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Caring for a pregnant woman with gestational diabetes mellitus
DVOŘÁKOVÁ, Adéla
This bachelor thesis deals with gestational diabetes mellitus and the care that is provided to women suffering from this disease. The work consists of theoretical and practical part. In the theoretical part of the work, the terms physiological and high-risk pregnancy are defined in the introduction. After explaining the concept of diates mellitus and analyzing its nature, the work focuses on gestational diabetes mellitus and its characteristics. Its etiology, possible complications, effect on the fetus, methods of examination and treatment are described. The last part focuses on the care of midwives, this part of the theoretical part of the work points to the possibilities and areas of education of pregnant women who suffer from gestational diabetes mellitus. The practical part was created with the help of a qualitative research survey. Two goals were set for the bachelor thesis. The first aim of the work was to find out what role a midwife plays in the care of women with gestational diabetes and the second to find out what knowledge pregnant women with this disease have. There are three research questions related to the objectives: "What role does a midwife play in caring for a woman with gestational diabetes?", "What knowledge do pregnant women lack about GDM?" And "What knowledge do pregnant women have about GDM?". To achieve the goals, the methodology of qualitative research was chosen in the form of semi-structured in-depth interviews. Two research groups were set up, consisting of pregnant women with personal experience of the disease and midwives caring for these women. The research itself took place during the months of March and April 2022 in the form of a personal meeting at home or in a prenatal clinic. After analyzing the obtained data, the results of the research survey were derived, which were processed into categories and subcategories. Research has found that midwives provide a wide range of education in their care for women diagnosed with GDM in addition to glycemic control, diabetes counseling, and oGTT. They most often educate about diet, diet and the principles of self-monitoring. Pregnant women often had only an awareness of the disease before their diagnosis and lacked the most information about the correctness of the diet.
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The menstrual cycle from the perspective of women
MAURICOVÁ, Michaela
This bachelor thesis deals with women's awareness in the field of menstrual cycle. The thesis is divided into two parts, a theoretical and a practical part. The theoretical part focuses on the anatomy of female genitals, the physiology of the menstrual cycle, it also mentions the disorders of the menstrual cycle. Last but not least, it solves period supplies and related hygiene and menstrual poverty. The theoretical part also mentions the impact of the global SARS-CoV-2 pandemic on a woman's menstrual cycle and the role of a midwife in education. Two goals have been set for the practical part. The first goal was to find out what information women have about the menstrual cycle. The second goal was to map if women are informed about menstruation by a midwife. The research survey has been conducted on the basis of a questionnaire survey. The self-designed questionnaire consisted of closed and semi-closed questions. The Mann-Whitney test for two independent samples and the two relative frequency agreement tests have been used to evaluate the hypotheses. The research group consisted of 1 499 respondents. Respondents were divided intocategories according to age 18-25, 26-35, 36-45, 46-60 and 61 and over. The questionnaire was shared on the social network Facebook. Women aged 18-25 had the largest proportion of the total number of respondents. Related to the above objectives, the hypotheses have been set this way: H1: Women aged 18-35 are more informed about menstruation than women aged 36 and over. H2: Women aged 18-35 had more information from their mothers at the onset menstruation than women aged 36 and over. H3: Women get information about menstruation from the Internet rather than from a midwife. The research survey has found out that respondents obtained information about menstruation mainly from their mothers. 1 169 (77.9 %) of all women interviewed received information from their mothers, who rated information mainly as sufficient (31.4 %; 470 answers) or as average (22 %; 330 answers). Another 712 (47.4 %) women got information from the Internet and 602 (40.2 %) from school. 3.7% of women surveyed (56 women) stated that no one provided them with any information. Only 26 (1.7 %) women received information from the midwife. The research has also shown that women aged 18-35 have more knowledge of menstruation than women aged 36 and over. Regarding information from mothers, women aged 18-35 had more information from mothers at the start of menstruation thanwomen aged 36 and over. The proportion of women who mentioned the internet as a source of information is greater than the proportion of women who mentioned a midwife. Research has shown that women are informed about menstrual cycle. However, it is important to midwives to use sufficiently their competencies.
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The role of a midwife in supporting woman's partner during pregnancy, childbirth and the puerperium
ČEJKOVÁ, Tereza
This bachelor thesis dealt with the topic of the role of midwives in supporting a woman's partner during pregnancy, childbirth and the puerperium. The thesis consists of two parts, namely the theoretical part and the research part. In the theoretical part there is information about pregnancy, childbirth, puerperium and related issues. Education, involvement of the woman's partner and his cooperation with the midwife are issues that this bachelor thesis deals with. In the research part of the bachelor thesis, a quantitative method was used for data collection. The data was collected using a questionnaire consisting of 48 questions, of which 25 were closed, 9 semi-closed and 14 open questions. In the introduction, there were sorting questions. Next, the questions were divided into three basic areas: pregnancy, childbirth and the puerperium. The questionnaire was directed for men whose wife already gave birth. The questionnaire was distributed online, via the social network Facebook and via a direct link and sent to men of an unlimited age category whose wife already gave birth. A total of 120 men participated in the research. The questionnaire was processed using Microsoft Excel. Answers were processed using graphic representation accompanied by a verbal description. In this work, we set 1 goal: To find out what is the role of the midwife in supporting the woman's partner during pregnancy, childbirth and the puerperium. For the research part, 3 hypotheses were established. The first was to find out whether a partner who is educated by a midwife during pregnancy in a woman perceives this period more positively than a partner who is not educated about the period of pregnancy. Here, a dependence was not found between the partner's awareness of the course of pregnancy in a woman and a more positive perception of this period. The second hypothesis was to find out whether a partner who is educated by a midwife during the period of childbirth in a woman perceives this period more positively than a partner who is not educated about the period of childbirth. Hypothesis number two has been confirmed. The third hypothesis was to find out whether a partner who is educated by a midwife in the postpartum period in a woman perceives this period more positively than a partner who is not educated about the postpartum period. Hypothesis number three has also been confirmed.
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Midwife care for a woman during lactation
KRYGLOVÁ, Aneta
The bachelor thesis deals with the midwife´s care of a woman during Lactation. It is divided into a theoretical part and a practical part. The theoretical part contains information about the anatomy of the breast, lactation, the composition of mother´s milk and its benefits, the principles of proper breastfeeding, difficulties and problems with breastfeeding, breastfeeding support, and finally the cessation of lactation. For the practical part of the bachelor thesis the main aim was to find out what problems women most often face during lactation. Three research questions were set out to detremine this aim. The first research question dealt with where women most often seek help in the event of a breastfeeding problem. The second research question investigates women´s experiences with midwife care in connection with lactation, and the third research question adressed what knowledge and information women lacked. The practical part of the bachelor thesis was done by a qulitative research investigation in the form of individual semi-structured interviews. The research group consisted of ten women who were breastfeeding and had finished their puerperium. All women gave verbal consent to the interview and to its recording on a dictaphone. The women also agreed to the subsequent processing of the information obtained. The research survey took place from February to April 2022. Interviews with women consisted of twenty main questions, which were supplemented by supplementary questions in order to obtain more detailed information. The interviews were subsequently transcribed and analyzed. For data evaluation main categories and subcategories were determined, which are described in the research part of the bachelor thesis. Three categories and fourteen subcategories were created. The results of this bachelor thesis can be used by professional seminars and as informational material for midwifes who, based on our results, can change their attitude towards women and education in the field of lactation.
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Awareness of university students about pregnancy after the age of 35.
KLOFÁČOVÁ, Petra
The topic of this bachelor thesis is ´ Awareness of university students about pregnancy after the age of 35.´. The thesis is divided into two parts, a theoretical one and a practical one. The theoretical part describes what changes a female body goes through during pregnancy, what planned parenthood is and how fertility changes with regard to age. Furthermore, the theoretical part mentions the methods of assisted reproduction and possible risks connected to assisted reproduction, risk factors related to the mother after 35 years of age, risk factors for the baby and last but not least, being educated by the midwife. The practical part of this bachelor thesis has used a quantitative survey using a self-structured questionnaire. The questionnaire consisted of 28 questions. In total, one objective was chosen for this thesis. The objective of the thesis was to: ´Map out university students´ awareness of the issue of pregnancy after the age of 35´. Subsequently, two hypotheses were set together with the objective. The first hypothesis says: ´Awareness of pregnancy risks after the age of 35 is greater in university students focusing on health care than in students focusing on other study subjects´. This hypothesis is valid. The other hypothesis says: ´Awareness of pregnancy risks after the age of 35 is greater in female university students than in male university students´. This hypothesis is not valid. The research file consisted of a total of 225 university students. The respondents were split, based on gender, into males (22.70%) and females (77.30%) and further on based on their study subject focus - medical (23.50%) and non-medical (76.50%) subjects. 76.90% respondents understand pregnancy after 35 years of age to be one of the pregnancy risk factors. 64.40% respondents have stated that pregnancy after the age of 35 is risky. The most frequent reason for postponing maternity is, according to the respondents, financial independence mentioned by 90.20% of respondents. The bachelor thesis survey results are showing that both, male and female university students have got rather a poor awareness of risks connected to pregnancy after the age of 35. Thus, the results may serve as feedback to pre-natal care providers in the Czech Republic, but also to schools where this topic should be studied. At the same time, this thesis may serve as information material to high school as well as university students when studying issues related to pregnancy, planned parenthood, postponed motherhood or assisted reproduction.
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Birth Plan at Birth
HOUŠKOVÁ, Daniela
The bachelor thesis deals with the birth plan and its use during childbirth. It is divided into the theoretical and practical parts. The theoretical part is focuses on childbirth, birth periods, postpartum care, treatment of the newborn and caesarean section. Furthermore, the theoretical part deals with the birth plan, its writing and the various points that may occur in the birth plan. The practical part of the bachelor's thesis was carried out using a qualitative research investigation in the form of a semi-structured interview. The interview consisted of twelve questions. The interviews were conducted with eight women who used a birth plan during labor. For this bachelor thesis were set three main goals. The first goal was to find out the reasons for writing a birth plan by mothers. The informants wanted the birth to go according to their wishes. During the writing process, they sorted out what was important to them. Reasons for this included a negative experience from a previous birth. The second goal was to point out compliance with the birth plan at birth. The research investigation revealed that the birth plan is usually followed. Three of the eight informants indicated that not all points of the birth plan had been followed. Five of the eight informants said that their birth plan had been followed. The third goal was to determine changes in the birth plan during labor. During childbirth, the informants from the research surevy changed their attitude towards the repture of the bladder pouch and the intake of painkillers. Informants gave birth in a different position than they originally intended. Informants also changed their birth plan because of birth complications, namely that bonding could not take place or they were not allowed to move freely during labor.
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A midwife's personal experience with pregnancy and labor
JAREŠOVÁ, Natálie
A midwife's personal experience with pregnancy and labor Bachelor theses is focused on personal experience with pregnancy and labor of midwife. Defined in the theoretical part of the Bachelor theses is the profession of a midwife, her competencies and role in prenatal counselling and during labor. Subsequently, the theoretical part contains the characteristics of pregnancy and physical and mental changes that are closely related to pregnancy. Last but not least, the theoretical section describes childbirth and all periods of childbirth. For Bachelor theses there were two goals, the first goal was to identify if professes of midwife affect their own pregnancy and labor experience. The second goal was to identify if their own pregnancy and labor experience affects a midwifes approach to pregnant women and women after childbirth. Based on set goals, the research questions were created. The first research question focused on how the midwifes profession affected the experience of her own pregnancy and labor. The second question examined how the midwife's own pregnancy and labor affect her approach to providing care to a women within her competencies. To obtain the results of a qualitative research survey, two research sets were created. The first research group consisted of midwives who practiced the profession of a midwife in primary care and had been pregnant and gave birth at least once. For the second research group, which consisted of midwives, the criterion of performing the profession of midwife in the delivery room was determined, as well as at least one experienced pregnancy and childbirth. The survey itself took the form of individual semi-structured interviews, which took place during a personal meeting in the period from March to May 2021. Before the start, all informants gave their approval to the interviews and their recording to the mobile phone and also their data processing. The obtained data was analyzed and the main categories and subcategories were created based on the results. After evaluating the data with midwives working in primary care, 3 main categories were set (Perception of own pregnancy, Prenatal counseling, Return to work) and 6 subcategories (Own experience with pregnancy, Influence of own pregnancy on the profession of midwife, Prenatal preparation, Course of care in prenatal counseling, Access of medical staff, Changes in the care of pregnant women). After evaluating the data with the midwives who worked in the delivery room, 3 main categories were set (Perception of own childbirth, Provision of health care, Return to work) and 5 subcategories (Course of own childbirth, Experience of own childbirth, Place of childbirth, Access of medical staff, Changes in the care of women in labor). The first research question was devoted to how the profession of midwife influenced their pregnancy and labor. The research found that midwives during own pregnancy were influenced by their profession mainly in the perception of care for themselves in the prenatal counseling and in the perception of the approach of medical staff for themselves. The second research question dealt with the influence of their own pregnancy and labor on the approach to pregnant women and childbirth after returning to work within their competencies. It was found that after returning to work, midwives were affected by their pregnancy and thus perceived certain changes in the approach to pregnant women. The experience of giving birth also had an effect on the performance of their profession after returning to work.
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Epidural analgesia during childbirth
MAŘÍKOVÁ, Tereza
This thesis focuses on the topic of epidural analgesia during childbirth. The work consists of two main parts-theoretical and practical. The theoretical section first and foremost defines the concept of childbirth and describes all birth times. Last but not least, it is also dedicated to the role of midwife in childbirth. Another topic is obstetric pain, which is followed by the theme of pharmacological methods to labor pain relief. The issue of epidural analgesia is described in detail and divided into additional subchapters. These are devoted to the description of the procedure for administering epidural analgesia in childbirth, it's indications and contraindications, the advantages and disadvantages, the complications of epidural analgesia in childbirth and, last but not least, the role of the midwife in the care of the woman with epidural analgesia. The theoretical section concludes with a chapter on non-pharmacological methods of controlling birth pain. The first objective of the work was to determine whether women use epidural analgesia during childbirth. The second goal was to map women's satisfaction with the effects of epidural analgesia in childbirth. The third and final goal was to see if women worked better with midwives after receiving epidural analgesia. Three hypotheses have been set for the objectives. H1: First-time mothers are more likely to use epidural analgesia than multi-parents. H2: Younger women (under 30) are more satisfied with the effects of epidural analgesia in childbirth than older women (over 30). H3: Women with epidural analgesia at birth cooperate better with midwives than women without epidural analgesia. The objectives were achieved by a quantitative research investigation in the form of own design questionnaires, which consisted of both open and closed questions. The assessment of the questionnaires was carried out using a statistical chi-square test which determined the significance or insignificance of the results. The first research set consisted of 205 women active on the Facebook social network. Of the total number of respondents, women in the 26-30 age range had the highest representation. The second research set included 102 midwives working in the delivery room. Midwives in the 20 to 30 age range had the highest representation of total respondents. The research investigation revealed that more than half of the respondents had used epidural analgesia during childbirth. However, only a third of women are certain that they would also use epidural analgesia for their next birth. The other two-thirds of women do not know whether they would use the epidural analgesia method or are certain that they do not want epidural analgesia in their next childbirth. We also wanted to find out whether younger women (under 30) are more satisfied with the effects of epidural analgesia in childbirth than older women (over 30). This hypothesis has not been confirmed. This was due to the low representation of the group of women over 30. We also wanted to find out whether first-time mothers use epidural analgesia more often than multi-time mothers. The result of the research showed that the largest representation of our female respondents who took advantage of epidural analgesia was just 7 % more first-time mothers. However, the difference is not statistically significant. We also wondered if women with epidural analgesia at birth cooperate better with midwives than women without epidural analgesia. According to the research investigation, the vast majority of midwives think that women with epidural analgesia cooperate better during childbirth than women without epidural analgesia.
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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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Midwife's care of a woman at risk of imminent preterm birth
BUBENÍČKOVÁ, Veronika
This bachelor thesis deals with the topic of care for a pregnant woman with impending preterm birth. The bachelor thesis is divided into theoretical and practical parts. In the theoretical part, the is described preterm birth, its incidence in the Czech Republic, causes of preterm birth, diagnostic methods, therapeutic procedures in preterm birth, the needs of pregnant women with this diagnosis, and the care of midwives for women at risk of preterm birth. Qualitative survey research was used to develop the practical part. The first research group consisted of 10 women with a diagnosis of preterm birth, who answered questions in a semi-structured interview. The second research group consisted of 7 midwives at the Risk Pregnancy Station. The research was conducted during April and July 2021. Participation in the research was entirely voluntary. Before the start of the interview, the participants of the interview were informed about the topic of the bachelor's thesis and about the protection of personal data. The interviews were conducted anonymously and, after approval by the informants, recorded on a mobile phone. To maintain anonymity, the informants were marked with numbers I1 to I10 and P1 to P7. After that, the interviews were literally transcribed, analyzed, and processed using coding, the paper and pencil method. For the research of this bachelor thesis, two research questions were determined to find out how women perceive the care of a midwife in case of imminent preterm birth and how midwives perceive the care of a woman with a diagnosis of preterm birth. Based on the research survey, it was found that all informants were satisfied with the care of midwives. Research has shown that there were several factors for women's satisfaction with the care of midwives during hospitalization. These factors included the approach of midwives to their willingness and ability to communicate with women. Even though all informants were satisfied with the care and communication from the midwives, the research showed the dissatisfaction of women with the communication with the attending physicians. Dissatisfaction was expressed by informants I1, I3, and I6 when information from doctors seemed to be insufficient to them. Research has further shown that midwives are aware of the importance of their empathic approach in the care of women hospitalized with a diagnosis of preterm birth and also perceive the changing needs of women during hospitalization, which need to be taken into account during care. This work points out the importance of a kind and empathic approach of a midwife to a woman with a diagnosis of preterm birth because that approach of a midwife is one of the most important aspects for a woman to overcome hospitalization at the Risk Pregnancy Station of the gynecology and obstetrics department. The work also shows the influence of the communication of doctors to patients on the female psyche and the experience of hospitalization. The results within this bachelor's thesis can be used as feedback on the work of midwives at the Risk Pregnancy Station of the Gynecology and Obstetrics Department to improve the care of midwives for women with imminent premature birth and increase client satisfaction in the medical facility.
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