1
|
Rice AR, Durowaye TD, Konkle ATM, Phillips KP. Exploring online reproductive health promotion in Canada: a focus on behavioral and environmental influences from a sex and gender perspective. BMC Public Health 2024; 24:1647. [PMID: 38902656 PMCID: PMC11188500 DOI: 10.1186/s12889-024-19159-5] [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: 01/12/2024] [Accepted: 06/14/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Reproductive health promotion can enable early mitigation of behavioral and environmental risk factors associated with adverse pregnancy outcomes, while optimizing health of women + (all genders that can gestate a fetus) and babies. Although the biological and social influences of partners on pregnancy are well established, it is unknown whether online Canadian government reproductive health promotion also targets men and partners throughout the reproductive lifespan. METHODS Reproductive health promotion, designed for the general public, was assessed in a multi-jurisdictional sample of Canadian government (federal, provincial/territorial, and municipal) and select non-governmental organization (NGO) websites. For each website, information related to environmental and behavioral influences on reproductive health (preconception, pregnancy, postpartum) was evaluated based on comprehensiveness, audience-specificity, and scientific quality. RESULTS Government and NGO websites provided sparse reproductive health promotion for partners which was generally limited to preconception behavior topics with little coverage of environmental hazard topics. For women + , environmental and behavioral influences on reproductive health were well promoted for pregnancy, with content gaps for preconception and postpartum stages. CONCLUSION Although it is well established that partners influence pregnancy outcomes and fetal/infant health, Canadian government website promotion of partner-specific environmental and behavioral risks was limited. Most websites across jurisdictions promoted behavioral influences on pregnancy, however gaps were apparent in the provision of health information related to environmental hazards. As all reproductive stages, including preconception and postpartum, may be susceptible to environmental and behavioral influences, online health promotion should use a sex- and gender-lens to address biological contributions to embryo, fetal and infant development, as well as contributions of partners to the physical and social environments of the home.
Collapse
Affiliation(s)
- Alexandra R Rice
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, 25 Université Private, Ottawa, ON, K1N 6N5, Canada
| | - Toluwanimi D Durowaye
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, 25 Université Private, Ottawa, ON, K1N 6N5, Canada
| | - Anne T M Konkle
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, 25 Université Private, Ottawa, ON, K1N 6N5, Canada
- University of Ottawa Brain and Mind Research Institute, University of Ottawa, Ottawa, ON, K1H 8M5, Canada
| | - Karen P Phillips
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, 25 Université Private, Ottawa, ON, K1N 6N5, Canada.
| |
Collapse
|
2
|
Hadjigeorgiou E, Frangou M, Koliandri Y, Christofi MD, Middleton N. Description of the culture of childbirth and parenting classes in Cyprus: An ethnographic approach. Eur J Midwifery 2024; 8:EJM-8-25. [PMID: 38832252 PMCID: PMC11145719 DOI: 10.18332/ejm/186665] [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: 09/05/2023] [Revised: 03/29/2024] [Accepted: 04/15/2024] [Indexed: 06/05/2024] Open
Abstract
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.
Collapse
Affiliation(s)
- Eleni Hadjigeorgiou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Maria Frangou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Yianna Koliandri
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Maria-Dolores Christofi
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Nicos Middleton
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| |
Collapse
|
3
|
Greenwald A. Prompting and Modeling of Coping Strategies during Childbirth. Behav Anal Pract 2024; 17:283-295. [PMID: 38405273 PMCID: PMC10891025 DOI: 10.1007/s40617-023-00837-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2023] [Indexed: 02/27/2024] Open
Abstract
There is ample evidence to suggest that upright positions and mobility during labor improve birth outcome, including shorter duration of childbirth and reduced risk of cesarean section. The use of nonpharmacological interventions for pain management during childbirth are recommended by major health-care institutions and medical providers, however, the current methodologies for training coping strategies for use during labor have not shown to be effective on mobility or birth outcome. The purpose of this study was to apply an in-vivo teaching technology to the current childbirth model to prompt an imitative repertoire of empirically demonstrated labor coping strategies. Results of this study concluded that the introduction of a software using immediate prompting and video modeling increased the frequency and variability of labor behaviors during unmedicated labor for birthing persons and their partners.
Collapse
Affiliation(s)
- Ashley Greenwald
- University of Nevada Reno, 1664 North Virginia Street, Reno, NV 89557 USA
| |
Collapse
|
4
|
Deering RE, Donnelly GM, Brockwell E, Bo K, Davenport MH, De Vivo M, Dufour S, Forner L, Mills H, Moore IS, Olson A, Christopher SM. Clinical and exercise professional opinion on designing a postpartum return-to-running training programme: an international Delphi study and consensus statement. Br J Sports Med 2024; 58:183-195. [PMID: 38191239 DOI: 10.1136/bjsports-2023-107490] [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] [Accepted: 12/12/2023] [Indexed: 01/10/2024]
Abstract
Returning to running postpartum presents challenges such as musculoskeletal pain and pelvic floor dysfunction for some females, but there is little guidance on developing and progressing postpartum training programmes. This study aims to establish expert consensus recommendations on designing and modifying a postpartum return-to-running training programme, highlight costs and access to qualified professionals as potential barriers and discuss clinical, research and sports policy implications.A three-round Delphi survey of clinical and exercise professionals working with postpartum runners was conducted. Round I consisted of open-ended questions related to designing the training plan, modifications based on biopsychosocial factors, key muscle groups to train and referral and payment sources. Rounds II and III involved Likert-scale voting to identify consensus (≥75% agreement).118 participants completed Round I, 107 completed Round II (response rate 90.6%) and 95 completed Round III (response rate 80.5%). Consensus was reached in 42/47 (89%) statements, including recommendations for a period of relative rest, gradual increases in duration and intensity, starting with a walk-run protocol and incorporating strength training. Training should be modified based on musculoskeletal or pelvic symptoms, sleep, mental health, lactation or energy availability concerns. Cost and access to experienced postpartum running professionals were identified as potential barriers for runners to receive care.Consensus recommendations for a postpartum return-to-running programme include an individualised exercise prescription, gradual increases in physical activity, walk-run protocols and targeted muscle strengthening. Further research and improved access to clinical and exercise professionals are needed to inform and facilitate best practices.
Collapse
Affiliation(s)
- Rita E Deering
- Department of Physical Therapy, Carroll University, Waukesha, Wisconsin, USA
- Department of Orthopedics and Rehabilitation, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Gráinne M Donnelly
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | | | - Kari Bo
- Department of Sport Medicine, Norwegian School of Sports Sciences, Oslo, Norway
- Department of Obstetrics and Gynaecology, Akershus University Hospital, Lorenskog, Norway
| | - Margie H Davenport
- Program for Pregnancy and Postpartum Health, Physical Activity and Diabetes Laboratory, Faculty of Kinesiology, Sport and Recreation, Women and Children's Health Research Institute, Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Marlize De Vivo
- The Active Pregnancy Foundation, England, UK
- Sheffield Hallam University, Sheffield, UK
- Perinatal Physical Activity Research Group, School of Psychology and Life Sciences, Section of Sport, Exercise and Rehabilitation Science, Canterbury Christ Church University, Canterbury, Kent, UK
| | - Sinead Dufour
- McMaster University Faculty of Health Sciences, Hamilton, southeastern Ontario, Canada
| | - Lori Forner
- University of Queensland, Brisbane, Queensland, Australia
| | - Hayley Mills
- Perinatal Physical Activity Research Group, School of Psychology and Life Sciences, Section of Sport, Exercise and Rehabilitation Science, Canterbury Christ Church University, Canterbury, Kent, UK
| | - Isabel S Moore
- Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | | | - Shefali Mathur Christopher
- Doctor of Physical Therapy Program, Tufts University, Seattle, Washington, USA
- Elon University, Elon, North Carolina, USA
| |
Collapse
|
5
|
Feyisa Balcha W, Mulat Awoke A, Tagele A, Geremew E, Giza T, Aragaw B, Daniel N. Practice of Birth Preparedness and Complication Readiness and Its Associated Factors:A Health Facility-Based Cross-Sectional Study Design. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2024; 61:469580241236016. [PMID: 38445309 PMCID: PMC10916477 DOI: 10.1177/00469580241236016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 01/01/2024] [Accepted: 02/12/2024] [Indexed: 03/07/2024]
Abstract
Time of labor or time of emergency is not the time to decide what to do, instead it is time to seek care from skilled health care providers. Birth preparedness and complication readiness is the process of planning for a normal birth and anticipating the action needed in case of an emergency, which helps to minimize obstetric complications. Even though birth preparedness and complication readiness reduce maternal and newborn morbidity and mortality, the practice of birth preparedness and complication readiness is still low in Ethiopia. This study aimed to assess the practice of birth preparedness and complication readiness and its associated factors among pregnant women who attended antenatal care in the public health facilities of Debre Tabor town, northwest, Ethiopia. A health facility-based cross-sectional study was conducted from August 1/2022 to September 15/2022 among 397 pregnant mothers. The study was collected using a systematic random sampling technique and the collected data were entered and analyzed using SPSS version 25.0. Bivariate and multivariate logistic regression analyses were employed to estimate the crude and adjusted odds ratio and considered significant at a confidence interval of 95% and a P-value of less than .05. The proportion of birth preparedness and complication readiness practice was found to be 32.2%. Having formal education, primigravida, starting antenatal care contact in the first trimester of pregnancy, having knowledge of danger signs of labor and delivery, and birth preparedness and complication readiness were significantly associated with the practice of preparedness and complication readiness. In this study area, the practice of birth preparedness and complication readiness was low. Therefore, it is important to strengthen counseling on the advantage of starting antenatal care contact early and creating awareness of birth preparedness and complication readiness.
Collapse
Affiliation(s)
- Wondu Feyisa Balcha
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Amlaku Mulat Awoke
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Assefa Tagele
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Elias Geremew
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tigist Giza
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Betelhem Aragaw
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Nigist Daniel
- Department of Midwifery, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| |
Collapse
|
6
|
Beyuo TK, Lawrence ER, Oppong SA, Kobernik EK, Amoakoh-Coleman M, Grobbee DE, Browne JL, Bloemenkamp KWM. Impact of antenatal care on severe maternal and neonatal outcomes in pregnancies complicated by preeclampsia and eclampsia in Ghana. Pregnancy Hypertens 2023; 33:46-51. [PMID: 37586135 DOI: 10.1016/j.preghy.2023.07.177] [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: 11/02/2022] [Revised: 07/26/2023] [Accepted: 07/27/2023] [Indexed: 08/18/2023]
Abstract
OBJECTIVES To explore how specific measures of antenatal care utilization are associated with outcomes in pregnancies complicated by preeclampsia and eclampsia in Ghana. STUDY DESIGN Participants were adult pregnant women with preeclampsia or eclampsia at a tertiary hospital in Ghana. Antenatal care utilization measures included timing of first visit, total visits, facility and provider type, and referral status. Antenatal visits were characterized by former and current World Health Organization recommendations, and by gestational age-based adequacy. MAIN OUTCOME MEASURES Composites of maternal complications and poor neonatal outcomes. Multivariate logistic regressions identified associations with antenatal care factors. RESULTS Among 1176 participants, median number of antenatal visits was 5.0 (IQR 3.0-7.0), with 72.9% attending ≥4 visits, 19.4% attending ≥8 visits, and 54.9% attending adequate visits adjusted for gestational age. Care was most frequently provided in a government polyclinic (n = 522, 47.2%) and by a midwife (n = 704, 65.1%). Odds of the composite maternal complications were lower in women receiving antenatal care at a tertiary hospital (aOR 0.47, p = 0.01). Odds of poor neonatal outcomes were lower in women receiving antenatal care at a tertiary hospital (aOR 0.56, p < 0.001), by a specialist Obstetrician/Gynecologist (aOR 0.58, p < 0.001), and who attended ≥8 visits (aOR 0.67, p = 0.04). Referred women had twice the odds of a maternal complication (aOR 2.12, p = 0.007) and poor neonatal outcome (aOR 1.68, p = 0.002). CONCLUSIONS Fewer complications are seen after receiving antenatal care at tertiary facilities. Attending ≥8 visits reduced poor neonatal outcomes, but didn't impact maternal complications. Quality, not just quantity, of antenatal care is essential.
Collapse
Affiliation(s)
- Titus K Beyuo
- Department of Obstetrics and Gynaecology, University of Ghana Medical School, P.O. Box 4236, Accra, Ghana
| | - Emma R Lawrence
- Department of Obstetrics and Gynecology, University of Michigan, 1500 E. Medical Center Dr., Ann Arbor, MI 48109 USA.
| | - Samuel A Oppong
- Department of Obstetrics and Gynaecology, University of Ghana Medical School, P.O. Box 4236, Accra, Ghana.
| | - Emily K Kobernik
- Department of Learning Health Sciences, University of Michigan, 1111 East Catherine Street, Ann Arbor, MI 48109 USA
| | - Mary Amoakoh-Coleman
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of Ghana, Ghana
| | - Diederick E Grobbee
- Julius Global Health, Julius Center for Health Science and Primary Care, University Medical Center Utrecht, Utrecht University, the Netherlands.
| | - Joyce L Browne
- Julius Global Health, Julius Center for Health Science and Primary Care, University Medical Center Utrecht, Utrecht University, the Netherlands.
| | - K W M Bloemenkamp
- Wilhelmina's Children Hospital, UMC Utrecht, Department of Obstetrics, Division Woman and Baby, Utrecht, the Netherlands.
| |
Collapse
|
7
|
Mena-Tudela D, Soriano-Vidal FJ, Vila-Candel R, Quesada JA, Aguilar L, Franco-Antonio C. Effect of Mobile-Based Counselling on Breastfeeding in Spain: A Randomized Controlled Trial Protocol (COMLACT Study). Healthcare (Basel) 2023; 11:healthcare11101434. [PMID: 37239720 DOI: 10.3390/healthcare11101434] [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: 03/10/2023] [Revised: 05/11/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
PURPOSE The primary aim of this study is to determine the influence of an intervention in women based on a free mobile application (LactApp®, Barcelona, Spain) in maintaining breastfeeding (BF) up to 6 months postpartum. The secondary aim is to assess the effect of health literacy (HL) on breastfeeding duration. METHODS A multicenter, randomized controlled clinical trial of parallel groups will be carried out. Women will be randomly assigned to each of the parallel groups. In the control group, usual clinical practice will be followed from the third trimester of pregnancy to promote BF. In the intervention group, and in addition to usual clinical practice, the women will use a free mobile application (LactApp®) from the third trimester to 6 months postpartum. The type of BF at birth, at 15 days and at 3 and 6 months postpartum and the causes of cessation of BF in both groups will be monitored. The hypothesis will be tested using inferential analysis, considering an alpha of 5%. The study protocol was approved by the Clinical Research Ethics Committee of Hospital de la Ribera (Alzira, Valencia, Spain) in February 2021. A per protocol analysis and an intention-to-treat analysis will be performed. DISCUSSION This study will identify the influence of a mobile application on improving BF rates. If the application proves effective, we will have a tool with free information available to any user at any time of day, which may be complemented by normal clinical practice and be integrated into our health care system. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT05432700.
Collapse
Affiliation(s)
- Desirée Mena-Tudela
- Department of Nursing, Feminist Institute University Institute for Feminist and Gender Studies, Universitat Jaume I, 12071 Castellon de la Plana, Spain
| | - Francisco Javier Soriano-Vidal
- Department of Nursing, Universitat de València, 46007 Valencia, Spain
- Department of Obstetrics and Gynecology, Xativa-Oninyent Health Department, 46800 Xativa, Spain
| | - Rafael Vila-Candel
- Department of Nursing, Universitat de València, 46007 Valencia, Spain
- Department of Obstetrics and Gynecology, Hospital Universitario de la Ribera, 46600 Alzira, Spain
| | - José Antonio Quesada
- Department of Clinical Medicine, Universidad Miguel Hernández, 03202 Elche, Spain
- Network for Research on Chronicity, Primary Care and Health Promotion (RICAPPS), 03550 Alicante, Spain
| | - Laia Aguilar
- Midwifery at Lactapp Women Health, 08011 Barcelona, Spain
| | | |
Collapse
|
8
|
Delaney J, Nunes GDC, Simoneau J, Beltempo M, Malhamé I, Goudie C, Altit G. Thrombocytopenia and neonatal outcomes among extremely premature infants exposed to maternal hypertension. Pediatr Blood Cancer 2023; 70:e30131. [PMID: 36478101 DOI: 10.1002/pbc.30131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 11/04/2022] [Accepted: 11/12/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Hypertensive disorders of pregnancy (HDP) are associated with neonatal hematological disturbances, such as thrombocytopenia. The association of HDP to platelet counts in the context of extreme prematurity, to trends of platelet counts during neonatal hospitalization, and to frequency of platelet transfusions remain to be explored. PROCEDURE Retrospective study of infants born at less than 29 weeks born between 2015 and 2019. Platelet counts were collected on initial complete blood count, at 2 weeks, 32 weeks post-menstrual age (PMA), 36 weeks PMA, and closest to discharge. We examined the association between HDP and platelet counts at each time point, frequency of platelet transfusions and intraventricular hemorrhage (IVH) grade 3 or more. RESULTS Total 296 infants were included, 43 exposed to HDP. Infants exposed had lower platelet counts at each time point, as well as a higher prevalence of platelet less than 150 × 109 /L on one of the time points (32% vs. 65%, p < .001). Infants exposed to maternal hypertension were more frequently exposed to platelet transfusions (63% vs. 18%, p < .001). Mixed effect model demonstrated an association between HDP and a lower trend in platelet counts at each time point (β = -94 × 103 /μl, p < .001). Although initial platelet count was associated with severe IVH, it was not associated to exposure to HDP. CONCLUSION Premature infants exposed to HDP have a higher prevalence of thrombocytopenia, increased frequency of platelet transfusion, and an altered trend in platelet counts during neonatal hospitalization.
Collapse
Affiliation(s)
- Joanne Delaney
- Department of Pediatrics, Hematology-Oncology, Montreal Children's Hospital, McGill University Health Centre, McGill University, Montreal, Quebec, Canada
| | - Gabriela De Carvalho Nunes
- Department of Pediatrics, Neonatology, Montreal Children's Hospital, McGill University Health Centre, McGill University, Montreal, Quebec, Canada
| | - Jessica Simoneau
- Department of Pediatrics, Neonatology, Montreal Children's Hospital, McGill University Health Centre, McGill University, Montreal, Quebec, Canada
| | - Marc Beltempo
- Department of Pediatrics, Neonatology, Montreal Children's Hospital, McGill University Health Centre, McGill University, Montreal, Quebec, Canada
| | - Isabelle Malhamé
- Department of Medicine, General Internal Medicine, McGill University Health Centre, McGill University, Montreal, Quebec, Canada
| | - Catherine Goudie
- Department of Pediatrics, Hematology-Oncology, Montreal Children's Hospital, McGill University Health Centre, McGill University, Montreal, Quebec, Canada
| | - Gabriel Altit
- Department of Pediatrics, Neonatology, Montreal Children's Hospital, McGill University Health Centre, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
9
|
Lin KY, Tsai YJ, Yang JF, Wu MH. Factors associated with utilization of physical therapy services during pregnancy and after childbirth. Heliyon 2023; 9:e13247. [PMID: 36798765 PMCID: PMC9925962 DOI: 10.1016/j.heliyon.2023.e13247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 01/03/2023] [Accepted: 01/23/2023] [Indexed: 01/27/2023] Open
Abstract
Objective To explore demographic and clinical factors associated with utilization of antepartum/postpartum physical therapy. Methods This is a secondary analysis of a cross-sectional survey of 298 women who were receiving or had received obstetric care at a medical center in southern Taiwan. Data were collected between May 2021 and May 2022 using an online questionnaire, which included demographic, medical, and obstetric details, the symptom severity questionnaires, management strategies, and experience and perception about physical therapy. Descriptive statistics, independent t-test, chi-square analysis and multivariate logistic regression model were used to analyze data. Results Among 298 respondents, 190 (63.8%) were pregnant and 108 (36.2%) were postpartum. Thirteen percent of pregnant participants and 27% of postpartum participants had received physical therapy during and/or after childbirth. Multivariate analyses showed that being postpartum, having an associate degree and below, and experiencing depressive symptoms were significantly associated with an increased utilization of physical therapy (postpartum: OR = 3.039, 95% CI = 1.530, 6.035; associate degree and below: OR = 2.521, 95% CI = 1.007, 6.316; depressive symptoms: OR = 3.606, 95% CI = 1.067, 12.185). The odds of utilizing physical therapy decreased with age (OR = 0.935, 95% CI = 0.874, 1.000). Conclusions Individual factors, such as age, education level, pregnancy status, and experience of depressive symptoms, have a significant association with utilization of antepartum/postpartum physical therapy and should be considered when developing obstetric care pathways to optimize clinical and healthcare utilization outcomes.
Collapse
Affiliation(s)
- Kuan-Yin Lin
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Corresponding author. Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| | - Yi-Ju Tsai
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jeng-Feng Yang
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Physical Therapy Center, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Meng-Hsing Wu
- Department of Obstetrics and Gynecology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Obstetrics and Gynecology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| |
Collapse
|
10
|
Atluri N, Beyuo TK, Oppong SA, Compton SD, Moyer CA, Lawrence ER. Benefits and barriers of home blood pressure monitoring in pregnancy: perspectives of obstetric doctors from a Ghanaian tertiary hospital. BMC Pregnancy Childbirth 2023; 23:42. [PMID: 36658509 PMCID: PMC9854160 DOI: 10.1186/s12884-023-05363-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 01/09/2023] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Delayed diagnosis of preeclampsia contributes to maternal morbidity and mortality. Patient-performed home blood pressure monitoring facilitates more frequent monitoring and earlier diagnosis. However, challenges may exist to implementation in low- and middle income-countries. METHODS This cross-sectional mixed methods study evaluated obstetric doctors' perspectives on the benefits of and barriers to the implementation of home blood pressure monitoring among pregnant women in Ghana. Participants were doctors providing obstetric care at Korle Bu Teaching Hospital. Electronic surveys were completed by 75 participants (response rate 49.3%), consisting of demographics and questions on attitudes and perceived benefits and challenges of home BP monitoring. Semi-structured interviews were completed by 22 participants to expand on their perspectives. RESULTS Quantitative and qualitative results converged to highlight that the current state of blood pressure monitoring among pregnant women in Ghana is inadequate. The majority agreed that delayed diagnosis of preeclampsia leads to poor health outcomes in their patients (90.6%, n = 68) and earlier detection would improve outcomes (98.7%, n = 74). Key qualitative benefits to the adoption of home blood pressure monitoring were patient empowerment and trust of diagnosis, more quantity and quality of blood pressure data, and improvement in systems-level efficiency. The most significant barriers were the cost of monitors, lack of a communication system to convey abnormal values, and low health literacy. Overall, doctors felt that most barriers could be overcome with patient education and counseling, and that benefits far outweighed barriers. The majority of doctors (81.3%, n = 61), would use home BP data to inform their clinical decisions and 89% (n = 67) would take immediate action based on elevated home BP values. 91% (n = 68) would recommend home BP monitoring to their pregnant patients. CONCLUSION Obstetric doctors in Ghana strongly support the implementation of home blood pressure monitoring, would use values to inform their clinical management, and believe it would improve patient outcomes. Addressing the most significant barriers, including cost of blood pressure monitors, lack of a communication system to convey abnormal values, and need for patient education, is essential for successful implementation.
Collapse
Affiliation(s)
- Namratha Atluri
- grid.214458.e0000000086837370University of Michigan Medical School, 1301 Catherine St, MI 48109 Ann Arbor, USA
| | - Titus K. Beyuo
- grid.8652.90000 0004 1937 1485Department of Obstetrics and Gynaecology, University of Ghana Medical School, Korle Bu, Accra, P.O. Box 4236, Ghana
| | - Samuel A. Oppong
- grid.8652.90000 0004 1937 1485Department of Obstetrics and Gynaecology, University of Ghana Medical School, Korle Bu, Accra, P.O. Box 4236, Ghana
| | - Sarah D. Compton
- grid.214458.e0000000086837370Department of Obstetrics and Gynecology, University of Michigan, 1500 E. Medical Center Dr, 48109 Ann Arbor, MI USA
| | - Cheryl A. Moyer
- grid.214458.e0000000086837370Department of Obstetrics and Gynecology, University of Michigan, 1500 E. Medical Center Dr, 48109 Ann Arbor, MI USA
| | - Emma R. Lawrence
- grid.214458.e0000000086837370Department of Obstetrics and Gynecology, University of Michigan, 1500 E. Medical Center Dr, 48109 Ann Arbor, MI USA
| |
Collapse
|
11
|
Belete GD, Msganaw Shiferaw A. The Influence of Adopting New Reference Breathing Parameters on ICRP66 Model on the Regional Deposition of the Inhaled Attached Radon-222 Daughters Within the Human Airways. ENVIRONMENTAL HEALTH INSIGHTS 2023; 17:11786302221149401. [PMID: 36655013 PMCID: PMC9841841 DOI: 10.1177/11786302221149401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
The radiation dose from internal radiation exposure is difficult to measure directly and hence different lung models were developed. The dose on the lung is the result of the regional deposition of aerosols carrying radon daughters in the respiratory tract. Deposition of aerosols can be take place during inhalation and exhalation in the 5 regions of the respiratory tract due to variation of aerosol sizes and other biological factors such as breathing rate. In this paper, a modified breathing rate is instead applied on the assumptions developed by the ICRP66 model to analyze the regional deposition of radioactive aerosols and a comparison has been made with the result of ICRP66 model deposition. According to the result, as the diameter of aerosols increases from 1 to 10 μm, the percentage deposition fraction in extrathoracic regions, in ET1 region increases from 6.53% to 48.43% and in ET2 region increases from 7.3% to 50.33%. The aerodynamic deposition of the attached fraction of radon aerosols along the bronchial regions (bronchi (BB), and bronchiolar (bb) region) is found small and almost constant. For 1 μm diameter aerosols, the percentage deposition is found 0.82%, for 5 μm diameter aerosols, the deposition is predicted 2.56% and at 10 μm the deposition is predicted about 1.93% in bronchi (BB) region. In the bronchiolar region (bb) for 1 μm aerosols, the deposition predicted is 1.5% and at 10 μm about 0.88% is predicted. The deposition of small size attached fraction of radon aerosols is found maximum in the alveolar region as compared to other regions of the respiratory tract and the deposition becomes almost negligible for large size aerosols in this region.
Collapse
Affiliation(s)
- Guadie Degu Belete
- Guadie Degu Belete, Department of Physics, College of Natural and Computational Sciences, Assosa University, Assosa 5220, Ethiopia.
| | | |
Collapse
|
12
|
Soucy NL, Terrell RM, Chedid RA, Phillips KP. Best practices in prenatal health promotion: Perceptions, experiences, and recommendations of Ottawa, Canada, prenatal key informants. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057231158223. [PMID: 36869650 PMCID: PMC9989378 DOI: 10.1177/17455057231158223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
BACKGROUND Prenatal health promotion includes the provision of evidence-based information and practical skills to optimize maternal-fetal outcomes. Increasingly, prenatal education is delivered by both healthcare professionals and allied childbirth educators, in community- or hospital-based group classes, targeted outreach programs, and online modules. OBJECTIVES To better understand how prenatal health promotion relates to a diverse urban community, we assessed the perspectives of Ottawa, Canada prenatal key informants. DESIGN This is a qualitative research with key informant interviews. METHODS Semi-structured interviews were conducted with 11 prenatal key informants, responsible for the design, delivery, or promotion of publicly available prenatal health services. Interviews explored concepts and delivery of prenatal health promotion, strategies to address existing and emerging prenatal topics, identification of barriers to prenatal health services, and recommendations. RESULTS Key informants recommended a lifespan approach to prenatal health promotion, with an emphasis on healthy behaviors, emotional health, labor and delivery, and postpartum/early parenting. Recognizing community health disparities, key informants used community outreach, and intersectoral collaborations for Indigenous and other at-risk communities to mitigate barriers to prenatal service uptake. CONCLUSIONS Ottawa key informants conceptualized prenatal health promotion as inclusive, comprehensive, and as an extension of preconception, school-based sexual education. Respondents recommended the design and delivery of prenatal interventions as culturally safe and trauma informed, using online modalities to complement in-person activities. The experience and intersectoral networks of community-based prenatal health promotion programs represent potential capacity to address emergent public health risks to pregnancy, particularly among at-risk populations. PLAIN LANGUAGE SUMMARY A broad and diverse community of professionals deliver prenatal education to help people have healthy babies. We interviewed Ottawa, Canada experts in prenatal care/education to learn about the design and delivery of reproductive health promotion. We found that Ottawa experts emphasized healthy behaviors beginning before conception and through pregnancy. Community outreach was identified as a successful strategy to promote prenatal education to marginalized groups.
Collapse
Affiliation(s)
- Nura L Soucy
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Rowan M Terrell
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Rebecca A Chedid
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Karen P Phillips
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| |
Collapse
|
13
|
Belete GD, Shiferaw AM. A Review of Studies on the Seasonal Variation of Indoor Radon-222 Concentration. Oncol Rev 2022; 16:10570. [PMID: 36531161 PMCID: PMC9756844 DOI: 10.3389/or.2022.10570] [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] [Received: 04/13/2022] [Accepted: 06/24/2022] [Indexed: 09/14/2023] Open
Abstract
Due to their electrostatic nature, radon decay products can attach to solid particles and aerosols in the air. Inhalation and ingestion are therefore the two main routes through which people are exposed to radon and its decay products. During the inhalation of these radioactive aerosols, deposition takes place in different regions of the human respiratory tract. The deposited aerosols carrying radon and its progeny undergo a continuous radioactive transformation and expose the lung to ionizing alpha radiation, which can destroy the sensitive cells in the lung, causing a mutation that turns cancerous. Radon which is a colorless, odorless, and tasteless radioactive noble gas is a major health concern and is the second leading cause of lung cancer. To address this, an indoor radon survey was conducted in many countries internationally, with results showing that indoor radon concentration has a seasonal variation. This is due to the fluctuation of environmental parameters and the geological nature of buildings. Its concentration was found to be maximum in the cool (winter) season and a minimum concentration was recorded in the warm (summer) season of the year.
Collapse
|
14
|
Nakić Radoš S, Martinić L, Matijaš M, Brekalo M, Martin CR. The relationship between birth satisfaction, posttraumatic stress disorder and postnatal depression symptoms in Croatian women. Stress Health 2022; 38:500-508. [PMID: 34762758 DOI: 10.1002/smi.3112] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 10/27/2021] [Accepted: 11/07/2021] [Indexed: 12/24/2022]
Abstract
Studies show that a woman's dissatisfaction with her birth experience may affect her well-being. This study aimed to examine: (1) the birth satisfaction in Croatian women and compare it with UK normative data; (2) the association of different dimensions of birth satisfaction with posttraumatic stress disorder (PTSD) and depressive symptoms. In a cross-sectional online study, 603 postnatal Croatian women completed the Birth Satisfaction Scale-Revised (subscales: Stress experienced during labour (SL), Women's personal attributes (WA), and Quality of care provision (QC)); City Birth Trauma Scale (subscales: Birth-related symptoms and General symptoms); and Edinburgh Postnatal Depression Scale. Subscale and total scale scores were calculated. Path analysis tested the model of three aspects of birth satisfaction effect on PTSD dimensions and depressive symptoms. The average birth satisfaction score was significantly lower compared to the UK data on the total scale and all three subscale scores. Path analysis revealed that all three dimensions of birth satisfaction (SL, WA, and QC) had an effect on Birth-related symptoms. However, only Women's personal attributes (i.e., feeling anxiety or being in control during childbirth) had an effect on General symptoms and depressive symptoms, as well. Different aspects of birth satisfaction are important for maternal mental health following childbirth.
Collapse
Affiliation(s)
- Sandra Nakić Radoš
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
| | - Laura Martinić
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
| | - Marijana Matijaš
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
| | - Maja Brekalo
- Department of Psychology, Catholic University of Croatia, Zagreb, Croatia
| | - Colin R Martin
- Institute for Health and Wellbeing, University of Suffolk, England, UK
| |
Collapse
|
15
|
Aune I, Voldhagen H, Welve I, Dahlberg U. Early discharge from hospital after birth:How Norwegian parents experience postnatal home visits by midwives - A qualitative study. SEXUAL & REPRODUCTIVE HEALTHCARE 2021; 30:100672. [PMID: 34741842 DOI: 10.1016/j.srhc.2021.100672] [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: 05/26/2021] [Revised: 10/06/2021] [Accepted: 10/18/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND According to the WHO, the quality of care is not conditioned by the length of stay at the postnatal ward. As long as the postnatal care provided is of high quality, it could be better for the family to stay in their home. AIM Firstly, to examine parents' experiences of early discharge and home visits by the postnatal ward midwife, in cases where the mother and baby have been discharged within 24 h after birth. Secondly, to examine participants' motivation for opting for early discharge from the hospital. METHODS 10 individual interviews were conducted, including five where both parents were present. The interviews were carried out 4-12 weeks after birth. The data were analysed using systematic text condensation. RESULTS The choice of early discharge was influenced by external factors like a wish to be together as a family while receiving sufficient support from both family and midwife. Internal factors, like previous experience, were also significant. The presence and attitude of the midwife, both in professional and practical terms, affected how the parents perceived postnatal care. Home visits from the midwife also affected the parents' feeling of security. CONCLUSION An offer of home visits from the midwife of the postnatal ward enables parents who wish to leave the hospital shortly after birth to receive the necessary care and support in the early postnatal period. This offer is suitable for healthy women who have given birth to a healthy baby and wish to return home not long after birth.
Collapse
Affiliation(s)
- Ingvild Aune
- Midwifery Education, Faculty of Medicine and Health Sciences, Department of Clinical and Molecular Medicine, NTNU - Norwegian University of Science and Technology, Olav Kyrres Gate 11, 7006 Trondheim, Norway.
| | - Heidi Voldhagen
- St. Olavs University Hospital, Department of Women's Health, Olav Kyrres Gt. 11, 7006 Trondheim, Norway
| | - Ina Welve
- St. Olavs University Hospital, Department of Women's Health, Olav Kyrres Gt. 11, 7006 Trondheim, Norway
| | - Unn Dahlberg
- St. Olavs University Hospital, Department of Women's Health, Olav Kyrres Gt. 11, 7006 Trondheim, Norway
| |
Collapse
|
16
|
Zbiri S, Rozenberg P, Milcent C. Access-to-care: evidence from home-based postnatal coordinated care after hospital discharge. BMC Health Serv Res 2021; 21:1137. [PMID: 34674698 PMCID: PMC8532282 DOI: 10.1186/s12913-021-07151-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 09/11/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Home-based postnatal care after hospital discharge has become an integral part of postnatal care. This study aimed to determine the factors relating either to individuals or the healthcare system that affect enrollment and full participation (adherence) in the French home-based postnatal coordinated care program (PRADO). METHODS All admitted women for delivery in a French district over one year and eligible for this home-based midwifery support after hospital discharge were included (N = 4189). Both a simple probit model and a probit Heckman selection model were used. The control variables were the characteristics of the women, the municipalities, and the hospitals. RESULTS Approximately 68% of the eligible women chose to enroll in the PRADO program, of who nearly 60% fully participated in this program. Enrollment in the program was influenced mostly by the family context, such as the woman's age at the time of her pregnancy and the number of children in the household, the woman's level of prenatal education and information about postnatal care, as well as some hospital variables such as the characteristics and organization of the maternity units. Full participation in the program was influenced by the accessibility to health professionals, particularly midwives. Furthermore, the women's level of prenatal education and information about postnatal care, as well as their accessibility to health professionals, correlated with the socioeconomic environment. CONCLUSION While individual factors impacted enrollment in the PRADO program, only healthcare system-related factors influenced full participation in the program. A public health policy promoting home-based postnatal care could increase the women's participation by improving their level of prenatal education and information about postnatal care. In addition, reducing regional inequality is likely to have a positive impact, as the availability of health professionals is a key factor for participation in home-based postnatal coordinated care.
Collapse
Affiliation(s)
- Saad Zbiri
- EA 7285, Versailles Saint-Quentin University, Montigny-le-Bretonneux, France.
- International School of Public Health, Mohammed VI University of Health Sciences, Casablanca, Morocco.
| | - Patrick Rozenberg
- EA 7285, Versailles Saint-Quentin University, Montigny-le-Bretonneux, France
- Department of Obstetrics and Gynecology, Poissy Saint-Germain Hospital, Poissy, France
| | - Carine Milcent
- French National Center for Scientific Research (CNRS), Paris, France.
- Paris School of Economics (PSE), Paris, France.
| |
Collapse
|
17
|
Oommen H, Oddbjørn Tveit T, Eskedal LT, Myr R, Swanson DM, Vistad I. The association between intrapartum opioid fentanyl and early breastfeeding: A prospective observational study. Acta Obstet Gynecol Scand 2021; 100:2294-2302. [PMID: 34622936 DOI: 10.1111/aogs.14268] [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: 10/28/2020] [Revised: 08/23/2021] [Accepted: 08/30/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Intrapartum opioids in labor may interfere with the early breastfeeding phase and cause breastfeeding difficulties. This study examines the effects of intrapartum fentanyl given intravenously (IV) or through epidural analgesia (EDA) on early breastfeeding. MATERIAL AND METHODS This is a prospective observational study conducted in a regional maternity unit. We included 1101 healthy mothers of term singleton babies in vertex presentation born between 2016 and 2018 (468 nulliparous and 633 multiparous). The main data were collected prospectively, and additional data were retrieved from hospital records. The main outcome measures were exclusive breastfeeding at discharge, spontaneous suckling, and breastfeeding problems after birth. We assessed the outcomes in four groups categorized by intrapartum opioid exposure: none, IV fentanyl, EDA fentanyl and IV+EDA fentanyl. We also analyzed the dose-response relation of fentanyl administered by epidural or IV and early breastfeeding. Ultimately, we dichotomized the IV fentanyl group into two groups (≤200 µg and >200 µg) to further study the effect on early breastfeeding. RESULTS The odds of non-exclusive breastfeeding were doubled with EDA fentanyl (odds ratio [OR] 2.45, 95% CI 1.34-4.48, p = 0.004) and four times higher with IV+EDA fentanyl (OR 4.20, 95% CI 2.49-7.09, p < 0.001) compared with no opioid exposure. Spontaneous suckling was negatively associated with intrapartum fentanyl use (p < 0.001) irrespective of mode of administration. When the IV fentanyl doses exceeded 200 µg compared with less than 200 µg, we found a reduction in exclusive breastfeeding (81% vs. 89%; p = 0.014) and spontaneous suckling (68% vs. 83%; p < 0.001) and an increase in breastfeeding problems (41% vs. 27%; p = 0.004). CONCLUSIONS Fentanyl in labor is associated with breastfeeding difficulties. However, IV fentanyl in low doses (≤200 µg) seems to affect breastfeeding less than EDA fentanyl and is therefore a viable alternative when labor analgesia is needed. This could be most relevant for multiparous women, where a shorter labor is expected. More research is needed to determine the optimal dose and route of administration of fentanyl for labor analgesia.
Collapse
Affiliation(s)
- Hanna Oommen
- Department of Obstetrics and Gynecology, Sørlandet Hospital Kristiansand, Kristiansand, Norway.,Department of Life Science and Education, University of South Wales, Pontypridd, UK
| | - Tor Oddbjørn Tveit
- Department of Anesthesiology and Intensive Care, Sørlandet Hospital, Kristiansand, Norway.,Research Department, Sørlandet Hospital, Kristiansand, Norway.,Faculty of Health and Sport Science, University of Agder, Kristiansand, Norway
| | - Leif T Eskedal
- Research Department, Sørlandet Hospital, Kristiansand, Norway
| | - Rachel Myr
- Department of Obstetrics and Gynecology, Sørlandet Hospital Kristiansand, Kristiansand, Norway
| | - David M Swanson
- Oslo Center for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Ingvild Vistad
- Department of Obstetrics and Gynecology, Sørlandet Hospital Kristiansand, Kristiansand, Norway.,Research Department, Sørlandet Hospital, Kristiansand, Norway.,Faculty of Health and Sport Science, University of Agder, Kristiansand, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| |
Collapse
|
18
|
Chan AW, Reid C, Skeffington P, Gorman E, Marriott R. Experiences of using the Edinburgh Postnatal Depression Scale in the context of antenatal care for Aboriginal mothers: Women and midwives' perspectives. Women Birth 2021; 35:367-377. [PMID: 34531165 DOI: 10.1016/j.wombi.2021.09.004] [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: 06/23/2021] [Revised: 08/15/2021] [Accepted: 09/07/2021] [Indexed: 11/16/2022]
Abstract
PROBLEM Routine administration of the Edinburgh Postnatal Depression Scale (EPDS) is intended to promote early detection and preventative support for those who may be at risk of perinatal depression and anxiety. The cultural suitability of the EPDS has not been validated in the Aboriginal Australian context. BACKGROUND Marked differences in health outcomes and service access between Australian Aboriginal and non-Aboriginal women and infants continue to exist. AIM This study aimed to explore the cultural validity of the EPDS through understanding the experiences of Aboriginal women and midwives. METHODS Qualitative data was drawn from semi-structured interviews/yarns with 13 Perth-based Aboriginal antenatal women and 10 non-Aboriginal midwives. FINDINGS Utilising a grounded theory approach, thematic analysis of verbatim transcripts revealed that, surprisingly, women expressed generally favourable views of the EPDS, especially when the relationships between women and midwives were focused on. Midwives, however, expressed reservations about administering the EPDS and used the EPDS as a conversation-starter rather than as a standardised, standalone tool. DISCUSSION In attempt to reconcile conflicting perspectives, analysis of recordings extended to evaluate micro-processes in the interviews. At the process level, it was clear that demand characteristics operated in some interviews, including socially desirable response biases, demand biases and acquiescent response styles. CONCLUSION This highlights the need for researchers and clinicians to be trained in non-leading interview questioning techniques and in yarning methodology. Researchers and clinicians should also be aware of the cognitive biases and demand characteristics that may influence responding, likely perpetuated by dominant forces of a colonised society.
Collapse
Affiliation(s)
| | - Corinne Reid
- Victoria University, Australia; Ngangk Yira: Research Centre for Aboriginal Health and Social Equity, Murdoch University, Australia
| | - Petra Skeffington
- Murdoch University, Australia; Ngangk Yira: Research Centre for Aboriginal Health and Social Equity, Murdoch University, Australia
| | | | - Rhonda Marriott
- Murdoch University, Australia; Ngangk Yira: Research Centre for Aboriginal Health and Social Equity, Murdoch University, Australia
| |
Collapse
|
19
|
General Overview of Radon Studies in Health Hazard Perspectives. JOURNAL OF ONCOLOGY 2021; 2021:6659795. [PMID: 34381503 PMCID: PMC8352703 DOI: 10.1155/2021/6659795] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 07/26/2021] [Indexed: 11/17/2022]
Abstract
The adverse human health effects due to ionizing radiation are well known. Radon is the major source of background radiation among those that are of natural origin. It contributes about 55% of the natural radiation dose to humans. It is a colorless, odorless, and tasteless radioactive noble gas that comes from the natural radioactive decay series of uranium. Radon can be found everywhere in the atmosphere and become attached to aerosols in the air. The aerosols carrying radon and its progeny can be inhaled and deposited in different regions of the human respiratory tract. The deposited radioactive aerosols continue to decay and exposing the lung to ionizing radiation can destroy sensitive cells in the lung, causing a mutation that turns to be cancerous. Different countries and international and national organizations put their action levels to reduce radon lung cancer risk. The Environmental Protection Agency recommends 148 Bq/m3 as the action level. On the other hand, International Commission for Radiation Protection (ICRP) recommends 200 Bq/m3 as the action level. The main objective of this review is to focus on how radon is established as a health hazard, ways of radon detection and measurements, methods of reducing and controlling high indoor radon concentration, and what are the recommended international action levels of radon concentrations. It mainly focuses on the health perspective of radon studies because it is now a crucial and hot issue in the world. In most developing countries like our country Ethiopia, radon studies are not well investigated.
Collapse
|
20
|
Busumani W, Mundagowa PT. Outcomes of pregnancy-related referrals from rural health facilities to two central hospitals in Harare, Zimbabwe: a prospective descriptive study. BMC Health Serv Res 2021; 21:276. [PMID: 33766018 PMCID: PMC7993539 DOI: 10.1186/s12913-021-06289-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/16/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Between the years 2000 and 2017, the global maternal mortality rate dropped by 38% however, 94% of maternal deaths still emanated from low-to middle-income countries. Rural women are at a significantly higher risk of dying from pregnancy when compared to their urban counterparts. Early detection of complications and prompt referral to higher levels of care can reduce the associated maternal and perinatal mortality. This study aimed to determine the maternal and perinatal outcomes of pregnancy-related referrals from rural health facilities to central hospitals in Harare, Zimbabwe. METHODS A prospective descriptive study was conducted using a sample of 206 patients. All mothers who were referred from rural healthcare facilities were recruited for participation. Data were extracted from patient notes using a structured questionnaire and missing information was obtained from the mother after she had recovered. Bivariate analysis was done using IBM SPSS. RESULTS The average age of study participants was 27.4 ± 7.7 years. 87.4% had booked for antenatal care and 81.6% presented to the tertiary facility with their referral notes. The major reasons for referring patients were previous cesarean section (20.4%) and hypertensive disorders in pregnancy (18.4%). There were nine maternal deaths thus a case fatality rate of 4.4% while the perinatal mortality rate was 151/1000 live births. Young mothers were at a higher risk of having adverse perinatal outcomes while primiparous mothers were more likely to have a blood transfusion. Mothers who traveled for > 100 km to the tertiary facility and those who did not attend any antenatal visit were more likely to need blood transfusion. Delivering at the rural health facility was significantly associated with receiving a blood transfusion at the tertiary facility. Mothers who did not attend antenatal visits were more likely to have negative perinatal outcomes. CONCLUSION The proportion of obstetric patients being referred from rural facilities to tertiary institutions for complications reveals how primary and secondary healthcare facilities in Zimbabwe are falling short of offering the services they should be offering. Equipping these facilities with skilled human resources as well as contemporary equipment could help decongest the central hospitals consequently reducing the adverse maternal and perinatal outcomes.
Collapse
Affiliation(s)
- William Busumani
- Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
- Ministry of Health and Child Care, Bulawayo, Zimbabwe
| | | |
Collapse
|
21
|
Schlaff RA, Baruth M, LaFramboise FC. Preparing for postpartum: health care provider discussions and predictors of patient satisfaction. Women Health 2021; 61:345-354. [PMID: 33648432 DOI: 10.1080/03630242.2021.1892902] [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: 10/22/2022]
Abstract
Women's health care providers are trusted sources of patient education during pregnancy and postpartum; however, little is known about discussion prevalence or patient satisfaction. The purposes of this study were to describe patient-provider discussion prevalence and identify demographic and pregnancy-related factors associated with discussion occurrence and satisfaction. An electronic survey was completed by 319 postpartum women who received prenatal care for a singleton pregnancy within the last 12 months in the United States. Participants reported demographic and pregnancy-related information, and occurrence and satisfaction with information shared during prenatal and postpartum health care. Descriptive statistics and odds ratios were calculated. During pregnancy and postpartum, college graduates were more likely to report any discussion (pregnancy: OR = 1.70, 95% C.I. 1.01, 2.86; postpartum: OR = 1.94, 95% C.I. 1.16, 3.25). Participants with gestational diabetes were less likely to report any discussion during pregnancy (OR = 0.43, 95% C.I. 0.20, 0.92). Obese participants were less likely to report any postpartum discussion compared to underweight/normal weight participants (OR = 0.51, 95% C.I. 0.29, 0.89). Within postpartum health care, college graduates (p = .01) and those with a cesarean section (p = .01) reported lower satisfaction; multiparous women reported higher satisfaction (p = .03). Findings highlight potential inequities in clinical practice and risk factors for postpartum anticipatory care satisfaction.
Collapse
Affiliation(s)
- Rebecca A Schlaff
- Department of Health Science, Saginaw Valley State University, University Center, Michigan, USA
| | - Meghan Baruth
- Department of Health Science, Saginaw Valley State University, University Center, Michigan, USA
| | - Faith C LaFramboise
- Department of Kinesiology, Saginaw Valley State University, University Center, Michigan, USA
| |
Collapse
|
22
|
Jarneid H, Gjestad K, Røseth I, Dahl B. Fathers' Experiences of Being Present at an Unplanned Out-of-Hospital Birth: A Qualitative Study. J Multidiscip Healthc 2020; 13:1235-1244. [PMID: 33132700 PMCID: PMC7591965 DOI: 10.2147/jmdh.s272021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 09/24/2020] [Indexed: 01/20/2023] Open
Abstract
PURPOSE The purpose of this study was to investigate fathers' experiences of being present at an unplanned birth outside a maternity facility. MATERIALS AND METHODS This was a qualitative interview study with 12 fathers from six of Norway's eleven counties. All had been present at an unplanned out-of-hospital birth in 2015-2020. Data were analyzed using systematic text condensation. RESULTS The data analysis resulted in four themes. The first theme described the fathers' stress and worry and how they managed to keep a cool head and think rationally in a totally unprepared situation. The second theme described the fathers' need for help and the reassuring feeling provided by contact with health professionals. The third theme described how the birth increased the father's attachment to his partner and baby, while the fourth theme described fathers' feelings of exclusion and their reactions following the birth. CONCLUSION Fathers' perceived lack of expertise and their fear of complications led to stress, worry and anxiety, but support from health personnel provided reassurance and control. Many fathers experienced mastery, pride and joy after the birth, but when arriving at hospital, they felt rejected and wished that maternity care staff had approached them to talk about the experience.
Collapse
Affiliation(s)
- Henriette Jarneid
- Centre for Women's, Family and Child Health, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg N-3603, Norway
| | - Kristin Gjestad
- Centre for Women's, Family and Child Health, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg N-3603, Norway
| | - Idun Røseth
- Centre for Women's, Family and Child Health, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg N-3603, Norway.,Department of Child and Adolescent Mental Health, Telemark Hospital, Skien, Norway
| | - Bente Dahl
- Centre for Women's, Family and Child Health, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg N-3603, Norway
| |
Collapse
|
23
|
Joshi A, Beyuo T, Oppong SA, Moyer CA, Lawrence ER. Preeclampsia knowledge among postpartum women treated for preeclampsia and eclampsia at Korle Bu Teaching Hospital in Accra, Ghana. BMC Pregnancy Childbirth 2020; 20:625. [PMID: 33059625 PMCID: PMC7566025 DOI: 10.1186/s12884-020-03316-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 10/06/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Preeclampsia/eclampsia is a major cause of maternal morbidity and mortality worldwide, yet patients' perspectives about their diagnosis are not well understood. Our study examines patient knowledge among women with preeclampsia/eclampsia in a large urban hospital in Ghana. METHODS Postpartum women diagnosed with preeclampsia or eclampsia were asked to complete a survey 2-5 days after delivery that assessed demographic information, key obstetric factors, and questions regarding provider counseling. Provider counseling on diagnosis, causes, complications, and future health effects of preeclampsia/eclampsia was quantified on a 4-point scale ('Counseling Composite Score'). Participants also completed an objective knowledge assessment regarding preeclampsia/eclampsia, scored from 0 to 22 points ('Preeclampsia/Eclampsia Knowledge Score' (PEKS)). Linear regression was used to identify predictors of knowledge score. RESULTS A total of 150 participants were recruited, 88.7% (133) with preeclampsia and 11.3% (17) with eclampsia. Participants had a median age of 32 years, median parity of 2, and mean number of 5.4 antenatal visits. Approximately half of participants reported primary education as their highest level of education. While 74% of women reported having a complication during pregnancy, only 32% of participants with preeclampsia were able to correctly identify their diagnosis, and no participants diagnosed with eclampsia could correctly identify their diagnosis. Thirty-one percent of participants reported receiving no counseling from providers, and only 11% received counseling in all four categories. Even when counseled, 40-50% of participants reported incomplete understanding. Out of 22 possible points on a cumulative knowledge assessment scale, participants had a mean score of 12.9 ± 0.38. Adjusting for age, parity, and the number of antenatal visits, higher scores on the knowledge assessment are associated with more provider counseling (β 1.4, SE 0.3, p < 0.001) and higher level of education (β 1.3, SE 0.48, p = 0.008). CONCLUSIONS Counseling by healthcare providers is associated with higher performance on a knowledge assessment about preeclampsia/eclampsia. Patient knowledge about preeclampsia/eclampsia is important for efforts to encourage informed healthcare decisions, promote early antenatal care, and improve self-recognition of warning signs-ultimately improving morbidity and reducing mortality.
Collapse
Affiliation(s)
- Avina Joshi
- University of Massachusetts Medical School, 55 N. Lake Ave, Worcester, MA, 01655, USA
| | - Titus Beyuo
- University of Ghana School of Medicine and Dentistry, Slater Avenue, Accra, Ghana.
- Department of Obstetrics & Gynaecology, Korle Bu Teaching Hospital, Guggisberg Avenue, Accra, Ghana.
| | - Samuel A Oppong
- University of Ghana School of Medicine and Dentistry, Slater Avenue, Accra, Ghana
- Department of Obstetrics & Gynaecology, Korle Bu Teaching Hospital, Guggisberg Avenue, Accra, Ghana
| | - Cheryl A Moyer
- Global REACH, University of Michigan Medical School, 1301 Catherine St, Ann Arbor, MI, 48109, USA
- Department of Obstetrics & Gynecology, University of Michigan Medical School, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109, USA
| | - Emma R Lawrence
- Department of Obstetrics & Gynecology, University of Michigan Medical School, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109, USA
| |
Collapse
|
24
|
Rabiu KA, Akinlusi FM, Adewunmi AA, Alausa TG, Durojaiye IA. Risk Factors for Postcesarean Wound Infection in a Tertiary Hospital in Lagos, Nigeria. Niger Med J 2020; 61:262-268. [PMID: 33487850 PMCID: PMC7808289 DOI: 10.4103/nmj.nmj_1_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 06/29/2020] [Accepted: 08/24/2020] [Indexed: 12/02/2022] Open
Abstract
Background: There has been a global increase in cesarean section rates. While this has improved perinatal outcome, it is associated with complications such as wound infection. We determined risk factors for cesarean section wound infection in a tertiary hospital in Lagos, Nigeria. Materials and Methods: We prospectively studied a cohort of 906 women who had cesarean section at the Obstetrics Unit of the Lagos State University Teaching Hospital between January 1, 2011, and December 31, 2011. A comparison was made between 176 women who had wound infection and 730 women who did not using logistic regression. Results: Of the 2134 deliveries during the study, 906 (42.5%) had cesarean section and of which 176 (19.4%) had wound infection. Independent risk factors for wound infection were: preoperative anemia (adjusted odds ratio [aOR] = 1.88; 95% confidence intervals [CI] = 1.03–3.41; P = 0.0396), presence of diabetes mellitus (aOR = 7.94; 95% CI = 1.60–39.27; P = 0.0111), HIV infection (aOR = 6.34; 95% CI = 1.74–23.06; P = 0.0051), prolonged operation time (aOR = 2.30; 95% CI = 1.19–4.42; P = 0.0127), excessive blood loss at surgery (aOR = 5.05; 95% CI = 2.18–11.66; P = 0.0002), and chorioamnionitis (aOR = 9.00; 95% CI = 1.37–59.32; P = 0.0224). Conclusions: Patients with HIV infection, diabetes mellitus, preoperative anemia and chorioamnionitis have an increased risk of postcesarean wound infection as is when surgical time exceeds 1 h or when associated with blood loss >11.
Collapse
Affiliation(s)
- Kabiru Afolarin Rabiu
- Department of Obstetrics and Gynaecology, Lagos State University College of Medicine, Ikeja, Lagos State, Nigeria
| | - Fatimat Motunrayo Akinlusi
- Department of Obstetrics and Gynaecology, Lagos State University College of Medicine, Ikeja, Lagos State, Nigeria
| | - Adeniyi Abiodun Adewunmi
- Department of Obstetrics and Gynaecology, Lagos State University College of Medicine, Ikeja, Lagos State, Nigeria
| | - Taiwo Ganiyat Alausa
- Department of Obstetrics and Gynaecology, Lagos State University Teaching Hospital, Ikeja, Lagos State, Nigeria
| | - Idayat Adejumoke Durojaiye
- Department of Obstetrics and Gynaecology, Lagos State University Teaching Hospital, Ikeja, Lagos State, Nigeria
| |
Collapse
|
25
|
Epidurals during normal labour and birth - Midwives' attitudes and experiences. Women Birth 2020; 34:e384-e389. [PMID: 32843237 DOI: 10.1016/j.wombi.2020.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 08/13/2020] [Accepted: 08/13/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Midwives have their own beliefs and values regarding pain during childbirth. Their preferences concerning labour pain management may influence women's choices. AIM To gain a deeper understanding of midwives' attitudes and experiences regarding the use of an epidural during normal labour. METHODS A qualitative approach was chosen for data collection. Ten in-depth interviews were conducted with midwives working in three different obstetric units in Norway. The transcribed interviews were analysed using Malterud's systematic text condensation. FINDINGS The analysis provided two main themes: "Normal childbirth as the goal" and "Challenges to the practice, knowledge, philosophy and experience of midwives". Distinctive differences in experiences and attitudes were found. The workplace culture in the obstetric units affected the midwives' attitudes and their midwifery practice. How they attended to women with epidural also differed. An epidural was often used as a substitute for continuous support when the obstetric unit was busy. DISCUSSION Midwives estimate labour pain differently, and this might impact the midwifery care. However, midwives' interests and preferences concerning labour pain management should not influence women's choices. Midwives are affected by the setting where they work, and research highlights that an epidural might lead to a focus on medical procedures instead of the normality of labour. CONCLUSION Midwives should be aware of how powerful their position is and how the workplace culture might influence their attitudes. The focus should be on "working with" women to promote a normal birth process, even with an epidural.
Collapse
|
26
|
Silverman JG, Fonseka RW, Dehingia N, Boyce SC, Chandurkar D, Singh K, Hay K, Atmavilas Y, Raj A. Associations between recent intimate partner violence and receipt and quality of perinatal health services in Uttar Pradesh. PLoS One 2020; 15:e0232079. [PMID: 32407320 PMCID: PMC7224484 DOI: 10.1371/journal.pone.0232079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 04/07/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND India suffers some of the highest maternal and neonatal mortality rates in the world. Intimate partner violence (IPV) can be a barrier to utilization of perinatal care, and has been associated with poor maternal and neonatal health outcomes. However, studies that assess the relationship between IPV and perinatal health care often focus solely on receipt of services, and not the quality of the services received. METHODS AND FINDINGS Data were collected in 2016-2017 from a representative sample of women (15-49yrs) in Uttar Pradesh, India who had given birth within the previous 12 months (N = 5020), including use of perinatal health services and past 12 months experiences of physical and sexual IPV. Multivariate logistic regression models assessed whether physical or sexual IPV were associated with perinatal health service utilization and quality. Reports of IPV were not associated with odds of receiving antenatal care or a health worker home visit during the third trimester, but physical IPV was associated with fewer diagnostic tests during antenatal visits (beta = -0.30), and fewer health topics covered during home visits (beta = -0.44). Recent physical and recent sexual IPV were both associated with decreased odds of institutional delivery (physical IPV AOR 0.65; sexual IPV AOR 0.61), and recent sexual IPV was associated with leaving a delivery facility earlier than recommended (AOR = 1.87). Neither form of IPV was associated with receipt of a postnatal home visit, but recent physical IPV was associated with fewer health topics discussed during such visits (beta = -0.26). CONCLUSIONS In this study, reduced quantity and quality of perinatal health care were associated with recent IPV experiences. In cases where IPV was not related to care receipt, IPV remained associated with diminished care quality. Additional study to understand the mechanisms underlying associations between IPV and care qualities is required to inform health services.
Collapse
Affiliation(s)
- Jay G. Silverman
- Center on Gender Equity and Health (GEH), University of California, San Diego, California, United States of America
| | - Ruvani W. Fonseka
- Center on Gender Equity and Health (GEH), University of California, San Diego, California, United States of America
| | - Nabamallika Dehingia
- Center on Gender Equity and Health (GEH), University of California, San Diego, California, United States of America
| | - Sabrina C. Boyce
- Center on Gender Equity and Health (GEH), University of California, San Diego, California, United States of America
| | | | - Kultar Singh
- Sambodhi Research and Communications Pvt. Ltd., Noida, Uttar Pradesh, India
| | - Katherine Hay
- Bill & Melinda Gates Foundation Seattle Office, Seattle, Washington, United States of America
| | - Yamini Atmavilas
- Bill & Melinda Gates Foundation India Country Office, Delhi, Uttar Pradesh, India
| | - Anita Raj
- Center on Gender Equity and Health (GEH), University of California, San Diego, California, United States of America
| |
Collapse
|
27
|
Corscadden L, Callander EJ, Topp SM, Watson DE. Experiences of maternity care in New South Wales among women with mental health conditions. BMC Pregnancy Childbirth 2020; 20:286. [PMID: 32393194 PMCID: PMC7216645 DOI: 10.1186/s12884-020-02972-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 04/26/2020] [Indexed: 11/16/2022] Open
Abstract
Background High quality maternity care is increasingly understood to represent a continuum of care. As well as ensuring a positive experience for mothers and families, integrated maternity care is responsive to mental health needs of mothers. The aim of this paper is to summarize differences in women’s experiences of maternity care between women with and without a self-reported mental health condition. Methods Secondary analyses of a randomized, stratified sample patient experience survey of 4787 women who gave birth in a New South Wales public hospital in 2017. We focused on 64 measures of experiences of antenatal care, hospital care during and following birth and follow up at home. Experiences covered eight dimensions: overall impressions, emotional support, respect for preferences, information, involvement, physical comfort and continuity. Multivariable logistic regression was used to compare experiences of women with and without a self-reported longstanding mental health condition. Results Compared to women without a condition, women with a longstanding mental health condition (n = 353) reported significantly less positive experiences by eight percentage points on average, with significant differences on 41 out of 64 measures after adjusting for age, education, language, parity, type of birth and region. Disparities were pronounced for key measures of emotional support (discussion of worries and fears, trust in providers), physical comfort (assistance, pain management) and overall impressions of care. Most women with mental health conditions (75% or more) reported positive experiences for measures related to guidelines for maternity care for women with mental illness (discussion of emotional health, healthy behaviours, weight gain). Their experiences were not significantly different from those of women with no reported conditions. Conclusions Women with a mental health condition had significantly less positive experiences of maternity care across all stages of care compared to women with no condition. However, for some measures, including those related to guidelines for maternity care for women with mental illness, there were highly positive ratings and no significant differences between groups. This suggests disparities in experiences of care for women with mental health conditions are not inevitable. More can be done to improve experiences of maternity care for women with mental health conditions.
Collapse
Affiliation(s)
- L Corscadden
- Australian Institute of Tropical Health and Medicine, James Cook University, 1 James Cook Dr, Douglas, Queensland, 4811, Australia. .,Bureau of Health Information, Level 11, 67 Albert Avenue, Chatswood, NSW, 2067, Australia.
| | - E J Callander
- School of Medicine, Griffiths University, 170 Kessels Rd, Nathan, QLD, 4111, Australia
| | - S M Topp
- College of Public Health, Medical & Veterinary Sciences, James Cook University, 1 James Cook Dr, Douglas, Queensland, 4811, Australia
| | - D E Watson
- Bureau of Health Information, Level 11, 67 Albert Avenue, Chatswood, NSW, 2067, Australia
| |
Collapse
|
28
|
Martin CE, Terplan M, Krans EE. Pain, Opioids, and Pregnancy: Historical Context and Medical Management. Clin Perinatol 2019; 46:833-847. [PMID: 31653311 DOI: 10.1016/j.clp.2019.08.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Women are being disproportionately affected by the opioid crisis, including during pregnancy. Pain and other vulnerabilities to addiction differ between men and women. Management of opioid use disorder should be gender informed and accessible across the lifespan. During pregnancy, care teams should be multidisciplinary to include obstetrics, addiction, social work, anesthesia, pediatrics, and behavioral health. Pain management for women with opioid use disorder requires tailored approaches, including integration of trauma-informed care and addressing psychosocial needs. Thus, coordinated continued care by obstetric and addiction providers through pregnancy into postpartum is key to supporting women in recovery.
Collapse
Affiliation(s)
- Caitlin E Martin
- Department of Obstetrics and Gynecology, Virginia Commonwealth University, 1250 East Marshall Street, Richmond, VA 23298-0268, USA
| | - Mishka Terplan
- Friends Research Institute, 1040 Park Ave, Suite 103, Baltimore MD 21202, USA.
| | - Elizabeth E Krans
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Magee-Womens Research Institute, 300 Halket Street, Pittsburgh, PA 15213, USA
| |
Collapse
|
29
|
Millington S, Magarey J, Dekker GA, Clark RA. Cardiac conditions in pregnancy and the role of midwives: A discussion paper. Nurs Open 2019; 6:722-732. [PMID: 31367393 PMCID: PMC6650682 DOI: 10.1002/nop2.269] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 02/09/2019] [Accepted: 02/18/2019] [Indexed: 11/28/2022] Open
Abstract
AIM This paper provides an overview of the two broad categories of cardiac conditions observed in pregnancy (congenital and acquired). It also identifies the midwives' role in the childbirth continuum and includes assessment, track and trigger systems and management during labour and delivery. DESIGN Discussion paper. METHODS Data were collected by reviewing international evidence and by searching computerized databases. RESULTS Research has identified that women with associated risk factors of a cardiac condition who delay pregnancy have an increased risk of experiencing cardiovascular complications in pregnancy with poorer outcomes. The Three Ps in a Pod clinical initiative in the United Kingdom highlights working as a team in multidisciplinary programmes to improve mothers' care and save lives. Midwives play a key role during pregnancy and need to be appraised in relation to cardiovascular disease observed in pregnancy, its potential risks and anticipated problems and within the continuum of care.
Collapse
Affiliation(s)
- Sandra Millington
- Adelaide Nursing SchoolThe University of AdelaideAdelaideSouth AustraliaAustralia
| | - Judith Magarey
- Adelaide Nursing SchoolThe University of AdelaideAdelaideSouth AustraliaAustralia
| | - Gustaaf A. Dekker
- Northern Campus Women's and Children's Division, Lyell McEwin HospitalThe University of AdelaideElizabeth ValeSouth AustraliaAustralia
| | - Robyn A. Clark
- School of Nursing and MidwiferyFlinders UniversityAdelaideSouth AustraliaAustralia
| |
Collapse
|
30
|
Kalanlar B. Hospital practices and family support in maternity wards. Health Serv Manage Res 2019; 32:191-198. [PMID: 31225761 DOI: 10.1177/0951484819858818] [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: 11/16/2022]
Abstract
This study aims to determine the hospital practices implemented before, during, and after birth in Turkey, and to identify the support to families during this process. Purposive sampling was used in the study to identify the hospitals to be surveyed. Ankara, İstanbul, and İzmir, the provinces with the highest number of hospitals in Turkey, were selected for the collection of data. There were 178 eligible private hospitals in these provinces. The questionnaire form of the Canadian Hospitals Maternity Policies and Practices Survey was used to collect data and the necessary permissions were obtained. There are many restrictions and variations in maternity-related hospital practices in Turkey. 71.4% of the responding private hospitals identified themselves as baby-friendly. 57.1% had a policy facilitating families being together immediately after birth, 39.5% encouraged the presence of the father in the delivery room. 44.9% did not have any policy for assessing women who were going home to potentially violent situations. Eighty-five percent reported that they did not have a written policy or guidelines about procedures regarding labor, birth, or postpartum periods. This study recommended that private hospitals should review their maternal practices and routines in an evidence-based way that helps parents, culturally sensitive standards for mothers should be developed and supervised by related health authorities, and structures should be created to effectively deal with patients’ complaints.
Collapse
Affiliation(s)
- Bilge Kalanlar
- Hacettepe Universitesi, Hacettepe Üniversitesi Hemşirelik Fakültesi, Ankara, Turkey
| |
Collapse
|
31
|
Outcomes of uninsured midwifery clients in Ontario, Canada: A retrospective cohort study. Midwifery 2019; 77:24-31. [PMID: 31247482 DOI: 10.1016/j.midw.2019.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 06/12/2019] [Accepted: 06/14/2019] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To describe the characteristics, health service utilization, and clinical outcomes of Ontario residents who are not covered by the Ontario Health Insurance Plan and receive services from Ontario midwives. DESIGN Retrospective cohort study. SETTING Ontario, Canada. PARTICIPANTS All midwifery courses of care resulting in births between April 1, 2012 to March 31, 2015 and captured in the BORN perinatal registry. Within this cohort we compared midwifery clients without publicly funded health insurance to those covered by the Ontario Health Insurance Plan (OHIP). MEASUREMENTS AND FINDINGS Of 55, 634 midwifery clients assessed in Ontario, 92.8% were insured by OHIP and 7.2% were not insured. Among uninsured clients, 66.3% attended a prenatal visit during the first trimester compared to 92.8% of insured women, with uninsured clients presenting with fewer pre-existing conditions. A higher proportion of uninsured clients (33.9%) planned to birth at home and 28.7% of clients' actual place birth was in the home, compared to 19.6% and 16.6% of insured clients respectively. Rates of both spontaneous labour and spontaneous vaginal birth were higher among uninsured clients (82.1% and 81.1%, respectively), compared to insured clients (77.3% and 78.1%, respectively). Clinical outcomes were generally similar, with postpartum hemorrhage (3.4%), preterm birth (5%), and small-for-gestational age (2.1%) slightly more common among uninsured clients compared to insured clients (2.9%, 4.4%, and 1.7%, respectively). Rates of most complications were lower for uninsured clients. KEY CONCLUSIONS Overall, uninsured clients used less services compared to insured clients and had good clinical outcomes under midwifery care in Ontario. Findings of this study support the policy decision in Ontario to fund midwifery care for uninsured clients and suggest that uninsured clients are well suited for midwifery care. IMPLICATIONS FOR PRACTICE Funding midwives to serve uninsured clients is appropriate and may improve uninsured clients access to care.
Collapse
|
32
|
Brasher MI, Chiume M. Potential effect of regionalised care in a low-resource setting. LANCET GLOBAL HEALTH 2019; 7:e825-e826. [PMID: 31200880 DOI: 10.1016/s2214-109x(19)30235-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 05/14/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Maya I Brasher
- Dr Kelli DeScioli Global Child Health Residency, Baylor College of Medicine, Houston, TX 77030, USA.
| | | |
Collapse
|
33
|
Park M, Park KM. [Effects of a Reinforcement Program for Postpartum Care Behavioral Skills of Couples with Their First Baby]. J Korean Acad Nurs 2019; 49:137-148. [PMID: 31064967 DOI: 10.4040/jkan.2019.49.2.137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 01/31/2019] [Accepted: 02/01/2019] [Indexed: 11/09/2022]
Abstract
PURPOSE This study aimed to investigate the effects of a reinforcement program for behavioral skills in postpartum care for couples with their first baby. METHODS The study used a non-equivalent control group and pretest-posttest design. It was conducted from January 14 to April 10, 2016 at a postpartum care center in D city. It analyzed 43 couples (22 in the experimental group and 21 in the control group.) For data analysis, descriptive statistics, test of homogeneity in pretest, independent t-tests, and repeated measures ANOVA were used. RESULTS For maternal fulfillment of postpartum care and postpartum fatigue, there was no significant difference in the interaction between group and time. In terms of parent-newborns attachment, the interaction between group and time showed a significant difference for mothers (F=13.63, p=.001) and fathers (F=6.51, p=.001). In marital intimacy, the interaction between group and time showed a significant difference for mothers (F=14.40, p<.001) and fathers (F=9.46, p=.004). In parenting stress, the interaction between group and time showed a significant difference for mothers (F=31.8, p<.001) and fathers (F=11.69, p=.001). A significant difference was found for the mothers' postpartum sleeping hours (F=0.14 p=.004). CONCLUSION This program for behavioral skills in postpartum care, which is based on the information-motivation-behavioral skills model, improves postpartum care, parent-newborn attachment, marital intimacy, parenting stress, and maternal postpartum sleeping, by reinforcing behavioral skills required for postpartum care.
Collapse
Affiliation(s)
- Meera Park
- Department of Nursing, Changshin University, Changwon, Korea
| | | |
Collapse
|
34
|
Chedid RA, Phillips KP. Best Practices for the Design, Implementation and Evaluation of Prenatal Health Programs. Matern Child Health J 2019; 23:109-119. [PMID: 30066301 DOI: 10.1007/s10995-018-2600-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Introduction Prenatal health programs provide health education, reproductive care and related services to women. Programs may be administered individually or collaboratively by agencies including public health units, hospitals, health clinics, community and non-governmental organizations. Prenatal health disparities among populations at-risk may be reduced through the provision of accessible health education, services and resources to help women mitigate modifiable risks to pregnancy. Although standardized guidelines inform clinical screening, testing and maternity care, gaps exist regarding the design, implementation and evaluation for comprehensive prenatal health programs. Methods Using a multijurisdictional approach, prenatal health guidance documents released by clinical associations and regional governments across Canada, Australia, the United States, the United Kingdom and Ireland were systematically evaluated to identify standards and practices regarding the design, implementation and evaluation of prenatal health programs. Results Evidence-based, surveillance/monitoring, and expert/stakeholder collaborations were principles affirmed by guidance documents across all jurisdictions. Each jurisdiction described tailored strategies to optimize prenatal health in their respective communities. Divergence between jurisdictions was noted for patient care models and promotion of providers and companions of choice. Discussion A best practices model is proposed describing recommendations as follows: prenatal health programs should be grounded in a theoretical approach, fundamentally woman-centered and designed to address interacting prenatal health determinants across the lifespan. Accessible and inclusive prenatal health care can be achieved through provider training and community stakeholder collaborations. Identification of best practices for prenatal health program design, implementation and evaluation ensures that service standards are harmonized across communities, thereby optimizing maternal and child health.
Collapse
Affiliation(s)
- Rebecca A Chedid
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, 25 Universite Priv, Ottawa, ON, K1N 6N5, Canada
| | - Karen P Phillips
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, 25 Universite Priv, Ottawa, ON, K1N 6N5, Canada.
| |
Collapse
|
35
|
Cesar JA, Marmitt LP, Dziekaniak AC, Leite SS, Leão OA, Sauer JP. Non-performance of urinalysis among pregnant women in Brazil. Int J Health Care Qual Assur 2019; 32:224-232. [PMID: 30859876 DOI: 10.1108/ijhcqa-11-2017-0210] [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: 11/17/2022]
Abstract
PURPOSE The purpose of this paper is to measure the prevalence, evaluate the trend and identify the factors associated with the non-performance of qualitative urine test (QUT) among pregnant women living in the extreme south of Brazil between 2007 and 2016. DESIGN/METHODOLOGY/APPROACH All births occurred in the local maternity wards from January 1 to December 31 of 2007, 2010, 2013 and 2016. Mothers were interviewed within 48h after delivery. The outcome was the non-performance of QUT during pregnancy. χ2 test was used to compare proportions and Poisson regression with robust variance adjustment for the multivariate analysis. The effect measure used was the prevalence ratio. FINDINGS Of the 10,331 new mothers identified, 10,004 (96.8 percent) performed at least one prenatal visit. The prevalence of non-performance of QUT was 3.3 percent (95% CI 2.9-3.7 percent), ranging from 1.5 percent in 2007 to 5.3 percent in 2016 ( p<0.001). The analysis showed that not living with a companion, having under four years of schooling, living with seven or more people in the household, having five or more children, having had one to three prenatal visits and not having been supplemented with ferrous sulfate during pregnancy showed a significantly higher prevalence rate to the non-performance of QUT. ORIGINALITY/VALUE The rate of non-performance of this test among pregnant women has clearly increased. Mothers at higher risk of unfavorable outcomes in pregnancy were the ones with the highest probability of not performing QUT. Increasing the number of prenatal visits is a high-impact measure toward the performance of this test.
Collapse
Affiliation(s)
- Juraci A Cesar
- Postgraduate Program in Public Health, Faculty of Medicine, Universidade Federal do Rio Grande , Rio Grande, Brazil
| | - Luana P Marmitt
- Postgraduate Program in Public Health, Faculty of Medicine, Universidade Federal do Rio Grande , Rio Grande, Brazil
| | - Alessandra C Dziekaniak
- Postgraduate Program in Public Health, Faculty of Medicine, Universidade Federal do Rio Grande , Rio Grande, Brazil
| | - Sabrina S Leite
- Postgraduate Program in Public Health, Faculty of Medicine, Universidade Federal do Rio Grande , Rio Grande, Brazil
| | - Otávio A Leão
- Postgraduate Program in Public Health, Faculty of Medicine, Universidade Federal do Rio Grande , Rio Grande, Brazil
| | - Jéssica P Sauer
- Postgraduate Program in Public Health, Faculty of Medicine, Universidade Federal do Rio Grande , Rio Grande, Brazil
| |
Collapse
|
36
|
Xie RH, Tan H, Taljaard M, Liao Y, Krewski D, Du Q, Wen SW. The Impact of a Maternal Education Program Through Text Messaging in Rural China: Cluster Randomized Controlled Trial. JMIR Mhealth Uhealth 2018; 6:e11213. [PMID: 30567693 PMCID: PMC6315224 DOI: 10.2196/11213] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 10/15/2018] [Accepted: 10/30/2018] [Indexed: 01/06/2023] Open
Abstract
Background In recent years, attempts have been made to use mobile phone text messaging (short message service, SMS) to achieve positive results for a range of health issues. Reports on the impact of maternal education programs based on this widely available, inexpensive, and instant communication tool are sparse. Objective This study aimed to explore the impact of a maternal education program through text messaging. Methods We conducted a cluster randomized trial in a remote region in the Chinese province of Hunan between October 1, 2011, and December 31, 2012. We used county as the unit of randomization (a total of 10 counties), with half of the counties randomly allocated to the intervention arm (with maternal education material adapted from the World Health Organization being delivered by text messaging to village health workers and pregnant women alike) and the other half to the control arm (normal care without text messaging). Data on maternal and infant health outcomes and health behaviors were collected and compared between the 2 arms, with maternal and perinatal mortality as the primary outcomes. Results A total of 13,937 pregnant women completed the follow-up and were included in the final analysis. Among them, 6771 were allocated to the intervention arm and 6966 were allocated to the control arm. At the county level, the mean (SD) of maternal mortality and perinatal mortality rate were 0.0% (0.1) and 1.3% (0.6), respectively, in the intervention arm and 0.1% (0.2) and 1.5% (0.4), respectively, in the control arm. However, these differences were not statistically significant. At the individual level, there were 3 maternal deaths (0.04%) and 84 perinatal deaths (1.24%) in the intervention arm and 6 maternal deaths (0.09%) and 101 perinatal deaths (1.45%) in the control arm. However, the differences were again not statistically significant. Conclusions Adequate resources should be secured to launch large-scale cluster randomized trials with smaller cluster units and more intensive implementation to confirm the benefits of the text messaging–based maternal education program suggested by this trial. Trial Registration ClinicalTrials.gov NCT01775150; https://clinicaltrials.gov/ct2/show/NCT01775150 (Archived by WebCite at http://www.webcitation.org/74cHmUexo)
Collapse
Affiliation(s)
- Ri-Hua Xie
- Department of Nursing, Nanhai Hospital, Southern Medical University, Foshan, China.,General Practice Center, Nanhai Hospital, Southern Medical University, Foshan, China.,McLaughlin Centre for Population Health Risk Assessment, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Hongzhuan Tan
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Monica Taljaard
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Yan Liao
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Daniel Krewski
- McLaughlin Centre for Population Health Risk Assessment, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Qingfeng Du
- General Practice Center, Nanhai Hospital, Southern Medical University, Foshan, China
| | - Shi Wu Wen
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.,Obstetrics Maternal Newborn Investigation Research Group, Department of Obstetrics & Gynecology, University of Ottawa, Ottawa, ON, Canada
| |
Collapse
|
37
|
Kaasen A, Aanstad KJ, Pay ASD, Økland I, Blix E. National survey of routines for intrapartum fetal monitoring in Norway. Acta Obstet Gynecol Scand 2018; 98:390-395. [PMID: 30375643 DOI: 10.1111/aogs.13500] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 10/24/2018] [Indexed: 11/30/2022]
Abstract
INTRODUCTION This study describes clinical routines for intrapartum fetal monitoring in Norway and compliance with national clinical recommendations. MATERIAL AND METHODS A national survey of all (n = 48) birth units in Norway, using a self-reporting questionnaire about fetal monitoring methods and devices available in the birth units, admission cardiotocography (CTG) use, intrapartum fetal monitoring methods for women with and without risk factors, the availability of fetal scalp blood sampling facilities, and umbilical cord blood sampling routines. RESULTS All birth units responded. They all had access to Pinard stethoscopes, hand-held Doppler devices, and CTG. Half of the units used ST waveform analysis (STAN) as an adjunct to CTG. Furthermore, 23 of 48 units analyzed fetal blood samples and 43 of 48 umbilical cord blood gas samples. In 11 units, admission CTG was routinely offered to all women. No units used continuous CTG during labor in low-risk women. However, three units routinely used intermittent CTG during the first stage of labor. Three units used CTG without having access to fetal blood samples or STAN. CONCLUSIONS Our findings indicate some deviations from clinical recommendations in the use of intrapartum fetal monitoring in Norway. Three units used intermittent CTG for women without risk factors. Almost one in four units routinely used admission CTG, despite national clinical recommendations. The lack of access to fetal blood samples or STAN in units using CTG is of concern.
Collapse
Affiliation(s)
- Anne Kaasen
- Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Kristin J Aanstad
- Department of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway
| | - Aase S D Pay
- Department of Obstetrics and Gynecology, Oslo University Hospital, Oslo, Norway
| | - Inger Økland
- Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway
| | - Ellen Blix
- Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| |
Collapse
|
38
|
Brunstad A, Aasekjær K, Aune I, Nilsen ABV. Fathers' experiences during the first postnatal week at home after early discharge of mother and baby from the maternity unit: A meta-synthesis. Scand J Public Health 2018; 48:362-375. [PMID: 30426850 DOI: 10.1177/1403494818809856] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aim: The aim of this study was to explore and describe fathers' experiences during the first postnatal week after early discharge of mother and baby from the maternity unit. Methods: A meta-synthesis. Inclusion criteria: peer-reviewed qualitative single studies of fathers' experiences during the first week after early discharge (defined as less than 72 hours postpartum) from hospital after the birth of a healthy singleton baby born between weeks 37 and 40. Databases: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Maternity and Infant Care, Joanna Briggs, SweMed+ and PsycInfo were searched in May 2015 and May 2018. Of the 940 titles scanned for eligibility, three articles met the inclusion criteria. The consolidated criteria for reporting qualitative research checklist was used. Findings: All included studies were conducted in Sweden during the period 2002-2012. The total sample of participants in the meta-synthesis comprised 35 fathers. Analysis of the included studies generated two themes: building confidence and coping with responsibility. Conclusions: The fathers' experiences were affected by the emotional support of midwives, which boosted their confidence. This seems to be a premise for taking and coping with responsibility during the first days at home. Good cooperation between hospitals and municipalities is vital, and midwives must be available and present in order to ensure continuity in maternity care.
Collapse
Affiliation(s)
- Anne Brunstad
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Norway
| | - Katrine Aasekjær
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Norway
| | - Ingvild Aune
- Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Norway
| | - Anne Britt Vika Nilsen
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Norway
| |
Collapse
|
39
|
Thitipitchayanant K, Somrongthong R, Kumar R, Kanchanakharn N. Effectiveness of self-empowerment-affirmation-relaxation (Self-EAR) program for postpartum blues mothers: A randomize controlled trial. Pak J Med Sci 2018; 34:1488-1493. [PMID: 30559809 PMCID: PMC6290217 DOI: 10.12669/pjms.346.15986] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background and Objecvites: Approximately 55-85% of women worldwide have experienced postpartum blues (PPB) during 6-9 weeks after delivery without receiving the counseling program; more than 20% of them have developed into postpartum depression. Study objectives were to evaluate the effect of the Self-EAR program to improve the postpartum blues scores and serum allopregnanolone level among newly blues mothers. Methods: During June 2015 to May 2016, the randomized controlled trial was conducted among 76 Nulliparous blues mothers who were screened with Stein’s postpartum blues scores ≥ 3. All participants were randomly assigned either to the intervention group (Self-EAR program) and the control group (standard postpartum care program). The Self-EAR program was transformed into audio files which were installed in an MP3 digital device before providing it to the intervention group in order to be implemented at home three times per day for four weeks. Participants were assessed at baseline, 1-month, 2-month and 3-month follow-up for serum allopregnanolone level. Data were analyzed by using descriptive statistic, chi-square test, t-test, and repeated measure analysis of variance. Result: After the 3-month follow-up, the results revealed positive effects of the Self-EAR program on postpartum blues scores (p-value=0.002) and serum allopregnanolone concertation (p-value=0.001). The participants in the intervention group had experienced significantly lower postpartum blues scores; on the other hand, they had significantly higher serum allopregnanolone level when compared with the control group. Conclusions: The findings suggested that the Self-EAR program was effective to improve postpartum blues scores and allopregnanolone level among newly postpartum blues mothers.
Collapse
Affiliation(s)
- Krittipitch Thitipitchayanant
- Krittipitch Thitipitchayanant, School of Nursing, University of Phayao, Thailand. College of Public Health Sciences, Chulalongkorn University, Thailand
| | - Ratana Somrongthong
- Ratana Somrongthong, College of Public Health Sciences, Chulalongkorn University, Thailand
| | - Ramesh Kumar
- Ramesh Kumar, Health Services Academy Islamabad, Pakistan
| | - Naowarat Kanchanakharn
- Naowarat Kanchanakharn, College of Public Health Sciences, Chulalongkorn University, Thailand
| |
Collapse
|
40
|
Lindstad Løvåsmoen EM, Nyland Bjørgo M, Lukasse M, Schei B, Henriksen L. Women's preference for caesarean section and the actual mode of delivery - Comparing five sites in Norway. SEXUAL & REPRODUCTIVE HEALTHCARE 2018; 16:206-212. [PMID: 29804768 DOI: 10.1016/j.srhc.2018.04.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 03/06/2018] [Accepted: 04/16/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The caesarean (CS) section rate varies among hospitals in Norway, and little is known about whether this is influenced by women's preferences. The aim of this study was to investigate the differences in women's preferred mode of delivery during pregnancy between five hospitals in Norway, and to relate this to the actual mode of delivery. STUDY DESIGN A prospective cohort study of 2,177 unselected pregnant women in five hospitals in Norway. Women were recruited at their standard ultrasound examinations, and data was collected through questionnaires and electronic patient charts. The exposure was a CS preference and the main outcome measure was the actual mode of delivery. RESULTS In total, 3.5% of the primiparous women and 9.6% of the multiparous women reported a preference for CS. This was associated with fear of childbirth and education between 10 and 13 years in both groups, symptoms of depression and an age over 35 years old among the primiparous women, and a previous CS and/or negative birth experience among the multiparous. The multiparous women in Drammen and Tromsø were less likely to prefer a CS, and none of the primiparous women in Tromsø preferred a CS. A total of 67.8% of those who preferred a CS gave birth with this mode of delivery. CONCLUSION There were significant differences between the hospitals according to the CS preference. This preference was associated with the previous obstetric history and psychological factors. Therefore, creating good birth experiences and offering women counselling may reduce the CS preference rate.
Collapse
Affiliation(s)
- Elin Marie Lindstad Løvåsmoen
- Department of Nursing and Health Promotion, Oslo and Akershus University College of Applied Sciences, P.O. Box 4 St. Olavs plass, 0130 Oslo, Norway.
| | - Mari Nyland Bjørgo
- Department of Nursing and Health Promotion, Oslo and Akershus University College of Applied Sciences, P.O. Box 4 St. Olavs plass, 0130 Oslo, Norway.
| | - Mirjam Lukasse
- Department of Nursing and Health Promotion, Oslo and Akershus University College of Applied Sciences, P.O. Box 4 St. Olavs plass, 0130 Oslo, Norway.
| | - Berit Schei
- Department of Public Health and General Practice at the Faculty of Medicine, The Norwegian University of Science and Technology (NTNU), Håkon Jarls gate 11, N-7489 Trondheim, Norway; Department of Gynaecology at the Women's Clinic, St.Olavs Hospital, Trondheim University Hospital, Postbox 3250 Sluppen, N-7006 Trondheim, Norway.
| | - Lena Henriksen
- Department of Nursing and Health Promotion, Oslo and Akershus University College of Applied Sciences, P.O. Box 4 St. Olavs plass, 0130 Oslo, Norway; Division of General Gynaecology and Obstetrics, Oslo University Hospital, P.O Box 4950 Nydalen, N-0424 Oslo, Norway.
| |
Collapse
|
41
|
Akinlusi FM, Rabiu KA, Durojaiye IA, Adewunmi AA, Ottun TA, Oshodi YA. Caesarean delivery-related blood transfusion: correlates in a tertiary hospital in Southwest Nigeria. BMC Pregnancy Childbirth 2018; 18:24. [PMID: 29320992 PMCID: PMC5764010 DOI: 10.1186/s12884-017-1643-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 12/21/2017] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Caesarean delivery carries a risk of major intra-operative blood loss and its performance is often delayed by non-availability of blood and blood products. Unnecessary cross-matching and reservation of blood lead to apparent scarcity in centres with limited supply. This study set out to identify the risk factors for blood transfusion in women who underwent caesarean delivery at a tertiary obstetric unit with a view to ensuring efficient blood utilization. METHODS A prospective cohort analysis of 906 women who had caesarean deliveries at the Lagos State University Teaching Hospital, Nigeria between January and December, 2011. A comparison was made between 188 women who underwent blood transfusion and 718 who did not. Data were obtained on a daily basis by investigators from patients, clinical notes and referral letters using structured pre-tested data collecting form. Socio-demographic characteristics; antenatal, perioperative and intraoperative details; blood loss; transfusion; and puerperal observations were recorded. EPI-Info statistical software version 3.5.3 was used for multivariable analysis to determine independent risk factors for blood transfusion. RESULTS Of the 2134 deliveries during the study period, 906 (42.5%) had caesarean deliveries and of which 188 (20.8%) were transfused. The modal unit of blood transfused was 3 pints (41.3%). The most common indication for caesarean section was cephalo-pelvic disproportion (25.7%).The independent risk factors for blood transfusion at caesarean section were second stage Caesarean Section (aOR = 76.14, 95% CI = 1.25-4622.06, p = 0.04), placenta previa (aOR = 32.57, 95% CI = 2.22-476.26, p = 0.01), placental abruption (aOR = 25.35, 95% CI = 3.06-211.02, p < 0.001), pre-operative anaemia (aOR = 12.15, 95% = CI 4.02-36.71, p < 0.001), prolonged operation time (aOR = 10.72 95% CI = 1.37-36.02, p < 0.001), co-morbidities like previous uterine scar (aOR = 7.02, 95% CI = 1.37-36.02, p = 0.02) and hypertensive disorders in pregnancy (aOR = 5.19, 95% CI = 1.84-14.68, p < 0.001). Obesity reduced the risk for blood transfusion (aOR = 0.24, 95% CI = 0.09-0.61, p = 0.0024). CONCLUSION The overall risk of blood transfusion in cesarean delivery is high. Paturients with the second stage Caesarean section, placenta previa, abruptio placentae and preoperative maternal anaemia have an increased risk of blood transfusion. Hence, adequate peri-operative preparations for blood transfusion are essential in these situations. Optimizing maternal hemoglobin concentration during antenatal period may reduce the incidence of caesarean-associated blood transfusion.
Collapse
Affiliation(s)
- Fatimat M. Akinlusi
- Department of Obstetrics and Gynaecology, Lagos State University College of Medicine/Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
| | - Kabiru A. Rabiu
- Department of Obstetrics and Gynaecology, Lagos State University College of Medicine/Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
| | - Idayat A. Durojaiye
- Department of Obstetrics and Gynaecology, Lagos State University College of Medicine/Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
| | - Adeniyi A. Adewunmi
- Department of Obstetrics and Gynaecology, Lagos State University College of Medicine/Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
| | - Tawaqualit A. Ottun
- Department of Obstetrics and Gynaecology, Lagos State University College of Medicine/Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
| | - Yusuf A. Oshodi
- Department of Obstetrics and Gynaecology, Lagos State University College of Medicine/Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
| |
Collapse
|
42
|
Zanardo V, Giliberti L, Volpe F, Simbi A, Guerrini P, Parotto M, Straface G. Short hospitalization after caesarean delivery: effects on maternal pain and stress at discharge. J Matern Fetal Neonatal Med 2017; 31:2332-2337. [DOI: 10.1080/14767058.2017.1342802] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Vincenzo Zanardo
- Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy
| | - Lara Giliberti
- Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy
| | - Francesca Volpe
- Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy
| | - Alphonse Simbi
- Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy
| | - Pietro Guerrini
- Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy
| | - Matteo Parotto
- Department of Anesthesiology, University of Toronto, Toronto, Canada
| | - Gianluca Straface
- Division of Perinatal Medicine, Policlinico Abano Terme, Abano Terme, Italy
| |
Collapse
|
43
|
Barandon S, Balès M, Melchior M, Glangeaud-Freudenthal N, Pambrun E, Bois C, Verdoux H, Sutter-Dallay AL. Entretien prénatal précoce et séances de préparation à la naissance et à la parentalité : caractéristiques psychosociales et obstétricales associées chez les femmes de la cohorte ELFE. ACTA ACUST UNITED AC 2016; 45:599-607. [DOI: 10.1016/j.jgyn.2015.06.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 06/16/2015] [Accepted: 06/19/2015] [Indexed: 10/23/2022]
|
44
|
Li YP, Lin SY, Yeh CH, Hsu HC, Yang YL, Lee CN, Kuo SC. A proposed mother-friendly childbirth model for Taiwanese women and obstetricians' attitudes toward it. Taiwan J Obstet Gynecol 2015; 54:666-70. [PMID: 26700982 DOI: 10.1016/j.tjog.2014.09.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2014] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE Pleasant and humane childbirth is every mother's wish. The objective of this study was to propose a practicable mother-friendly childbirth model tailored to Taiwanese women in order to improve the quality of perinatal care and maternal satisfaction. MATERIAL AND METHODS In this study, the guidelines of several countries were systematically reviewed, and a standard set of clinical guidelines were established by a focus group. In addition, a total of 172 Taiwanese obstetricians were visited, and a cross-sectional study of these obstetricians' attitudes toward the practicality and effectiveness of the model was performed using questionnaires. RESULTS A total of 10 suggestions were developed for this woman-friendly childbirth model, including: (1) intermittent fetal monitoring for low-risk pregnancy, (2) no routine enema, (3) no routine perineal shaving, (4) no routine restricted oral intake, (5) no routine parenteral fluid support, (6) no routine elective amniotomy, (7) nonpharmacological pain management, (8) upright position during childbirth, (9) delayed pushing, and (10) restrictive episiotomy. Taiwanese obstetricians approved of no routine oral intake restriction and providing nonmedical pain relief. The majority of obstetricians disagreed that perineal shaving and routine elective amniotomy were necessary, and agreed to modify their practice according to the suggestions. Suggestions were still being debated, such as no routine parenteral fluid support, using an upright position for childbirth, and delayed pushing. Intermittent fetal monitoring for low-risk pregnancy, no routine enema, and restrictive episiotomy were questioned by many Taiwanese obstetricians. CONCLUSION Several suggestions were made in this model. However, there was still no consensus of Taiwanese obstetricians. More evidence for the advantages and disadvantages of the various suggestions was needed to convince Taiwanese obstetrician to modify their routine practice.
Collapse
Affiliation(s)
- Yi-Ping Li
- Department of Obstetrics and Gynecology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Shin-Yu Lin
- Department of Obstetrics and Gynecology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chih-Hsin Yeh
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Heng-Cheng Hsu
- Department of Obstetrics and Gynecology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ya-Ling Yang
- Department of Nursing, National Taiwan University College of Medicine, Taipei, Taiwan.
| | - Chien-Nan Lee
- Department of Obstetrics and Gynecology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
| | - Su-Chen Kuo
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| |
Collapse
|
45
|
Li YP, Yeh CH, Lin SY, Chen TC, Yang YL, Lee CN, Kuo SC. A proposed mother-friendly childbirth model for Taiwanese women, the implementation and satisfaction survey. Taiwan J Obstet Gynecol 2015; 54:731-6. [PMID: 26700994 DOI: 10.1016/j.tjog.2015.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2015] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVES Pleasant and humane childbirth is every mother's wish. We established one practicable and tailored Taiwanese mother-friendly childbirth model, and the objective of this study was to investigate the implementation, pregnancy outcomes, and women's satisfaction. MATERIALS AND METHODS We used the Taiwanese mother-friendly childbirth model. Women from eight hospitals were divided into an experimental group and control group. The experimental group received prenatal care modified by the Taiwanese mother-friendly childbirth model and the control group received routine prenatal care according to their hospital. We performed a quasi-experimental study of women's satisfaction toward this mother-friendly childbirth model by questionnaires and surveyed the practicality and effectiveness of this model. RESULTS Seven hundred and fifty-one women from eight hospitals, including three medical centers and five regional hospitals were included. There was significantly different practices between the two groups, such as: (1) intermittent fetal monitoring for low-risk pregnancy; (2) no routine enema; (3) no perineal shaving; (4) less routine parenteral fluid support; (5) using an upright position; and (6) restrictive episiotomy. The mean maternal height, body weight gain, gestational age, birth weight, and episiotomy wound infection rate were indifferent. The epidural anesthesia rate and induction medication use were significantly lower in the experimental group. The self-reported pain score was higher in the experimental group and the self-reported satisfactory score was also higher in the experimental group, without statistical significance. CONCLUSION Women receiving standardized prenatal care modified by the woman-friendly childbirth model of prenatal care had less epidural anesthesia, less induction medication, higher self-reported satisfaction score, and indifferent pregnancy outcomes such as gestational age, birth weight, and wound infection rate.
Collapse
Affiliation(s)
- Yi-Ping Li
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
| | - Chih-Hsin Yeh
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Shin-Yu Lin
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan
| | - Tai-Chang Chen
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, Taiwan
| | - Ya-Ling Yang
- Department of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.
| | - Chien-Nan Lee
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan.
| | - Su-Chen Kuo
- National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| |
Collapse
|
46
|
Till SR, Everetts D, Haas DM. Incentives for increasing prenatal care use by women in order to improve maternal and neonatal outcomes. Cochrane Database Syst Rev 2015; 2015:CD009916. [PMID: 26671418 PMCID: PMC8692585 DOI: 10.1002/14651858.cd009916.pub2] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Prenatal care is recommended during pregnancy as a method to improve neonatal and maternal outcomes. Improving the use of prenatal care is important, particularly for women at moderate to high risk of adverse outcomes. Incentives are sometimes utilized to encourage women to attend prenatal care visits. OBJECTIVES To determine whether incentives are an effective tool to increase utilization of timely prenatal care among women. SEARCH METHODS We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 January 2015) and the reference lists of all retrieved studies. SELECTION CRITERIA Randomized controlled trials (RCTs), quasi-RCTs, and cluster-RCTs that utilized direct incentives to pregnant women explicitly linked to initiation and frequency of prenatal care were included. Incentives could include cash, vouchers, coupons or products not generally offered to women as a standard of prenatal care. Comparisons were to no incentives and to incentives not linked directly to utilization of care. We also planned to compare different types of interventions, i.e. monetary versus products or services. DATA COLLECTION AND ANALYSIS Two review authors independently assessed studies for inclusion and methodological quality. Two review authors independently extracted data. Data were checked for accuracy. MAIN RESULTS We identified 11 studies (19 reports), six of which we excluded. Five studies, involving 11,935 pregnancies were included, but only 1893 pregnancies contributed data regarding our specified outcomes. Incentives in the studies included cash, gift card, baby carrier, baby blanket or taxicab voucher and were compared with no incentives. Meta-analysis was performed for only one outcome 'Return for postpartum care' and this outcome was not pre-specified in our protocol. Other analyses were restricted to data from single studies.Trials were at a moderate risk of bias overall. Randomization and allocation were adequate and risk of selection bias was low in three studies and unclear in two studies. None of the studies were blinded to the participants. Blinding of outcome assessors was adequate in one study, but was limited or not described in the remaining four studies. Risk of attrition was deemed to be low in all studies that contributed data to the review. Two of the studies reported or analyzed data in a manner that was not consistent with the predetermined protocol and thus were deemed to be at high risk. The other three studies were low risk for reporting bias. The largest two of the five studies comprising the majority of participants took place in rural, low-income, homogenously Hispanic communities in Central America. This setting introduces a number of confounding factors that may affect generalizability of these findings to ethnically and economically diverse urban communities in developed countries.The five included studies of incentive programs did not report any of this review's primary outcomes: preterm birth, small-for-gestational age, or perinatal death.In terms of this review's secondary outcomes, pregnant women receiving incentives were no more likely to initiate prenatal care (risk ratio (RR) 1.04, 95% confidence interval (CI) 0.78 to 1.38, one study, 104 pregnancies). Pregnant women receiving incentives were more likely to attend prenatal visits on a frequent basis (RR 1.18, 95% CI 1.01 to 1.38, one study, 606 pregnancies) and obtain adequate prenatal care defined by number of "procedures" such as testing blood sugar or blood pressure, vaccinations and counseling about breastfeeding and birth control (mean difference (MD) 5.84, 95% CI 1.88 to 9.80, one study, 892 pregnancies). In contrast, women who received incentives were more likely to deliver by cesarean section (RR 1.97, 95% CI 1.18 to 3.30, one study, 979 pregnancies) compared to those women who did not receive incentives.Women who received incentives were no more likely to return for postpartum care based on results of meta-analysis (average RR 0.75, 95% CI 0.21 to 2.64, two studies, 833 pregnancies, Tau² = 0.81, I² = 98%). However, there was substantial heterogeneity in this analysis so a subgroup analysis was performed and this identified a clear difference between subgroups based on the type of incentive being offered. In one study, women receiving non-cash incentives were more likely to return for postpartum care (RR 1.26, 95% CI 1.09 to 1.47, 240 pregnancies) than women who did not receive non-cash incentives. In another study, women receiving cash incentives were less likely to return for postpartum care (RR 0.43, 95% CI 0.30 to 0.62, 593 pregnancies) than women who did not receive cash incentives.No data were identified for the following secondary outcomes: frequency of prenatal care; pre-eclampsia; satisfaction with birth experience; maternal mortality; low birthweight (less than 2500 g); infant macrosomia (birthweight greater than 4000 g); or five-minute Apgar less than seven. AUTHORS' CONCLUSIONS The included studies did not report on this review's main outcomes: preterm birth, small-for-gestational age, or perinatal death. There is limited evidence that incentives may increase utilization and quality of prenatal care, but may also increase cesarean rate. Overall, there is insufficient evidence to fully evaluate the impact of incentives on prenatal care initiation. There are conflicting data as to the impact of incentives on return for postpartum care. Two of the five studies which accounted for the majority of women in this review were conducted in rural, low-income, overwhelmingly Hispanic communities in Central America, thus limiting the external validity of these results.There is a need for high-quality RCTs to determine whether incentive program increase prenatal care use and improve maternal and neonatal outcomes. Incentive programs, in particular cash-based programs, as suggested in this review and in several observational studies may improve the frequency and ensure adequate quality of prenatal care. No peer-reviewed data have been made publicly available for one of the largest incentive-based prenatal programs - the statewide Medicaid-based programs within the United States. These observational data represent an important starting point for future research with significant implications for policy development and allocation of healthcare resources. The disparate findings related to attending postpartum care should also be further explored as the findings were limited by the number of studies. Future large RCTs are needed to focus on the outcomes of preterm birth, small-for-gestational age and perinatal outcomes.
Collapse
Affiliation(s)
- Sara R Till
- Indiana University School of MedicineDepartment of Obstetrics and Gynecology1001 West 10th Street, F‐5IndianapolisIndianaUSA46202
- University of North Carolina, Chapel HillDepartment of Obstetrics and GynecologyNorth CarolinaUSA
| | - David Everetts
- Indiana University School of MedicineDepartment of Public Health714 North Senate Avenue, EF250IndianapolisIndianaUSA46202
| | - David M Haas
- Indiana University School of MedicineDepartment of Obstetrics and Gynecology1001 West 10th Street, F‐5IndianapolisIndianaUSA46202
| | | |
Collapse
|
47
|
Godin KM, Alton GD, Gangodawilage HP, Procter TD, Bourdages NB, Blue SE, Edwards SA, Horan MJ. Knowledge change associated with participation in prenatal education programs in Ontario: A cohort study. Canadian Journal of Public Health 2015; 106:e401-7. [PMID: 26680432 DOI: 10.17269/cjph.106.5057] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 10/08/2015] [Accepted: 08/03/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The primary objective was to examine how participation in prenatal programs delivered by Ontario public health units influences pregnant women's pregnancy-related knowledge. Secondary objectives were to examine the socio-demographic characteristics of women participating in these programs and assess program satisfaction. METHODS A cohort study was conducted of 511 adult pregnant women who were registered for a prenatal program within one of seven Ontario public health units. Participants completed a pre-program survey, which examined socio-demographic and pregnancy characteristics, and baseline pregnancyrelated knowledge. After finishing the program, participants completed a post-program survey investigating pregnancy-related knowledge and program satisfaction. Pregnancy-related knowledge was assessed using the Healthy Pregnancies Knowledge Survey, which captures knowledge within three subtopic areas: healthy pregnancies, healthy lifestyles and breastfeeding. RESULTS Participants demonstrated a significant increase in mean knowledge scores, both overall and across each subtopic area. Most participants reported that their program satisfied their questions either mostly or very well across all content areas examined. CONCLUSION This study is the first large-scale effort to examine the ability of prenatal programs offered through Ontario public health units to influence clients' pregnancy-related knowledge. These findings contribute to the evidence base for prenatal education program planning.
Collapse
|
48
|
Yeoh PL, Hornetz K, Ahmad Shauki NI, Dahlui M. Assessing the Extent of Adherence to the Recommended Antenatal Care Content in Malaysia: Room for Improvement. PLoS One 2015; 10:e0135301. [PMID: 26270471 PMCID: PMC4536216 DOI: 10.1371/journal.pone.0135301] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 07/20/2015] [Indexed: 11/29/2022] Open
Abstract
Background Recent papers on monitoring of health services affirmed that while antenatal care (ANC) is an effective measure, quality is still a problem. Quality in maternal services “…involves providing a minimum level of care to all pregnant women…” Yet adherence to a minimum level of recommended ANC content appears to be unmet. Comprehensive review of ANC content rendered in environments with rapid changes in demographic, socio-economic, lifestyle and morbidity was sparse. Malaysia is such a country that has undergone these transitions with tremendous progress in health. However, recent progress in pregnancy outcomes is stagnating. This study aims to analyse adherence to recommended ANC; specifically, to examine the extent of adherence to recommended ANC content and to determine the factors influencing ANC content score. Methods A retrospective cohort study of 522 randomly selected women who used ANC was conducted. Data were extracted from individual records. The study examined adherence to essential ANC guidelines using weighted scoring for physical examination, health screening, case management, and health education. GLM Univariate analysis procedure was used to determine the factors associated with ANC content score. Binary logistic regression was used to assess ANC content level and pregnancy outcomes, controlled for ANC utilisation. Results Around half of the women had <80% of recommended ANC content documented. Health education had the lowest mean score, at around 35%. The low-risk pregnancies had a higher ANC content score than the high-risk pregnancies (78% vs. 75%; P = 0.002). The smallest clinics had a higher ANC content score than the bigger clinics (78% vs. 74–76%; P<0.001). ANC content score among the women with “adequate” ANC utilisation, as defined by the modified Adequacy of Prenatal Care Utilisation Index, was lower than the women with “adequate-plus” ANC utilisation (75% vs. 78%, P<0.001). Assessment of symphysis-fundal height, foetal presentation and foetal heart auscultation were initiated earlier than recommended. Inadequate ANC content was associated with higher prevalence of preterm birth. Conclusions Our findings indicate the presence of issues related to delivery of recommended ANC content. We advocate for all pregnant women to be ensured of adherence to the recommended ANC content. We also recommend monitoring the delivery of health advice. Conforming to recommended timing of initiation for ANC practices is essential due to resource implication and possible implication on maternal wellbeing. The association of inadequate ANC content and preterm birth may be due to lesser opportunities to receive some of the care because of lower number of ANC visits among preterm birth; this may also indicate the importance of having adequate ANC content.
Collapse
Affiliation(s)
- Ping Ling Yeoh
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Mediconsult Sdn. Bhd., Ampang, Malaysia
- * E-mail:
| | | | | | - Maznah Dahlui
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| |
Collapse
|
49
|
He HG, Vehviläinen-Julkunen K, Qian XF, Sapountzi-Krepia D, Gong Y, Wang W. Fathers' feelings related to their partners' childbirth and views on their presence during labour and childbirth: A descriptive quantitative study. Int J Nurs Pract 2015; 21 Suppl 2:71-9. [DOI: 10.1111/ijn.12339] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Hong-Gu He
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore; Singapore
| | - Katri Vehviläinen-Julkunen
- Department of Nursing Science; Kuopio University Hospital; University of Eastern Finland; Kuopio Finland
| | - Xiao-Fang Qian
- Department of Nursing; Fujian Provincial Women's and Children's Hospital; Fuzhou Fujian China
- School of Nursing; Fujian Medical University; Fuzhou Fujian China
| | | | - Yuhua Gong
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore; Singapore
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore; Singapore
| |
Collapse
|
50
|
Fabian H, Sarkadi A, Åhman A. Challenges and benefits of conducting parental classes in Sweden: Midwives' perspectives. SEXUAL & REPRODUCTIVE HEALTHCARE 2015; 6:236-42. [PMID: 26614607 DOI: 10.1016/j.srhc.2015.05.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Revised: 05/27/2015] [Accepted: 05/29/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE There is lack of knowledge regarding antenatal care midwives' perspectives concerning parental classes provided during pregnancy, and this study aimed to explore midwives' experiences and thoughts about these parental class activities. METHODS Twenty-six semi-structured, individual, telephone interviews were carried out with midwives at antenatal clinics across Sweden, and the data were analysed using systematic text condensation (STC). RESULTS The midwives noted that parental classes were a demanding task, and they appeared to lack the confidence and skills required to manage the classes. They expressed a "need for collaborators to achieve the objectives" (theme 1). The midwives felt that "creating new networks is most valuable for parents" (theme 2), and they were also "striving to give the 'whole picture' to both parents" (theme 3), i.e. looking beyond just the delivery. Although they had the ambition, midwives realised it was "not possible to reach all" (theme 4). CONCLUSIONS Organisational resources as well as developing skills to lead groups are imperative for midwives to fulfil the goals of the parental classes. The midwives are aware that they cannot reach all parents with the group format; thus, it is important to acknowledge the needs of minority populations and develop multidisciplinary collaborations to be able to better address their needs.
Collapse
Affiliation(s)
- Helena Fabian
- Department of Women's and Children's Health, Uppsala University Hospital, SE-751 85 Uppsala, Sweden.
| | - Anna Sarkadi
- Department of Women's and Children's Health, Uppsala University Hospital, SE-751 85 Uppsala, Sweden
| | - Annika Åhman
- Department of Women's and Children's Health, Uppsala University Hospital, SE-751 85 Uppsala, Sweden
| |
Collapse
|