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Collins CH, Skarparis K. The experiences of pregnancy and NHS maternity care for women who have been trafficked: A qualitative study. Midwifery 2024; 135:104040. [PMID: 38878620 DOI: 10.1016/j.midw.2024.104040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 05/23/2024] [Accepted: 05/28/2024] [Indexed: 07/07/2024]
Abstract
PROBLEM Little is known about the maternity experiences of women who have been trafficked and further investigation is needed to better inform midwifery practice and to ensure that the voices of women are heard when developing guidance. BACKGROUND People who have been trafficked experience a range of health problems that could impact on pregnancy. AIM The aim of this study was to explore the experiences of pregnancy and NHS maternity care for women who have been trafficked, as well as increasing understanding of social and health factors that may impact on pregnancy outcomes. METHODS A qualitative interview study was conducted. Participants (professionals and service users) were recruited using purposive sampling. Data were analysed using thematic analysis. FINDINGS Seventeen interviews were conducted (5 service users and 12 professionals). Five themes were identified: 'One Size Fits All', 'Loss of Control', 'Social Complexity', 'Bridging Gaps', and 'Emotional Load'. DISCUSSION Our findings identify that women are expected to fit into a standardised model of maternity care that does not always recognise their complex individual physical, emotional or social needs, or provide them with control. Support workers play a vital role in helping women navigate and make sense of their maternity care. CONCLUSION Despite the issues identified, our research highlighted the positive impact of individualised care, particularly when women received continuity of care. A joined-up, trauma-informed approach between midwives and support workers could help improve care for women who have been trafficked.
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Affiliation(s)
- Catherine H Collins
- Northumbria University, Coach Lane Campus East, Newcastle upon Tyne, NE7 7XA, United Kingdom; Department of Nursing Midwifery and Health, Faculty of Health and Life Sciences, (At the time when research was conducted), United Kingdom.
| | - Katy Skarparis
- Northumbria University, Coach Lane Campus East, Newcastle upon Tyne, NE7 7XA, United Kingdom; Department of Nursing Midwifery and Health, Faculty of Health and Life Sciences, (At the time when research was conducted), United Kingdom
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Huo W, He M, Zeng Z, Bao X, Lu Y, Tian W, Feng J, Feng R. Impact Analysis of COVID-19 Pandemic on Hospital Reviews on Dianping Website in Shanghai, China: Empirical Study. J Med Internet Res 2024; 26:e52992. [PMID: 38954461 PMCID: PMC11252617 DOI: 10.2196/52992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 01/24/2024] [Accepted: 05/21/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND In the era of the internet, individuals have increasingly accustomed themselves to gathering necessary information and expressing their opinions on public web-based platforms. The health care sector is no exception, as these comments, to a certain extent, influence people's health care decisions. During the onset of the COVID-19 pandemic, how the medical experience of Chinese patients and their evaluations of hospitals have changed remains to be studied. Therefore, we plan to collect patient medical visit data from the internet to reflect the current status of medical relationships under specific circumstances. OBJECTIVE This study aims to explore the differences in patient comments across various stages (during, before, and after) of the COVID-19 pandemic, as well as among different types of hospitals (children's hospitals, maternity hospitals, and tumor hospitals). Additionally, by leveraging ChatGPT (OpenAI), the study categorizes the elements of negative hospital evaluations. An analysis is conducted on the acquired data, and potential solutions that could improve patient satisfaction are proposed. This study is intended to assist hospital managers in providing a better experience for patients who are seeking care amid an emergent public health crisis. METHODS Selecting the top 50 comprehensive hospitals nationwide and the top specialized hospitals (children's hospitals, tumor hospitals, and maternity hospitals), we collected patient reviews from these hospitals on the Dianping website. Using ChatGPT, we classified the content of negative reviews. Additionally, we conducted statistical analysis using SPSS (IBM Corp) to examine the scoring and composition of negative evaluations. RESULTS A total of 30,317 pieces of effective comment information were collected from January 1, 2018, to August 15, 2023, including 7696 pieces of negative comment information. Manual inspection results indicated that ChatGPT had an accuracy rate of 92.05%. The F1-score was 0.914. The analysis of this data revealed a significant correlation between the comments and ratings received by hospitals during the pandemic. Overall, there was a significant increase in average comment scores during the outbreak (P<.001). Furthermore, there were notable differences in the composition of negative comments among different types of hospitals (P<.001). Children's hospitals received sensitive feedback regarding waiting times and treatment effectiveness, while patients at maternity hospitals showed a greater concern for the attitude of health care providers. Patients at tumor hospitals expressed a desire for timely examinations and treatments, especially during the pandemic period. CONCLUSIONS The COVID-19 pandemic had some association with patient comment scores. There were variations in the scores and content of comments among different types of specialized hospitals. Using ChatGPT to analyze patient comment content represents an innovative approach for statistically assessing factors contributing to patient dissatisfaction. The findings of this study could provide valuable insights for hospital administrators to foster more harmonious physician-patient relationships and enhance hospital performance during public health emergencies.
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Affiliation(s)
- Weixue Huo
- Department of Vascular Surgery, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Mengwei He
- Department of Vascular Surgery, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Zhaoxiang Zeng
- Department of Vascular Surgery, Changhai Hospital, Navy Medical University, Shanghai, China
| | - Xianhao Bao
- Department of Vascular Surgery, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Ye Lu
- Department of Vascular Surgery, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Wen Tian
- Department of Vascular Surgery, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China
| | - Jiaxuan Feng
- Vascular Surgery Department, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Rui Feng
- Department of Vascular Surgery, Shanghai General Hospital, Shanghai Jiaotong University, Shanghai, China
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Behmanesh F, Alijanpour M, Yahyavi F, Nikpour M, Haghighi T, Karimnezhad Sorkhi F, Mohsenzadeh F, Hajian K, Faramarzi M. Spiritual Health, Anxiety and Fear of Childbirth in Iran: Is there Any Relationship? JOURNAL OF RELIGION AND HEALTH 2024:10.1007/s10943-024-02067-8. [PMID: 38850299 DOI: 10.1007/s10943-024-02067-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/18/2024] [Indexed: 06/10/2024]
Abstract
The most common reason for mothers' request for a cesarean section is fear of childbirth. The present study was conducted to determine the relationship between spiritual health and anxiety and fear of childbirth in pregnant women. This correlational cross-sectional study was performed on 426 pregnant women who were referred to Yahyanejad Hospital in Babol, Iran, during 2018-2021. These pregnant women were hospitalized in the maternity ward for vaginal delivery. Convenience sampling bases on inclusion criteria were done to select the subjects. The questionnaires used in this study included Demographic and Obstetric Questionnaire, Anxiety and Fear of Childbirth Questionnaire by Pirdel et al., and Palutzian & Ellison Spiritual Well-being Scale. Data were analyzed using SPSS version 16 using descriptive and analytical indicators and linear and multiple correlation tests. The results of the study showed that all pregnant women experienced moderate (23.1) or severe (76.9) fear and anxiety, and none of the women had low fear and anxiety. Moreover, all women in this study had moderate (50.5) or high (49.5) spiritual health. The results of linear regression test showed that there is a significant and inverse relationship between spiritual health and anxiety and fear of childbirth (R: - 0.12, CI - 0.14, - 0.019, P = 0.011). Furthermore, the results of multivariate linear regression test after adjustments for intervening demographic and midwifery variables showed a significant relationship between spiritual health (R: - 0.12, CI - 0.14, - 0.02, P = 0.009), education level and number of pregnancies, and anxiety and fear of childbirth. The results of the study showed that with the increase in spiritual health, anxiety and fear of childbirth decreases. Therefore, it can be inferred that women need spiritual care in addition to medical care to deal with fear and anxiety during pregnancy and childbirth.
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Affiliation(s)
- Fereshteh Behmanesh
- Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Islamic Republic of Iran
| | - Masoumeh Alijanpour
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Islamic Republic of Iran
| | - Fatemeh Yahyavi
- Department of Midwifery, Babol Branch, Islamic Azad University, Babol, Islamic Republic of Iran
| | - Maryam Nikpour
- Non-Communicable Pediatric Diseases Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Islamic Republic of Iran.
| | - Tahereh Haghighi
- Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Islamic Republic of Iran
| | | | - Farideh Mohsenzadeh
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Islamic Republic of Iran
| | - Karimollah Hajian
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Islamic Republic of Iran
| | - Mahbobeh Faramarzi
- Population, Family and Spiritual Health Research Center, Health Research Center, Babol University of Medical Sciences, Babol, Islamic Republic of Iran
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Souto SP, Prata AP, Albuquerque RS, Caldeira S. Discussing the midwifery scope of practice within the NANDA-I taxonomy. Int J Nurs Knowl 2024. [PMID: 38829159 DOI: 10.1111/2047-3095.12473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 05/14/2024] [Indexed: 06/05/2024]
Abstract
PURPOSE To discuss the midwifery scope of practice within the NANDA-I taxonomy. METHODS Review of the NANDA-I taxonomy followed by critical analysis of the nursing diagnoses (NDs) within the scope of midwifery practice. Search terms were defined. Two authors independently analyzed all diagnoses, and another author validated the results. FINDINGS Of the 267 NDs in the NANDA-I taxonomy, 39 (14.6%) perceived a relationship with midwifery's scope of practice, and among these, 15 (5.6%) guaranteed greater specificity and accuracy for clinical reasoning. CONCLUSIONS The suitability of NDs for the broad spectrum of the midwifery scope of practice may need to be completed. Women's responses to life events and health conditions are simultaneously complex and specific, and many NDs in the NANDA-I terminology may be far from fully identified and developed to represent these responses. IMPLICATIONS FOR NURSING PRACTICE Improvements in NANDA-I diagnosis would contribute to advanced terminology and increased specificity and accuracy of the diagnostic process. This is important in achieving appropriate outcomes and safe and effective interventions for which the nurses and nurse-midwives are accountable. Many NDs would not necessarily be used in any other context since they are specific to midwifery; however, it would help to develop a NANDA-I taxonomy that is more inclusive and comprehensive internationally.
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Affiliation(s)
- Sandra P Souto
- Faculty of Health Sciences and Nursing, Centre for Interdisciplinary Research in Health, Universidade Católica Portuguesa, Porto, Portugal
| | - Ana Paula Prata
- CINTESIS@RISE-Centre for Health Technology and Services Research, Nursing School of Porto, Porto, Portugal
| | | | - Sílvia Caldeira
- Faculty of Health Sciences and Nursing, Centre for Interdisciplinary Research in Health, Universidade Católica Portuguesa, Lisbon, Portugal
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Nordin-Remberger C, Wells MB, Woodford J, Lindelöf KS, Johansson M. Preferences of support and barriers and facilitators to help-seeking in pregnant women with severe fear of childbirth in Sweden: a mixed-method study. BMC Pregnancy Childbirth 2024; 24:388. [PMID: 38796427 PMCID: PMC11127315 DOI: 10.1186/s12884-024-06580-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 05/13/2024] [Indexed: 05/28/2024] Open
Abstract
BACKGROUND There are few support interventions for women with fear of childbirth tailored towards type of fears and parity. To inform the future development of an acceptable and relevant intervention for women with severe fear of childbirth, primary objectives were to examine: (1) pregnant women's experiences of and preferences for support and (2) barriers and facilitators to help-seeking. Secondary objectives were to examine if there are any differences based on pregnant women's parity. METHODS Pregnant women with a severe fear of childbirth in Sweden completed an online cross-sectional survey between February and September 2022. Severe fear of childbirth was measured using the fear of childbirth scale. Quantitative data were analysed using descriptive and inferential statistics and free answers were analysed using manifest content analysis. A contiguous approach to integration was adopted with qualitative and quantitative findings reported separately. RESULTS In total, 609 participants, 364 nulliparous and 245 parous women, had severe fear of childbirth. The main category "A twisting road to walk towards receiving support for fear of childbirth" was explored and described by the generic categories: Longing for support, Struggling to ask for support, and Facilitating aspects of seeking support. Over half (63.5%), of pregnant women without planned or ongoing treatment, wanted support for fear of childbirth. Most (60.2%) pregnant women with ongoing or completed fear of childbirth treatment regarded the treatment as less helpful or not at all helpful. If fear of childbirth treatment was not planned, 35.8% of women would have liked to have received treatment. Barriers to help seeking included stigma surrounding fear of childbirth, previous negative experiences with healthcare contacts, fear of not being believed, fear of not being listened to, and discomfort of having to face their fears. Facilitators to help seeking included receiving respectful professional support that was easily available, flexible, and close to home. CONCLUSIONS Most pregnant women with severe fear of childbirth felt unsupported during pregnancy. Findings emphasise the need to develop individual and easily accessible psychological support for women with severe fear of childbirth, delivered by trained professionals with an empathetic and respectful attitude.
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Affiliation(s)
- Carita Nordin-Remberger
- Obstetric and Reproductive Health Research, Department of Women´s and Children´s Health, Uppsala University, Uppsala, 752 37, Sweden.
- Women's Mental Health during the Reproductive Lifespan - WOMHER, Uppsala University, Uppsala, Sweden.
| | - Michael B Wells
- Women's and Children's Health, Karolinska Institute, Solna, Sweden
| | - Joanne Woodford
- Healthcare Sciences and e-Health, Department of Women´s and Children´s Health, Uppsala University, Uppsala, Sweden
| | | | - Margareta Johansson
- Obstetric and Reproductive Health Research, Department of Women´s and Children´s Health, Uppsala University, Uppsala, 752 37, Sweden
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Chen C, Hussein SZB, Nasri NWM, Yao J, Qin Y, Zhao Z, Zuo K. Fear of childbirth among pregnant women: A concept analysis. J Adv Nurs 2024. [PMID: 38738562 DOI: 10.1111/jan.16218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 04/01/2024] [Accepted: 04/24/2024] [Indexed: 05/14/2024]
Abstract
AIM To clarify the concept of fear of childbirth among pregnant women and to examine its current measure tools. BACKGROUND Fear of childbirth is a psychological symptom, prevalent among pregnant women, which negatively impacts women's health and well-being. It has become an increasingly concerning issue in perinatal mental health. However, due to its poor conceptualization, it presents difficulty in conducting reliable assessments and identifying risk factors. METHODS The Walker and Avant approach to concept analysis guided this review. Six bibliographic databases were systematically searched for published research from their inception date to May 2023. Additional records were identified by manually searching the reference lists of relevant studies. Quantitative and qualitative studies investigating fear of childbirth in pregnant women were included. RESULTS Three critical attributes have been identified: cognitive impairments, affective disorders and somatic symptoms. Antecedents include perceived a real or anticipated threat of pregnancy or its outcomes, low perceived self-coping ability and unmet social support needs. Consequences include processing and avoiding behaviours. This study also identified the dimensions of fear of childbirth, including 6 primary categories and 14 subcategories. The content of five scales was analysed and none covered all domains. CONCLUSIONS The current analysis provides healthcare providers with a more comprehensive framework to assess and identify fear of childbirth. Further research is needed to develop a suitable instrument that covers all the attributes and dimensions of this concept and assesses its severity. IMPACT This conceptual analysis provides a comprehensive insight into the phenomenon of fear of childbirth. This will help family members, healthcare providers and policymakers to identify the psychological needs of pregnant women and improve the quality of antenatal care. PATIENT OR PUBLIC CONTRIBUTION Not applicable as no new data were generated.
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Affiliation(s)
- Chunning Chen
- School of Nursing, Hebei Medical University, Shijiazhuang, Hebei, China
- Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Noor Wahidah Mohd Nasri
- Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Jiasi Yao
- School of Nursing, Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yanyue Qin
- School of Nursing, Hebei Medical University, Shijiazhuang, Hebei, China
| | - Ziteng Zhao
- School of Nursing, Hebei Medical University, Shijiazhuang, Hebei, China
| | - Ke Zuo
- School of Nursing, Hebei Medical University, Shijiazhuang, Hebei, China
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Bartholomew V, Hundley V, Clark CJ, Parris BA. The RETHINK Study: Could pain catastrophising explain why some women are more likely to attend hospital during the latent phase of labour. SEXUAL & REPRODUCTIVE HEALTHCARE 2024; 39:100941. [PMID: 38104503 DOI: 10.1016/j.srhc.2023.100941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 12/01/2023] [Accepted: 12/04/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVE To examine the prevalence of pain catastrophising and identify whether it impacts on the timing of hospital admission when in labour. METHODS A longitudinal cohort study. Nulliparous women, experiencing an uncomplicated pregnancy in England, were recruited between 25 and 33 weeks gestation. Participants completed two online questionnaires, (1) on recruitment, including the Pain Catastrophizing Scale (PCS) and the Wijma Delivery Expectancy Questionnaire (WDEQ-A) (2) at three weeks postnatal. RESULTS A total of 389 eligible participants entered the study. The percentage of women who were pain catastrophisers (PCS ≥ 20) was 28.1 %, while 7.6 % had a high pain catastrophising score (PCS ≥ 30). There was no association between pain catastrophising and the timing of hospital admission. The percentage of women reporting fear of childbirth (WDEQ-A score of ≥ 85) was 10.6 %. Fear of childbirth was highly associated with PCS scores (p <.001) at both the lower (≥20) and higher (≥30) thresholds. CONCLUSION Although not statistically significant, there was a tendency for women who pain catastrophise to present to hospital in the latent phase. The highly significant association between PCS and WDEQ-A scores has implications for the identification of these women and suggests that the PCS can be used as a screening tool to identify those women who have heightened fear around pain and who may also go on to develop clinically relevant fear of childbirth. Further studies are needed to confirm the acceptability of the PCS as a screening tool with women.
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Affiliation(s)
- V Bartholomew
- Centre for Midwifery & Women's Health, Bournemouth University, Faculty of Health and Social Sciences, Bournemouth Gateway Building, St Paul's Lane, Bournemouth BH8 8GP, United Kingdom.
| | - V Hundley
- Centre for Midwifery & Women's Health, Bournemouth University, Faculty of Health and Social Sciences, Bournemouth Gateway Building, St Paul's Lane, Bournemouth BH8 8GP, United Kingdom
| | - C J Clark
- Centre for Midwifery & Women's Health, Bournemouth University, Faculty of Health and Social Sciences, Bournemouth Gateway Building, St Paul's Lane, Bournemouth BH8 8GP, United Kingdom
| | - B A Parris
- Department of Psychology, Bournemouth University, Poole House P331, Talbot Campus, Fern Barrow, Poole BH12 5BB, United Kingdom
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Gökçe İsbir G, Serçekuş P, Yenal K, Okumuş H, Durgun Ozan Y, Karabulut Ö, Abbasoğlu D, Gönenç İM, Sarı E, Aktaş S, Erdoğan S. The prevalence and associated factors of fear of childbirth among Turkish pregnant women. J Reprod Infant Psychol 2024; 42:62-77. [PMID: 35345941 DOI: 10.1080/02646838.2022.2057938] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 03/20/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE This study was conducted to determine the prevalence of fear of childbirth and affecting factors in pregnant women in Turkey. MATERIALS AND METHODS This was a cross-sectional study and included a total of 2025. Pregnant Women Assessment, some variables related to previous and current perinatal processes and Wijma Delivery Expectancy/Experience Questionnaire (version A) were used for data collection. FINDINGS In this sample, 42.4% of the women reported fear of childbirth. What the women were afraid of most was the development of unwanted conditions at childbirth, obscurity/uncertainty, and negative attitudes of health professionals. The factors causing fear of childbirth were the low education level, unemployment status, low financial status, stillbirth, unplanned pregnancy, indecisiveness about the type of delivery, not attending prenatal education programs, negative effects of other people, insufficient social support, confiding in the healthcare centre and health professional, negative, and indecisive birth perceptions, prior negative birth experiences and not feeling ready for childbirth (p < 0.001). CONCLUSIONS The prevalence of fear of childbirth in this Turkish sample, especially in the multipara is higher than in Western countries. Causes of fear of childbirth can vary with countries and even with each region of a country.
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Affiliation(s)
- Gözde Gökçe İsbir
- School of Health, Midwifery Department, Mersin University, Mersin, Turkey
| | - Pınar Serçekuş
- Faculty of Nursing, Pamukkale University, Denizli, Turkey
| | - Kerziban Yenal
- School of Health, Nursing Department, European University of Lefke, Turkish Republic of Northern, Cyprus
| | - Hülya Okumuş
- Faculty of Nursing, (Retaıred), Dokuz Eylul University, İzmir, Turkey
| | - Yeter Durgun Ozan
- Ataturk Faculty of Health Scıence, Nursıng Department, Dicle University, Diyarbakır, Turkey
| | | | - Döne Abbasoğlu
- Midwife, Istanbul Zeynep Kamil Hospital, İstanbul, Turkey
| | | | - Esra Sarı
- Faculty of Health Scıences, Mıdwıfery Department, Van Yuzuncu Yil University, Van, Turkey
| | - Songül Aktaş
- Faculty of Health Sciences, Mıdwıfery Department, Karadeniz Teknik University, Trabzon, Turkey
| | - Semra Erdoğan
- Faculty of Medical, Mersin University, Mersin, Turkey
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Ketley R, Darwin Z, Masterson C, McGowan L. Women's experience of post-traumatic growth following a traumatic birth: an interpretive phenomenological analysis. J Reprod Infant Psychol 2024; 42:126-137. [PMID: 35475719 DOI: 10.1080/02646838.2022.2070608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 04/20/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Approximately 3-5% of women experience post-traumatic stress disorder following birth; positive experiences that can follow traumatic birth are under-researched. AIMS AND OBJECTIVES To explore how women experience post-traumatic growth following a traumatic birth. METHODS Interpretative Phenomenological Analysis was used to explore experiences of women who self-identified as having found positive benefits through coping with a traumatic birth. Eight women who had birthed in the past five years in the UK were recruited online and interviewed face-to-face. RESULTS Three superordinate themes were developed: 'The total opposite to what I'd expected' (participants' struggle to understand and integrate their birth experience in the postnatal period); 'I see it a bit differently now' (processes experienced in coming to a place of growth); and 'A much better place' (experienced growth 'outcomes'). DISCUSSION Faced with shattered assumptions whereby their birth experiences contrasted with their expectations, participants felt their identities as women and mothers were challenged. In overcoming these challenges, participants described actively striving to cope and make sense of their experience. Multiple factors facilitated this, notably partner support, telling their birth story, acknowledging the impact and developing a compassionate narrative. Although growth was experienced in ways commonly reported by survivors of challenging life events, some aspects appeared pertinent to birth trauma. CONCLUSIONS Widening our understanding of the range of experiences following traumatic birth and making these narratives public may offer hope for some women and families and inform health professionals' education and practice. Further research would be needed before advocating interventions to foster post-traumatic growth.
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Affiliation(s)
- Rhianna Ketley
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
- Sexual Health Psychology Service., Central and North West London NHS Foundation Trust, London, UK
| | - Zoe Darwin
- School of Human and Health Sciences, University of Huddersfield, UK
| | - Ciara Masterson
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Linda McGowan
- School of Healthcare, University of Leeds, Leeds, UK
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Ibrahim HA, Alshahrani MS, Elgzar WTI. Determinants of Prenatal Childbirth Fear during the Third Trimester among Low-Risk Expectant Mothers: A Cross-Sectional Study. Healthcare (Basel) 2023; 12:50. [PMID: 38200956 PMCID: PMC10778686 DOI: 10.3390/healthcare12010050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 12/14/2023] [Accepted: 12/22/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Fear of Childbirth (FOC) can significantly impact women's physical and psychological health; therefore, healthcare providers must provide proactive care, which means they have to intervene before FOC becomes tokophobia. This study's purpose is to evaluate the determinants of prenatal childbirth fear during the third trimester among low-risk expectant mothers. METHODS A cross-sectional comparative study was conducted at the Maternal and Children Hospital's outpatient clinics in Najran City, Saudi Arabia, from April to July 2023. The study involved 377 nulliparous and multiparous women, using a systemic random sampling technique. The data were collected using an interview schedule composed of questions related to demographic and obstetrics characteristics, the FOC questionnaire, and a multidimensional scale of perceived social support. Significant FOC predictors were examined using a binary logistic regression model. RESULTS There was a statistically significant difference between nulliparous and multiparous participants concerning FOC; 80.0% of nulliparous participants had significant FOC compared to 67.8% of multiparous participants (p = 0.011). A binary logistic regression clarified that regular antenatal care and family and spousal support were significantly negatively correlated with significant FOC among multiparous and nulliparous women (p < 0.05). For multiparas, FOC was associated with pregnancy planning and previous labor-related complications. In addition, friends' support was an important predictor of significantly lower FOC among nulliparous women (p < 0.05). CONCLUSIONS Significant FOC was higher in nulliparous women when compared to multiparous women. Numerous obstetric variables and different types of social support play important roles in significant FOC. Special attention and support should be provided to high-risk women for proper FOC management during prenatal classes to improve their childbirth experiences.
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Affiliation(s)
- Heba A. Ibrahim
- Nursing College, Najran University, Najran 66261, Saudi Arabia
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Dai J, Shi Y, Guo L, Wang Y, Kong X. Discrepancy in parental fear of childbirth: A scoping review. Midwifery 2023; 126:103830. [PMID: 37769587 DOI: 10.1016/j.midw.2023.103830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/15/2023] [Accepted: 08/25/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Fear of childbirth is a prevalent clinical psychological issue for both mother and father; however, there is a lack of research comparing and summarizing discrepancies in parental fear of childbirth. AIM This study aimed to explore differences in parental fear of childbirth, identify gaps in related research area, and provide directions for future studies. METHODS Original references were searched from six databases by using subject terms associated with fear of childbirth. The guideline of the scoping review framework proposed by Arksey and O' Malley were applied. RESULTS The review covered 203 publications in all. Of them, 181 were maternal studies and 22 were paternal studies. 105 articles examined prevalence and influencing factors ranging from 0.7 % to 89.3 % in mothers and 5 % to 54.3 % in fathers. The current study included 84 influencing factors, 9 of which were common to parents and 75 of which were different, containing fathers' specific influences on fear of childbirth are perceived pregnancy difficulties, perceived birth difficulties, feelings about the upcoming birth, more frequent thoughts of birth in the middle of pregnancy and not attending parent education classes. 12 articles dealt with the experience of fear of childbirth, and the parents' fear of childbirth had 5 common themes, including fear of the birthing process, fear related to the baby, fear of lack of support, fear of postnatal health and life, and adverse psychological problems. But they have different sub-themes. 61 articles on fear of childbirth interventions, including 8 mother-specific approaches and 4 identical approaches for parents, and all of these methods were effective in reducing the prevalence of parental fear of childbirth. CONCLUSION Factors such as marital status, personality, etc., that are specific to mothers can also be applied to paternal fear of childbirth. Cognitive-behavioral therapy and group discussion, which are unique to maternal fear of childbirth, may be attempted for paternal fear of childbirth. In addition, future research should be devoted to developing a specific measurement tool for fathers, studying paternal fear of childbirth in depth from various aspects.
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Affiliation(s)
- Jiayang Dai
- School of Nursing and School of Public Health, Yangzhou University, China
| | - Ya Shi
- School of Nursing and School of Public Health, Yangzhou University, China; School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, England
| | - Lu Guo
- School of Nursing and School of Public Health, Yangzhou University, China
| | - Yuanyuan Wang
- School of Nursing and School of Public Health, Yangzhou University, China
| | - Xiang Kong
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, Jiangsu Province, China; Jiangsu Key Laboratory of Experimental & Translational Non-coding RNA Research, Yangzhou, Jiangsu Province, China; Department of Obstetrics and Gynecology, Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu Province, China.
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12
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Mbata MK, Boesing M, Lüthi-Corridori G, Jaun F, Vetter G, Gröbli-Stäheli J, Leuppi-Taegtmeyer AB, Frey Tirri B, Leuppi JD. The Correct Indication to Induce Labour in a Swiss Cantonal Hospital. J Clin Med 2023; 12:6515. [PMID: 37892653 PMCID: PMC10607527 DOI: 10.3390/jcm12206515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/04/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Induction of labour (IOL) is a way to stimulate the onset of labour using mechanical and pharmacological methods. IOL is one of the most frequently performed obstetric procedures worldwide. We aimed to determine compliance with guidelines and to investigate factors associated with the success of labour. METHODS In this retrospective, observational study, we analysed all induced deliveries in a Swiss hospital between January 2020 and December 2022. RESULTS Out of 1705 deliveries, 349 women underwent IOL, and 278 were included in this study, with an average age of 32 years (range 19-44 years). Most of the women were induced for missed deadlines (20.1%), the premature rupture of membranes (16.5%), and gestational diabetes mellitus (9.3%), and there was a good adherence to the guideline, especially with the indication and IOL monitoring (100%). However, an improvement needs to be made in measuring and documenting the Bishop score (41%). The success of labour was associated with multiparity (81.8% vs. 62.4% p = 0.001) and maternal non-obesity (73.4 vs. 54.1% p = 0.026). CONCLUSIONS An improvement is needed in the measurement and documentation of the Bishop score. Further research is needed to confirm the found associations between parity, obesity, and the success of IOL.
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Affiliation(s)
- Munachimso Kizito Mbata
- University Institute of Internal Medicine, Cantonal Hospital Baselland, Rheinstrasse 26, 4410 Liestal, Switzerland
- Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056 Basel, Switzerland
| | - Maria Boesing
- University Institute of Internal Medicine, Cantonal Hospital Baselland, Rheinstrasse 26, 4410 Liestal, Switzerland
- Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056 Basel, Switzerland
| | - Giorgia Lüthi-Corridori
- University Institute of Internal Medicine, Cantonal Hospital Baselland, Rheinstrasse 26, 4410 Liestal, Switzerland
- Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056 Basel, Switzerland
| | - Fabienne Jaun
- University Institute of Internal Medicine, Cantonal Hospital Baselland, Rheinstrasse 26, 4410 Liestal, Switzerland
- Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056 Basel, Switzerland
| | - Grit Vetter
- Department of Gynaecology and Obstetrics, Cantonal Hospital Baselland, Rheinstrasse 26, 4410 Liestal, Switzerland
| | - Jeanette Gröbli-Stäheli
- Department of Gynaecology and Obstetrics, Cantonal Hospital Baselland, Rheinstrasse 26, 4410 Liestal, Switzerland
| | - Anne B. Leuppi-Taegtmeyer
- Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056 Basel, Switzerland
- Hospital Pharmacy, Cantonal Hospital Baselland, Rheinstrasse 26, 4410 Liestal, Switzerland
- Department of Patient Safety, Medical Directorate, University Hospital Basel, Schanzenstrasse 55, 4056 Basel, Switzerland
| | - Brigitte Frey Tirri
- Department of Gynaecology and Obstetrics, Cantonal Hospital Baselland, Rheinstrasse 26, 4410 Liestal, Switzerland
| | - Jörg D. Leuppi
- University Institute of Internal Medicine, Cantonal Hospital Baselland, Rheinstrasse 26, 4410 Liestal, Switzerland
- Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056 Basel, Switzerland
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Mefrouche ML, Siegmann EM, Böhme S, Berking M, Kornhuber J. The Effect of Digital Mindfulness Interventions on Depressive, Anxiety, and Stress Symptoms in Pregnant Women: A Systematic Review and Meta-Analysis. Eur J Investig Health Psychol Educ 2023; 13:1694-1706. [PMID: 37754461 PMCID: PMC10529137 DOI: 10.3390/ejihpe13090122] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/21/2023] [Accepted: 08/25/2023] [Indexed: 09/28/2023] Open
Abstract
Introduction. Pregnancy is a unique time in a woman's life that can be both exciting and challenging. It is also a period that can be associated with significant stress, anxiety, and depression, which can have negative consequences for both the mother and the baby. Mindfulness interventions are known to be a well-suited treatment and prevention method for psychiatric symptoms in pregnancy, and web-based applications have been explored. We here present an up-to-date systematic review and meta-analysis of randomized-controlled trials to investigate the effect of digital-based mindfulness interventions on depressive, anxiety, and stress symptoms during pregnancy. Methods. The systematic literature search and data extraction was performed by two independent raters. It resulted in 13 eligible studies overall comprising 1373 participants. We conducted random-effects meta-analyses for depressive, anxiety, and stress symptoms after completion of a digital mindfulness intervention (compared to a control group). Results. Digital mindfulness intervention methods were significantly able to reduce depression (g = -0.47, 95% CI [-0.9; -0.09]) and anxiety symptoms (g = -0.41, 95% CI [-0.77; -0.05]), but not stress symptoms. These effects were moderated by the attrition rate (βDepression = 0.025, pDepression < 0.01; βAnxiety = 0.022, pAnxiety < 0.01; βStress = 0.022, pStress < 0.01). Primiparity also had a significant influence on the intervention effect regarding depression symptoms (β = 0.033, p = 0.024). Conclusions. Digital mindfulness interventions are a promising method to reduce mental health symptoms in pregnant women. We identified certain parameters moderating this effect, for example, primiparity and the attrition rate.
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Affiliation(s)
- Monique L. Mefrouche
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (M.L.M.)
- Department of Clinical Psychology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Eva-Maria Siegmann
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (M.L.M.)
| | - Stephanie Böhme
- Department of Clinical Psychology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Matthias Berking
- Department of Clinical Psychology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander University Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (M.L.M.)
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Mirzaee F, Hasanpoor-Azghady SB, Amiri-Farahani L. Investigating and comparing the dimensions of worry of Iranian primiparous women in each trimester of pregnancy. Eur J Med Res 2023; 28:285. [PMID: 37587539 PMCID: PMC10428520 DOI: 10.1186/s40001-023-01258-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 08/01/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Pregnancy and childbirth are considered natural events in the life cycle of women. However, it is also a stressful experience along with physiological and psychological changes. Therefore, it is important to study the dimensions that cause more worry in each of the pregnant trimesters. This study aimed to determine and compare the dimensions of worry of Iranian primiparous women in each trimester of pregnancy. METHODS This cross-sectional study was conducted on 300 primiparous women (n = 100 in each trimester) referred to seven health centers affiliated with the Iran University of Medical Sciences, Tehran, Iran. The sampling was multistage. We collected data from a demographic and fertility questionnaire and the Cambridge Worry Scale (CWS). RESULTS The mean score of worry during the entire pregnancy was 28.16. The mean and standard deviation of the worry score in the first trimester was (27.35 ± 12.22). The second trimester was (27.80 ± 12.53) and the third trimester was (29.34 ± 11.11). The highest mean score of worry in the first and third trimmers was the dimension of own health. The second trimester was the dimension of socio-medical. The lowest mean score of worry in all trimmers was the dimension of relationships. Among CWS-related items, the highest mean score of worry in the first trimester was giving birth (3.34) and the possibility of miscarriage (3.22). In the second trimester was the possibility of going into labour too early (3.3) and the possibility of miscarriage (3.12), and in the third trimester was the possibility of going into labour too early (3.33) and giving birth (3.27). The lowest mean score of worry in all three trimesters was related to problems with the law. CONCLUSION pregnancy worry in the third trimester was more than the other two trimesters, and worrying about own health was the most important dimension of worry for pregnant women. Paying attention to the dimensions of worry of pregnant women helps design appropriate interventions to increase the mental and physical health of pregnant women.
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Affiliation(s)
- Foruzan Mirzaee
- Department of Midwifery and Reproductive, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Rashid Yasemi St., Valiasr St., Tehran, 1996713883, Iran
| | - Seyedeh Batool Hasanpoor-Azghady
- Department of Midwifery and Reproductive, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Rashid Yasemi St., Valiasr St., Tehran, 1996713883, Iran.
| | - Leila Amiri-Farahani
- Department of Midwifery and Reproductive, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Rashid Yasemi St., Valiasr St., Tehran, 1996713883, Iran
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15
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Women's sense of control during labour and birth with epidural analgesia: A qualitative descriptive study. Midwifery 2023; 116:103496. [PMID: 36223662 DOI: 10.1016/j.midw.2022.103496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 09/08/2022] [Accepted: 09/25/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Sense of control during childbirth is a critical issue concerning the association between high-quality maternity care and infant health. This study explored the facilitators of or barriers to a sense of control and the need for interventions to raise women's experience in childbirth. METHODS The data came from 17 participants. Data collection was conducted in the childbirth room and within three days following childbirth, respectively. For tackling the research problems, participant observation and interviewing were applied. Thematic analysis was applied to the data analyzed. RESULTS Two themes were identified: (1) facilitators of or barriers to practice a sense of control and (2) Care needed for a sense of control. The effectiveness of a sense of control is related to energy refill, mental loading subsided, control over decisions, non-pharmacological usage, and support from the meaningful person. Care needed includes showing empathy, providing information, using complementary pain-relief strategies, and adjusting care by parturient conditions. CONCLUSION This study highlights the influencing factors and interventions relating to women's sense of control during childbirth with epidural analgesia. The findings suggest that many approaches, such as white noise, benefit women's sense of control after an epidural. Using non-pharmacological methods, such as a birth ball, should be appropriately regulated by situations to enhance women's sense of control. Through the assessment, education, attention to maternal needs, and recognizing the barriers to a sense of control, women will benefit from the interventions designed to improve their sense of control during childbirth.
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Gagnon R, Orellana PL. Humanization of birth, women’s empowerment, and midwives’ actions and knowledge: experiences from Quebec and Chile. SAÚDE EM DEBATE 2022. [DOI: 10.1590/0103-1104202213503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
ABSTRACT Whether in pre-pregnancy, pregnancy, birth and/or the postnatal and neonatal periods, midwives’ practices are underpinned by humanism. However, in this era of postmodernity, there is an ever-growing need for rehumanization. This article adopts an auto-ethnographic approach in order to undertake a reflective analysis on the humanization of birth based on the practice of midwifery in two different contexts, namely Quebec (Canada) and Chile. In light of the evolution of the profession in these two countries, and the influence of health policies and social movements, there are factors such as the systematic use of technology and the hypermedicalization of reproductive processes which are maintaining women’s ignorance and keeping them from being able to participate in their maternity process. Women’s autonomy and empowerment become a key element for their participation in decisions regarding their maternity, assistance methods, or type of care. Concurrently, midwives’ autonomy is a prerequisite for fully exercising their role in supporting and assisting women in this re-appropriation of their power by means of a comprehensive approach that takes into account psychological and social aspects as well as biomedical ones.
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17
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Kizilirmak A, Calpbinici P. Investigation of the effect of pregnant women's childbirth-related Internet use on fear of childbirth. J OBSTET GYNAECOL 2022; 42:3007-3013. [PMID: 36149311 DOI: 10.1080/01443615.2022.2125297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
This research was carried out to examine the effect of childbirth-related Internet use by pregnant women on fear of childbirth (FOC). The descriptive study was conducted with 350 pregnant women who applied to the Outpatient Polyclinic of Gynaecology and Obstetrics. Of the pregnant women who used the Internet, 72.9% did so to research information about childbirth. The pregnant women used the Internet mostly to obtain information about coping with labour pain (43.4%), the delivery process (46.9%), the needs list at delivery (39.4%), about C-section/epidural analgesia for labour (26.8%), and about the environment of the delivery room (25.7%). It was determined that there was a statistically significant difference (p < .05) between the delivery-related video viewing status of the pregnant women, the mean score of the W-DEQ Version A (p < .05), and the FOC was lower in those who watched videos about delivery.IMPACT STATEMENTWhat is already known on this subject? Previous studies have shown that pregnant women frequently use the Internet as a source of information about childbirth.What do the results of this study add? The findings of this study reveal that watching videos and listening to or reading the narrations significantly affected the FOC.What are the implications of these findings for clinical practice or further research? Nurses who provide preconception and antenatal care should consider Internet use as a risk factor for FOC and should guide pregnant women to reliable sources.
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Affiliation(s)
- Aynur Kizilirmak
- Department of Obstetrics and Gynecology Nursing, Nevşehir Hacı Bektaş Veli University, Semra and Vefa Küçük Faculty of Health Sciences, Nevsehir, Turkey
| | - Pelin Calpbinici
- Department of Obstetrics and Gynecology Nursing, Nevşehir Hacı Bektaş Veli University, Semra and Vefa Küçük Faculty of Health Sciences, Nevsehir, Turkey
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18
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Labouring Together: Women's Experiences of “Getting the Care that I Want and Need” in Maternity Care. Midwifery 2022; 113:103420. [DOI: 10.1016/j.midw.2022.103420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 04/24/2022] [Accepted: 07/01/2022] [Indexed: 11/24/2022]
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Kuo TC, Au HK, Chen SR, Chipojola R, Lee GT, Lee PH, Kuo SY. Effects of an integrated childbirth education program to reduce fear of childbirth, anxiety, and depression, and improve dispositional mindfulness: A single-blind randomised controlled trial. Midwifery 2022; 113:103438. [DOI: 10.1016/j.midw.2022.103438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 07/24/2022] [Accepted: 07/26/2022] [Indexed: 11/30/2022]
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20
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Keskin G, Gümüşsoy S, Yıldırım GÖ. Assessment of mental health issues in pregnant women with fetal complications: Relation to attachment and anxiety. Perspect Psychiatr Care 2022; 58:994-1002. [PMID: 34101838 DOI: 10.1111/ppc.12890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 04/29/2021] [Accepted: 05/22/2021] [Indexed: 11/27/2022] Open
Abstract
PURPOSE Pregnancy period is important for all women. The aim of this study was to evaluate mental status, antenatal depression, attachment, and anxiety in pregnant women with fetal complications. DESIGN AND METHODS Mothers who had been diagnosed with fetal complications during pregnancy were interviewed after the delivery of their babies. FINDINGS The results showed that anxiety and depression scores were significantly higher in the mothers who had received psychiatric support treatment. Maternal attachment scores were found low, depression scores were found high in mothers of children with congenital anomalies. CONCLUSION According to the results of the study, a maternal attachment was low and depression was high in mothers with congenital anomalies. PRACTICE IMPLICATIONS Possible psychological problems after birth can be prevented by psychotherapeutic nursing interventions during pregnancy to pregnant women who have babies with fetal anomalies.
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Affiliation(s)
| | | | - Gül Ö Yıldırım
- Atatürk Medical Vocational Training School, İzmir, Turkey
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Green G, Tesler R, Marques A. Primiparous and Multiparous Women's Mode of Birth and Negative Emotions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095189. [PMID: 35564584 PMCID: PMC9103235 DOI: 10.3390/ijerph19095189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/18/2022] [Accepted: 04/20/2022] [Indexed: 12/10/2022]
Abstract
Negative childbirth experiences may result in negative emotions that may lead to negative outcomes, such as post-traumatic stress disorder. We aimed to examine the differences in emotions between primiparous and multiparous women and mode of birth. We used a retrospective cross-sectional study design with three hundred and fifty women. Primiparous women reported higher levels of fear, lack of control, and dissociation emotions compared to multiparous women. The EmCs (emergency cesarean section) group experienced the most fear, lack of control, anger, and conflict emotions. It is important to conduct follow up work with women who underwent unplanned birth procedures since negative childbirth experiences may lead to further negative effects on women's psychosocial health and well-being.
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Affiliation(s)
- Gizell Green
- Nursing Department, Ariel University, Ariel 40700, Israel
- Correspondence:
| | - Riki Tesler
- Department of Health Systems Management, School of Health Sciences, Ariel University, Ariel 40700, Israel;
| | - Adilson Marques
- Centro Interdisciplinar do Estudo da Performance Humana, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002 Cruz Quebrada, Portugal;
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, 1499-002 Lisbon, Portugal
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The magnitude and associated factors of childbirth fear among pregnant women attending antenatal care at public hospitals in Ethiopia: a cross-sectional study. BMC Pregnancy Childbirth 2022; 22:222. [PMID: 35305600 PMCID: PMC8933614 DOI: 10.1186/s12884-022-04544-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 03/07/2022] [Indexed: 11/10/2022] Open
Abstract
Background Childbirth fear affects 5–40% of all mothers around the world, and there is mounting evidence that it has harmful impacts on women’s health. It could potentially lead pregnant women to feel isolated and unsupported if not identified. But studies addressing this issue are limited in Ethiopia. Therefore, this study was aimed at assessing the magnitude and associated factors of childbirth fear among pregnant women attending antenatal care at public hospitals in West Wollega Zone. Methods Facility-based cross-sectional study was conducted among 304 pregnant women selected by systematic random sampling from 20 March to 20 April 2020. A structured interviewer-administered questionnaire was adapted and used to collect data. Data were entered into EpiData version 3.1 and exported to IBM SPSS statistics version 26 for analysis. Descriptive statistics were done to calculate frequencies, mean scores, and standard deviation. Bivariate and multivariable logistic regression was used to identify factors associated with childbirth fear. Variables with p < 0.25 in bivariate analyses were selected for multivariable analysis. Finally, statistical significance was declared at p < 0.05. Results Out of the total of 304 participants, 298 completed the interview making the response rate 98%. The overall prevalence of childbirth fear was 28.9% with 95% CI (23.5, 34.2). Mean age of the respondents was 27.60 (SD ± 4.56) years. Having previous pregnancy complications [AOR (95% CI)], [6.949 (2.060 – 23.445), presence of long time during childbirth [AOR (95% CI)], [4.765 (1.161 – 19.564)], presence of episiotomy [AOR (95% CI)], [4.197 (1.107 – 15.917)], low social support [AOR (95% CI)], [.011 (.003 – .050)] were significantly associated with childbirth fear. Conclusion Pregnant women in the study area have a significant level of childbirth fear. Previous pregnancy complications, prolonged labor, labor pain, previous perineal tear, and social support were all found to be significantly linked with childbirth fear. This calls for the need to identify and develop interventions for women to reduce childbirth fear during pregnancy.
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Malaju MT, Alene GD, Azale T. Impact of maternal morbidities on the longitudinal health-related quality of life trajectories among women who gave childbirth in four hospitals of Northwest Ethiopia: a group-based trajectory modelling study. BMJ Open 2022; 12:e057012. [PMID: 35288392 PMCID: PMC8921913 DOI: 10.1136/bmjopen-2021-057012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES To identify distinct trajectories of health-related quality of life and its predictors among postpartum women in Northwest Ethiopia. DESIGN Health facility-linked community-based prospective follow-up study. SETTING South Gondar zone, Northwest Ethiopia. PARTICIPANTS We recruited 775 mothers (252 exposed and 523 non-exposed) after childbirth and before discharge. Exposed and non-exposed mothers were identified based on the criteria published by the WHO Maternal Morbidity Working Group. OUTCOME MEASURES The primary outcome measure of this study was trajectories of health-related quality of life. The Stata Traj package was used to determine the trajectories using a group-based trajectory modelling. Multinomial logistic regression model was used to identify predictors of trajectory membership. RESULTS Four distinct trajectories for physical and psychological and five trajectories for the social relationships and environmental health-related quality of life were identified. Direct and indirect maternal morbidities, lower educational status, poor social support, being government employed and merchant/student in occupation, vaginal delivery, lower monthly expenditure, stress, fear of childbirth and anxiety were found to be predictors of lower health-related quality of life trajectory group membership. CONCLUSIONS Health professionals should target maternal morbidities and mental health problems when developing health intervention strategies to improve maternal health-related quality of life in the postpartum period. Developing encouraging strategies for social support and providing health education or counselling for women with less or no education are essential to avert the decrease in health-related quality of life trajectories of postpartum women.
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Affiliation(s)
- Marelign Tilahun Malaju
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Amhara, Ethiopia
| | - Getu Degu Alene
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Amhara, Ethiopia
| | - Telake Azale
- Department of Health Promotion and Behavioral Sciences, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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STEWART J, WATTS DK, HUGHES DAJ, SLADE PP, SPIBY PH. The importance of face to face, group antenatal education classes for first time mothers: A qualitative study. Midwifery 2022; 109:103295. [DOI: 10.1016/j.midw.2022.103295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 01/28/2022] [Accepted: 02/23/2022] [Indexed: 11/29/2022]
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25
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Buran G, Aksu H. Effect of Hypnobirthing Training on Fear, Pain, Satisfaction Related to Birth, and Birth Outcomes: A Randomized Controlled Trial. Clin Nurs Res 2022; 31:918-930. [PMID: 35083920 DOI: 10.1177/10547738211073394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We aimed to determine the effect of Hypnobirthing training on fear of childbirth (FOC), birth pain, birth satisfaction and birth outcomes. This randomized controlled trial study was conducted with 80 nulliparous pregnant who were divided into two groups (experimental group n = 40 and control n = 40) in a maternity hospital. The couples received the training in groups(4 weeks, once a week, 3-hour, group session). The mean score of hypnobirthing group for the whole Wijma Birth Expectancy/Experience Scale was significantly lower than that of the routine care group (p < .001).In the latent, active, and transitional phases of labor, the Visual Analog Scale (VAS)scores of the experimental groups were found to be significantly lower than those of the control group (p < .001).The experimental group's rates of birth intervention were significantly lower and their deliveries period were shorter, than those that of the routine control group (p < .001).In addition, the vaginal delivery rates (p = .037)and the scores for the Birth Satisfaction Scale-Revised (BSS-R) were also found to be higher than those of the control group (p < .001).
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Malaju MT, Alene GD, Azale T. Longitudinal functional status trajectories and its predictors among postpartum women with and without maternal morbidities in Northwest Ethiopia: a group based multi-trajectory modelling. BMJ Glob Health 2022; 7:e007483. [PMID: 35039310 PMCID: PMC8764995 DOI: 10.1136/bmjgh-2021-007483] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 12/16/2021] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Unlike physiological recovery, return to full functional status following childbirth takes longer than 6 weeks (42 days) of the traditionally defined postnatal period, and women with maternal morbidity usually require a longer period to recover. However, the extent to which this morbidity collectively impacts on women's functional status is not well investigated in Ethiopia. We aim to determine the distinct trajectories and predictors of functional status among postpartum women in Northwest Ethiopia. METHODS Health facility linked community-based follow-up study was conducted in Northwest Ethiopia from October 2020-March 2021. A sample of 779 delivering women was recruited after childbirth and before discharge using the criteria published by the WHO Maternal Morbidity Working Group. Functional status was measured by the Amharic version of the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) instrument. The Stata Traj package was used to determine trajectories of functional status using group-based multi-trajectory modelling. The multinomial logistic regression model was used to identify predictors of trajectory group membership. RESULTS A total of 775 women participated at the first, second and third follow-up of the study (6th week, 12th week and 18th week of postpartum period). Three distinct functional status trajectory groups with different longitudinal patterns were identified across the six domains of WHODAS 2.0. Direct and indirect maternal morbidities, lower educational status, poor social support, vaginal delivery, stress, anxiety, posttraumatic stress disorder and fear of childbirth were found to be predictors of poor functioning trajectories. CONCLUSION Early diagnosis and treatment of maternal morbidities and mental health problems, developing encouraging strategies for social support and providing health education or counselling for women with less or no education are essential to improve functioning trajectories of postpartum women.
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Affiliation(s)
- Marelign Tilahun Malaju
- Department of Public Health, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Getu Degu Alene
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Telake Azale
- School of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Tomazin KJDCG, Miot HA, Stoll K, Gonçalves IR, Spiri WC, Felipe TRL, Jamas MT. Cross-cultural Adaptation and Validation of the Childbirth Fear Prior to Pregnancy Scale in Brazil. Open Nurs J 2021. [DOI: 10.2174/1874434602115010179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
The fear of childbirth can range from apprehension to intense fear (tokophobia), with serious consequences for maternal health. Therefore, a standardized scale is needed to measure the fear of childbirth before pregnancy.
Objective:
This study aimed to adapt the Childbirth Fear Prior to Pregnancy (CFPP) scale to the Brazilian context and analyse its validity and reliability.
Methods:
A cross-sectional survey was completed by 146 nursing students at two Brazilian universities. A committee of experts evaluated the cross-cultural adaptation of the CFPP scale. Construct validity was verified using item-total correlations and Exploratory Factor Analysis (EFA). The validity of divergent concurrent criteria was evaluated by associating the score obtained using the Brazilian CFPP with the Depression, Anxiety, and Stress Scale (DASS-21). Reliability was analysed using Cronbach’s alpha coefficient and test-retest.
Results:
Correlation analysis revealed a predominance of moderate inter-item correlation and strong item-total correlation (>0.62). The EFA indicated that all items related to a single factor, with factor loadings and communalities >0.5. These results reinforced the one-dimensionality of the Brazilian CFPP. The validity of divergent concurrent criteria was confirmed via weak correlations with DASS-21 scores (r = 0.32, p < 0.001). The Cronbach’s alpha (0.86) and the intra-class correlation coefficient (0.99) indicated reliability and strong temporal stability, respectively.
Conclusion:
The Brazilian version of the CFPP provides evidence of validity and reliability to measure fear of childbirth before pregnancy in young adults in Brazil.
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Shakarami A, Mirghafourvand M, Abdolalipour S, Jafarabadi MA, Iravani M. Comparison of fear, anxiety and self-efficacy of childbirth among primiparous and multiparous women. BMC Pregnancy Childbirth 2021; 21:642. [PMID: 34548055 PMCID: PMC8456545 DOI: 10.1186/s12884-021-04114-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 09/10/2021] [Indexed: 01/21/2023] Open
Abstract
Background The aim of this study was to compare fear of childbirth, state and trait anxiety, and childbirth self-efficacy among primiparous and multiparous women in Ahvaz, southwest of Iran. Methods This cross-sectional study was conducted with 200 pregnant women (100 primiparous and 100 multiparous women) who had been admitted to the maternity ward of hospitals affiliated to Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. The instruments used for data collection in this study included a demographic questionnaire, Delivery Fear Scale (DFS), Spielberger's State-Trait Anxiety Inventory (STAI), and Childbirth Self-Efficacy Inventory (CBSEI). The data were analyzed by chi-square test and independent t-test. Also, the univariate general linear model was used by adjusting for the socio-demographic and obstetric characteristics that were considered as possible confounding variables. Results The mean score of DFS in primiparous women was significantly higher than that of multiparous women. The mean of the overall score of childbirth self-efficacy of primiparous women was significantly lower than that of multiparous women. The mean score of the outcome expectancies and self-efficacy expectancies was significantly lower in primiparous women compared with multiparous women. There was no statistically significant difference between the two groups in terms of the mean score of STAI. After adjusting for possible confounding variables, the differences between the two groups in terms of fear of childbirth scores, overall childbirth self-efficacy score and self-efficacy expectancies remained significant. Conclusion Given the high fear of childbirth and low childbirth self-efficacy in primiparous women compared to the multiparous women, appropriate interventions should be adopted by health care providers in order to reduce fear and improve childbirth self-efficacy in primiparous women.
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Affiliation(s)
- Aazam Shakarami
- Midwifery Department, Faculty of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Islamic Republic of Iran
| | - Somyieh Abdolalipour
- Midwifery Department, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari Jafarabadi
- Department of Statistics and Epidemiology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran.,Center for the development of Interdisciplinary Research in Islamic Sciences and Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mina Iravani
- Midwifery Department, Reproductive Health Promotion Research Center, Faculty of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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González-Timoneda A, Hernández Hernández V, Pardo Moya S, Alfaro Blazquez R. Experiences and attitudes of midwives during the birth of a pregnant woman with COVID-19 infection: A qualitative study. Women Birth 2021; 34:465-472. [PMID: 33358355 PMCID: PMC7724562 DOI: 10.1016/j.wombi.2020.12.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 11/26/2020] [Accepted: 12/01/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND The COVID-19 pandemic has become one of the most important threats to global health. Midwives are at the core of the response to the pandemic. Women still need midwifery support and care. The work of midwives is acknowledged as emotionally demanding, and their welfare may be compromised by a range of workplace and personal stress factors. AIM To investigate the experiences and attitudes of midwives who have provided pregnancy and childbirth care to women with a confirmed or suspected COVID-19 infection. METHODS A qualitative phenomenological study was carried out in two Spanish tertiary hospitals. Fourteen midwives were recruited by purposive sampling technique. Data were collected through individual in-depth interviews and analysed using Giorgi's descriptive method. FINDINGS Three themes emerged: "challenges and differences when working in a pandemic", "emotional and mental health and wellbeing" and "women's emotional impact perceived by midwives". Midwives pointed to several factors tied to a safe, supportive and empowering work place: support from staff and managers, access to adequate personal protective equipment, and reliable guidelines. They also dealt with professional and personal challenges during the pandemic, showing feelings of fear, anxiety, uncertainty, discomfort, lack of support, and knowledge. Finally, midwives expressed their concerns about the feelings of pregnant women with COVID-19, such as fear, anxiety, and loneliness. CONCLUSION The results of this study show some of the challenges for midwives during the course of the COVID-19 pandemic, emphasizing the value of a good communication, emotional support, and stress management, to provide woman-centred care.
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Affiliation(s)
- Alba González-Timoneda
- Midwife. Department of Obstetrics and Gynaecology, University and Polytechnic Hospital "La Fe", Valencia, Spain; School of Nursing and Podiatry, University of Valencia, Spain
| | | | - Sonia Pardo Moya
- Midwife. Department of Obstetrics and Gynaecology, University and Polytechnic Hospital "La Fe", Valencia, Spain
| | - Ruben Alfaro Blazquez
- Midwife. Department of Obstetrics and Gynaecology, University and Polytechnic Hospital "La Fe", Valencia, Spain; School of Nursing and Podiatry, University of Valencia, Spain.
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O'Connell MA, Khashan AS, Leahy-Warren P, Stewart F, O'Neill SM. Interventions for fear of childbirth including tocophobia. Cochrane Database Syst Rev 2021; 7:CD013321. [PMID: 34231203 PMCID: PMC8261458 DOI: 10.1002/14651858.cd013321.pub2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Many women experience fear of childbirth (FOC). While fears about childbirth may be normal during pregnancy, some women experience high to severe FOC. At the extreme end of the fear spectrum is tocophobia, which is considered a specific condition that may cause distress, affect well-being during pregnancy and impede the transition to parenthood. Various interventions have been trialled, which support women to reduce and manage high to severe FOC, including tocophobia. OBJECTIVES To investigate the effectiveness of non-pharmacological interventions for reducing fear of childbirth (FOC) compared with standard maternity care in pregnant women with high to severe FOC, including tocophobia. SEARCH METHODS In July 2020, we searched Cochrane Pregnancy and Childbirth's Trials Register, ClinicalTrials.gov, the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP), and reference lists of retrieved studies. We contacted researchers of trials which were registered and appeared to be ongoing. SELECTION CRITERIA We included randomised clinical trials which recruited pregnant women with high or severe FOC (as defined by the individual trial), for treatment intended to reduce FOC. Two review authors independently screened and selected titles and abstracts for inclusion. We excluded quasi-randomised and cross-over trials. DATA COLLECTION AND ANALYSIS We used standard methodological approaches as recommended by Cochrane. Two review authors independently extracted data and assessed the studies for risk of bias. A third review author checked the data analysis for accuracy. We used GRADE to assess the certainty of the evidence. The primary outcome was a reduction in FOC. Secondary outcomes were caesarean section, depression, birth preference for caesarean section or spontaneous vaginal delivery, and epidural use. MAIN RESULTS We included seven trials with a total of 1357 participants. The interventions included psychoeducation, cognitive behavioural therapy, group discussion, peer education and art therapy. We judged four studies as high or unclear risk of bias in terms of allocation concealment; we judged three studies as high risk in terms of incomplete outcome data; and in all studies, there was a high risk of bias due to lack of blinding. We downgraded the certainty of the evidence due to concerns about risk of bias, imprecision and inconsistency. None of the studies reported data about women's anxiety. Participating in non-pharmacological interventions may reduce levels of fear of childbirth, as measured by the Wijma Delivery Expectancy Questionnaire (W-DEQ), but the reduction may not be clinically meaningful (mean difference (MD) -7.08, 95% confidence interval (CI) -12.19 to -1.97; 7 studies, 828 women; low-certainty evidence). The W-DEQ tool is scored from 0 to 165 (higher score = greater fear). Non-pharmacological interventions probably reduce the number of women having a caesarean section (RR 0.70, 95% CI 0.55 to 0.89; 5 studies, 557 women; moderate-certainty evidence). There may be little to no difference between non-pharmacological interventions and usual care in depression scores measured with the Edinburgh Postnatal Depression Scale (EPDS) (MD 0.09, 95% CI -1.23 to 1.40; 2 studies, 399 women; low-certainty evidence). The EPDS tool is scored from 0 to 30 (higher score = greater depression). Non-pharmacological interventions probably lead to fewer women preferring a caesarean section (RR 0.37, 95% CI 0.15 to 0.89; 3 studies, 276 women; moderate-certainty evidence). Non-pharmacological interventions may increase epidural use compared with usual care, but the 95% CI includes the possibility of a slight reduction in epidural use (RR 1.21, 95% CI 0.98 to 1.48; 2 studies, 380 women; low-certainty evidence). AUTHORS' CONCLUSIONS The effect of non-pharmacological interventions for women with high to severe fear of childbirth in terms of reducing fear is uncertain. Fear of childbirth, as measured by W-DEQ, may be reduced but it is not certain if this represents a meaningful clinical reduction of fear. There may be little or no difference in depression, but there may be a reduction in caesarean section delivery. Future trials should recruit adequate numbers of women and measure birth satisfaction and anxiety.
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Affiliation(s)
- Maeve Anne O'Connell
- School of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Ali S Khashan
- School of Public Health, University College Cork, Cork, Ireland
| | | | - Fiona Stewart
- Cochrane Children and Families Network, c/o Cochrane Pregnancy and Childbirth, Department of Women's and Children's Health, The University of Liverpool, Liverpool, UK
| | - Sinéad M O'Neill
- School of Epidemiology and Public Health Alumna, University College Cork, Cork, Ireland
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Zhou X, Liu H, Li X, Zhang S. Fear of Childbirth and Associated Risk Factors in Healthy Pregnant Women in Northwest of China: A Cross-Sectional Study. Psychol Res Behav Manag 2021; 14:731-741. [PMID: 34135648 PMCID: PMC8200453 DOI: 10.2147/prbm.s309889] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 05/20/2021] [Indexed: 11/23/2022] Open
Abstract
AIM Fear of childbirth (FOC) is an extreme state of anxiety, distress and worry about childbirth. Despite its common occurrence, the prevalence and risk factors for FOC are inadequately understood in the northwestern region of China. PURPOSE This study aimed to examine the prevalence and risk factors for fear of childbirth (FOC) in a cohort of pregnant women in northwest of China. PATIENTS AND METHODS A total of 922 healthy pregnant women were included in this cross-sectional study. Participants filled out a questionnaire on socio-demographic characteristics, as well as the Childbirth Attitudes Questionnaire (CAQ), the Multidimensional Scale of Perceived Social Support (MSPSS), the Edinburgh Postnatal Depression Scale (EPDS), and the Pregnancy Pressure Scale (PPS). Psychosocial factors were analyzed to determine their association with fear of childbirth. Optimal scale regression analysis was used to determine the risk factors associated with FOC. RESULTS The mean score on the CAQ was 33.92 ± 10.17. A total of 72% of participants reported low to mild FOC. Six percent (n=51/922) and 22% (n=199/922) of pregnant women reported severe and moderate FOC, respectively. Based on optimal scaling regression analysis, the factors most strongly associated with FOC were residence, marital status, parity, gestational age, relationship with partner, pregnancy stress, social support and depressive symptoms. CONCLUSION This study indicates the high prevalence of FOC (70.3%, ranging from mild to severe) in healthy pregnant women in northwest of China. FOC showed a positive correlation with pregnancy-related stress and depressive symptoms and a negative correlation with social support. Screening for FOC and helping pregnant women identify a support system early in pregnancy could reduce a woman's stress level and severity of depression.
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Affiliation(s)
- Xiaolan Zhou
- School of Nursing, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
- School of Nursing, Xi’an Medical University, Xi’an, Shaanxi, People’s Republic of China
| | - Hua Liu
- School of Nursing, Xi’an Medical University, Xi’an, Shaanxi, People’s Republic of China
| | - Xiaohong Li
- School of Nursing, Xi’an Medical University, Xi’an, Shaanxi, People’s Republic of China
| | - Shaoru Zhang
- School of Nursing, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China
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Small KA, Sidebotham M, Fenwick J, Gamble J. "I'm not doing what I should be doing as a midwife": An ethnographic exploration of central fetal monitoring and perceptions of clinical safety. Women Birth 2021; 35:193-200. [PMID: 34092530 DOI: 10.1016/j.wombi.2021.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 04/18/2021] [Accepted: 05/20/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Central fetal monitoring systems transmit cardiotocograph data to a central site in a maternity service. Despite a paucity of evidence of safety, the installation of central fetal monitoring systems is common. AIM This qualitative research sought to explore whether, and how, clinicians modified their clinical safety related behaviours following the introduction of a central monitoring system. METHODS An Institutional Ethnographic enquiry was conducted at an Australian hospital where a central fetal monitoring system had been installed in 2016. Informants (n=50) were midwifery and obstetric staff. Data collection consisted of interviews and observations that were analysed to understand whether and how clinicians modified their clinical safety related behaviours. FINDINGS The introduction of the central monitoring system was associated with clinical decision making without complete clinical information. Midwives' work was disrupted. Higher levels of anxiety were described for midwives and birthing women. Midwives reported higher rates of intervention in response to the visibility of the cardiotocograph at the central monitoring station. Midwives described a shift in focus away from the birthing woman towards documenting in the central monitoring system. DISCUSSION The introduction of central fetal monitoring prompted new behaviours among midwifery and obstetric staff that may potentially undermine clinical safety. CONCLUSION This research raises concerns that central fetal monitoring systems may not promote safe intrapartum care. We argue that research examining the safety of central fetal monitoring systems is required.
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Affiliation(s)
- Kirsten A Small
- Transforming Maternity Care Collaborative, School of Nursing & Midwifery, Griffith University, Australia.
| | - Mary Sidebotham
- Transforming Maternity Care Collaborative, School of Nursing & Midwifery, Griffith University, Australia.
| | - Jennifer Fenwick
- Transforming Maternity Care Collaborative, School of Nursing & Midwifery, Griffith University, Australia.
| | - Jenny Gamble
- Transforming Maternity Care Collaborative, School of Nursing & Midwifery, Griffith University, Australia.
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Callander EJ, Gamble J, Creedy DK. Postnatal Major Depressive Disorder in Australia: Inequalities and Costs of Healthcare to Individuals, Governments and Insurers. PHARMACOECONOMICS 2021; 39:731-739. [PMID: 33682021 DOI: 10.1007/s40273-021-01013-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/18/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Perinatal mental health has pervasive impacts on the wellbeing of both the mother and child, affecting quality of life, bonding and attachment and cognitive development. OBJECTIVES The aim of this study was to (i) quantify the costs to government healthcare funders, private health insurers and individuals through out-of-pocket fees, of women with postnatal major depressive disorder (MDD); and (ii) identify any socioeconomic inequalities in health service use and costs amongst these women. METHODS A whole-of-population linked administrative dataset containing the clinical records and health service use for all births in the state of Queensland, Australia between 01 July 2012 and 30 June 2015 was used (n = 189,081). Postnatal MDD was classified according to ICD-10 code, with women hospitalised for MDD in the 12 months after birth classified as having 'postnatal MDD' (n = 728). Health service use and costs from birth to 12 months post-birth were included. Total costs included cost to government funders and private health insurers and out-of-pocket fees. Total costs and costs to different funders were compared for women with postnatal MDD and for women without an inpatient event for postnatal MDD, with unadjusted means presented. A generalised linear model was used to compare the difference in total costs, adjusting for key confounders. Costs to different funders and number of different services accessed were then compared for women with postnatal MDD by socioeconomic status, with unadjusted means presented. RESULTS The total costs from birth to 12 months post-birth were 636% higher for women with postnatal MDD than women without an inpatient event for postnatal MDD, after accounting for differences in private hospital use, mode of birth, clinical characteristics and socioeconomic status. Amongst women with postnatal MDD, the cost of all services accessed was higher for women of highest socioeconomic status than for women of lowest socioeconomic status (A$15,787.66 vs A$11,916.94). The cost of services for women of highest socioeconomic status was higher for private health insurers (A$8941.25 vs A$2555.26), but lower for public hospital funders (A$2423.39 vs A$6582.09) relative to women of lowest socioeconomic status. Outside of public hospitals, costs to government funders was higher for women of highest socioeconomic status (A$2766.80 vs A$1952.00). Women of highest socioeconomic status accessed more inpatient (8.2 vs 3.1) and specialist services (13.4 vs 5.5) and a higher proportion had access to psychiatric specialist care (39.7% vs 13.6%) and antidepressants (97.6% vs 93.8%). CONCLUSION MDD is costly to all funders of healthcare. Amongst women with MDD, there are large differences in the types of services accessed and costs to different funders based on socioeconomic status. There may be significant financial and structural barriers preventing equal access to care for women with postnatal MDD.
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Affiliation(s)
- Emily J Callander
- Transforming Maternity Care Collaborative, Meadowbrook, QLD, Australia.
- School of Public Health and Preventive Medicine, 553 St Kilda Rd, Melbourne, VIC, 3181, Australia.
- School of Nursing and Midwifery, Griffith University, Meadowbrook, QLD, Australia.
| | - Jenny Gamble
- Transforming Maternity Care Collaborative, Meadowbrook, QLD, Australia
- School of Nursing and Midwifery, Griffith University, Meadowbrook, QLD, Australia
| | - Debra K Creedy
- Transforming Maternity Care Collaborative, Meadowbrook, QLD, Australia
- School of Nursing and Midwifery, Griffith University, Meadowbrook, QLD, Australia
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Nguyen LD, Nguyen LH, Ninh LT, Nguyen HTT, Nguyen AD, Vu LG, Nguyen CT, Vu GT, Doan LP, Latkin CA, Ho CSH, Ho RCM. Fear of Childbirth and Preferences for Prevention Services among Urban Pregnant Women in a Developing Country: A Multicenter, Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5382. [PMID: 34070085 PMCID: PMC8158107 DOI: 10.3390/ijerph18105382] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/11/2021] [Accepted: 05/15/2021] [Indexed: 12/28/2022]
Abstract
This study aimed to examine fear of childbirth and willingness to pay for fear-prevention services in pregnant women. A multicenter, cross-sectional study was conducted on pregnant women in two obstetric hospitals in Vietnam. The Fear of Birth Scale was utilized to evaluate fear of childbirth. Multivariable, generalized linear regression and logistic regression models were performed to identify associated factors with fear of childbirth, demand, and willingness to pay for prevention services. Of 900 pregnant women, fear of childbirth was moderately high with a mean score of 18.1 (SD = 2.3). Age of partner; ever having complications of pregnancy; attitudes toward different aspects of childbirth delivery; satisfactions with friends, parents, and siblings' care; and information support were associated with fear of childbirth. Only 33.8% participants had a demand for the prevention service, and 43.7% were willing to pay for this service with an average amount of $US 10.0 per month (SD = 72.0). Our study suggested that individualized psychological counseling and information-seeking guidance should be provided appropriately and differently for multiparous and nulliparous women for reducing fear and improving the acceptability of the prevention services.
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Affiliation(s)
- Lam Duc Nguyen
- Department of Anaesthesiology, Hanoi Medical University, Hanoi 100000, Vietnam;
| | - Long Hoang Nguyen
- Department of Global Public Health, Karolinska Institutet, SE-171 77 Stockholm, Sweden;
| | - Ly Thi Ninh
- Social Affair Department, Ca Mau Obstetrics & Pediatrics Hospital, Ca Mau 98000, Vietnam;
| | - Ha Thu Thi Nguyen
- Hanoi Obstetrics and Gynecology Hospital, Hanoi 100000, Vietnam; (H.T.T.N.); (A.D.N.)
| | - Anh Duy Nguyen
- Hanoi Obstetrics and Gynecology Hospital, Hanoi 100000, Vietnam; (H.T.T.N.); (A.D.N.)
| | - Linh Gia Vu
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam; (C.T.N.); (L.P.D.)
- Faculty of Medicine, Duy Tan University, Da Nang 550000, Vietnam
| | - Cuong Tat Nguyen
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam; (C.T.N.); (L.P.D.)
- Faculty of Medicine, Duy Tan University, Da Nang 550000, Vietnam
| | - Giang Thu Vu
- Center of Excellence in Evidence-Based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 70000, Vietnam;
| | - Linh Phuong Doan
- Institute for Global Health Innovations, Duy Tan University, Da Nang 550000, Vietnam; (C.T.N.); (L.P.D.)
- Faculty of Medicine, Duy Tan University, Da Nang 550000, Vietnam
| | - Carl A. Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA;
| | - Cyrus S. H. Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore; (C.S.H.H.); (R.C.M.H.)
- Department of Psychological Medicine, National University Health System, Singapore 119228, Singapore
| | - Roger C. M. Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore; (C.S.H.H.); (R.C.M.H.)
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore 119077, Singapore
- Institute of Health Economics and Technology, Hanoi 100000, Vietnam
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Onchonga D, Hammoud S, Kuriakose S, Muhammad EAK. Exploring fear of childbirth in Kenya through evaluation of the readability of Wijma Delivery Expectancy/Experience Questionnaire Version A (W-DEQ-A). SEXUAL & REPRODUCTIVE HEALTHCARE 2021; 28:100605. [PMID: 33626433 DOI: 10.1016/j.srhc.2021.100605] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/24/2021] [Accepted: 02/02/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Several tools measuring fear of childbirth (FOC) have been developed in the last three decades, however concerns about their readability have been raised. AIM To explore the fear of childbirth in a sample of women of reproductive age by evaluating the readability of Wijma Delivery Expectancy/Experience Questionnaire version A (W-DEQ-A). METHODS The Flesch Reading Ease Formula, the Flesch-Kincaid Grade Level, the FOG Scale, the SMOG Index, the Coleman-Liau Index, the Automated Readability Index, and the Linsear Write Formula were used to evaluate the readability of the W-DEQ-A. Also, focus group discussions were held to validate the findings of the readability scales mentioned above. FINDINGS The SMOG Index (score = 7.6), Coleman-Liau Index (score = 7.6), and the Linsear Write Formula (score = 9.4) were easily readable by women of reproductive age who had at least secondary school education (grade 12). Concerns were raised over some terms used such as desolate and deserted, which were rarely used in day to day English language conversations. CONCLUSIONS In this study, participants observed that W-DEQ- A was readable if administered to expectant women with a basic secondary school certificate; but there is a need to simplify some words. It was emphasized that societal dynamics play an important role in the fear of childbirth and therefore the questionnaire should address all aspects contributing to fear of childbirth and not merely the feelings and thoughts women may have at the prospect of labor and delivery.
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Affiliation(s)
- David Onchonga
- Doctoral School of Health Sciences, University of Pécs, Hungary.
| | - Sahar Hammoud
- Doctoral School of Health Sciences, University of Pécs, Hungary.
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Salarvand S, Mousavi MS, Esmaeilbeigy D, Changaee F, Almasian M. The Perceived Health Needs of Primiparous Mothers Referring to Primary Health Care Centers: A Qualitative Study. Int J Womens Health 2020; 12:745-753. [PMID: 33061663 PMCID: PMC7520153 DOI: 10.2147/ijwh.s258446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 09/02/2020] [Indexed: 11/23/2022] Open
Abstract
Background Since the first step in meeting the health needs of primiparous women involves understanding their conditions, the present study aimed to determine the health needs of primiparous women from their own viewpoints. Methods This study had a qualitative approach based on the conventional qualitative content analysis method, in which the purposive sampling method was used. Data were collected by semi-structured interviews. Data saturation was achieved by interviewing 12 participants. To ensure the study was rigorous, the four criteria of credibility, dependability, confirmability, and transferability were taken into account. Results The findings of this study consisted of 150 codes, 19 subcategories, and 6 categories, as follows: 1) the intense need for social support, 2) the need for prior preparation for pregnancy, 3) fears and worries, 4) the necessity of the availability of the needed infrastructures and requirements in the health center, 5) falling in love with the baby, and 6) seeking information from appropriate sources. Conclusion The present study showed that primiparous women need to receive more social and psychological support from family members and healthcare workers and that it is essential to improve the available infrastructures and services in healthcare centers and to provide the needed counseling to pregnant mothers to enable them to go through the pregnancy period smoothly.
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Affiliation(s)
- Shahin Salarvand
- Hepatitis Research Center, Faculty of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Masoumeh-Sadat Mousavi
- Nursing and Midwifery Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Darya Esmaeilbeigy
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Farahnaz Changaee
- Social determinants of Health Research Center, Faculty of Nursing and Midwifery, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mohammad Almasian
- Department of the English Language, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
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Wigert H, Nilsson C, Dencker A, Begley C, Jangsten E, Sparud-Lundin C, Mollberg M, Patel H. Women's experiences of fear of childbirth: a metasynthesis of qualitative studies. Int J Qual Stud Health Well-being 2020; 15:1704484. [PMID: 31858891 PMCID: PMC6968519 DOI: 10.1080/17482631.2019.1704484] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Purpose: Women’s experiences of pregnancy, labour and birth are for some pregnant women negative and they develop a fear of childbirth, which can have consequences for their wellbeing and health. The aim was to synthesize qualitative literature to deepen the understanding of women’s experiences of fear of childbirth. Methods: A systematic literature search and a meta-synthesis that included 14 qualitative papers. Results: The main results demonstrate a deepened understanding of women’s experiences of fear of childbirth interpreted through the metaphor “being at a point of no return”. Being at this point meant that the women thought there was no turning back from their situation, further described in the three themes: To suffer consequences from traumatic births, To lack warranty and understanding, and To face the fear. Conclusions: Women with fear of childbirth are need of support that can meet their existential issues about being at this point of no return, allowing them to express and integrate their feelings, experiences and expectations during pregnancy, childbirth and after birth. Women with fear after birth, i.e., after an earlier negative birth experience, need support that enables them to regain trust in maternity care professionals and their willingness to provide them with good care that offers the support that individual women require. Women pregnant for the first time require similar support to reassure them that other’s experiences will not happen to them.
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Affiliation(s)
- Helena Wigert
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Division of Neonatology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Christina Nilsson
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Anna Dencker
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Cecily Begley
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Chair of Nursing and Midwifery, School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Elisabeth Jangsten
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Carina Sparud-Lundin
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Margareta Mollberg
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Harshida Patel
- Institute of Health and Care Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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Kazemi F, Masoumi SZ, Soltani F, Oshvandi K, Ghelichkhani S, Niazy Z. Postpartum women's perception of stressors in the delivery ward: a qualitative study. BMC Res Notes 2020; 13:335. [PMID: 32660523 PMCID: PMC7359504 DOI: 10.1186/s13104-020-05176-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 07/07/2020] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Delivery is a challenging event in women's lives. What happens during childbirth is stressful for most women. Regarding the short and long-term effects of stressors of the delivery ward on childbirth and neonatal outcomes, and given that understanding the stressors are influenced by existing social culture and factors, the present qualitative study was conducted to investigate women's perception of stressors in the delivery ward. Participants were 13 newly delivered women who were monitored in the recovery room at the Fatemieh Hospital of Hamadan, Iran. Purposive sampling was performed and continued until data saturation. The data collection method was in-depth and semi-structured. RESULTS The content analysis of qualitative data led to the emergence of two themes of human stressors and environmental stressors as well as four categories; i.e., personal factors, care staff-related factors, environmental factors, and equipment-related factors. The research findings indicated that several personal, environmental, staff-related, and equipment-related factors could lead to stress in the labor and delivery ward. Although ignoring them and increasing stress during childbirth may jeopardize the childbirth consequences, most of them are ignored and overlooked. It is necessary to consider measures to control these factors as much as possible.
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Affiliation(s)
- Farideh Kazemi
- Department of Midwifery, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyedeh Zahra Masoumi
- Department of Midwifery, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Farzaneh Soltani
- Department of Midwifery, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Khodayar Oshvandi
- Department of Midwifery, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Samereh Ghelichkhani
- Department of Midwifery, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ziba Niazy
- Department of Midwifery, Mother and Child Care Research Center, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
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Abdollahi S, Faramarzi M, Delavar MA, Bakouei F, Chehrazi M, Gholinia H. Effect of Psychotherapy on Reduction of Fear of Childbirth and Pregnancy Stress: A Randomized Controlled Trial. Front Psychol 2020; 11:787. [PMID: 32528340 PMCID: PMC7265090 DOI: 10.3389/fpsyg.2020.00787] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 03/31/2020] [Indexed: 01/24/2023] Open
Abstract
Introduction The fear of childbirth (FOC) has an adverse effect on the physical and mental health of pregnant women and increases adverse maternal and fetal outcomes. Previous research reported the effect of psychological interventions such as cognitive behavioral therapy, relaxation therapies, and short-term psycho-educational intervention on FOC. We examined whether adding motivational interviewing (MI) psychotherapy to prenatal usual care (PUC) is superior to PUC alone to reduce the scores of FOC, pregnancy stress, and self-efficacy. Materials and Methods An RCT with two-arm parallel groups and 1:1 allocation ratio assigned 70 pregnant women (aged 18–50) attending public health centers in an education hospital in Iran to receive five sessions of group MI psychotherapy plus PUC (N = 35) or to receive PUC alone (N = 35). The primary outcomes were the FOC scores (Wijma Delivery Expectancy/Experience Questionnaire, W-DEQ), pregnancy-specific stress (Prenatal Distress Questionnaire, NuPDQ), anxiety (Spielberger state anxiety), and Childbirth Self-Efficacy Index (CBSI) at 5 weeks post-randomization. Additional measures included subscales of the W-DEQ and the NuPDQ, patients’ compliance, and satisfaction with psychotherapy intervention at 5 weeks post-randomization as secondary outcomes. Main Results The post-trial results indicated that the outcome scores diminished more considerably in psychotherapy than in PUC for total FOC scale with a large effect size (B = −23.54, p = < 0.001, η2η2 = 0.27), for total pregnancy stress with a large effect size (B = −4.51, p = < 0.001, η2 = 19), and for state anxiety with a large effect size (B = −12.42, p = < 0.001, η2 = 0.22). However, the score of self-efficacy and concern about physical symptoms did not differ between the psychotherapy and PUC groups (P < 0.05). Discussion Adding 5 weeks of group psychotherapy to PUC could be considered as an adjunctive care option for reducing FOC, pregnancy stress, and general anxiety in pregnant women in the third trimester. Future research may focus on sustaining the effects and evaluating the economic impacts of adding psychotherapy to PUC.
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Affiliation(s)
- Somayeh Abdollahi
- Counseling in Midwifery, Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Mahbobeh Faramarzi
- Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran
| | - Mouloud Agajani Delavar
- Community Health, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Fatemeh Bakouei
- Reproductive Health, Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Chehrazi
- Department of Epidemiology & Biostatics, Babol University of Medical Sciences, Babol, Iran
| | - Hemmat Gholinia
- Biostatistics, Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Effects of ear and body acupressure on labor pain and duration of labor active phase: A randomized controlled trial. Complement Ther Med 2020; 51:102413. [PMID: 32507430 DOI: 10.1016/j.ctim.2020.102413] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 04/02/2020] [Accepted: 04/16/2020] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES This study sought to compare the effects of multi-point ear and body acupressure on labor pain and the duration of labor active phase. DESIGN Three-armed randomized controlled trial. SETTING Kowsar Hospital, Qazvin, Iran. INTERVENTION Participants in the body acupressure group received acupressure on GB21, GB30, BL32, LI4, and SP6 points, each for two minutes, at cervical dilation of four, six, and eight centimeters. For participants in the ear acupressure group, adhesive auriculotherapy-specific Vaccaria seeds were attached to their auricles on the zero, genitalia, Shen Men, thalamic, and uterine 1 and 2 acupoints. The seeds were compressed every thirty minutes, each time for thirty seconds. Participants in the control group received routine care services. MAIN OUTCOME MEASURES Labor pain intensity was assessed using a visual analogue scale at cervical dilation of four and ten centimeters. RESULTS While there was no significant difference between mean scores of pain among three groups, mean score of labor pain in both acupressure groups was significantly less than that in the control group (P < 0.001). However, the difference between the acupressure groups was not statistically significant (P = 0.12). Moreover, the duration of labor active phase in the ear acupressure group was significantly less than those in the body acupressure and the control groups (P < 0.001). CONCLUSION Ear acupressure was significantly effective in reducing labor pain and shortening labor active phase. However, body acupressure solely reduces labor pain. Therefore, ear acupressure can be used to reduce labor pain and shorten labor active phase.
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Midwife-led integrated pre-birth training and its impact on the fear of childbirth. A qualitative interview study. SEXUAL & REPRODUCTIVE HEALTHCARE 2020; 25:100512. [PMID: 32305869 DOI: 10.1016/j.srhc.2020.100512] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 03/24/2020] [Accepted: 04/06/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Although most expectant women with severe fear of childbirth take pre-birth training sessions, the available literature does not provide substantial emphirical data on its impacts, especially in developing countries like Kenya. AIM The study aimed at exploring women's experience from midwife-led integrated pre-birth training and its impact on the fear of childbirth. METHOD A qualitative interview was conducted using a thematic analysis. Thirty-three women who had experienced high and severe fear of childbirth, and had completed midwife-led integrated pre-birth training were interviewed one month after giving birth. The interviews were conducted in a maternal and child health clinic in Samburu, Kenya from December 2019 to January 2020. Collected data was analysed based on thematic analysis. RESULTS The general theme 'midwife-led integrated pre-birth training promoted constructive disposition and enhanced trust in the process of giving birth' was validated by the interviewed participants. Their contributions covered three themes: 'the significance of midwife-led pre-birth training', 'the role of efficient communication during pregnancy,' and 'adaptation to procedures for improved childbirth experience'. CONCLUSIONS In this study 85% (n = 29) of the participants revealed that midwife-led integrated pre-birth training enhanced their expectations for birth processes. They demonstrated readiness and preparedness for this process, which would lead to improved childbirth outcomes.
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Onchonga D, MoghaddamHosseini V, Keraka M, Várnagy Á. Prevalence of fear of childbirth in a sample of gravida women in Kenya. SEXUAL & REPRODUCTIVE HEALTHCARE 2020; 24:100510. [PMID: 32217359 DOI: 10.1016/j.srhc.2020.100510] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/07/2020] [Accepted: 03/19/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of the study was to determine the prevalence of fear of childbirth (FOC) using a sample of gravida women in Kenya, a developing country where it is not fully acknowledged. MATERIALS AND METHODS This were a cross-sectional study on gravida women visiting health facilities to receive routine antenatal care. The study applied multistage sampling to enrol eligible expectant women. A researcher-developed questionnaire was used alongside Wijma Delivery Expectancy/Experience Questionnaire (version A) to collect respondents' demographic characteristics and to measure their fear of childbirth levels, respectively. RESULTS Approximately 29.5% had low, 40.4% moderate, 22.1% high, and 8% recorded severe FOC levels. Comparing by parity, the prevalence of severe FOC was higher on primigravida at 13.8% than multigravida, 8.0%. The results revealed a significant relationship between marital status (p = 0.045), parity (p = 0.000), literacy status (p = 0.000), regular check-up of pregnancy at health facilities (p = 0.003), having trust in healthcare providers (p = 0.000), and physical activity for gravida women with fear of childbirth (p = 0.000). CONCLUSION From the findings, special attention on the identified predictors of fear of childbirth during prenatal sessions would help in managing fear of childbirth before they give birth.
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Affiliation(s)
- David Onchonga
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Hungary.
| | - Vahideh MoghaddamHosseini
- Department of Midwifery, Faculty of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran; Non-Communicable Diseases Research Centre, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | | | - Ákos Várnagy
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Hungary
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Quality of life and the related factors in early postnatal women in Malawi. Midwifery 2020; 85:102700. [PMID: 32179390 DOI: 10.1016/j.midw.2020.102700] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 02/27/2020] [Accepted: 03/06/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To explore the quality of life (QOL) and related factors in early postnatal women. DESIGN A descriptive, cross-sectional study. SETTING Liwonde, Malawi. PARTICIPANTS Women who underwent a normal vaginal birth (N = 173) were included from August to September 2018. MEASUREMENTS The QOL of participants was assessed using a World Health Organization QOL instrument. Demographic, obstetric, and health variables were collected using a structured questionnaire. Childbirth fear and depression were respectively assessed using the Wijma Delivery Experience Questionnaire and the Edinburgh Postnatal Depression Scale. A multiple linear regression was used to examine factors associated with the QOL. RESULTS The mean age of participants was 29 (standard deviation 6.7) years. The overall QOL and health were satisfactory. The mean score of the QOL was highest in the psychological health and social relationships domains, followed by the environmental and physical health domains. A higher educational level was negatively related to the physical health of QOL (p ≤ 0.01), with physician care positively related (p = 0.01). The employment status was positively related to psychological health and the environmental QOL (p ≤ 0.01). Furthermore, a higher income, and physician care were positively related to the environmental QOL (p ≤ 0.05). High levels of childbirth fear and depressive symptoms were negatively related to all domains of the QOL (p ≤ 0.05), except for the social relationships domain. CONCLUSION AND IMPLICATIONS FOR PRACTICE The physical health QOL was lower in postnatal mothers in Malawi. Measures to improve physical health aspects and address women's fears and depressive symptoms during postpartum care are warranted. The findings should alert the health providers of the importance of assessing and improving women's physical health and psychological well-being during postpartum care.
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Hajarian Abhari Z, Karimi FZ, Taghizdeh Z, Mazloum SR, Asghari Nekah SM. Effects of counseling based on Gamble's approach on psychological birth trauma in primiparous women: a randomized clinical trial. J Matern Fetal Neonatal Med 2020; 35:668-676. [PMID: 32089025 DOI: 10.1080/14767058.2020.1730799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background: Psychological birth trauma has persistent adverse effects on the performance and health of women during and after childbirth. Therefore, Interventions to prevent and mitigate psychological birth trauma are of paramount importance.Objective: The present study aimed to investigate the effects of counseling based on Gamble's approach on psychological birth trauma in primiparous women.Materials and methods: This randomized clinical trial was conducted on 60 primiparous women referring to the health centers in Mashhad, Iran in 2018. In the intervention group, counseling was provided by an obstetrician based on Gamble's strategy to each participant in three sessions before delivery and one session postpartum. The participants in the control group only received routine prenatal care. Data were collected using demographic and obstetrics characteristics questionnaire and psychological birth trauma questionnaire. The data were analyzed using SPSS, version 21 and chi-square and independent t-test. p-value less than .05 was considered significant.Results: The mean age of the women in the intervention and control groups was 23.3 ± 3.9 and 24.4 ± 4.4, and the mean prenatal age upon delivery was 40.8 ± 5.7 and 39.8 ± 1.2 weeks respectively. The mean score of psychological birth trauma in the intervention (counseling) and control groups was 37.2 ± 10.4 and 47.6 ± 16.3, respectively, which was significantly lower in the intervention group (p = .003).Conclusion: According to the results, counseling based on Gamble's approach could reduce psychological birth trauma in primiparous women. Therefore, this effective, simple, cost-effective, and harmless approach could be employed to reduce intrapartum and postpartum maternal traumas and prevent adverse events for the mother and the newborn.
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Affiliation(s)
- Zahra Hajarian Abhari
- School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fatemeh Zahra Karimi
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Midwifery, School of Nursing and Midwifery, Mashhad University Medical of Medical Sciences, Mashhad, Iran
| | - Ziba Taghizdeh
- Department of Reproductive Health, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Reza Mazloum
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Seyyed Mohsen Asghari Nekah
- Department of Education and Psychology of Exceptional Children, Department of Educational Sciences, Ferdowsi University of Mashhad, Mashhad, Iran
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Reasons for Increased Caesarean Section Rate in Vietnam: A Qualitative Study among Vietnamese Mothers and Health Care Professionals. Healthcare (Basel) 2020; 8:healthcare8010041. [PMID: 32098136 PMCID: PMC7151040 DOI: 10.3390/healthcare8010041] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 02/17/2020] [Accepted: 02/18/2020] [Indexed: 12/24/2022] Open
Abstract
The Caesarean section rate in urban Vietnam is 43% in 2014, which is more than twice the recommended rate (10%-15%) by the World Health Organization. This qualitative study aims to identify the perceptions of pregnant mothers and health care professionals on the medical and social factors related to the increased Caesarean section rate in Vietnam. A qualitative descriptive study was conducted among pregnant mothers and healthcare professionals at two public hospitals in Nha Trang city. A content analysis was adopted in order to identify social and medical factors. As a result, 29 pregnant women and 19 health care professionals were invited to participate in the qualitative interviews. Private interviews were conducted with 10 women who wished to have a Caesarean section, and the others participated in focus group interviews. The main themes of the social factors were 'request for Caesarean section,' 'mental strain of obstetricians,' and 'decision-making process.' To conclude, this qualitative study suggests that there were unnecessary caesarean sections without a clear medical indication, which were requested by women and family members. Psychological fear occurred among women and family, and doctors were the main determinants for driving the requests for Caesarean section, which implies that education and emotional encouragement is necessary by midwives. In addition, a multi-faced approach including a mandatory reporting system in clinical fields and involving family members in antenatal education is important.
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Dissatisfaction with the husband support increases childbirth fear among Indonesian primigravida. ENFERMERIA CLINICA 2019. [DOI: 10.1016/j.enfcli.2019.04.047] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Uçar T, Golbasi Z. Effect of an educational program based on cognitive behavioral techniques on fear of childbirth and the birth process. J Psychosom Obstet Gynaecol 2019; 40:146-155. [PMID: 29583056 DOI: 10.1080/0167482x.2018.1453800] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
Objective: This study determined the effect of an educational program based on cognitive behavioral techniques (CBT) provided for pregnant women to address their fear of childbirth. Methods: This study was conducted experimentally using pretest-posttest and a control group. A total of 111 Turkish pregnant women were recruited with 52 in the intervention group and 59 in the control group. The intervention group attended the educational program on coping with childbirth fears based on CBT, which took 3 weeks over six sessions. The Wijma Delivery Expectancy/Experience Questionnaire, version-A (W-DEQ-A) was administered to both groups as the posttest. The researchers monitored the pregnant women's labor and delivery and the State Anxiety Inventory (SAI), Numeric Pain Rating Scale (NPRS) and Birth Process Evaluation Form were completed. Results: The post-education W-DEQ-A score was 63.5 in the control group and 39.4 in the intervention group (p < .001). Their labor pain was lower, the second stage of labor was shorter and birth was more satisfactory for the intervention group than for the control group (p < .05). The CBT-based educational program and pain severity during childbirth were the significant predictors of satisfaction with childbirth (β = 0.354; β = -0.324, respectively; p < .05 for all). Conclusions: The CBT-based educational program on coping with childbirth fears reduced pregnant women's fear of childbirth and positively affected their birth experience.
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Affiliation(s)
- Tuba Uçar
- a Department of Midwifery , İnönü University , Malatya , Turkey
| | - Zehra Golbasi
- b Department of Nursing , Cumhuriyet University , Sivas , Turkey
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From experiences to expectations: A quantitative study on the fear of childbirth among multigravida women. Arch Psychiatr Nurs 2019; 33:248-253. [PMID: 31227077 DOI: 10.1016/j.apnu.2018.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 07/14/2018] [Accepted: 11/09/2018] [Indexed: 11/24/2022]
Abstract
There is a strong relationship between women's previous birth experiences and their predetermined expectations. Childbirth expectations play an important role in the women's response to the birthing experience and postpartum period. The negative emotions and expectations, such as fear of childbirth, may result in negative experiences in subsequent childbirths. The aim of this study is to examine the relationship between previous birth experiences and the fear of childbirth in current pregnancy. A sample of 309 healthy women with normal pregnancies was recruited for this study. A chi-square test of independence and a multinomial logistic regression were used to explain the association between previous birth experiences and the fear of childbirth in current pregnancy. The level of childbirth fear that pregnant women feel appears to differ based upon their previous pregnancy experiences. Pregnant women who describe their previous births as happy and proud tend to experience a moderate level of childbirth fear about their current pregnancies, whereas pregnant women who remember their previous births as either fearful or painful have lower levels of childbirth fear. The level of childbirth fear tends to decrease as pregnant women have more children. Gestational week does not seem to be influential on the level of childbirth fear. According to the findings of this study, counterintuitively there is a negative relationship between the previous birth experience and childbirth fear. The level of childbirth fear is lower for pregnant women who remember their previous births as a negative experience compared to those who remember their previous births positively.
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O'Connell MA, O'Neill SM, Dempsey E, Khashan AS, Leahy-Warren P, Smyth RMD, Kenny LC. Interventions for fear of childbirth (tocophobia). THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2019. [DOI: 10.1002/14651858.cd013321] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Maeve Anne O'Connell
- P.O. Box 15503; RCSI Bahrain; Adliya Bahrain
- University College Cork; Irish Centre for Fetal and Neonatal Translational Research; Cork Ireland
| | - Sinéad M O'Neill
- Health Information and Quality Authority; Health Technology Assessment Directorate; Unit 1301, City Gate Mahon Cork Munster Ireland T12 Y2XT
| | - Eugene Dempsey
- Cork University Maternity Hospital; Neonatology; Wilton Cork Ireland
| | - Ali S Khashan
- University College Cork; School of Public Health; Cork Ireland
| | - Patricia Leahy-Warren
- University College Cork; School of Nursing and Midwifery; Brookfield Health Sciences Complex Cork Ireland
| | - Rebecca MD Smyth
- The University of Manchester; Division of Nursing Midwifery and Social Work; Jean McFarlane Building Oxford Road Manchester UK M13 9PL
| | - Louise C Kenny
- University of Liverpool; Faculty of Health and Life Sciences; Foundation Building, 765 Brownlow Hill Liverpool Merseyside UK
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O'Connell MA, Leahy‐Warren P, Kenny LC, O'Neill SM, Khashan AS. The prevalence and risk factors of fear of childbirth among pregnant women: A cross‐sectional study in Ireland. Acta Obstet Gynecol Scand 2019; 98:1014-1023. [DOI: 10.1111/aogs.13599] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 02/26/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Maeve A. O'Connell
- The Irish Center for Fetal and Neonatal Translational Research (INFANT Center) University College Cork Cork Ireland
- Department of Obstetrics and Gynecology University College Cork Cork Ireland
| | | | - Louise C. Kenny
- Department of Women's and Children's Health Institute of Translational Medicine University of Liverpool Liverpool UK
| | - Sinéad M. O'Neill
- Health Technology Assessment Directorate Health Information and Quality Authority Cork Ireland
| | - Ali S. Khashan
- The Irish Center for Fetal and Neonatal Translational Research (INFANT Center) University College Cork Cork Ireland
- School of Public Health University College Cork Cork Ireland
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