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Kashiha M, Hosseini J, Samadaee Gelehkolaee K. Mothers' Perceptions About Childbirth Preparation Classes: A Qualitative Study. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2023; 11:278-286. [PMID: 37901189 PMCID: PMC10611932 DOI: 10.30476/ijcbnm.2023.98607.2247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 08/28/2023] [Accepted: 09/04/2023] [Indexed: 10/31/2023]
Abstract
Background Childbirth preparation classes are designed for better adaptation of couples to physiological and psychological changes related to pregnancy and childbirth. Therefore, we aimed to explore the mothers' perceptions about childbirth preparation classes. Methods A qualitative study was conducted using the conventional qualitative content analysis method from May to August 2022. Eighteen women who had given birth in the last six months in one of the hospitals in Tehran and at least 20 days had passed since their delivery were included in the study; also, five husbands, two midwives, and two obstetricians were interviewed. The participants were purposefully selected according to the inclusion criteria. Sampling continued until data saturation. Data were collected through individual, in-depth, and semi-structured interviews and analyzed by the MAXQDA version 10 software. Results Mothers' age ranged from 17 to 37 years. 128 primary codes, 7 sub-sub themes, 3 sub-themes, and one theme were extracted. The sub-themes included satisfaction from the choice (perception forming for better choices, common consent), making the wait pleasant (dignity-oriented professional care, adaptation to change, feeling of empowerment), and good termination (free and conscious choice for birth mode, self-control during delivery process). Finally, a theme called "making motherhood pleasant" was extracted. Conclusion Making motherhood pleasant can be a meaningful achievement of childbirth preparation classes. Paying more attention to improving the quality of these classes can help improve family health. Therefore, policymakers should implement strategies to facilitate women's access to these classes.
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Affiliation(s)
- Mina Kashiha
- Men’s Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Jalil Hosseini
- Men’s Health and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Keshvar Samadaee Gelehkolaee
- Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Reproductive Health and Midwifery, School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
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Moridi A, Abedi P, Iravani M, Khosravi S, Alianmoghaddam N, Maraghi E, Saadati N. Experiences of health providers regarding implementation of the physiologic birth program in Iran: A qualitative content analysis. PLoS One 2023; 18:e0283022. [PMID: 37390105 PMCID: PMC10313046 DOI: 10.1371/journal.pone.0283022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 02/28/2023] [Indexed: 07/02/2023] Open
Abstract
INTRODUCTION The rate of cesarean section is on the rise in both developed and developing countries, and Iran is no exception. According to the WHO, physiologic labor is one of the main strategies for reducing cesarean section and improving the health of mothers and newborns. The aim of this qualitative study was to explain the experiences of health providers regarding implementation of the physiologic birth program in Iran. METHODS This study is a part of a mixed-methods study, in which 22 health providers were interviewed from January 2022 to June 2022. Data analysis was performed using Graneheim and Lundman's conventional content analysis approach and using MAXQDA10 software. RESULTS Two main categories and nine subcategories emerged from the results of this study. The main categories included "the obstacles to the implementation of the physiologic birth program" and "strategies for improving implementation of the program". The subcategories of the first category included: lack of continuous midwifery care in the healthcare system, lack of free accompanying midwives, lack of integrated healthcare and hospitals in service provision, low quality of childbirth preparation and implementation of physiologic birth classes, and lack of requirements for the implementation of physiologic birth in the maternity ward. The second category included the following subcategories: Supervising the implementation of childbirth preparation classes and physiologic childbirth, support of midwives by insurance companies, holding training courses on physiologic birth, and evaluation of program implementation. CONCLUSIONS The experiences of the health providers with the physiologic birth program revealed that policymakers should provide the ground for the implementation of this type of labor by removing the obstacles and providing the particular operational strategies needed in Iran. Important measures that can contribute to the implementation of the physiologic labor program in Iran include the following: Setting the stage for physiologic birth in the healthcare system, creating low- and high-risk wards in maternity hospitals, providing professional autonomy for midwifery, training childbirth providers on physiologic birth, monitoring the quality of program implementation, and providing insurance support for midwifery services.
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Affiliation(s)
- Azam Moridi
- Department of Midwifery, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Parvin Abedi
- Department of Midwifery, Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mina Iravani
- Department of Midwifery, Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Shala Khosravi
- Department of Community Medicine, Faculty Member of Medicine School, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Elham Maraghi
- Department of Biostatistics and Epidemiology, Faculty of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Najmieh Saadati
- Obstetrics and Gynecology, Fertility Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Mirzania M, Shakibazadeh E, Bohren MA, Hantoushzadeh S, Babaey F, Khajavi A, Foroushani AR. Mistreatment of women during childbirth and its influencing factors in public maternity hospitals in Tehran, Iran: a multi-stakeholder qualitative study. Reprod Health 2023; 20:79. [PMID: 37226263 DOI: 10.1186/s12978-023-01620-0] [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: 09/20/2022] [Accepted: 05/14/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Mistreatment during labour and childbirth is a common experience for many women around the world. This study aimed to explore the manifestations of mistreatment and its influencing factors in public maternity hospitals in Tehran. METHODS A formative qualitative study was conducted using a phenomenological approach in five public hospitals between October 2021 and May 2022. Sixty in-depth face-to-face interviews were conducted with a purposive sample of women, maternity healthcare providers, and managers. Data were analyzed with content analysis using MAXQDA 18. RESULTS Mistreatment of women during labour and childbirth was manifested in four form: (1) physical abuse (fundal pressure); (2) verbal abuse (judgmental comments, harsh and rude language, and threats of poor outcomes); (3) failure to meet professional standards of care (painful vaginal exams, neglect and abandonment, and refusal to provide pain relief); and (4) poor rapport between women and providers (lack of supportive care and denial of mobility). Four themes were also identified as influencing factors: (1) individual-level factors (e.g., providers' perception about women's limited knowledge on childbirth process), (2) healthcare provider-level factors (e.g., provider stress and stressful working conditions); (3) hospital-level factors (e.g., staff shortages); and (4) national health system-level factors (e.g., lack of access to pain management during labour and childbirth). CONCLUSIONS Our study showed that women experienced various forms of mistreatment during labour and childbirth. There were also multiple level drivers for mistreatment at individual, healthcare provider, hospital and health system levels. Addressing these factors requires urgent multifaceted interventions.
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Affiliation(s)
- Marjan Mirzania
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Shakibazadeh
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Meghan A Bohren
- Gender and Women's Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia
| | - Sedigheh Hantoushzadeh
- Department of Obstetrics and Gynecology, School of Medicine, Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farah Babaey
- Head of Department of Midwifery, Ministry of Health and Medical Education, Tehran, Iran
| | - Abdoljavad Khajavi
- Department of Social Medicine, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Abbas Rahimi Foroushani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Moridi A, Abedi P, Iravani M, Khosravi S, Alianmoghaddam N, Maraghi E, Saadati N. Women's experiences with implementation of the physiologic birth program in Iran: a qualitative content analysis study. Front Glob Womens Health 2023; 4:1115365. [PMID: 37260781 PMCID: PMC10228727 DOI: 10.3389/fgwh.2023.1115365] [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: 12/03/2022] [Accepted: 04/26/2023] [Indexed: 06/02/2023] Open
Abstract
Introduction Increased rate of caesarean section (CS) without medical indication is a global concern. According to the guidelines of the World Health Organization (WHO), the physiologic birth program is one of the strategies for reducing the rate of unnecessary caesarean sections. The aim of this study is to explain women's experiences with the implementation of the physiologic birth program in Iran. Materials and methods This study is a part of a mixed-method study involving 15 targeted semi-structured interviews individually conducted with women attending physiologic birth classes between January 2022 and June 2022. Interviews continued until data saturation was achieved. Data were analyzed using conventional content analysis approach based on the criteria proposed by Graneheim and Lundman, using MAXQDA10 software. Results Analysis of the findings of the study led to the emergence of 2 themes, 4 categories, and 10 subcategories. The first theme was the positive experiences of the women ("satisfaction with pregnancy" and "making the childbirth process pleasant"), and the second theme was their negative experiences with physiologic birth ("challenges and limitation of physiologic birth program" and "lack of high-quality obstetric services in the public health system"). Conclusion The results of this study showed that childbirth preparation classes reduced women's fear and stress and enhanced their positive attitude toward vaginal delivery by preparing them for childbirth. Also, effective communication with midwives and their support along with efficient implementation of physiologic birth techniques led to successful pain management and satisfaction with the birth process. Policymakers should implement strategies to remove limitations and make this program accessible to all women.
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Affiliation(s)
- Azam Moridi
- Department of Midwifery, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Parvin Abedi
- Department of Midwifery, Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mina Iravani
- Department of Midwifery, Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Shahla Khosravi
- Department of Community Medicine, Faculty Member of Medicine School, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Elham Maraghi
- Department of Biostatistics and Epidemiology, Faculty of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Najmieh Saadati
- Obstetrics and Gynecology, Fertility, Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Kiani Z, Moghasemi M, Elyasi F, Shirvani MA, Hamzehgardeshi Z, Tayebi T, Tabari NSM, Azarfar H, Moosazadeh M, Khani S. Design, implementation, and validation of an application for childbirth preparation classes to improve the performance of midwifery students: Study protocol. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:137. [PMID: 37397094 PMCID: PMC10312412 DOI: 10.4103/jehp.jehp_611_22] [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: 04/29/2022] [Accepted: 07/30/2022] [Indexed: 07/04/2023]
Abstract
BACKGROUND Childbirth preparation classes are incredibly useful for midwifery students as future medical personnel. Nowadays, given the outbreak of Covid-19 pandemic and as mobile applications are extensively welcomed, virtual space can be used for education in the area of childbirth preparation classes. Given the lack of an application for childbirth preparation classes, this study will be conducted to design, implement and validate such an application to improve the performance of midwifery students in the areas of pregnancy and safe delivery. MATERIALS AND METHODS The present study will be conducted in three phases. In the first phase, content will be provided to Information Technology experts based on the content of the national guidelines for physiological delivery in Iran, and the application will be designed and validated for the use of midwifery students, then develop app for other medical students, midwives and physicians. In the second phase, the assessment will be based on Kirkpatrick's model. In the third stage, develop app for other medical students, midwives and physicians based on the results of the first and second phase. SPSS version 17 will be used in this phase for analysis of data through descriptive and analytical tests. CONCLUSION Owing to the expansion of virtual space and the outbreak of Covid-19 pandemic, design, validation, and evaluation of an application for childbirth preparation classes is an exceptionally significant necessity which contributes to the process of educating midwifery students.
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Affiliation(s)
- Zahra Kiani
- Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mobina Moghasemi
- Student Research Committee, School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
| | - Forouzan Elyasi
- Psychiatry and Behavioral Sciences Research Center, Sexual and Reproductive Health Research Center, Addiction Institute, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Marjan Ahmadi Shirvani
- Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zeinab Hamzehgardeshi
- Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Tahereh Tayebi
- Department of Midwifery, School of Nursing and Midwifery, Mazandaran University of Medical Science, Sari, Iran
| | | | - Hamidreza Azarfar
- Information Technology Department, Vice- Chancellor in Research Affairs, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahmood Moosazadeh
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Soghra Khani
- Sexual and Reproductive Health Research Center, Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, Iran
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Zeng T, Li B, Zhang K, Chen Y, Yuan M, Wu M, Zhao H, Zhu Z, Ju D. The association between childbirth-related fear, childbirth readiness, and fertility intentions, and childbirth readiness as the mediator. Reprod Health 2023; 20:62. [PMID: 37085786 PMCID: PMC10122374 DOI: 10.1186/s12978-023-01607-x] [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: 06/07/2022] [Accepted: 04/02/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND Fertility intentions have been proved to be a reliable predictor of actual fertility behaviour. Also, childbirth-related fear (CBRF) has been proven to be negatively associated with childbirth readiness and fertility intentions among women, while childbirth readiness was positively related to fertility intentions. However, the associations and potential mechanisms between CBRF, childbirth readiness, and fertility intentions remain unknown. This study aimed to investigate the unique association between CBRF, childbirth readiness, and fertility intentions and whether childbirth readiness would mediate the relationship between CBRF and fertility intentions. METHOD A cross-sectional study of women (N = 1119, aged 16-53 years) who gave birth within 72 h was conducted. Using a convenience sampling, women were recruited from obstetric wards-10 comprehensive hospitals and 3 specialized hospitals in 7 provinces in mainland China. Pearson correlation was used to examine the relationship between CBRF, childbirth readiness, fertility intentions, and social support. Multivariate linear regression was further used to analyze the association between demographic and personal characteristics, CBRF, childbirth readiness, and fertility intentions. Mediation analysis was used to examine whether childbirth readiness mediates the relationship between CBRF and fertility intentions. RESULTS Women with high childbirth readiness (β = 0.09, P = 0.002) had higher fertility intentions. However, women with high CBRF (β = - 0.17, P < 0.001) were more likely to have lower fertility intentions. CBRF had both direct and indirect effects on the level of fertility intentions. As predicted, childbirth readiness mediated the relationship between CBRF and the level of fertility intentions (estimate = - 0.012, 95% bootstrap CI: - 0.021 to - 0.005). Higher CBRF was associated with lower scores of childbirth readiness, which was associated with lower levels of fertility intentions. CONCLUSIONS This study established the evidence that CBRF had both direct and indirect effects on the level of fertility intentions and childbirth readiness mediated the relationship between CBRF and the level of fertility intentions. Specifically, higher CBRF was associated with lower scores of childbirth readiness, which was associated with lower levels of fertility intentions. This finding suggested that it is important for health policymakers and health providers to pay more attention to improving women's childbirth readiness, which might reduce the negative influence of CBRF on fertility intentions, thus strengthening their fertility intentions.
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Affiliation(s)
- Tieying Zeng
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China.
| | - Bingbing Li
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
| | - Ke Zhang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
| | - Ye Chen
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
| | - Mengmei Yuan
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
| | - Meiliyang Wu
- Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, 430030, China
| | - Huimin Zhao
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
| | - Zining Zhu
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
| | - Dandan Ju
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan, 430030, China
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Arora N, Jiwan T, Juneja SK, Tandon P. Effectiveness of Parental Preparedness Package among Couples Conceived with Artificial Reproductive Techniques. Int J Appl Basic Med Res 2023; 13:40-43. [PMID: 37266526 PMCID: PMC10230524 DOI: 10.4103/ijabmr.ijabmr_447_22] [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: 08/03/2022] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 06/03/2023] Open
Abstract
Introduction The problem of infertility is experienced as a crisis or major life stressor with potentially serious negative effects on the couple's relationship and preparation toward the parenthood. According to Sharlip et al., it has been estimated that about 15% of couple would have trouble in conception, and at present, 48.5 million couples experience infertility globally. To decrease the stress among parents to be and to promote healthy parenting for bringing out healthy parent-child relationships, an intervention of Parent Education Program was planned and executed. A study was conducted with the aim to assess the effectiveness of parental preparedness package (PPP) on physical health among couple conceived with artificial reproductive techniques (ART). Materials and Methods The study was conducted to evaluate the effectiveness of PPP in fifty couples conceived with ART at Dayanand Medical College and Hospital, Ludhiana. Quantitative approach was used to collect the data of couples by doing pre- and postinterventional assessment of physical health of couple using the Structured Physical Health Assessment Scale. Analysis was done with the help of descriptive and inferential statistics. Results The study revealed that mean score of physical health of couple (both husband and wife) increased significantly after the intervention which infers the effectiveness of PPP (P = 0.001). Conclusion Our study concludes that PPP should be incorporated in the antenatal care protocol in all couples who conceive using ART.
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Affiliation(s)
- Nidhi Arora
- Department of Obstetric Nursing, DMCH College of Nursing, Ludhiana, Punjab, India
| | - Triza Jiwan
- Department of Psychiatric Mental Health Nursing, DMCH College of Nursing, Ludhiana, Punjab, India
| | - Sunil Kumar Juneja
- Department of Obstetrics and Gynaecology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Pooja Tandon
- Department of Obstetrics and Gynaecology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
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Mohaghegh Z, Javadnoori M, Najafian M, Abedi P, Kazemnejad Leyli E, Montazeri S, Bakhtiari S. Effect of birth plans integrated into childbirth preparation classes on maternal and neonatal outcomes of Iranian women: A randomized controlled trial. Front Glob Womens Health 2023; 4:1120335. [PMID: 37091299 PMCID: PMC10117766 DOI: 10.3389/fgwh.2023.1120335] [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: 12/09/2022] [Accepted: 03/22/2023] [Indexed: 04/25/2023] Open
Abstract
Background Involvement of women in the decision-making process during childbirth plays an important role in their physical and psychosocial preparation. A birth plan allows the woman to express her expectations and facilitates her participation in her own care. The present study is the first to assess the implementation of birth plans integrated into childbirth preparation classes in Tehran, Iran. Methods This study is a randomized controlled clinical trial performed on 300 pregnant women at 32-33 weeks of gestation referring to four public health centers in Tehran, Iran. The participants were randomly allocated into intervention and control groups using block randomization method. A training session on the items of the birth plan checklist was held in the fifth session of childbirth preparation classes for the participants in the intervention group. Accordingly, a birth plan was prepared according to the requests of mothers. The birth plan was implemented after the women were admitted to the maternity ward. The primary outcomes were frequency of vaginal birth, mean duration of labor stages, and mean score of childbirth satisfaction. We used a checklist of maternal and neonatal outcomes, Mackey's childbirth satisfaction questionnaire, and a partogram form for data collection. Independent t-test, Mann-Whitney U-test, Chi-square test, Fisher's exact test, and logistic regression were used for data analysis. Results Vaginal birth rates were significantly higher in women who had birth plans compared with those without (81.9% vs. 48.7%, p < 0.001). Also, the lengths of the first and the second stages of labor were significantly shorter in women having a birth plan (p = 0.02). Women in the birth plan group were significantly more satisfied with the process of labor and childbearing (p < 0.001), and started breastfeeding after birth earlier than those in the control group (p < 0.001). Conclusion Having a birth plan and attending childbirth preparation classes can increase the rate of normal vaginal birth. Also, according to our results, women's participation in the decision- making process and fulfilling their preferences during birth can improve maternal and neonatal outcomes and childbirth satisfaction.Trial registration: IRCT20190415043283N2. 2020-12-07.
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Affiliation(s)
- Zaynab Mohaghegh
- Department of Midwifery, Nursing & Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mojgan Javadnoori
- Department of Midwifery, Reproductive Health Promotion Research Center, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Correspondence: Mojgan Javadnoori
| | - Mahin Najafian
- Department of Obstetrics and Gynecology, School of Medicine, Fertility, Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Parvin Abedi
- Department of Midwifery, Menopause Andropause Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ehsan Kazemnejad Leyli
- Department of Biostatistics, Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Simin Montazeri
- Department of Midwifery, Reproductive Health Promotion Research Center, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Shahla Bakhtiari
- Midwifery Department, Rosie Hospital, Cambridge University Hospitals NHS, Cambridge, United Kingdom
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Alkhunaizi AN, Alyousef SM, Alhamidi SA, Almoammar DN. Saudi Arabian Primigravid Women's Experiences of Mindfulness to Reduce Childbirth Stress: A Qualitative Study. SAGE Open Nurs 2023; 9:23779608231175214. [PMID: 37214232 PMCID: PMC10192671 DOI: 10.1177/23779608231175214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 04/18/2023] [Indexed: 05/24/2023] Open
Abstract
Introduction Pregnancy is a significant transitional life experience. It can also be one of the most stressful experiences in life and some women go on to develop postpartum depression. Adopting mindfulness techniques during childbirth may allow women to experience less labor pain and require fewer medical interventions, which improve the mother's health. Objective To investigate the effectiveness of mindfulness in reducing childbirth stress in primigravid women in Saudi Arabia. Methods The researcher recruited primigravid women from an antenatal clinic in a government hospital in the Eastern Province of Saudi Arabia. The study adopted a qualitative interpretive descriptive design, using individual interviews to collect the data before conducting thematic content analysis using NVivo 10.1 software. Results Five key themes emerged from the data: (a) stress reduction, (b) recognition of thoughts and feelings, (c) life satisfaction, (d) insufficient knowledge leads to challenges, and (e) empowerment of a spiritual aspect. Conclusions Mindfulness is an effective technique that supports a mother's physical and psychological well-being.
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Affiliation(s)
- Anwar Nader Alkhunaizi
- Department of Maternal and Child Health
Nurse, King Saud University, Riyadh, Saudi Arabia
| | - Seham Mansour Alyousef
- Community and Psychiatric Department,
Nursing College, King Saud University, Riyadh, Saudi Arabia
| | - Sami Abdulrahman Alhamidi
- Department of Maternal and Child
Health, Nursing College, King Saud University, Riyadh, Saudi Arabia
| | - Danah Nasser Almoammar
- Department of Psychiatric and Mental
Health Care, College of Nursing, King Saud University, Riyadh, Saudi Arabia
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10
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Alahmed S, Meedya S, Mutair AA, Fernandez R. Saudi Women's Breastfeeding Knowledge, Attitude, and Practices: A Systematic Review and Meta-analysis. J Transcult Nurs 2023; 34:68-82. [PMID: 36239560 DOI: 10.1177/10436596221129228] [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: 02/02/2023] Open
Abstract
INTRODUCTION Despite the health benefits of breastfeeding, Saudi women do not exclusively breastfeed their babies. The purpose of this article was to synthesize Saudi women's breastfeeding knowledge, attitude, and practices and identify the factors that women reported for their breastfeeding cessation. METHODOLOGY A systematic review and meta-analysis of randomized clinical trials and cross-sectional studies was undertaken. RESULTS Saudi women reported poor knowledge in managing breastfeeding challenges and had a positive attitude toward formula feeding. Giving premade formula and sugar water was a common practice. The breastfeeding initiation rate (31.5%, 95% confidence interval [CI]: [22%, 41.8%]) and exclusive breastfeeding at 6 months were low (15.15, 95% CI: [8%, 24%]). Perceived low milk supply, returning to work, and using contraception were the main reasons for early breastfeeding cessation. DISCUSSION The integration of Islamic, political, and economic cultures in Saudi Arabia can influence women's breastfeeding practices. There is a need for culturally appropriate breastfeeding educational programs for Saudi women.
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Affiliation(s)
- Salma Alahmed
- University of Wollongong, NSW, Australia.,King Saud University, Riyadh, Saudi Arabia
| | | | - Abbas Al Mutair
- University of Wollongong, NSW, Australia.,Almoosa Specialist Hospital, Al Mubarraz, Saudi Arabia.,Princess Nourah Bent Abdulrahman University, Riyadh, Saudi Arabia
| | - Ritin Fernandez
- University of Wollongong, NSW, Australia.,Joanna Briggs Centre of Excellence, Wollongong, NSW, Australia
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Tong S, Rao C, Min S, Li H, Quan D, Chen D, Zhu Y. Obstetric anesthesia clinic childbirth course combined with labor epidural analgesia is associated with a decreased risk of postpartum depression : a prospective cohort study. BMC Anesthesiol 2022; 22:389. [PMID: 36522711 PMCID: PMC9753281 DOI: 10.1186/s12871-022-01931-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Postpartum depression (PPD) is a serious complication commonly seen in postnatal women. In this paper, an investigation was conducted to see if obstetric anesthesia clinic childbirth course combined with labor epidural analgesia (LEA) was associated with a decreased risk of PPD. METHODS Six hundred fifty-five nulliparous women were enrolled in this prospective cohort study. The parturients were divided into 4 groups, with Group C being the control group, Group AC received the obstetric anesthesia clinic childbirth course only, Group LEA received LEA only, and Group AC + LEA received both the obstetric anesthesia clinic childbirth course and LEA. Maternal and neonatal variables in the perinatal period were recorded. PPD at 6 weeks was assessed using the Chinese version of the Edinburgh Postpartum Depression Scale (EPDS), where a score ≥ 10 is the threshold for PPD. Multivariate logistic regression analysis was performed to assess the association between obstetric anesthesia clinic childbirth course combined with LEA and postpartum depression. RESULTS A total of 124 maternities had EPDS ≥10 points, the incidence of PPD was 18.9%。The incidence of PPD and EPDS scores were significantly lower in Group AC + LEA than in Group C (12.1% vs 26.8%, P < 0.05; 6 (5, 7) vs 7 (5, 11), P < 0.05). Received an anesthesia clinic childbirth course combined with LEA was associated with a decreased risk of PPD (OR 0.273, 95% CI, 0.100-0.743, P = 0.013). Multivariate logistic regression analysis identified 5 other independent factors for PPD, including maternal SAS score in the delivery room, W-DEQ score in the delivery room, living in a confinement center, EPDS score at 1st week postpartum and perinatal care satisfaction . CONCLUSIONS Received an obstetrics anesthesia clinic childbirth course combined with LEA for nulliparous women with a single term cephalic pregnancy was associated with a decreased risk of PPD at 6 weeks. TRIAL REGISTRATION Chinese Clinical Trial Registry, ChiCTR2000039163. Registered on 20/10/2020.
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Affiliation(s)
- Shanshan Tong
- grid.452206.70000 0004 1758 417XDepartment of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016 People’s Republic of China
| | - Chuanhua Rao
- grid.452506.0Department of Anesthesiology, Jiangjin Central Hospital of Chongqing, No.725 Jiangzhou Avenue, Dingshan Street, Jiangjin District, Chongqing, China
| | - Su Min
- grid.452206.70000 0004 1758 417XDepartment of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016 People’s Republic of China
| | - Hua Li
- grid.452506.0Department of Obstetrics, Jiangjin Central Hospital of Chongqing, Chongqing, China
| | - Dongqun Quan
- grid.452506.0Department of Obstetrics, Jiangjin Central Hospital of Chongqing, Chongqing, China
| | - Daping Chen
- grid.452506.0Department of Obstetrics, Jiangjin Central Hospital of Chongqing, Chongqing, China
| | - Yuanmao Zhu
- grid.452506.0Department of Pain, Jiangjin Central Hospital of Chongqing, Chongqing, China
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Aslantekin Özçoban F, Ergün S, Erkal Aksoy Y. Effects of health literacy education on adaptation to pregnancy, self-efficacy, fear of childbirth and health literacy in Turkish pregnant women: A randomized, controlled trial. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e537-e549. [PMID: 34957621 DOI: 10.1111/hsc.13690] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 11/25/2021] [Accepted: 12/09/2021] [Indexed: 06/14/2023]
Abstract
This research aims to evaluate the effects of health literacy (HL) education on Turkish pregnant women's adaptations to pregnancy, self-efficacy, fear of childbirth and HL levels. This was a randomised, controlled trial. The research was carried out in the Marmara region of Turkey between July 2018 and April 2019. This research was conducted with three groups including one control (n = 73) and two intervention (n = 109) groups. One of the intervention groups was given antenatal education (AE) for improving HL (HL-AE) (n = 53), and the other was provided AE (n = 56) only. A Pregnancy Information Form, Prenatal Self-Evaluation Questionnaire, Fear of Childbirth and The Postpartum Period Scale, General Self-Efficacy Scale and Turkey Health Literacy Scale-32 were used for data collection. Results show that adaptation to pregnancy, general self-efficacy and HL levels significantly improved while fear of childbirth decreased in the group that was provided HL-AE intervention group. Additional when the pre-education and post-education scale scores were compared in the AE group, it was found that there was a significant difference in other scale scores, but not for fear of childbirth.
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Affiliation(s)
| | - Sibel Ergün
- Department of Nursing, Faculty of Health Sciences, Balıkesir University, Balıkesir, Turkey
| | - Yasemin Erkal Aksoy
- Department of Midwifery, Faculty of Health Sciences, Selcuk University, Konya, Turkey
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Hassanzadeh R, Abbas-Alizadeh F, Meedya S, Mohammad-Alizadeh-Charandabi S, Mirghafourvand M. Perceptions of primiparous women about the effect of childbirth preparation classes on their childbirth experience: A qualitative study. Midwifery 2021; 103:103154. [PMID: 34627102 DOI: 10.1016/j.midw.2021.103154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 09/07/2021] [Accepted: 09/26/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE to evaluate the perceptions of primiparous women about the effect of childbirth preparation classes on their childbirth experience. DESIGN descriptive qualitative study. PARTICIPANTS AND SETTING 13 Iranian women who participated in childbirth preparation classes and had a vaginal delivery were interviewed. MEASUREMENTS semi-structured interviews were used to collect data. FINDINGS six main themes were extracted from the data analysis: incentive and learning about pregnancy and childbirth; active participation in labour; sense of self-control; use of non- medical pain relief methods during labour; preferring vaginal birth to caesarean section; and positive childbirth experience. KEY CONCLUSIONS women reported that participation in childbirth preparation classes prepared them well for a vaginal birth, and these classes were perceived to be associated with a positive childbirth experience. IMPLICATIONS FOR PRACTICE attendance at childbirth preparation classes is perceived to have a positive effect on vaginal birth. Therefore, encouraging and supporting women to attend the full course of classes has the potential to increase women's preference towards vaginal birth, resulting in a reduction in the caesarean section rate.
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Affiliation(s)
- Robab Hassanzadeh
- Department of Midwifery, Bonab Branch, Islamic Azad University, Bonab, Iran
| | - Fatemeh Abbas-Alizadeh
- Reproductive Health Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shahla Meedya
- Member of South Asia Infant Feeding Research Network, School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | | | - Mojgan Mirghafourvand
- Social Determinants of Health Research Centre, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran.
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Hassanzadeh R, Abbas-Alizadeh F, Meedya S, Mohammad-Alizadeh-Charandabi S, Mirghafourvand M. Primiparous women's knowledge and satisfaction based on their attendance at childbirth preparation classes. Nurs Open 2021; 8:2558-2566. [PMID: 33626230 PMCID: PMC8363339 DOI: 10.1002/nop2.787] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 01/06/2021] [Accepted: 01/21/2021] [Indexed: 11/06/2022] Open
Abstract
AIM To compare primiparous women's childbirth knowledge and their satisfaction with the childbirth preparation classes between regular and irregular attenders. DESIGN A cross-sectional study. METHOD This study was conducted on 136 primiparous pregnant women attending health centres in Tabriz, Iran. Women's knowledge on childbirth and their satisfaction with childbirth preparation classes were measured by using reliable tools via interviews. An independent t test was applied to compare women's knowledge and satisfaction scores between regular and irregular attenders. RESULTS The mean score of knowledge was significantly higher among women who were regular attenders compared to irregular attenders (p < .001). Although there were no significant differences in total satisfaction score between the women (p = .342), women with regular attendance reported that childbirth preparation classes reduced their anxiety about labour. CONCLUSIONS Regular attendance at childbirth preparation classes is associated with higher women's knowledge and lower feelings of anxiety regarding labour and birth.
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Affiliation(s)
| | - Fatemeh Abbas-Alizadeh
- Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shahla Meedya
- Member of South Asia Infant Feeding Research Network (SAIFRN), School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | | | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Hassanzadeh R, Asghari Jafarabadi M, Abbas-Alizadeh F, Meedya S, Mohammad-Alizadeh-Charandabi S, Mirghafourvand M. Psychometric properties of satisfaction with the childbirth education class questionnaire for Iranian population. BMC Pregnancy Childbirth 2020; 20:669. [PMID: 33153442 PMCID: PMC7643332 DOI: 10.1186/s12884-020-03349-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 10/20/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Childbirth preparation classes can reduce pregnant women's anxiety and fear for their childbirth. However, to evaluate women's feedback and their satisfaction with these classes, there is a need for a standard instrument that is suitable for Iranian context. This study is aimed to translate and conduct a psychometric analysis of the Satisfaction with the Childbirth Education Class Questionnaire (SCECQ) for Iranian population. METHODS The questionnaire was translated from English into Persian through the forward-backward translation method. The cluster sampling method was employed to select 205 pregnant women with gestational age of 35-37 weeks from all health complexes of Tabriz, Iran. The face, content, and construct validity of the research instrument were assessed through exploratory and confirmatory factor analyses. Internal consistency and test-retest reliability were measured to evaluate the overall reliability of the questionnaire. RESULTS The impact scores of all items were above 1.5. The content validity index (CVI) and content validity ratio (CVR) of the questionnaire were 0.88 and 0.94, respectively. The convergent construct validity of the whole questionnaire and those of its three subscales were confirmed through the exploratory factor analysis (EFA). The factor loadings of no items were below 0.3, and the X2/df ratio was smaller than 5. The overall model validity was confirmed by having the Root Mean Square Error of Approximation (RMSEA) smaller than 0.08. Cronbach's alpha and intraclass correlation coefficient (ICC) were 0.93 and 0.96, respectively, indicating the acceptable reliability of the questionnaire. CONCLUSION The Persian version of this questionnaire, entitled SCECQ is a valid and reliable instrument for measuring Iranian women's satisfaction with childbirth education classes.
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Affiliation(s)
- Robab Hassanzadeh
- Students’ Research Committee, Tabriz University of Medical sciences, Tabriz, Iran
| | | | - Fatemeh Abbas-Alizadeh
- Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shahla Meedya
- Member of South Asia Infant Feeding Research Network (SAIFRN), School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | | | - Mojgan Mirghafourvand
- Social determinants of Health Research Center, Tabriz University of Medical sciences, Tabriz, Iran
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Hassanzadeh R, Abbas-Alizadeh F, Meedya S, Mohammad-Alizadeh-Charandabi S, Mirghafourvand M. Comparison of childbirth experiences and postpartum depression among primiparous women based on their attendance in childbirth preparation classes. J Matern Fetal Neonatal Med 2020; 35:3612-3619. [PMID: 33076724 DOI: 10.1080/14767058.2020.1834531] [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] [Indexed: 10/23/2022]
Abstract
BACKGROUND Assessment of women's childbirth experience is an important indicator in maternity services. Positive childbirth experiences improve mothers' health, whereas negative childbirth experiences can cause psychological stresses and, in extreme cases, may lead to postpartum depression. METHODS In this cohort study, 204 women at 35-37 weeks of gestation were selected using cluster sampling from the health centers of Tabriz, Iran. Women were divided into three groups (68 women in each group) based on their attendance in childbirth preparation classes: (a) non-attenders (did not attend any sessions), (b) irregular attenders (attended 1-3 sessions), and (c) regular attendants (attended 4-8 sessions). Interviews were conducted at one month postpartum to complete the Childbirth Experience Questionnaire (CEQ) and Edinburgh Postnatal Depression Scale (EPDS). The general linear model (GLM) was used to identify associations between women's attendance to the classes and either their childbirth experience or postpartum depression scores. RESULTS Based on the GLM, the mean score of childbirth experience among the regular attenders was significantly higher than women who were irregular attenders (p = .032) or non-attenders (p < .001). In addition, the mean score of postpartum depression scale was significantly lower among regular attenders compared with non-attenders (p < .001). However, there was no significant difference in postpartum depression score among regular and irregular attenders (p = .257). CONCLUSIONS Attending prenatal classes was associated with positive childbirth experience and low postpartum depression score.
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Affiliation(s)
- Robab Hassanzadeh
- Midwifery Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Abbas-Alizadeh
- Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shahla Meedya
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | | | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Hassanzadeh R, Abbas-Alizadeh F, Meedya S, Mohammad-Alizadeh-Charandabi S, Mirghafourvand M. Fear of childbirth, anxiety and depression in three groups of primiparous pregnant women not attending, irregularly attending and regularly attending childbirth preparation classes. BMC WOMENS HEALTH 2020; 20:180. [PMID: 32799875 PMCID: PMC7429472 DOI: 10.1186/s12905-020-01048-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 08/06/2020] [Indexed: 11/28/2022]
Abstract
Background Lack of knowledge and fear of the unknown during pregnancy and childbirth make mothers fearful, worried, and anxious. Maternal fear and anxiety can lead to problems such as preterm childbirth and low birth weight. Increasing women’s knowledge through prenatal education can prepare them for childbirth and improve their health. The present study was conducted to compare fear of childbirth, anxiety and depression during pregnancy in three groups of primiparous pregnant women who were either not attending, irregularly attending, or regularly attending childbirth preparation classes. Methods A total of 204 primiparous pregnant women attending health centers in Tabriz, Iran, were selected by cluster sampling and assigned to the following three groups: Not attending, irregularly attending (attending one to three sessions of classes) and regularly attending (attending four to eight sessions of classes). Childbirth fear, pregnancy anxiety and depression questionnaires were completed for them through interviews. The general linear model was used to compare their fear of childbirth and prenatal anxiety and depression. Results According to the general linear model, the scores of fear of childbirth (p < 0.001), anxiety (p < 0.001) and depression (p = 0.006) were significantly lower in the group of pregnant women regularly attending the classes compared to the non-attending group of women. No significant differences were observed between the regularly-attending and irregularly-attending groups in terms of fear of childbirth (p = 0.066), anxiety (p = 0.078), and depression (p = 0.128). Conclusion Prenatal training can reduce fear, anxiety and depression in primiparous women. Incorporating such training into prenatal care helps improve maternal health.
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Affiliation(s)
- Robab Hassanzadeh
- Midwifery Department, Tabriz University of Medical sciences, Tabriz, Iran
| | - Fateme Abbas-Alizadeh
- Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shahla Meedya
- South Asia Infant Feeding Research Network (SAIFRN), School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | | | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
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