Gill Thomson

University of Central Lancashire | UCLAN · Community Health and Midwifery

Women in prison who are pregnant or recently had a baby are a highly vulnerable population due to complex histories, increased risks of poorer outcomes, and mother-infant separation. During the COVID-19 pandemic, these women faced additional challenges due to infection risks and enforced social isolation. In England in March 2020, the Ministry of J...

Background Minoritised ethnic perinatal women can experience judgemental and stigmatising care due to systemic racism. Discriminatory care contributes to increased risks of poor maternal and infant outcomes, including higher rates of mental ill-health. This study aimed to explore minoritised ethnic women’s experiences of maternity services, includi...

Background The COVID-19 pandemic had a severe impact on women’s birth experiences. To date, there are no studies that use both quantitative and qualitative data to compare women’s birth experiences before and during the pandemic, across more than one country. Aim To examine women’s birth experiences during the COVID-19 pandemic and to compare the...

Background

Background: A traumatic childbirth experience affects ~30% of women each year, with negative impacts on maternal, infant, and family wellbeing. Women classified as vulnerable or marginalised are those more likely to experience a psychologically traumatising birth. A key contributory factor for a traumatic childbirth experience is women's relations...

Background Midwifery students’ education regarding labor and birth is crucial because it directly affects the quality of care provided to women in labor. Aims Exploring educators’ experiences of delivering labor and birth education to midwifery students and evaluating the circumstances that affect the quality of labor and birth education Methods...

Objective: To examine factors associated with birth-related post-traumatic stress disorder (PTSD) among women who had preterm birth in their last pregnancy in Turkey.Methods: 304 women were asked to report sociodemographic factors, perinatal factors, birth-related factors, preterm birth/premature infant characteristics, and social support factors a...

Background Over a third of pregnant women (~250,000) each year in the United Kingdom have experienced trauma such as domestic abuse, childhood trauma or sexual assault. These experiences can have a long-term impact on women's mental and physical health. This global qualitative evidence synthesis explores the views of women and maternity care profes...

Aim: To explore the content, experiences, and outcomes of interventions designed to increase early skin-to-skin contact (SSC) in high-income settings. Methods: A mixed-methods systematic review was undertaken across six bibliographic databases. References of all included studies were hand-searched. All papers were quality appraised using a mixed...

Objective: The aim of this systematic review was to explore the impact of the COVID-19 pandemic on breastfeeding support services and continuation rates. Methods: Electronic searches were undertaken in seven databases: Academic Search Complete, Springer Nature Journals, CINAHL Medline, Health Source: Nursing/Academic Edition, Masterfile premier,...

The perinatal period is a high risk for onset and relapse of mental health problems. The COVID-19 pandemic is a particularly stressful occurrence with reported negative impacts on perinatal mental health, hence the need to understand these impacts on pregnant and post-partum childbearing women and people, and prioritise interventions to alleviate...

Background: Preterm infants often need admission to a neonatal unit causing prolonged stress for parents. Evidence has shown that neonatal early supported transfer to home interventions may reduce stress levels. This systematic review investigates effectiveness of neonatal early supported transfer to home interventions for parents and preterm infan...

Background: The COVID-19 pandemic has resulted in profound and far-reaching impacts on maternal and newborn care and outcomes. As part of the ASPIRE COVID-19 project, we describe processes and outcome measures relating to safe and personalised maternity care in England. Methods: We undertook a mixed-methods system-wide case study using quantitative...

Introduction A positive childbirth experience promotes women’s health, both during and beyond the perinatal period. Understanding what constitutes a positive childbirth experience is thus critical to providing high‐quality maternity care. Currently, there is no clear, inclusive, woman‐centered definition of a positive childbirth experience to guide...

This study aimed to explore the psychosocial needs of parents whose infants required neonatal care and to identify strategies to optimise parental psychosocial wellbeing. An exploratory qualitative study, comprising semi-structured interviews was undertaken with nineteen parents (mothers = 16, fathers = 3). The data were analysed thematically, and...

The early post-natal period is a critical period in women's infant feeding journeys, often marked by high levels of unintended breastfeeding cessation. Previous research has argued that infant feeding should be perceived within a complex system whereby factors operating at different ecological levels (i.e., individual, social/community networks, cu...

Abstract Objective: To map the existing literature on health content from social media influencers and its impact on the health behaviours, health and wellbeing of members of the public exposed to it (i.e., followers and subscribers). Introduction: Health content from social media influencers has become popular in recent years and is now a key so...

Background: Many women experience giving birth as a negative or even as a traumatic event. Birth space and its occupants are fundamentally interconnected with negative and traumatic experiences, highlighting the importance of the social space of birth. Aim: To explore experiences of women who have had a negative or traumatic birth to identify the...

Most perinatal research relating to COVID‐19 focuses on its negative impact on maternal and parental mental health. Currently, there are limited data on how to optimise positive health during the pandemic. We aimed to bridge this knowledge gap by exploring how women have adapted to becoming a new parent during the pandemic and to identify elements...

Background The COVID-19 pandemic had a severe impact on women’s birth experiences. To date, there are no studies that use both quantitative and qualitative data to compare women’s birth experiences before and during the pandemic, across more than one country. Aim To examine women’s birth experiences during the COVID-19 pandemic and to compare the...

Introduction Many women experience giving birth as traumatic. Although women's subjective experiences of trauma are considered the most important, currently there is no clear inclusive definition of a traumatic birth to help guide practice, education, and research. Aim To formulate a woman-centered, inclusive definition of a traumatic childbirth e...

Background The national health care response to coronavirus (COVID-19) has varied between countries. The United Kingdom (UK) and the Netherlands (NL) have comparable maternity and neonatal care systems, and experienced similar numbers of COVID-19 infections, but had different organisational responses to the pandemic. Understanding why and how simil...

Purpose This paper reports on insights from an evaluation of Birth Companions (BC) (a UK-based charity) perinatal support in two prison settings in England. The initiative involved the provision of group and/or one-to-one perinatal support and training women prisoners as peer supporters. Design/methodology/approach A mixed-methods study was undert...

Objectives To explore stakeholders’ and national organisational perspectives on companionship for women/birthing people using antenatal and intrapartum care in England during COVID-19, as part of the Achieving Safe and Personalised maternity care In Response to Epidemics (ASPIRE) COVID-19 UK study. Setting Maternity care provision in England. Par...

The coronavirus (COVID‐19) pandemic has resulted in rapid changes in many areas of health care worldwide.1 Some organisational and governance controls on innovation have been relaxed, to enable rapid adaptation to changing circumstances. The speed of innovation raises a range of ethical, governance and organisational issues. It is important to asse...

Background High numbers of women experience a traumatic birth, which can lead to childbirth-related post-traumatic stress disorder (CB-PTSD) onset, and negative and pervasive impacts for women, infants, and families. Policies, suitable service provision, and training are needed to identify and treat psychological morbidity following a traumatic bir...

Background Some childbearing women/birthing people prioritize out of maternity care organizational guidelines’ approaches to childbirth as a way of optimizing their chances of a normal physiological birth. Currently, there is little known about the experiences of midwives who support their choices. Aim To explore the experiences of UK midwives emp...

The national health care response to coronavirus (COVID-19) has varied between countries. The United Kingdom and the Netherlands have comparable maternity and neonatal care systems, and experienced similar numbers of COVID-19 infections, but had different organisational responses to the pandemic. Understanding why and how similarities and differenc...

Background Most qualitative research on breastfeeding the preterm or low-birthweight (LBW) infant has focused on negative insights; there are no comprehensive insights into how, when and why mothers experience positive breastfeeding experiences. We aimed to address this knowledge gap by exploring what characterizes and facilitates a positive breast...

This article is currently available as pre-print (https://www.authorea.com/doi/full/10.22541/au.163303575.51283208). The Manuscript is currently under review in BJOG.

In many high‐income countries such as the United Kingdom, inequalities in breastfeeding initiation and continuation rates exist, whereby socio‐economically advantaged mothers are most likely to breastfeed. Breastfeeding peer support interventions are recommended to address this inequality, with non‐profit breastfeeding organisations providing such...

OBJECTIVE Between 20%-50% of women experience birth as traumatic, with negative impacts for women, infants and families. Currently, there is a lack of evidence into supportive interventions to ameliorate women's adverse responses following a traumatic birth. In North-West UK, a 6-week psychoeducation group support program (Coping with Birth Trauma...

Midwife-led institutions, also called free-standing birth centres, offer birth assistance to women at low risk for complications. Free-standing birth centres, because they are the institutions that provide low intervention birth assistance, also present the possibility to conduct research on the skills and knowledge that are necessary to provide sa...

Objective During pregnancy and childbirth, vulnerable and disadvantaged women have poorer outcomes, have less opportunities,face barriers in accessing care,and are at a greater risk of experiencing a traumatic birth. A recent synthesis of women's negative experiences of maternity care gathered data from predominantly low-income countries. However,...

Background: Parents of infants born premature and/or sick and who require neonatal care are at risk of poor mental health. Currently, there is no comprehensive knowledge about interventions (ie, types, evidence, resources) that have been exclusively designed to improve the psychosocial well-being of this population group. Purpose: To undertake a...

Aims: Chronic loneliness is experienced by around a third of parents, but there is no comprehensive review into how, why and which parents experience loneliness. This scoping review aimed to provide insight into what is already known about parental loneliness and give directions for further applied and methodological research. Methods: Searches...

Background: High numbers of women experience a traumatic birth, which can lead to Post Traumatic Stress Disorder (PTSD) onset, and negative and pervasive impacts for women, infants and families. Policies, suitable service provision, and training are needed to identify and treat psychological morbidity following a traumatic birth experience, but cur...

Purpose This discussion article considers how an emotion-focused approach can be adopted to prevent psychological birth trauma and to optimize perinatal wellbeing for women and their families. Conclusion Emotion-focused approaches have a different perspective when compared to other classic psychotherapy methods. This approach may help women to res...

Objectives: To explore the impact of COVID-19 on companionship for women using maternity services in England, as part of the Achieving Safe and Personalised maternity care In Response to Epidemics (ASPIRE COVID-19 UK) study. Setting: Maternity care provision in England. Participants: Interviews were held with 26 national governmental, professional,...

Background There are inequalities in breastfeeding initiation and continuation rates, whereby socio-economically disadvantaged mothers are least likely to breastfeed. Breastfeeding peer support (BPS) interventions are recommended as a solution, and in the UK non-profit organisations are commissioned to deliver BPS services in areas of socio-economi...

Although breastfeeding is known to improve health, economic and environmental outcomes, breastfeeding initiation and continuation rates are low in the United Kingdom. The global WHO/UNICEF Baby Friendly Hospital Initiative (BFHI) aims to reverse declining rates of breastfeeding by shifting the culture of infant feeding care provision throughout hos...

UK legislation and government policy favour women’s rights to bodily autonomy and active involvement in childbirth decision-making including the right to decline recommendations of care/treatment. However, evidence suggests that both women and maternity professionals can face challenges enacting decisions outside of sociocultural norms. This study...

Objective: The workshop aimed to discuss and develop a statement on the current state of the evidence and opinion in the field of Fear of Childbirth (FoC) and Tokophobia (Tocophobia), and to provide some recommendations for research. Background: A group of international researchers, clinicians and a service user met in 2019 to discuss the state of...

Background: There are inequalities in breastfeeding initiation and continuation rates, whereby socio-economically disadvantaged mothers are least likely to breastfeed. Breastfeeding peer support (BPS) interventions are recommended as a solution, and in the UK non-profit organisations are commissioned to deliver BPS services in areas of socio-econom...

Background: A lack of perceived social support influences women's infant feeding behaviours. The Infant Feeding Genogram is a visual co-constructed diagram which details people/services that can provide support to women and can facilitate a connection between mothers and their existing assets landscape. The aim of this study is to explore women's a...

Background: A lack of perceived social support influences women's infant feeding behaviours. The Infant Feeding Genogram is a visual co-constructed diagram which details people/services that can provide support to women and can facilitate a connection between mothers and their existing assets landscape. The aim of this study is to explore women's...

Background Physical and emotional parent-infant closeness activate important neurobiological mechanisms involved in parenting. In a neonatal care context, most research focuses on physical (parental presence, skin-to-skin contact) aspects; insights into emotional closeness can be masked by findings that overemphasise the barriers or challenges to p...

While shared personal experiences are a valued prerequisite of the peer supporter–service‐user relationship, they have the potential to create harm. There are challenges in peer supporters being emotionally ready to hear the experiences of others, and how much personal information peers should disclose. As part of an international study that aimed...

Restraining patients is a practice that dates back at least three centuries. In recent years, there has been a mandate and advocacy in various countries for organizations to shift towards the minimization of restraint, whereby its use is only as a ‘last resort’. There is growing evidence internationally indicating the negative impact of the use of...

Aim: The purpose of this study was to summarise the evidence of the clinical and psychological impacts of COVID-19 on perinatal women and their infants. Methods: A rapid scoping review was conducted based on methods proposed by Arksey and O’Malley, and the World Health Organization’s (WHO) practical guide for rapid reviews. We searched EMBASE, MED...

Background: Post-traumatic stress disorder (PTSD) can develop after a traumatic childbirth. Objective: To test if providing psychological self-help materials would significantly lower the incidence of PTSD at 6-12 weeks postnatally. Design: Open label, randomised controlled trial, blinded outcome assessment. Setting: Community midwifery serv...

This paper presents a rapid evidence review into the clinical and psychological impacts of COVID-19 on perinatal women and their infants. Literature search revealed that there is very little formal evidence on the impact of COVID-19 on pregnant, labouring and postnatal women or their babies. The clinical evidence to date suggests that pregnant and...

Background The UK has low levels of breastfeeding initiation and continuation, with evident socioeconomic disparities. To be inclusive, peer-support interventions should be woman-centred rather than breastfeeding-centred. Assets-based approaches to public health focus on the positive capabilities of individuals and communities, rather than their de...

Background and context Breastfeeding peer support is valued by women, but UK trials have not demonstrated efficacy. The ABA feasibility trial offered proactive peer support underpinned by behaviour change theory and an assets‐based approach to women having their first baby, regardless of feeding intention. This paper explores women's and infant fee...

Introduction: Midwifery care is associated with positive birth outcomes, access to community birth options, and judicious use of interventions. The aim of this study was to characterize and compare maternity care preferences of university students across a range of maternity care systems and to explore whether preferences align with evidence-based...

In this chapter we draw on our research exploring ten women’s motivations to freebirth in the UK (Feeley, Thomson, 2016b, Feeley, Thomson, 2016a). First, we provide an overview of the context of birth and maternity care in the UK and discuss issues related to ‘birth choice’ within a lens of rhetoric versus reality. Such context provides valuable in...

Hermeneutic phenomenology (HP) as research method is increasingly used in health and social science studies to collect and analyze lived experiential descriptions (LEDs) of a phenomenon. However, currently there is little guidance in how to apply philosophical notions to interpret LEDs in HP studies and this approach has faced critique in how meani...

The UK has low breastfeeding rates, with socioeconomic disparities. The Assets‐based feeding help Before and After birth (ABA) intervention was designed to be inclusive and improve infant feeding behaviours. ABA is underpinned by the behaviour change wheel and offers an assets‐based approach focusing on positive capabilities of individuals and comm...

Objective: Pregnancy and the postnatal period offers an opportunity to optimise maternal health. A UK-based charity has developed parenting resources - Baby Buddy smartphone app, Baby Express magazine, and 'From Bump to Breastfeeding' DVD - designed to complement health service care to promote maternal wellbeing, breastfeeding and positive parenti...

Background A lack of perceived social support influences women’s infant feeding behaviours. The Infant Feeding Genogram is a visual co-constructed diagram which details people/services that can provide support to women and can facilitate a connection between mothers and their existing assets landscape. The aim of this study is to explore women’s an...

Background: A lack of perceived social support influences women’s infant feeding behaviours. The Infant Feeding Genogram is a visual co-constructed diagram which details people/services that can provide support to women and can facilitate a connection between mothers and their existing assets landscape. The aim of this study is to explore women’s a...

Background: A lack of perceived social support influences women’s infant feeding behaviours. The Infant Feeding Genogram is a visual co-constructed diagram which details people/services that can provide support to women and can facilitate a connection between mothers and their existing assets landscape. The aim of this study is to explore women’s a...

Coercive practices, such as physical restraint, are used globally to respond to violent, aggressive and other behaviours displayed by mental health service users.1 A number of approaches have been designed to aid staff working within services to minimise the use of restraint and other restrictive practices. One such approach, the ‘REsTRAIN Yourself...

Background: Breastfeeding peer support is advocated in national and international guidelines, but the evidence base is mixed. In the UK, breastfeeding peer support was found to be ineffective in randomised controlled trials, while women report positive impacts on breastfeeding experiences in qualitative studies. A key criticism levied against brea...

Letter to the Editor – ERRATUM - Gill Thomson, Fiona Dykes, Andy Bilson, Jane Putsey, Mary Whitmore, Sally Dickens

In this article, the authors use the context of childbirth to consider the power that is endemic in certain forms of evidence within maternity care research. First, there is consideration of how the current evidence hierarchy and experimental‐based studies are the gold standard to determine and direct women's maternity experiences, although this ca...

Peer support is a widely used intervention that offers information and emotional support to parents during their infant's admission to the neonatal unit and/or post-discharge. Despite its widespread use, there are no comprehensive insights into the nature and types of neonatal-related peer support, or the training and support offered to peer suppor...

Childbirth is a liminal life experience; a transcendental journey through which a mother and baby are born. However, as with other significant life transitions, childbirth can be experienced on a spectrum from an inherently positive and empowering event to one that is deeply distressing, with short and long-term implications for maternal wellbeing,...

Background: During pregnancy and postnatally, women seek information from a variety of sources. The potential to incorporate educational pregnancy and parenting resources into conventional health services is underexplored. In 2014-2016, UK-based charity Best Beginnings used an embedding model to embed three of their resources - the Baby Buddy app,...

Now published within my new monograph, this model depicts the sociocultural-political influence and impact upon midwives' who were willing to facilitate 'out of guidelines' physiological birth care. https://doi.org/10.4324/9781003265443

Background: Many women use pharmacological or non-pharmacological pain relief during childbirth. Evidence from Cochrane reviews shows that effective pain relief is not always associated with high maternal satisfaction scores. However, understanding women's views is important for good quality maternity care provision. We undertook a qualitative evi...

Introduction Safe staffing and coercive practices are of pressing concern for mental health services. These are inter‐dependent and the relationship is under‐researched. Aim To explore views on staffing levels in context of attempting to minimise physical restraint practices on mental health wards. Findings emerged from a wider dataset with the br...

The principal research question of this scoping review is "what is known about loneliness experienced by parents? We have identified several secondary questions to guide the scoping review, and to complement the broader research question. These questions will be refined as the search continues and will include, but will not be limited to: (1) What...

Objective Despite recommendations within postnatal care guidelines, many National Health Service (NHS) hospital trusts in the UK provide an afterbirth, debriefing type service for women who have had a traumatic/distressing birth. Currently there are a lack of insights into what, how, and when this support is provided. The aim of this study was to e...