3. Methodology

The project work will be provided by working groups; their representatives will take part in meetings, workshops and conferences and short-term scientific missions at national and international level.

The researchers are divided into 5 working groups that will process the necessary data according to their focus; also graduates and postgraduates will take part.

 

First working group: the researchers will engage in ensuring the ethical framework in the systems of provision of prenatal and early postnatal care, dealing specifically with issues related to indications for prenatal diagnostics in the first trimeter of FTPD (amniocentesis, termination of pregnancy, etc.), as well as indications for episiotomies and Caesarian sections in general, including foetuses around the 25th week of pregnancy. The working group will include workers from the area of ethics, genetics, obstetrics, neonatology and midwives. Prenatal psychology professor. Also students, particularly postgraduate students will take active part.

 

The second working group will engage in the description and analysis of clinical, psychological and socio-cultural results of different approaches to FTPD. Further, salutogenic approaches to physiological deliveries will be assessed, particularly the relation between provocation of premature uterine contractions for physiological deliveries, i.e. deliveries without episiotomies, without analgesic control. Further, medical and salutogenic principles for deliveries with episiotomies and indications for Caesarian sections will be compared. The team members will include physicians, obstetricians and neonatologists, psychologists, midwives and students of pregraduate and postgraduate study.

 

The third working group will deal with the issues and the level of care for pregnant immigrant mothers in the Czech Republic in the areas of prenatal, natal and postnatal care, with focus on their traditional cultural, religious customs from their countries of origin.

The working group members will take part in regular meetings of the European COST steering committee as well as in the meetings of national researchers.

 

The fourth working group will process and assess the results of own research. The research team members will consider the results they can use in integration of the medical and salutogenic principles. The results will be consulted in the central COST steering bodies. Further, external examination processes will take place. The research team members will hold lectures for service users and academic workers, publish, etc. The sources of the information will be national sources, but knowledge from central working groups from all over Europe will be used.

 

The fifth working group will deal with building of systems of www. sites, innovative transfer of knowledge and technologies. They will provide for connection to European networks dealing with the respective issues.

All working groups will include experts from the areas of medicine, ethics, bioethics, psychology, statistics and IT workers. The groups will make use of experience and knowledge of a broad range of coworkers and cooperating institutions. The results will bep rocessed statistically and graphically.

The working group members will take part in regular meetings of the European COST steering committee as well as in the meetings of national researchers.

 

Research sets:

The first set will be subject to secondary analysis of data of medical documentation. A database with assessment of selected medical and salutogenic principles will be created.
The data collection will be acquired from 250 records of physiological pregnancies and deliveries. The research will be implemented retrospectively in one part and prospectively in other part.

 

The first set will be subject to secondary analysis of data of medical documentation. A database with assessment of selected medical and salutogenic principles will be created.
Data collection from 200 deliveries with medical indications for episiotomies. The research will be implemented retrospectively in one part and prospectively in other part.

 

The first set will be subject to secondary analysis of data of medical documentation. A database with assessment of selected medical and salutogenic principles will be created. Data collection from 150 deliveries with medical indications for Caesarian sections. The research will be implemented retrospectively in one part and prospectively in other part.

 

The fourth set will be subject to interviews related to deliveries of children under 1000 grams.

 

The fifth set will be subject to secondary analysis of 150 case studies in which termination of pregnancy was performed.

 

The sixth set - 150 immigrant mothers - will be subject to qualitative or narrative research. A research team member will act as interviewer.

 

The secondary analysis of the medical documentation will be assessed according to selected medical and salutogenic influences.

 

The assessed salutogenic influences will include: lifestyle, housing level, place of delivery, partner relationship, age of parents, parity, father's activity in pregnancy and during birth, alcohol and tobacco or drug abuse, fear from delivery, experience from delivery, stresses in ages under 18, optimism, ability to relax, satisfaction in job, assertiveness, fear from future, etc.

 

The emphasized medical principles will include: indications for provocation of premature uterine contractions, indications for episiotomy, for Caesarian sections, baby's weight, mother's anamnesis, etc.

Informed consent will be available in indicated cases.

5. Partial stages

Identification number

Name

Start of research

End of research

E001

Monitor the current status of perinatal care and approaches of care on a sample of population of pregnant women and immigrant mothers in the Czech Republic. Create www sites of the project and interconnect with European databases.

03/2013

06/2014

E002

Monitor the comprehensive system of care and medical and salutogenic approaches in prenatal, intraanatal and postnatal care for pregnant women and mothers in the Czech Republic. Continue interconnecting with European databases.

03/2013

06/2014

E003

VElaborate a comprehensive proposal for integrated medical and salutogenic approaches in the issues of prenatal, intranatal and postnatal care for mother and child.

12/2013

06/2014

E004

Process the conclusions acquired in the project in form of final report and monograph, in Czech and in English. Elaborate a proposal for a new follow-up project for a national or European agency dealing with these issues.

01/2014

06/2014

1. Identification data of the project

Project registration number

LD13045

Project submission denomination

Milosj

Project name

Medical and salutogenic approaches and their integration in prenatal and postnatal care for Czech women with special emphasis on immigrants

COMPETITION OF TENDERERS

VSMSMTPMS12 - Competition of tenderers in research, development and innovations (VES13) - VaVaI programs for support of international cooperation in research and development

PROGRAM

LD - COST CZ

Research period

03/ 2013 – 6/2014

Receiver

University of South Bohemia in České Budějovice

Researcher

Velemínský Miloš MUDr. Ph.D.

4. Project goals

 

Project results

Identification number

Name

Achievement date

Implementation date

V001

Acquire information focused on care for pregnant immigrant woman, her needs and their implementation in the Czech Republic.

09/2013

12/2013

V002

Acquire information on current medical and salutogenic methods in perinatal care for Czech women

09/2013

01/2014

V003

Elaborate proposal for comprehensive care for immigrant mothers living in the Czech Republic

01/2014

06/2014

V004

Elaborate proposal for integrated medical and salutogenic prenatal care in the Czech Republic

12/2013

03/2014

V005

Elaborate proposal for integrated medical and salutogenic intranatal and postnatal care in the Czech Republic

12/2013

03/2014

V006

Create own www sites to inform about the results of the research related to integration of medical and salutogenic concepts

06/2013

06/2014

V007

Implement cooperation with European databases dealing with integration of medical and salutogenic procedures

08/2013

06/2014

V008

Elaborate a comprehensive final report related to integration of medical and salutogenic procedures in perinatal, intranatal and postnatal period of Czech women

03/2014

06/2014

2. Project mission

  • Monitor the medical approach in care for pregnant woman, foetus and newborn in the Czech Republic.
  • Monitor the salutogenic principles and influences in care for pregnant woman, foetus and newborn in the Czech Republic.
  • Monitor prenatal, intranatal and postnatal care for pregnant women, mothers, newborns of migrants - the least from among three countries.
  • Elaborate proposal for comprehensive care for the woman and the children in perinatal period, integrating medical and salutogenic principles and influences.
  •  A distinctive part of the project will consist in monitoring and elaboration of the system of care for pregnant immigrant mothers. - Elaborate a system of care corresponding to cultural conditions of the country of origin.
  • Another goal consists in preserving high standard in the Czech Republic, i.e. low values of mortality and morbidity of children and mothers under integrated approach of salutogenic and medical principles.
  •   Elaborate a system of care within European countries, corresponding to cultural and philosophical situation of the Czech Republic, to avoid and reduce the iatrogenic damage of the foetus, the newborn and the mother in the course of prenatal, intranatal and postnatal care.
  •   FTPD = first-trimester prenatal diagnosis.
  • Elaborate a system of comprehensive care for immigrant mothers and their children, by country of origin.
  • Based on monitoring and analysis of current medical procedures, elaborate a proposal related to perinatal care in Europe.
  • Develop scientific knowledge focused on improvement and provision of care in motherhood and on application of its results.
  • Publish the acquired experience and knowledge in peer-reviewed journals and cooperate with databases engaged in motherhood issues in Europe.
  •   Create websites to publish the newest pieces of knowledge and results both of Czech experts and of other participants of this project.
  •   Establish contacts to European networks containing the issues in question.
  • The research team will include also students of master and doctor study, which will support the growth of the young scientists.


The goals can be summarized in two paradigms.
Two paradigm areas will be researched:

  • prenatal diagnosis (FDTP, where the discussion of the risks becomes a part of prenatal care)
  • the influence of routine intervention into uterine contractions, i.e. medical provocation of uterine contractions on iatrogenic procedures of delivery guidance, including indications for so called "request" Caesarian sections.