which means that the second hypothesis was also confirmed. The findings of this thesis could be used in seminars for midwives or in antenatal courses.
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Awareness of pregnant women about cord blood donation
KOLMANOVÁ, Michaela
This bachelor's thesis is dedicated to donating umbilical cord blood. The thesis consists of a theoretical and practical part. The theoretical part contains a description of the placenta and its functions, umbilical cord blood, stem cells. Furthermore, the theoretical part contains a description of the technique of cord blood collection, contraindications of the collection and processing of umbilical cord blood. It also describes the education of midwives on this issue. Umbilical cord blood banks and legislative provisions are listed here. The aim of the bachelor's thesis was to find out how knowledgeable pregnant women are about this issue. A quantitative research survey was used in the practical part of this work. The questionnaire created contained 18 closed questions. The research team was pregnant women. This set consisted of 244 respondents. Of these, 155 (64%) first-time parents 89 (36%) multi-parents. Of these, 41.39% of respondents know the use of umbilical cord blood. Only 18.03% of respondents know what they need to do to be able to take umbilical cord blood. 19.67% of respondents reported the correct time of collection of umbilical cord blood. 13.52% of respondents reported that the maximum storage period of donated umbilical cord blood is 20 years. Two hypotheses were established in this work. The first hypothesis focused on whether pregnant women are given more information about this issue by a midwife or gynecologist. 5.70% of respondents received information from a midwife. 3.70% of respondents received information from a gynecologist. Statistical processing of the hypothesis has shown us that there is no difference in who gives information. Women are informed from the midwife as well as from the gynecologist. The second hypothesis was whether multi-parents are more informed about umbilical cord blood donation than first-time parents. Multi-parents accounted for 36%, and first-time parents 64%. 46.06% of multi-parents and 38.71% of first-time parents said they knew the use of umbilical cord blood. 20.22% of multi-parents and 19.35% of first-time parents know the time of collection of umbilical cord blood. 50.56% of multi-parents and 39.35% of first-time parents reported that the donation was not risky for newborns. We confirmed the second hypothesis. The results of this work show that women have very little information on the issue of umbilical cord blood donation. The midwife is a competent person, so women could be more education about this issue. This work can be used in seminars for midwives.
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Průběh porodu a puerperia u klisen
STAROBOVÁ, Hana
The subject of the bachelor's thesis is the course of childbirth and puerperium in mares. First, it deals with sexual activity in mares, including an analysis of indivi-dual important factors that affect it. Furthermore, the work focuses on fertilization and pregnancy of mares and their disorders. It outlines both the causes and the course and treatment options. The main part focuses on the birth itself, its complica-tions and subsequently the postpartum period. A survey of the course of parturition and puerperium was carried out as part of the work, which was to find out the characteristics of pregnant mares, the course of pregnancy and parturition, complications during and after parturition and basic in-formation about the foal born. The survey found that the most popular breed of horse among Czech respon-dents is the Czech Warmblood and they are mostly used for hobby riding. Mares are usually older than 8 years and it is their 3rd or subsequent pregnancy. The course of the birth was mostly problem-free and completed within one hour. Subsequently, the survey addressed the postpartum period, when it was found that the mares did not suffer from clinical signs or inflammation to a greater extent. The foals born were mostly stallions, who were largely independent, so they did not need help with the first drink and the departure of the pitch took place within a maximum of 4 hours.
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Birth plan from a midwife' s perspective
TOMÁŠKOVÁ, Barbora
The bachelor's thesis deals with the birth plan from a midwife's perspective. Two goals were established advance. The first goal was to find out the attitudes od midwives to the birth plan and the second goal was to find out what is the approach of midwives to mothers with a birth plan. The bachelor thesis is divided into two parts. The theoretical part and the practical part. The theoretical part introduces the profession of midwife and profession competencies. Furthermore, the theoretical part presents the importance of the birth plan, which women usually create a birth plan and the wishes that women can state in their birth plan. One of the chapters describes a childbirth and all his periods of birth (first, second, third and fourth). The end of the theoretical part is described the characteristic of the puerperium. The practical part of the bachelor thesis was based of a qualitative research survey. One research group was created with the help of semi-structured interviews, which was carried out with midwives working in the delivery room at Český Krumlov Hospital, a.s. and at the Hospital of České Budějovice, a.s. There were total an eleven midwives. The main criterion for the research survey was requirement for midwives to work in the delivery room and have experience with the birth plan. Before the interviews began, the topic of the bachelor's thesis was explained to all midwives and it was pointed out that the information obtained would remain anonymous. Interviews were conducted with the consent of the midwives. The individual interviews were recorded on a dictaphone and then literally transcribed. This was followed by data analysis and processing. To evaluate the data, two main categories and ten subcategories were identified.
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The role of midwife in care of women during a delivery
ŠATALÍKOVÁ, Nikola
This bachelor thesis deals with the role of a midwife in caring for a woman during childbirth as well as women's knowledge of the midwife's duties. The aim of the bachelor thesis was to find out how women perceive the role of a midwife. The bachelor thesis is divided into a theoretical part and a practical part. The theoretical part describes the definition of a midwife and gives a brief description of the development of this profession in a historical context. Basic information is presented about childbirth and the individual stages of labor. Subsequently, each of the chapters describes the care that is provided to the mothers by the midwife, from the reception to the birth itself to the period after birth. Furthermore, the theoretical part of the bachelor's thesis is divided into subchapters, which provide information on individual stages of labor, including information on the midwife's duties including accompanying the expectant mother to childbirth, the alleviation of labor pains as well as attending to birth injuries. The practical part consists of methodology, results and discussion. The practical part of the bachelor's thesis was carried out by means of a qualitative research survey using semi-structured interviews. The research group consisted of eleven women who underwent vaginal birth and were asked to assess the care that the midwife provided during labor. Interviews with informants were conducted with their prior consent, electronically recorded, literally transcribed and subsequently analyzed. The interviews took place from January to March 2020. To maintain the anonymity of the women, the informants were marked as Ž1 to Ž11. For the analysis of the obtained data, 2 categories and 6 subcategories were compiled. According to the above-mentioned goals of the bachelor's thesis, two research questions were determined for the research part. The first research question looked at how women perceive the role of a midwife during childbirth. Research has shown that most women perceive a midwife as a person with great responsibility and experience who accompanies a woman in childbirth. Most of the informants also stated that they perceive the midwifery profession as a mission. The research shows that the most important roles of a midwife during childbirth are the roles of a communicator, an educator and, finally, serving in a supporting role of an expectant mother during childbirth. The second research question examined the opinion of women regarding the competencies of midwives. Research has shown that women are well informed about the competencies of a midwife during pregnancy, childbirth and the puerperium. Based on the research survey, it was found that most women were aware of the profession of midwife before giving birth. None of the women report any significant negative experience with a midwife. On the contrary, most women were pleasantly surprised by the willingness and diligence of the midwife. The informants stated that they felt safe in the presence of the midwife and fully trusted her. The knowledge gained during the compilation of the bachelor's thesis may help women who do not have enough information about what care a midwife can provide and what actually falls within her competencies. The result of the bachelor's thesis is an information leaflet, which describes basic competencies of a midwife and the care provided by the midwife to mothers in individual stages of delivery.
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Problematics of cord blood collection.
VAŇKOVÁ, Barbora
This bachelor's thesis deals with the issue of umbilical cord blood collection. Due to the focus of the work, the theoretical part describes childbirth and all periods of childbirth, the procedure of collecting umbilical cord blood after a spontaneous delivery and after delivery per sectio caesarea and possible contraindications of umbilical cord blood collection. My thesis also describes the role of a midwife as a women's educator about the possibility of collecting umbilical cord blood and the role of a midwife during childbirth, including the collection of umbilical cord blood. Last but not least, the theoretical part mentions the importance of umbilical cord blood banks and their legislation concerning and stem cell transplantation. In total, three goals were set. The first goal was to find out if midwives have knowledge about the collection of umbilical cord blood. The second goal was set to reveal whether pregnant women have enough information about umbilical cord blood collection, and the third goal was to see whether pregnant women are interested in umbilical cord blood collection. Based on the goals set, research questions were assigned to each goal. The first research question asked about the knowledge of midwives about the collection of umbilical cord blood, the second question dealt with the pregnant women's knowledge of umbilical cord blood collection and the last question examined the attitude of pregnant women to the collection of umbilical cord blood. Two research files were identified in the research survey. The first group consisted of six midwives, labeled PA1 to PA6, who worked in the delivery room for at least one year. In the second research group there were six pregnant women, marked T1 to T6, who regularly attended an antenatal clinic. The research was conducted using web programs Skype or Teams in May 2020. A qualitative method was chosen to carry out the research part, which was implemented using individual semi-structured interviews. Before the interviews began, the informants gave oral consent to data processing. The data was later analyzed and main categories and subcategories were created based on the results. After evaluating data with the midwives, 2 categories and 8 subcategories were determined. After evaluating data with pregnant women, one category and 3 subcategories were determined. The first research question examined the knowledge of midwives about the collection of umbilical cord blood. Research has shown that midwives PA2 to PA6 have sufficient information on the procedure for collecting umbilical cord blood. Midwife PA1 stated that she had never seen the collection and did not know how such a collection would be performed. On the other hand, midwife PA5 stated that earlier, up to 15 samples per month were performed at her workplace. Therefore, she was the most informed of all the midwives interviewed. The second research question examined the pregnant woman's knowledge about the collection of umbilical cord blood. Research has shown that all pregnant women knew what umbilical cord blood is, but most (T1, T2, T3 and T5) do not know how it is collected and used. The third research question was aimed at the attitude of pregnant women towards the collection of umbilical cord blood. The research found that due to the lack of information, high financial cost and storage of umbilical cord blood, women are not interested in commercial collection of umbilical cord blood. The reason why women are not interested in umbilical cord blood donation was that women would have to choose to give birth at a hospital that allows this type of collection, namely maternity hospitals in Slaný, Česká Lípa and Thomayer Hospital in Prague. Pregnant women state that these hospitals are very distant from their family and place of residence, and that is the reason why not choose these hospitals for childbirth. Only pregnant woman T2 stated that she would consider collecting blood for her own purposes.
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Satisfaction of women with the midwife's care during childbirth
LEBEDOVÁ, Veronika
This bachelor thesis focuses on the satisfaction of mothers with the midwifery care during childbirth. Two goals were set for the elaboration of the bachelor thesis. The first goal was to find out how mothers perceive the care of midwives during childbirth. The second goal was to record what factors are important for the satisfaction of mothers during childbirth. The bachelor thesis is divided into theoretical and practical part. The theoretical part is divided into four main chapters. The first chapter deals with the description of childbirth and the care of the midwife during the various periods of childbirth. In this section we will also find a section on preparation for childbirth. The second chapter deals with the issue of pain during childbirth, discusses the pharmacological and non-pharmacological control of labour pain. The third chapter describes the issue of the presence of a close person in childbirth and the fourth chapter is devoted to the characteristics of a midwife. In the practical part of the bachelor thesis, a qualitative research survey was used. The research group consisted of ten women after childbirth. Data collection was performed through semi-structured interviews. The interview was completely voluntary. All informants were acquainted with the topic of the bachelor's thesis before the start of the individual interviews and were also informed about the protection of personal data during the processing of interviews (GDPR). The informants were marked with numbers I1 to I10. The informants expressed their verbal consent to the processing of the obtained information, and at the same time they agreed to the recording of the interview on a dictaphone or a mobile phone, if the interview was conducted via a mobile phone, due to easier elaboration of interviews. During the data processing, the interviews from the Dictaphone or mobile phone were transcribed in detail. The research survey lasted from March to April 2020. The research was divided into two main categories and further divided into individual subcategories. In the research part of the work, two research questions were chosen. The first research question asked how mothers evaluate the care of midwives during childbirth. The results of the research showed that all informants were satisfied and evaluated the care of midwives during childbirth very positively. Only informant I1 stated that her midwife was great, but during the reception she was cared for by another midwife whose behaviour she did not like. She was reportedly noisy, forceful and uncomfortable. The second research question dealt with the satisfaction of mothers during childbirth. Research has shown that maternal satisfaction during childbirth has several factors. As the most important factor of satisfaction during childbirth, the informants mentioned enough information and the overall approach not only of the midwife but also of the entire medical staff in the maternity hospital. Other important factors of satisfaction during the birth, the informants mentioned the presence of a close person at the birth and the pleasant environment of the delivery rooms. From the results of the research survey, it was found that mothers are satisfied with the care of midwives. All the interviewees informed that they were satisfied with their midwife during the birth. This work points out that it is important for the midwife to be friendly, kind and empathetic to the mother, because the midwife's approach is one of the most important aspects of satisfaction for the mother during childbirth. The results of the work can be used to improve and enhance the care of midwives, as well as for future midwives who acquire professional qualifications and are preparing for this profession. The results will be published at professional conferences for midwives and the results will also be presented to the maternity hospital in which the informants gave birth.
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A Birth House as a Compromise between Childbirth at Home or at Hospital
DVOŘÁČKOVÁ, Viktorie
This work is devoted to the topic of birth houses. The work consists of a theoretical part and a practical part. The theoretical part describes the choice of the place where to give birth. There is described the hospital birth (and its related birth plan) and home birth. The issue of birth centers is described in detail both in the world and in the Czech Republic. Another topic is birth itself and its possible alternatives. The theoretical part is closed by the definition and position of a midwife. The work intended to map the interest of Czech women in giving birth in the birth center. Four hypotheses were set for the goal. H1: University-educated women are more interested in giving birth in the birth center than women with lower education. H2: Women with a bad experience with giving birth in the hospital are more interested in giving birth in the birth center than women with a good experience. H3: Women who gave birth in hospitals are more interested in giving birth in the birth center than women who gave birth at home. H4: Women who have already given birth are more interested in giving birth in a birth center than women who have not given birth. The set goal was achieved by a quantitative research survey in the form of a questionnaire of own design. The questionnaires were evaluated by using a statistical chi-square test, which determined the significance or insignificance of the results. The research group consisted of 981 women active on the social network Facebook and various web servers related to pregnancy. The research showed, that university educated women show a higher interest in giving birth in the birth center than women with lower education. We also found, that women who have been dissatisfied with hospital care are more interested in birth centers than women who report having a good experience. We also wanted to find out whether the place of the previous birth influences the interest of women in giving birth in the birth center. This hypothesis has not been confirmed. The result is influenced by the small number of respondents who experience a home birth. The last hypothesis was related to whether women who have already given birth are more interested in giving birth in the birth center. It turned out that women´s opinions on childbirth in the birth center do not differ depending on whether the woman has already given birth or not. The research survey showed that 59,2 % (answers yes or rather yes) of women are interested in giving birth in a birth center. We can therefore assume that part of the women would like such a facility to exist in the Czech republic.
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Person accompanying during childbirth
BISKUPOVÁ, Iveta
This bachelor thesis deals with the issue of accompanying person during childbirth. Due to the topic of the bachelor thesis, there are introduced persons that a woman can choose to childbirth, including their specifics and differences, in the theoretical part. The individual stages of childbirth, the role of a midwife during childbirth and the communication of the midwife with the woman and her accompaniment are also described. There were established two goals of the thesis. The first goal was to find out how the woman perceived the presence of the accompanying person during childbirth, and the second was to find out what influenced the woman in choosing the accompanying person to childbirth. The research investigation was conducted through an individual semi-structured interview, so it was processed using a qualitative method. The data was collected from postpartum women who had already been released from the puerperium department for home treatment. However, the condition was that the women gave childbirth in 2020 and had an accompanying person during childbirth. The data collection took place in March and May 2020. In March, there was an increase in the number of infected people with coronavirus in the Czech Republic. There were put in place measures to prevent the spread of the disease, including a ban on accompaniment in the birth room. The interviews took place in a pre-arranged, calm and pleasant environment for the women. The obtained data recorded on a dictaphone was evaluated manually, using the "paper - pencil" method. There were created three main categories and their subcategories. The first category is called Accompanying Person and contains five subcategories - Accompanying person during childbirth, Factors influencing the choice of the accompanying person, Proposal for presence at childbirth, Satisfaction and Recommendation of the accompaniment. The second main category Childbirth has four subcategories - Preparation for childbirth, Coming to childbirth, Perception of the accompaniment during childbirth by a woman, and Process of the fourth stage of childbirth. The last category is Communication with three subcategories - Behavior and communication of the accompaniment with a woman, Communication with staff and Behavior of staff. The research revealed that women I1 - I9 chose their partner as their 7 accompanying person and woman I10 chose a dula. For women, the partner is the closest person they want to experience the most important moments. Woman I10 chose the doula on the base of recommendation of her colleague. Furthermore, it was found that women perceived their accompaniment primarily as psychological support, which calms them verbally or by their presence, but women I1, I4 and I7 considered their partners as an auxiliary person who assisted them in the shower, in moving or giving things. All the women were ultimately satisfied with their choice, despite flaws such as playing on the phone or too much effort.
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