Pregnant women: What do they need to know during pregnancy? A descriptive study

Description of the culture of childbirth and parenting classes in Cyprus: An ethnographic approach

INTRODUCTION

Childbirth and parenting classes are very important because they potentially help couples to make the right decisions during pregnancy, childbirth, and the postpartum period, which has a direct effect on the health of the mother and neonate. However, in Cyprus, the culture of childbirth and parenting classes has not been previously explored.

METHODS

An ethnographic study design was adopted, specifically non-participant observation was undertaken of 19 classes. Semi-structured telephone interviews were employed to collect data in addition to field notes and a reflective diary. Inductive content analysis was undertaken to analyze the data.

RESULTS

Four main thematic categories emerged from data analysis: 1) Views and opinions about the course, 2) Important perinatal topics, 3) Usefulness and reasons for attending the classes, and 4) The journey of learning. The importance of antenatal classes has not been given sufficient attention in Cyprus.

CONCLUSIONS

There is a clear need for a standardized curriculum within the current configuration of national maternity healthcare in Cyprus. Policymakers must implement a standardized curriculum, integrating diverse pedagogical methods to provide in-depth information for expectant parents and parents. While emphasizing the crucial role of midwives in perinatal education, this study also advocates for collaboration with other healthcare professionals emphasizing the imperative need for a comprehensive, standardized approach to perinatal education within the national healthcare system of Cyprus.

Attitudes and perceptions towards developing a health educational video to enhance optimal uptake of malaria preventive therapy among pregnant women in Uganda: a qualitative study involving pregnant women, health workers, and Ministry of health officials

BACKGROUND

Malaria in pregnancy remains a major global public health problem. Intermittent prophylaxis treatment of malaria in pregnancy with Sulphadoxine-pyrimethamine and co-trimoxazole is efficacious for prevention of malaria in pregnancy HIV negative and positive women, respectively. However, uptake of the recommended doses of therapies has remained suboptimal in Uganda, majorly due to inadequate knowledge among pregnant women. Therefore, this study aimed to explore attitudes and perceptions towards developing an educational video for malaria preventive therapy.

METHODS

We conducted an exploratory study with qualitative methods among pregnant women attending antenatal care at Kisenyi Health Center IV (KHCIV), health workers from KHCIV, and officials from the Ministry of Health. The study was conducted at KHCIV from October 2022 to March 2023. Focus group discussions (FGD) were conducted among purposively selected pregnant women and key informant interviews (KII) among health workers and Ministry of Health officials. Data were analyzed using inductive and deductive thematic methods in atlas ti.8.

RESULTS

A total of five FGDs comprising of 7-10 pregnant women were conducted; and KIIs were conducted among four mid-wives, two obstetricians, and two Ministry of Health officials. Generally, all respondents mentioned a need for interventions to improve malaria preventive knowledge among pregnant women; were positive about developing an educative video for malaria preventive therapy in pregnancy; and suggested a short, concise, and edutaining video focusing both the benefits of taking and risks of not taking malaria preventive therapy. They proposed that women may be encouraged to view the video as soon as they conceive and throughout the pregnancy. It also was suggested that the video may be viewed on television sets in maternal and reproductive health clinics and homes, and on smart phones.

CONCLUSION

Pregnant women, health workers, and Ministry of Health officials were positive about the development of a short edutaining video on malaria preventive therapy that focuses on both benefits of taking and risks of not taking the malaria preventive therapy in pregnancy. This information guided the video development and therefore, in the development of health educative videos, client and stakeholder inputs may always be solicited.

Exploring the healthcare needs and experiences of pregnant women with congenital heart disease: A qualitative study

PROBLEM

Little is known regarding the healthcare needs and experiences of pregnant women with congenital heart disease (CHD) during pregnancy.

BACKGROUND

Congenital heart diseases are the most common birth anomalies, and they embrace a wide range of defects ranging from mild to complex and life-threatening defects. Pregnancy carries many physiological and psychological changes that affect pregnant woman with CHD and need special attention and consideration.

AIM

To explore the healthcare needs and experiences of Jordanian women with CHD during pregnancy.

METHODS

A descriptive phenomenological design was used. Utilising purposive sampling, 15 participants were recruited. Data was collected using individualised semi-structured interviews. Interviews were recorded and transcribed verbatim. Data were analyzed using Colaizzi's method.

FINDINGS

Three themes were identified: a) A broad spectrum of health needs during pregnancy, b) not being cared for, c) and the healthcare journey: Challenges and recommendations. Findings revealed that pregnancy in women with CHD is associated with many challenges and needs, and the lived healthcare experiences are mostly negative.

DISCUSSION

This study addresses the healthcare needs and experiences of pregnant women with CHD during pregnancy. Our findings shed light on healthcare needs explored hidden aspects of the experiences of this vulnerable population and gave them the chance to make their voices heard.

CONCLUSION

The study concluded that pregnant women with CHD experience hardship associated with negative challenges and personal suffering. The findings highlight the importance of the basic values and the need for a holistic approach and effective teamwork to minimise suffering among pregnant women with CHD.

Social Media in Pregnancy Care: Exploring Adoption Factors and Digital Healthcare Information Utilization among Expectant Mothers in Ghana

Background

The Antenatal Care (ANC) Center is a conventional facility that caters for the prenatal healthcare needs of expectant mothers and ensures proper management by healthcare professionals; however, expectant mothers seek healthcare support from other sources. This study aimed to examine the utilization of social media for healthcare information among expectant mothers in the capital city of Ghana and explore the factors that influence its adoption.

Method

This study employed a non-experimental survey design. The study used a questionnaire to gather data from expectant mothers. Using 580 valid responses, SmartPLS structural equation modeling (SEM) was used to analyze the study model.

Results

The study findings demonstrated the significant influence of performance expectancy of social media (PESM) and facilitating conditions of social media (FCSM) on social media healthcare information usage (SMHLU). The results also revealed that emotional support on social media and perceived vulnerability were influential factors that shaped expectant mothers' choices to use social media for healthcare information. However, the study showed that perceived severity and the relative advantage of social media had no significant effects on SMHIU. Interestingly, FCSM was found to be significantly associated with PESM, emphasizing that social media support enhances performance expectancy.

Conclusion

This study showed that information is important to expectant mothers, which compels them to seek digital healthcare. With these findings, healthcare providers can incorporate digital health services into their ANC service to support women during pregnancy.

A systematic review of behaviour change techniques used in the context of stillbirth prevention

BACKGROUND

Stillbirth is one of the most devastating pregnancy outcomes that families can experience. Previous research has associated a wide range of risk factors with stillbirth, including maternal behaviours such as substance use, sleep position and attendance and engagement with antenatal care. Hence, some preventive efforts have been focused on tackling the behavioural risk factors for stillbirth. This study aimed to identify the Behaviour Change Techniques (BCTs) used in behaviour change interventions tacking behavioural risk factors for stillbirth such as substance use, sleep position, unattendance to antenatal care and weight management.

STUDY DESIGN

A systematic review of the literature was conducted in June 2021 and updated in November 2022 in five databases: CINHAL, Psyhinfo, SociIndex, PubMed and Web of Science. Studies published in high-income countries describing interventions designed in the context of stillbirth prevention, reporting stillbirth rates and changes in behaviour were eligible for inclusion. BCTs were identified using the Behaviour Change Technique Taxonomy v1.

RESULTS

Nine interventions were included in this review identified in 16 different publications. Of these, 4 interventions focused on more than one behaviour (smoking, monitoring fetal movements, sleep position, care-seeking behaviours), one focused on smoking, three on monitoring fetal movements and one on sleep position. Twenty-seven BCTs were identified across all interventions. The most commonly used was "Information about health consequences" (n = 7/9) followed by "Adding objects to the environment" (n = 6/9). One of the interventions included in this review has not been assessed for efficacy yet, of the remaining eight, three showed results in the reduction of stillbirth rates. and four interventions produced behaviour change (smoking reductions, increased knowledge, reduced supine sleeping time).

CONCLUSIONS

Our findings suggest that interventions designed to date have limited effects on the rates of stillbirth and utilise a limited number of BCTs which are mostly focused on information provision. Further research is necessary to design evidence base behaviour change interventions with a greater focus to tackle all the other factors influencing behaviour change during pregnancy (e.g.: social influence, environmental barriers).

Vaccine Hesitancy Phenomenon Evolution during Pregnancy over High-Risk Epidemiological Periods-"Repetitio Est Mater Studiorum"

(1) Background: The recent epidemiological events were high-stress level generators for humanity, particularly for pregnant women, influencing their attitude, behavior, and decisions regarding vaccination during pregnancy or regarding their future child. The aim of this study was to analyze the anti-pertussis vaccination decision-shaping factors in pregnant women during two epidemiological periods: the measles epidemic and the COVID-19 pandemic. (2) Methods: Two groups of pregnant women were invited to be part of a medical education program, having as the main theme the infectious disease risks and their prevention through vaccination. Before launching the program, participants received a 12-item questionnaire. From a total number of 362 pregnant women enrolled in the study, 182 participated in 2019, and 180 participated in 2022. (3) Results: The socio-demographic data revealed that the age of pregnant women participating in medical education programs increased in 2022 by 1.7 years (p < 0.01). In vitro fertilization was reported in a significantly higher proportion (20% in 2022 vs 9.8% in 2019, p < 0.01). Participation in community-initiated educational programs almost doubled during the pandemic time from 18.7% in 2019 to 33.9% in 2022 (p < 0.01). Pertussis vaccine acceptancy (VA) dropped from 85% in 2019 to 44.4% in 2022 (p < 0.01) (4) Conclusions: In this study, we reported fast-growing vaccine hesitancy and severe declared vaccine reluctance. The results of this complex long-term study, which evaluated pregnant women over several years, showed a five-fold increase in the percentage of pregnant women who disagreed with personal pertussis vaccination. This draws attention to the risks of pertussis epidemic outbreaks in pregnant women and their future infants in the first couple of months of life before the initiation of vaccination.

Exploring the lived experiences of women with congenital heart disease during pregnancy: A phenomenological study

OBJECTIVE

Congenital heart diseases (CHDs) are the most common birth anomalies, and they embraced a wide range of defects ranging from mild defects to complex and life-threatening defects. Medical advancement improved children's survival, and more females are reaching childbearing age. The purpose of this study was to explore and describe the lived experience of Jordanian pregnant women with CHD during pregnancy.

METHOD

This study used a descriptive phenomenological design. Purposive sampling was used in recruiting 15 women from Jordan with CHD who had given birth to at least one live newborn. The study was conducted from October 2019 to April 2020. Data was collected from a public cardiac centre using face-to-face semi-structured interviews. Interviews were recorded and transcribed verbatim. Analysis was done using Colaizzi's method.

FINDINGS

Three themes were identified: Being a woman with CHD, being pregnant with CHD, and being a CHD patient and healthcare-seeking behaviour. The findings revealed that pregnancy experiences of women with CHD are usually associated with many difficulties, negative emotions, and challenges.

CONCLUSION AND IMPLICATIONS FOR PRACTICE

The findings indicated the need for increased awareness and the importance of social support amongst both Jordanian women with CHD and healthcare providers. Also, the study provides new information to healthcare providers and policymakers to better understand the lived experiences of pregnant with CHD from their perspectives as it was associated with many difficulties, negative emotions, and challenges.

Antenatal Education Services in Oman: A Descriptive Qualitative Inquiry of Healthcare Provider's Perspective

Introduction

To ensure positive pregnancy and birth outcomes, healthcare providers working in antenatal clinics are expected to provide regular antenatal education to enable early detection and timely treatment of pregnancy-related morbidities to prevent complications during labor, birth, and postnatal period. Although antenatal education and services are provided through standard programs in developed countries, presently there are no well-structured programs in many developing countries. The study compares the current service with the national and international guidelines.

Objective

To identify the current practices of healthcare providers in antenatal education service in Oman with the aim of identifying any major implementation gaps.

Methods

A qualitative inquiry was implemented through semi-structured in-depth interviews guided by open-ended questions. The study population were healthcare providers who routinely provide antenatal services at healthcare facilities. A purposive non-probability sampling technique was used to select the key informants. Data was analyzed manually using the thematic analysis framework.

Results

The antenatal education services provided fall under four themes: In relation to "Education for safe pregnancy," the findings revealed that healthcare providers did not adequately address the needs. In relation to "Education for Safe labor and Birth," the pregnant women are briefed with inadequate information about labor and birth during the antenatal period. In relation to "Education related to Postpartum," healthcare providers generally do not provide information regarding pregnant women's psychological wellbeing, breastfeeding, family planning, hygiene, and nutrition during antenatal visits. In relation to "Education related to Newborn Care," the study findings indicate that contrary to what was stipulated by the WHO (2016) to establish antenatal educational programs to help pregnant women gain the skills and knowledge regarding proper newborn care, our findings demonstrated a lack of education about newborn care by providers.

Conclusion

The findings have the capacity to contribute towards the development of remedial strategies to improve maternal and neonatal outcomes in Oman. This can be achieved by addressing the practice gaps identified when comparing the current practices with international standards.

A Qualitative Inquiry of Women's Perspective of Antenatal Education Services in Oman

Introduction

Antenatal care (ANC) provides an opportunity for systematic assessment and follow-up of pregnant women to ensure positive outcomes for mother and foetus. Pregnant women should be offered evidence-based information with support to enable them to make informed decisions.

Objective

To identify the gap between the current practices and the recommended guidelines for antenatal education services in Oman.

Methods

A qualitative inquiry was implemented through semistructured in-depth interviews guided by open-ended questions and probes. A purposive non-probability sampling technique was used to select 13 pregnant women who had completed 30 weeks of gestation. The women were selected from 9 antenatal healthcare facilities among them: 7 primary health centers, one polyclinic and one, tertiary hospital.

Results

Antenatal education focused on four thematic areas of safe pregnancy; safe labor and birth; postpartum care; and new-born care. Regarding antenatal education for safe pregnancy, the findings indicate that most healthcare workers provided pregnant women adequate information to promote healthy dietary habits; cope with pregnancy symptoms; recognize and manage medical conditions, and to adhere to dietary supplements and medication. In addition, the findings revealed that the healthcare team did not provide the required antenatal education to meet the pregnant women's needs to ensure they had safe labor and birth, postpartum care, and new-born care.

Conclusion

This study is the first of its kind in Oman to provide baseline data regarding the current antenatal education services from the perspective of pregnant women. These findings will help in developing strategies to improve maternal and neonatal outcomes in the country.

Pregnant Women’s Perception of Pregnancy, Childbirth and Postpartum Care: Literature Review in Developing Countries

Background: Approximately 10.7 million pregnant women have passed away from 1990 to 2015 due to obstetric complications. Nearly all of them (99% of global maternal deaths) take place in developing countries. As a matter of fact, most people in dveloping countries have implemented many cultural practices which bring about negative effects on pregnant women’s health behaviour to potentially have greater risk of obstetric complications. Unfortunately, no comprehensive research yet conducted especially on pregnant women’s perceptions of pregnancy, childbirth, and postpartum care (PC) in developing countries.      Objective: To identify factors of pregnant women’s perception of pregnancy, childbirth, and postpartum care in developing countries   Method: The research was carried out through Literature Review in which electronic database search the so-called database Science Direct, PubMed, Elsevier (SCOPUS), Springerlink, and Google Schoolar was conducted in January 2021. The steps of systematic review were through Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) method.       Results: Modifying factors with pivotal role during the service of pregnancy, childbirth, and postpartum care in developing countries are knowledge, ethnicity, socioeconomics, and personality. Most individual beliefs in developing countries are perceived barriers. Whereas, Perceived susceptibility and severity of disease, perceived benefits, perceived self efficacy and perceived threat to make the most use of health service during pregnancy, childbirth, and postpartum care are also well-known with variables of external cues to action is among the most popular ones especially with personal experience and information from neighborhood with local habits and belief unsupportive to health service.   Conclusion: Factors to influence perception, practice, and access during pregnancy, childbirth, and postpartum care in developing countries are culture, knowledge, distance, education, experience, mental stress, no decision making autonomy and social supports. Thus, comprehensive research on the influence of modifying factors of individual behavior and cues to action needs to be carried out.     Keywords: Perception, Pregnancy, Childbirth, Postpartum Care

A qualitative study of assessing learning needs and digital health literacy in pregnancy: Baby Buddy Forward Greek findings

INTRODUCTION

The purpose of this study was to explore the learning needs and the digital health literacy of pregnant women in Greece regarding perinatal health and care issues.

METHODS

This was a qualitative study involving thirteen Greek pregnant women, in two focus groups of primiparous and multiparous. The interview topic guide was developed by consensus during a training workshop of the European Baby Buddy Forward research program. The interviews were recorded, transcribed and inductively content analyzed.

RESULTS

Pregnant women described a range of learning needs and identify antenatal classes, health professionals, Internet, books, friends and relatives, as their main sources of information. Women expressed satisfaction in terms of their communication with midwives, but they expressed ambiguity regarding communication with doctors. With regard to the Internet, women highlighted their concern about the validity of information and point out the difficulties they face in order to access reliable scientific resources. Moreover, the process of seeking information online occurs in parallel and independently from healthcare providers, who discourage it, thus, many women were reluctant to discuss any information they retrieved from the Internet with health professionals.

CONCLUSIONS

The content of antenatal classes should be tailored to address pregnant women learning needs more holistically. However, taking into consideration that a major source of information for pregnant women is the Internet, it is vital for health professionals to acknowledge this reality and provide pregnant women with trusted websites. It is also particularly important for health professionals to practice their communication skills and update their digital knowledge.

The Influence of Sociodemographic Factors, Lifestyle, and Risk Perception on Dietary Patterns in Pregnant Women Living in Highly Contaminated Areas: Data from the NEHO Birth Cohort

During pregnancy, maternal nutrition and lifestyle play a critical role in influencing fetal development and newborn health outcomes. The aim of this study is to investigate the factors influencing the adherence to dietary patterns in pregnant women living in highly contaminated areas, and whether women with higher environmental risk perception manifest different nutritional behaviors during pregnancy. Food consumption data on 816 pregnant women from the Neonatal Environment and Health Outcomes (NEHO) residential birth cohort were analyzed. Dietary patterns were computed by principal component analysis. A multinomial logistic regression was also applied to identify sociodemographic, lifestyle, and pregnancy-related determinants of adherence to dietary patterns during pregnancy. Three patterns of food consumption—explaining 24.9% of the total variance—were identified as “prudent”, “high energy”, and “vegetarian” patterns. Results suggest that food choices during pregnancy follow a social gradient and align with other health behaviors during pregnancy: older, better educated, and physically active women with higher risk perception are more likely to follow healthier dietary patterns. Knowledge about what is eaten can contribute to dietary choices. Interventions to improve the prenatal nutrition knowledge of pregnant women are needed, especially concerning younger mothers and those with lower educational levels.

The barriers and facilitators of Iranian men's involvement in perinatal care: a qualitative study

Introduction

Pregnancy and childbirth are crucial events in women's lives that can be done well with the support of people around them, especially their husbands. However, a number of factors can reduce or increase the supportive role of spouses during this period. The aim of the present study was to explore the barriers and facilitators of Iranian men's involvement in perinatal care.

Materials and methods

This was a qualitative phenomenological study that sampling of respondents (pregnant women or the women who have recently given birth (one week to six months after childbirth), spouses, policy makers and midwifery service providers) was done through purposive sampling. The inclusion criteria included: being Iranian, the ability to understand and transfer the concepts into Persian, and employment in a midwifery center for at least one year (for service providers). Data were collected through in-depth interviews until the data saturation. The collected data were analyzed by conventional content analysis based on Graneheim and Lundman method steps. MAXQDA version 10 software was used to manage the data and Guba and Lincoln criteria were also used to ensure the trustworthiness of findings.

Results

Men's involvement in perinatal care was found to be influenced by certain incentives, particular constraints and some gender authoritarian attitudes. There were 5, 4, and 3 subcategories in incentives, constraints, and gender attitudes respectively.

Conclusion

The results revealed that men face a dual mechanism in participating in perinatal care, in which some of these factors can facilitate their participation and others can reduce it.

Men's participation in the perinatal period can reduce the problems of this period and leave a good memory for the whole family. In this phenomenological qualitative study, through in-depth interviews, participants were asked to express their experiences and views on men's participation in the perinatal period and the factors that increase and decrease their participation. Finally, the data were analyzed using the proposed method of Graneheim and Lundman and MAXQDA software. Interviews were conducted with 21 people (data saturation limit) and the data were classified into 3 main categories and 12 sub-categories. The results revealed that men face a dual mechanism in participating in perinatal care, in which some of these factors can facilitate their participation and others can reduce it.

Eating Behaviors and Dietary Patterns of Women during Pregnancy: Optimizing the Universal 'Teachable Moment'

Understanding women’s perceptions of eating behaviors and dietary patterns can inform the ‘teachable moment’ model of pregnancy. Our objectives were to describe eating behaviors and dietary patterns in pregnancy. This was a cross-sectional, national electronic survey. Women were ≥18 years of age, living in the United States, currently pregnant or less than two years postpartum, and had internet access. Age, education, race, and marriage were included as covariates in ordinal and binary logistic regressions (significance p < 0.05). Women (n = 587 eligible) made positive or negative changes to their diets, while others maintained pre-existing eating behaviors. The majority of women did not try (84.9 to 95.1% across diets) and were unwilling to try (66.6 to 81%) specific dietary patterns during pregnancy. Concerns included not eating a balanced diet (60.1 to 65.9%), difficulty in implementation without family (63.2 to 64.8%), and expense (58.7 to 60.1%). Helpful strategies included being provided all meals and snacks (88.1 to 90.6%) and periodic consultations with a dietitian or nutritionist (85 to 86.7%). Responses differed across subgroups of parity, body mass index, and trimester, notably in women with obesity who reported healthier changes to their diet (p < 0.05). Our study underscores the importance of tailoring care early to individual needs, characteristics, and circumstances.

Information Needs During Pregnancy and Its Associated Factors in Afghan Pregnant Migrant Women in Iran

Background: Access to pregnancy-related information is an important requirement for all pregnant women, especially women at risk, such as immigrants. Regarding this, the present study was conducted to determine the information needs during pregnancy and its associated factors in the Afghan pregnant women. Methods: This cross-sectional study was conducted on 280 Afghan pregnant women who received care at the prenatal clinics of selected health care centers in the southeast of Tehran in 2018. The study population was selected using the continuous sampling method. The sampling was performed through the continuous sampling method from all the Afghan pregnant women who received care at the prenatal health centers of the southeast of Tehran. Results: Among the information needs during pregnancy, the fetal (83.34 ± 20.65) and smoking (62.61 ± 28.88) domains had the highest and lowest mean scores by percentage, respectively. The information needs during pregnancy showed a statistically significant relationship with age, women’s education level, husband’s education level, duration of living in Iran, place of residence, insurance status, number of children, place of the previous delivery, and routine prenatal care. Based on the multiple regression model, only the place of birth and place of residence accounted for 19% of information needs during pregnancy. Conclusion: As the findings indicated, the prenatal care–related education should address the domains that are unknown for Afghan women. Furthermore, in this education, the demographic and reproductive characteristics of the recipients should be taken into account to improve the pregnancy outcome among this population.

Sources of get information and related factors during pregnancy among Afghan migrant women in Iran

AIM

The present study aims to investigate the sources of information and its related factors among pregnant Afghan migrant women who reside in southeast Tehran Province, Iran.

DESIGN

Cross-sectional study.

METHODS

A total of 280 pregnant Afghan women who received care at the prenatal clinics of selected healthcare centres in southeast Tehran Province (Iran) in 2018 enrolled in this study. Data were collected by continuous sampling by a questionnaire that asked about demographic, obstetric and sources of information used during pregnancy.

RESULTS

The most important sources of information accessed by pregnant Afghan women were healthcare providers (65.1%), family and friends (47.55%), the Internet (32.1%) and media (18.9%). There was statistically a significant relationship between sources of information and education level, number of children, length of residence in Iran, place of birth and insurance status.

Technology-Supported Interventions for Pregnant Women: A Systematic Review

Technology is deeply embedded in daily life; thus, more pregnant women seek information through the Internet and incorporate the use of technological devices during their pregnancies. This systematic review aimed to examine to what extent and how technology-supported interventions were developed and delivered to pregnant women, as well as intervention effects on the targeted outcomes. Electronic data were collected from MEDLINE, CINAHL, and Scopus. Among the 11 selected studies, most were pilot studies to test the feasibility, acceptability, or preliminary effects of technology-supported interventions. The studies included both women with healthy pregnancies and pregnancies complicated by factors including preterm labor, smoking, and alcohol abuse. Most were conducted in the US, and most participants were white or African American. Interventions were primarily developed by research teams and focused on mental health issues including depression, anxiety, and stress. Interventions incorporated the use of technology including computers, mobile phones, and audiovisual aids. The overall interventions were reported to be feasible, acceptable, and beneficial in all the selected studies. Based on the review of literature, suggestions were provided for future research including the need for careful selection of intervention topics and objectives to target women who can benefit more from technology-supported interventions.

Keep Doing the Good Work: Impact of Coworker and Community Support on Continuation of Breastfeeding

Returning to work poses a challenge to new mothers' breastfeeding success during the first 6 months postpartum. While previous research has shown that breastfeeding-related workplace policy plays a significant role in women's decision to continue breastfeeding, the extent to which interpersonal factors such as coworkers' (lack of) support and stigma affect women's breastfeeding behavior is less understood. Through a cross-sectional survey with 500 working mothers, this research found that female coworker support of other women played an important role in affecting mothers' decision to continue breastfeeding after returning to work and contributed to breastfeeding self-efficacy. The findings suggest that mothers' perception of supportive coworker communication has an impact on sustained breastfeeding. Workplaces need to enhance the mother-friendly climate by encouraging and rewarding coworkers and providing support necessary for breastfeeding colleagues.

Consensus on priorities in maternal education: results of Delphi and nominal group technique approaches

Background

Maternal education is wide-ranging and covers many areas from pregnancy to the immediate postpartum period and childrearing. However, for it to be effective, more resources need to be assigned to key topics. The goal of this study was to identify and prioritize the most important issues in maternal education, so that specific objectives could subsequently be set and learning outcomes evaluated.

Methods

We drew up a comprehensive list of topics addressed in existing maternal education programs, based on a systematic review of information obtained from the Internet and the experience of the research team. The topics were presented to a multidisciplinary panel whose members were asked to rate them from 1 to 9, and consensus of opinion was reached using a two-round Delphi survey, with consensus defined beforehand as 80% agreement among panelists in awarding a score of 7, 8 or 9. The most highly-rated topics were then discussed and again prioritized by a multidisciplinary team of healthcare and non-healthcare experts, using a nominal group technique.

Results

Initially, 650 topics were identified and grouped into 80 categories which were then prioritized by 54 healthcare and non-healthcare experts using a Delphi survey with a study participation rate of around 20%. 63 topics were considered very important, so criteria were restricted and only the 24 highest-scoring selected (95% of agreement on scores ≥7 or 80% of agreement on scores ≥8). Using the nominal group technique, a group of 12 experts identified the following priorities: initiation and establishment of breastfeeding, development of a birth plan, identification of problems and self-care postpartum, nutrition and a healthy lifestyle, options for pain management in labor and birth and characteristics of a normal newborn/looking after a newborn baby.

Conclusion

This study, with a Delphi study and the Consensus among Experts: the nominal group technique, has succeeded in identifying priority topics in maternal education. We need to assess women’s needs in relation to these topics, design an intervention to respond to these needs and evaluate its effectiveness.

Health information needs, sources of information, and barriers to accessing health information among pregnant women: a systematic review of research

INTRODUCTION

Awareness of health information needs, sources of health information, and barriers to accessing health information among pregnant women is critical for the development of health interventions and provides high-quality prenatal care for them. Hence, the aim of this review study was to summarize evidence from studies evaluating health information needs, sources of information and barriers to accessing health information of women during pregnancy.

METHODS

A systematic literature search was conducted using Web of Science, Scopus, PubMed, ScienceDirect, and Google Scholar for relevant studies published between 1 January 2000 and 24 May 2018. The methodological quality of cross-sectional studies was assessed using the STROBE checklist. The Critical Appraisal Skills Programme (CASP, 2018) was used to appraise the qualitative studies. Data were analyzed descriptively.

RESULTS

Thirty-one studies from 14 countries met criteria for inclusion in this review. The majority of articles focused on information needs and sources of information used by women during pregnancy. The most common information needs among women during pregnancy were information about unborn child, nutrition, and labor/delivery. The most frequent information source used by women during pregnancy was health professionals followed by informal source (family and friends), and Internet. The most prominent barriers to information access included the following: feeling ashamed or embarrassed to talk about pregnancy-related issues, long waiting times at clinic to see a health provider, and lack of adequate information resources.

CONCLUSIONS

Due to the limited number of studies examining barriers to health information seeking among pregnant women, further research is warranted. Further qualitative research is also recommended to explore pregnant women's perceptions of, and satisfaction with the use of health information sources.

Mobile Web-based Education: Engagement and Satisfaction with HiChart among Pregnant Women

PURPOSE

This study aimed to examine engagement and satisfaction with a mobile web-based education program (HiChart) among pregnant women.

METHODS

A cross-sectional descriptive study was conducted of 97 pregnant women hospitalized for obstetric care. Data were collected from October 1 to November 30, 2016, and were analyzed with descriptive statistics.

RESULTS

Among participants, 16.5% engaged fully with HiChart, while 43.3% engaged partially. The overall satisfaction with HiChart was high. Some main reasons for not engaging with the education were participants' unawareness of the text messages, lack of time, and poor internet connection. The participants suggested that more educational content needed to be covered, such as coping with infant emergencies and information about the neonatal intensive care unit.

CONCLUSION

To increase pregnant women's engagement with mobile web-based education, efforts are needed to strengthen the system of sending text messages as part of mobile web-based education to all patients, to inform pregnant women that an educational web link was sent, and to encourage them to engage with mobile web-based education. Furthermore, it is essential to improve the HiChart service by providing educational content corresponding to users' needs.

Exploring woman -Nurse interaction in a Jordanian antenatal clinic: A qualitative study

BACKGROUND

Effective woman-nurse interaction is critical in providing quality nursing care and would improve the health outcomes and the level of women's satisfaction with health and nursing services.

AIM

To explore how Jordanian nurses and pregnant women perceive their interaction during antenatal visits.

METHODS

A descriptive qualitative study was conducted using a purposive sample of twelve pregnant women and twelve nurses. Data were collected through four focus group discussions organized at an antenatal clinic of a large hospital in Jordan. The data were analyzed using Giorgi's four stages of data analysis.

FINDINGS

Approaches to interaction; barriers to interaction; quality of interaction were the main themes emerged from the data. Nurses and pregnant women also provided suggestions for strengthening the womannurse interaction during antenatal visits.

CONCLUSION

The different aspects of interaction described by the participants of this study may raise awareness and appreciation of the important roles health care providers can play in promoting the health outcomes of pregnant women when effective interaction is built and strengthened. Relevant policies and guidelines on improving appointment systems, and continuing education on communication skills and health education would be needed. More attention is required to adopt appropriate antenatal clinical guidelines and protocols to meet women's needs in Jordan.

Pregnant in prison: An integrative literature review

BACKGROUND

Pregnant women in prisons are recognised as a marginalised group. However, there is a limited understanding of the women's unique maternity needs and how correctional institutions and maternity service providers respond to these needs.

AIM

The aims of the review are threefold.

METHOD

An integrative literature review was undertaken. A comprehensive search strategy using seven electronic databases resulted in the retrieval of 363 articles. Of them, 32 peer-reviewed studies met the final selection criteria and were included in this review which utilised the Critical Appraisal Skills Program tools and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flowchart. Thematic analysis identified universal themes.

FINDINGS

Three dominant themes emerged related to the experience of pregnant women in prison: (1) risks and vulnerability factors; (2) prison enablers and supports; and (3) prison barriers. Extant research on risks and vulnerability factors is disproportionate to research examining how prisons can enable or obstruct responding to the women's perinatal needs. Limited research on the midwifery support available to the women in prison is available. Significantly, only two out of 32 reviewed papers include research directly conducted with the pregnant women in prison.

CONCLUSION

Pregnant women in prisons have complex needs. More research is required to understand how prisons can enhance the pregnancy experience by engaging pregnant women in prisons as research participants.