Midwives' experiences using a peanut ball for women during labour: A qualitative study.

OBJECTIVE: To gain insight into the benefits, shortcomings, and practical considerations when using the peanut ball for women during labour. DESIGN & SETTING: We used a descriptive qualitative approach using semi-structured, in-depth interviews to explore the experiences of eight midwives working in a tertiary hospital birth unit in New South Wales, Australia when using the peanut ball for women during labour. PARTICIPANTS: Participants were recruited from the birthing unit of a tertiary hospital in New South Wales. The final sample included eight midwives working in the birth unit. FINDINGS: Three overarching themes were identified: 'Education and encouragement', 'benefits and disadvantages of peanut ball' and 'techniques'. The 'Education and encouragement' theme included three sub-themes: 'selling it to the woman', 'educating midwives' and 'becoming usual practice and improving confidence'. The 'Benefits and disadvantages of peanut ball' theme included two sub-themes: 'facilitates labour and birth' and 'discomfort'. The 'Techniques' theme included three subthemes: 'positioning', 'sizing' and 'using alternative techniques'. Midwives are confident in their practice with the peanut ball and acknowledge the importance of educating midwives and women to promote its use. Midwives also discussed favoured techniques when using the ball, especially relating to size and maternal positioning. CONCLUSION: Our study provides insight into midwives' experiences about using a peanut ball for women during labour. The midwives reported that the peanut ball encourages vaginal births and shortens labour times, whilst enabling women to participate actively in the birth. Education for midwives and women is vital for using peanut balls. IMPLICATIONS FOR PRACTICE: Peanut balls are not usual practice in birthing units in Australia and they are a novel intervention to improve labour and birthing outcomes for women, especially when using an epidural.

Prevalence and factors associated with mental health problems of psychological distress and depression among rural Victorians - analysis of cross-sectional data (Crossroads II).

BACKGROUND: Research suggests that rates of mental illness are similar in rural and urban Australia, although there are significant workforce shortages in rural regions along with higher rates of chronic disease and obesity and lower levels of socioeconomic status. However, there are variations across rural Australia and limited local data on mental health prevalence, risk, service use and protective factors. This study describes the prevalence of self-reported mental health problems of psychological distress and depression, in a rural region in Australia and aims to identify the factors associated with these problems. METHODS: The Crossroads II study was a large-scale cross-sectional study undertaken in the Goulburn Valley region of Victoria, Australia in 2016-18. Data were collected from randomly selected households across four rural and regional towns and then screening clinics from individuals from these households. The main outcome measures were self-reported mental health problems of psychological distress assessed by the Kessler 10 and depression assessed by Patient Health Questionnaire-9. Unadjusted odd ratios and 95% confidence intervals of factors associated with the two mental health problems were calculated using simple logistic regression with multiple logistic regression using hierarchical modelling to adjust for the potential confounders. RESULTS: Of the 741 adult participants (55.6% females), 67.4% were aged ≥ 55 years. Based on the questionnaires, 16.2% and 13.6% had threshold-level psychological distress and depression, respectively. Of those with threshold-level K-10 scores, 19.0% and 10.5% had seen a psychologist or a psychiatrist respectively while 24.2% and 9.5% of those experiencing depression had seen a psychologist or a psychiatrist, respectively in the past year. Factors such as being unmarried, current smoker, obesity, were significantly associated with a higher prevalence of mental health problems whereas physical activity, and community participation reduced the risk of mental health problems. Compared to rural towns, the regional town had higher risk of depression which was non-significant after adjusting for community participation and health conditions. CONCLUSIONS: The high prevalence of psychological distress and depression in this rural population was consistent with other rural studies. Personal and lifestyle factors were more relevant to mental health problems than degree of rurality in Victoria. Targeted lifestyle interventions could assist in reducing mental illness risk and preventing further distress.