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Marvin-Dowle, Katie, Ghazaleh Oshaghi, Frankie Fair, Josanne Ratcliffe e Hora Soltani. "Training on cultural competency for perinatal mental health peer supporters". British Journal of Midwifery 30, n.º 12 (2 de dezembro de 2022): 668–76. http://dx.doi.org/10.12968/bjom.2022.30.12.668.
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Background Women from migrant or minority ethnic backgrounds are particularly vulnerable to perinatal mental ill health. Peer support can be beneficial for those with perinatal mental ill health. This study's aim was to evaluate a training package combining perinatal mental health and the impact of migration to enable better support for women from ethnic minorities with perinatal mental ill health. Methods Peer supporters who undertook training completed a survey immediately afterwards and interviews were conducted 3 months later. A total of 10 peer supporters were trained. Results The participants all rated the training as ‘excellent’ or ‘very good’ and reported increased awareness of perinatal mental ill health, cultural issues and women's vulnerability. More complex scenarios were requested, given the multi-factorial nature of many women's needs. Conclusions The combined training provided participants from different backgrounds with opportunities to learn from one another. Further evaluation among participants new to peer supporting is required.
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Das, Ranjana. "Women's experiences of maternity and perinatal mental health services during the first Covid-19 lockdown". Journal of Health Visiting 9, n.º 7 (2 de julho de 2021): 297–303. http://dx.doi.org/10.12968/johv.2021.9.7.297.
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This article presents evidence relating to the effects of Covid-19 on perinatal wellbeing, pregnancy and maternity. It describes findings from a qualitative project with 14 pregnant women and new mothers, conducted in England during the spring lockdown of 2020. It reveals that those who have additional vulnerabilities, such as financial insecurities, poor social relationships, experiences of birth trauma or physical and mental health difficulties have experienced the pandemic and social distancing measures with heightened effects on their wellbeing. Infant feeding support, health visits and baby weigh-in sessions were the three services most missed in their in-person formats and there was a near unanimous assertion that these are sorely needed. There was wide variation in accessing digital support; some were significantly unaware of sources of online support, with others using informal connections, some being supported extensively, remotely, by perinatal mental health services.
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Liyanage, Rashmi Danwaththa, Lucy Bray e Lesley Briscoe. "A mixed-methods survey of perinatal mental health for Sri Lankan women in the UK". British Journal of Midwifery 31, n.º 4 (2 de abril de 2023): 188–94. http://dx.doi.org/10.12968/bjom.2023.31.4.188.
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Background/Aims The prevalence of perinatal mental health issues is significantly higher among South Asian women in the UK. However, little attention has been given to examine the views and opinions of sub-groups of South Asians in the UK. Although the prevalence of perinatal mental health issues is much higher in Sri Lanka, so far, no studies have focused on Sri Lankan women in the UK. This study's aim was to examine the views and opinions of Sri Lankan women living in the UK about perinatal mental health. Methods A convergent mixed-method online survey was administered in English and Sinhalese. A total of 34 Sri Lankan women living in the UK, from their baby's conception to 24 months postpartum, were recruited. Qualitative responses were interpreted using thematic analysis, supported by quantitative data. Results The participants reported that they maintained good perinatal mental health with the support of their partner and family. Midwives were most involved in inquiring about and providing information on perinatal mental health. Social stigma was a dominant barrier to accessing support. Conclusions Midwives need to ensure that perinatal mental health is discussed sensitively with Sri Lankan women. Future quantitative research needs to examine if existing tools are culturally sensitive and qualitative research should include women's partners and families to explore how best to care for this population.
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Ny, Pernilla, Rania Mahmoud Abdel Ghani e Atika Khalaf. "Does model of care affect women's health and wellbeing in the perinatal period in Sweden?" British Journal of Midwifery 31, n.º 5 (2 de maio de 2023): 260–67. http://dx.doi.org/10.12968/bjom.2023.31.5.260.
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Background/Aims Self-rated health before, during and after pregnancy is important for women's quality of life and promotes bonding between mother and child. However, diverse aspects of care models influence women's experiences during pregnancy. This study aimed to investigate low-risk women's self-rated health during the perinatal period in relation to different models of care in Sweden. Methods A retrospective study was conducted of computerised obstetric data from 167 523 women with low-risk pregnancies during 2010–2015. Descriptive analysis was used, as well as group comparisons and ordinal regression analysis, to establish links between self-rated health before, during and after pregnancy and sociodemographic characteristics. Results The majority of women, regardless of model of care, rated their health as very good or good before, during and after pregnancy. During pregnancy, primiparous women, those who attended <7 midwife visits and those followed up by a private centre were more likely to rate their health as good. Women who had more than four midwives, were under the age of 30 years or foreign-born had increased risk of rating their health as bad. Postnatally, women who used private care, primiparous women and those aged 25–29 years were at lower risk of rating their health as bad. Conclusions Women attending private healthcare services tended to rate their health as better. Vulnerable groups of women need special attention from healthcare authorities.
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Watson, Helen, e Hora Soltani. "Perinatal mental ill health: the experiences of women from ethnic minority groups". British Journal of Midwifery 27, n.º 10 (2 de outubro de 2019): 642–48. http://dx.doi.org/10.12968/bjom.2019.27.10.642.
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Objectives This study aimed to investigate ethnic minority women's experiences and opinions of perinatal mental health problems and the provision support services. Methods An exploratory survey was undertaken using a questionnaire. Quantitative data were analysed using descriptive statistics and a simple thematic analysis was used for the qualitative data. A total of 51 responses from women of 14 different ethnic minority backgrounds were analysed. Findings Women from minority ethnic groups face barriers to seeking help for perinatal mental ill health as a result of ongoing stigma, the poor attitudes and behaviours of health professionals and inappropriately designed services. Conclusions Future interventions should focus on providing adequate cultural competency for health professionals and ensure that all women are able to access culturally appropriate spaces to talk and be listened to in community settings and wider services.
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Hinic, Katherine. "Coping With the Unexpected in Childbirth: A Thematic Analysis". Journal of Perinatal Education 30, n.º 3 (1 de julho de 2021): 159–67. http://dx.doi.org/10.1891/j-pe-d-20-00061.
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This article reports original research that describes new mothers' experiences of birth and maternity care. Qualitative data were collected through a survey on birth satisfaction, which included space for women to provide comments about their birth and experience of care. Thirty-nine women provided comments that were analyzed using the thematic analysis method. Two themes emerged from the women's experiences: “Unexpected birth processes: expectations and reality” and “Coping with birth: the role of health-care staff.” Participants described unexpected birthing processes, their experiences of care, and maternity care staff's contributions to coping with birth. Implications for practice for childbirth professionals include promotion of physiologic birth, respectful person-centered care during all phases of perinatal care, and the value of childbirth preparation.
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Covington, Chandice, e John E. Collins. "Back to the Future of Women's Health and Perinatal Nursing in the 21st Century". Journal of Obstetric, Gynecologic & Neonatal Nursing 23, n.º 2 (fevereiro de 1994): 183–94. http://dx.doi.org/10.1111/j.1552-6909.1994.tb01870.x.
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Jacoby, Susan D., Monique Lucarelli, Fowsia Musse, Ashok Krishnamurthy e Vince Salyers. "A Mixed‐Methods Study of Immigrant Somali Women's Health Literacy and Perinatal Experiences in Maine". Journal of Midwifery & Women's Health 60, n.º 5 (outubro de 2015): 593–603. http://dx.doi.org/10.1111/jmwh.12332.
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Nagle, Ursula, e Mary Farrelly. "Women's views and experiences of having their mental health needs considered in the perinatal period". Midwifery 66 (novembro de 2018): 79–87. http://dx.doi.org/10.1016/j.midw.2018.07.015.
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Floris, Lucia, Benedicte Michoud-Bertinotti, Begoña Martinez de Tejada, Sara de Oliveira, Riccardo Pfister, Stéphanie Parguey, Harriet E. Thorn-Cole e Claire de Labrusse. "Exploring health care professionals’ experiences and knowledge of woman-centred care in a university hospital". PLOS ONE 18, n.º 7 (5 de julho de 2023): e0286852. http://dx.doi.org/10.1371/journal.pone.0286852.
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Inspired by the six quality-of-care goals developed by the Institute of Medicine, woman-centred care (WCC) as model of care is used in maternity services as it gives an emphasis on the woman as an individual and not her status as a patient. Bringing stronger attention to women’s needs and values, is proven to have clear benefits for perinatal outcomes, but fails to be known or recognised by healthcare professionals’ (HCPs) and implemented. Using a mixed-methods approach, this study aimed to explore HCPs definitions of WCC and identify the degree of agreement and knowledge regarding perinatal indicators when a WCC model of care is implemented. The quantitative part was carried using a self-administered questionnaire with perinatal indicators identified from the literature. Semi-structured interviews were realized using a purposive sample of 15 HCPs and an interview grid inspired by Leap’s WCC model. The study was conducted in the maternity of a university hospital in French-speaking part of Switzerland. Out of 318 HCPs working with mothers and their newborns, 51% had already heard of WCC without being familiar with Leap’s model. The HCPs were aware of the positive perinatal care outcomes when WCC was implemented: women’s satisfaction (99.2%), health promotion (97.6%), HCP’s job satisfaction (93.2%) and positive feelings about their work (85.6%), which were strongly emphasised in the interviews. The respondents reported institutional difficulties in implementing the model such as administrative overload and lack of time. The positive outcomes of WCC on spontaneous deliveries and improved neonatal adaptation were known by most HCPs (63.4% and 59.9%, respectively). However, fewer than half of the HCPs highlighted the model’s positive effects on analgesia and episiotomies or its financial benefits. Knowledge of quality-of-care outcomes (i.e women’s satisfaction, positive impact on practice…) was prevalent among most of HCPs. Without adhering to a common definition and without a specific model for consensus, most providers have integrated some aspects of WCC into their practice. However, specific perinatal indicators remain largely unknown, which may hinder the implementation of WCC.
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Kendall‐Tackett, Kathleen. "Long‐Chain Omega‐3 Fatty Acids and Women's Mental Health in the Perinatal Period and Beyond". Journal of Midwifery & Women's Health 55, n.º 6 (12 de novembro de 2010): 561–67. http://dx.doi.org/10.1016/j.jmwh.2010.02.014.
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McNiven, Patricia,, Karyn Kaufman e Murray Enkin. "MEASURING BIRTH OUTCOMES: VALIDATING THE PERINATAL OUTCOME INDEX". Canadian Journal of Midwifery Research and Practice 1, n.º 2 (28 de maio de 2024): 9–14. http://dx.doi.org/10.22374/cjmrp.v1i2.151.
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We undertook a study to assess the reliability and validity of a new measure of low risk maternity care. A Perinatal Outcome Index (POI), which combines intrapartum process of care and clinical outcome items into a summary index score, was originally developed and evaluated in the Netherlands. It was designed to measure the extent to which a labour and birth are "optimal", that is, one with minimal intervention resulting in a healthy mother and a healthy baby. We modified the Dutch index to make it applicable to a Canadian setting. A panel of experts who were not connected with the study reviewed the modified version for applicability, feasibility of obtaining data easily, and content validity. Data were abstracted from the health records of 324 women in one hospital and two midwifery practices to obtain Perinatal Outcome Index scores and examine aspects of construct validity. We measured the inter-rater reliability of the research assistants who abstracted information. The panel achieved consensus on all items in the modified Perinatal Outcome Index to establish content (face) validity. Labour and birth data were readily obtained from health records with high inter-rater reliability (Kappa 0.78). In a linear regression model, birth at home, multiparity, and having a midwife or family physician as a care provider were significantly associated with higher scores (having a more optimal birth) and accounted for 37% of the score variance. The Perinatal Outcome Index has satisfied our expectations for content and construct validity. Research assistants found it easy to use and data items were readily available from women's health records. Inter-rater reliability was acceptable. We believe the modified index will be useful for comparative studies among women at low or average risk, and for quality assurance programs.
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Mogilevkina, Iryna, e Nataliia Khadzhynova. "War in Ukraine: Challenges for women’s and perinatal health". Sexual & Reproductive Healthcare 32 (junho de 2022): 100735. http://dx.doi.org/10.1016/j.srhc.2022.100735.
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Ansule, Ilze, Anda Kīvīte - Urtāne e Inga Millere. "PATIENTS NEED TO RECEIVE THE SAME KIND OF INFORMATION ABOUT THE SAME ISSUE FROM EACH PROFESSIONAL". SOCIETY. INTEGRATION. EDUCATION. Proceedings of the International Scientific Conference 4 (28 de maio de 2021): 265–73. http://dx.doi.org/10.17770/sie2021vol4.6405.
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The questionnaire has been developed from a validated instrument “Women’s Experience of Maternity Care” (author - National Health Service, (Great Britain, 2019) and adapted to the situation in Latvia. The permission to use it has been obtained from authors. The questionnaire is meant for women regardless of their health status during the perinatal period or who have no co-morbidities, diagnosed in perinatal period of care. The questionnaire is designed to find out patients' experiences of receiving healthcare and its compliance with the guidelines, identifying potential problems and creating opportunities to correct them. There were 50 patients in Maternity Hospital postpartum unit interviewed. 12 of them were women living with HIV. Results. One of five main comment themes was - patients felt the need to receive the same kind of information about the same issue from all health care professional regardless of staff changes on call. The women point out that they have no problems with content in communication process during intranatal period, at labor unit. The problem with different kind of information about the same matter is emerging in postpartum period, at maternity unit. This issue is bothering both groups of patients in postnatal period, those women who live with HIV and those who have no co-morbidities, diagnosed in perinatal period. This shows that there is different kind of knowledge and professional skills among health care professionals, even if they work in the same field, the same hospital and the same unit. There should be done more research to identify the source of this problem. Is it the different experience, knowledge, informational field where professionals seek for information or totally different reason for this phenomena.
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SHARMA, Esther, Rebecca LABAN-SHARMAN, Baharak JAVAZIAN, Natasha HOWARD e Diane DUCLOS. "“When a story gets a face…”: Visual elicitation of Serbian perspectives on Afghan refugee women’s maternity experiences in Serbia". PLOS Global Public Health 4, n.º 2 (15 de fevereiro de 2024): e0002563. http://dx.doi.org/10.1371/journal.pgph.0002563.
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Serbia is a country through which many Afghans pass, en route to the European Union. Pregnancy and birth continues for Afghan women while journeying. This study aims to examine the understanding and attitudes of Serbian health professionals and members of women’s civil society organisations (CS0) about the perinatal experiences of Afghan women in Serbia, using a webcomic to elicit responses. A total of 38 respondents completed the questionnaire, including health professionals (n = 10), women’s CSO members (n = 6), and others (n = 10). The majority had little awareness of the experiences of Afghan women around the childbearing time and for most respondents, viewing the webcomic raised their awareness. Qualitative questionnaire data were analysed thematically, and four inductive themes developed: (1) maternal health provision as inadequate; (2) Afghan women face difficulties in Serbia; (3) solidarity with Afghan women; and (4) the webcomic raises awareness. Webcomics, as a visual modality, may play a valuable role in increasing empathy and awareness of refugee women’s perinatal experiences among citizens.
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Fairbairn, Sarah, e Cath McParlin. "The lived experience of staff caring for women in labour who have a BMI ≥40 kg/m2". British Journal of Midwifery 29, n.º 7 (2 de julho de 2021): 376–85. http://dx.doi.org/10.12968/bjom.2021.29.7.376.
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Background Obesity is a growing health concern nationally and internationally. During the perinatal period, obesity poses increased risks to both mother and fetus; however, few studies consider the challenges staff caring for these women face. Aims To explore the lived experience of the staff that provide labour care for women with a BMI≥40 kg/m2. Methods A qualitative study involving semi-structured interviews with practicing midwives was conducted. Interviews were recorded, transcribed verbatim and analysed thematically. Findings A total of five interviews were conducted and seven themes emerged, namely monitoring the fetal heart and mobilisation, assessing labour progress, different to caring for woman with a lower BMI, emotional issues, opinions regarding women's risk perception, addressing the issue of obesity, and education/training. Conclusions Further training would guide staff to deliver timely and appropriate information to women, assisting staff caring for women, particularly in labour, to feel more confident when discussing issues surrounding obesity.
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Hannon, Susan Elizabeth, Déirdre Daly e Agnes Higgins. "Resilience in the Perinatal Period and Early Motherhood: A Principle-Based Concept Analysis". International Journal of Environmental Research and Public Health 19, n.º 8 (14 de abril de 2022): 4754. http://dx.doi.org/10.3390/ijerph19084754.
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A context-specific delineation of research approaches to resilience in the perinatal and early motherhood literature is currently lacking. A principle-based concept analysis was used to establish a description of how women’s resilience is currently conceptualised and operationalised within empirical research in the perinatal period and early motherhood (defined as up to five-years postpartum). CINAHL, Medline, PsychInfo, EMBASE, ASSIA, Web of Science, Scielo, Maternity and Infant Care, the Cochrane Library, and the World Health Organization were systematically searched (January/February 2020 and March 2022). Fifty-six studies met the inclusion criteria. Analysis demonstrated interchangeable use of associated concepts such as ‘coping’, ‘coping strategies’, and ‘adaptation’. Resilience was frequently operationalised as the absence of illness symptomatology, rather than the presence of mental well-being. Investigations of positive areas of functioning were predominately related to the mother’s family role. There was limited qualitative exploration of women’s perspectives. Recommendations for the pragmatic application of resilience research were not well developed. The narrow operationalisation of resilience by mental ill-health and parental role, and the distinct absence of women’s perspectives, restricts the logical maturity and pragmatic application of the concept. Future research may benefit from exploration of women’s insights on indicators that might best reflect positive functioning and resilience in this period.
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Allen, Jyai, Debra K. Creedy, Kyly Mills e Jenny Gamble. "Health engagement: a systematic review of tools modifiable for use with vulnerable pregnant women". BMJ Open 13, n.º 3 (março de 2023): e065720. http://dx.doi.org/10.1136/bmjopen-2022-065720.
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ObjectiveTo examine available health engagement tools suitable to, or modifiable for, vulnerable pregnant populations.DesignSystematic review.Eligibility criteriaOriginal studies of tool development and validation related to health engagement, with abstract available in English, published between 2000 and 2022, sampling people receiving outpatient healthcare including pregnant women.Data sourcesCINAHL Complete, Medline, EMBASE and PubMed were searched in April 2022.Risk of biasStudy quality was independently assessed by two reviewers using an adapted COSMIN risk of bias quality appraisal checklist. Tools were also mapped against the Synergistic Health Engagement model, which centres on women’s buy-in to maternity care.Included studiesNineteen studies were included from Canada, Germany, Italy, the Netherlands, Sweden, the UK and the USA. Four tools were used with pregnant populations, two tools with vulnerable non-pregnant populations, six tools measured patient–provider relationship, four measured patient activation, and three tools measured both relationship and activation.ResultsTools that measured engagement in maternity care assessed some of the following constructs: communication or information sharing, woman-centred care, health guidance, shared decision-making, sufficient time, availability, provider attributes, discriminatory or respectful care. None of the maternity engagement tools assessed the key construct of buy-in. While non-maternity health engagement tools measured some elements of buy-in (self-care, feeling hopeful about treatment), other elements (disclosing risks to healthcare providers and acting on health advice), which are significant for vulnerable populations, were rarely measured.Conclusions and implicationsHealth engagement is hypothesised as the mechanism by which midwifery-led care reduces the risk of perinatal morbidity for vulnerable women. To test this hypothesis, a new assessment tool is required that addresses all the relevant constructs of the Synergistic Health Engagement model, developed for and psychometrically assessed in the target group.PROSPERO registration numberCRD42020214102.
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Hinton, Lisa, James Hodgkinson, Katherine L. Tucker, Linda Rozmovits, Lucy Chappell, Sheila Greenfield, Christine McCourt, Jane Sandall e Richard J. McManus. "Exploring the potential for introducing home monitoring of blood pressure during pregnancy into maternity care: current views and experiences of staff—a qualitative study". BMJ Open 10, n.º 12 (dezembro de 2020): e037874. http://dx.doi.org/10.1136/bmjopen-2020-037874.
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ObjectiveOne in 20 women are affected by pre-eclampsia, a major cause of maternal and perinatal morbidity, death and premature birth worldwide. Diagnosis is made from monitoring blood pressure (BP) and urine and symptoms at antenatal visits after 20 weeks of pregnancy. There are no randomised data from contemporary trials to guide the efficacy of self-monitoring of BP (SMBP) in pregnancy. We explored the perspectives of maternity staff to understand the context and health system challenges to introducing and implementing SMBP in maternity care, ahead of undertaking a trial.DesignExploratory study using a qualitative approach.SettingEight hospitals, English National Health Service.ParticipantsObstetricians, community and hospital midwives, pharmacists, trainee doctors (n=147).MethodsSemi-structured interviews with site research team members and clinicians, interviews and focus group discussions. Rapid content and thematic analysis undertaken.ResultsThe main themes to emerge around SMBP include (1) different BP changes in pregnancy, (2) reliability and accuracy of BP monitoring, (3) anticipated impact of SMBP on women, (4) anticipated impact of SMBP on the antenatal care system, (5) caution, uncertainty and evidence, (6) concerns over action/inaction and patient safety.ConclusionsThe potential impact of SMBP on maternity services is profound although nuanced. While introducing SMBP does not reduce the responsibility clinicians have for women’s health, it may enhance the responsibilities and agency of pregnant women, and introduces a new set of relationships into maternity care. This is a new space for reconfiguration of roles, mutual expectations and the relationships between and responsibilities of healthcare providers and women.Trial registration numberNCT03334149.
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Karmacharya, Shailendra Bir, Kalpana Upadhyaya Subedi, Sumit Agrawal, Noora Pradhan, Ritesh Barnwal e Prajwal Paudel. "Determinants of Mortality in Preterm Newborns Admitted in a Neonatal Intensive Care Unit: Findings from a Tertiary Level Maternity Hospital in Nepa". Journal of Nepal Paediatric Society 42, n.º 1 (27 de novembro de 2022): 33–38. http://dx.doi.org/10.3126/jnps.v42i1.39957.
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Introduction: Prematurity is a major cause of admission in the NICU in most hospitals. Premature babies are likely to face complications. Understanding the factors contributing to preterm mortality is needed to identify interventions required to reduce neonatal mortality rate. This study aims to determine the causes of mortality in preterm babies. Methods: A retrospective study was carried out in Paropakar Maternity and Women’s Hospital, Thapathali, Kathmandu, Nepal. All the preterm babies admitted in the sick newborn units were included. Descriptive statistics were performed using frequency and percentage. The bivariate and multivariate analyses were performed to determine the causes of mortality in preterm. Results: Total 205 (71.4%) admitted preterm babies had complications at the time of admission. LBW babies were three times more likely to have mortality among preterm admission (p – value < 0.0001). Co-morbidities such as sepsis (p - value < 0.05) and perinatal asphyxia (p – value < 0.0001) were significantly associated with preterm mortality. The duration of stay among preterm babies was higher compared to term babies. The mortality rate was higher among preterm admission compared to term admission (60% vs 40%). Conclusions: Preterm babies with LBW, neonatal sepsis and perinatal asphyxia are at greater risk of mortality. Improved antenatal and perinatal care, quality newborn care and appropriate infection prevention measures can help reduce preterm birth, prematurity related complications and mortality among these vulnerable group of newborns.
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Willey, Suzanne M., Rebecca P. Blackmore, Melanie E. Gibson-Helm, Razia Ali, Leanne M. Boyd, Jacqueline McBride e Jacqueline A. Boyle. "“If you don’t ask … you don’t tell”: Refugee women’s perspectives on perinatal mental health screening". Women and Birth 33, n.º 5 (setembro de 2020): e429-e437. http://dx.doi.org/10.1016/j.wombi.2019.10.003.
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Seet, Meei Jiun, Sohinee Bhattacharya e Ashalatha Shetty. "Maternal and Perinatal Outcomes in women with Hepatitis B Carrier State". Women Health Care and Issues 2, n.º 1 (22 de março de 2019): 01–04. http://dx.doi.org/10.31579/2642-9756/005.
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Introduction Hepatitis B is the most common form of viral hepatitis. Much has been done for the prevention of Hepatitis B transmission from mother to child. However, there is still very limited evidence looking at maternal obstetrics and perinatal outcomes, such as gestational diabetes, antepartum haemorrhage and preterm labour, hypertensive disorders in pregnancy and small for gestational age, with Hepatitis B infected women. These adverse pregnancy outcomes, if significant, may affect future antenatal care and have a negative impact on public health. This study aims to determine the association between these adverse pregnancy and neonatal outcomes with maternal Hepatitis B carrier state. Methods This is a retrospective cohort study comparing adverse pregnancy and neonatal outcomes in primigravid women who delivered singleton babies after 24 completed weeks of gestation and are carrier for Hepatitis B virus with those who are non-carrier for Hepatitis B virus, between 1992 and 2013 in Aberdeen Maternity Hospital. The adverse pregnancy and neonatal outcomes studied include hypertensive disorders in pregnancy, antepartum haemorrhage, preterm birth <37 weeks, induction of labour, caesarean delivery, low birth weight and admission to neonatal unit. Data was extracted from the Aberdeen Maternity and Neonatal Databank (AMND), which was established in 1950 to record all pregnancy-related events occurring in Aberdeen city and district in the northeast of Scotland. Statistical analysis was done with SPSS version 21 using independent samples t-test for normally distributed continuous variables and chi-squared test for categorical variables. Multivariate logistic regression analysis using a multilevel random effects regression model was also conducted to adjust for confounding factors. Results The data set contained a sample size of 35116 primigravid women with singleton pregnancies, with 59 being carrier for Hepatitis B virus (represented by positive HBsAg status). HBsAg-positive women had significantly lower mean Body Mass Index and were more likely to be from the manual social class (registrar general’s occupation-based social class). On unadjusted analysis, there were no significant differences in the prevalence of all maternal and perinatal outcomes in both groups. However, after adjusting for confounding factors, HBsAg-positive women were more likely to have smaller babies (aOR 4.28; 95% CI 1.57-11.66). Conclusion Our study suggested higher frequencies of low birth weight babies in women with hepatitis B infection. We found no statistically significant differences in other adverse pregnancy and perinatal outcomes. As current evidence still shows inconsistent results, further research evaluating the possible effects of Hepatitis B viraemia on pregnancy outcomes is justified.
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Schönborn, Claudia, Katia Castetbon, Mouctar Sow, Judith Racape e Myriam De Spiegelaere. "Mothers’ experiences of perinatal care in Belgian public hospitals: exploring the social inequalities. Protocol for a cross-sectional survey". BMJ Open 10, n.º 11 (novembro de 2020): e038400. http://dx.doi.org/10.1136/bmjopen-2020-038400.
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IntroductionIn Europe, the social inequalities in perinatal health are usually found to be to the disadvantage of non-European immigrants and women with lower levels of education and income. Among the possible underlying mechanisms are inadequate access to healthcare services and suboptimal care. To explore this hypothesis in the Belgian context, our research will describe detailed maternal socioeconomic and migration characteristics, explore how these factors relate to each other, and how they relate to women’s perinatal care trajectories and experiences of care.MethodsUsing a modified version of the Migrant-Friendly Maternity Care Questionnaire, we will survey 900 mothers of Belgian nationality or a nationality from a North or Sub-Saharan African country, and having given birth in four maternity wards in Brussels. The questionnaire has been adapted to the study objectives and the Belgian context. Interviewers will administer the 116-item questionnaire to all women agreeing to participate and meeting inclusion criteria, within 14 days of having given birth. Clinical information will be extracted from hospital records.AnalysisWe will estimate the associations of women’s socioeconomic and migration characteristics with:Women’s antenatal care trajectories (timing of first antenatal consultation, minimum recommended number of consultations, and problems accessing care).Obstetric practices such as episiotomies, emergency caesarean sections, and inductions.Patient experience such as feelings of discrimination, respect, and understanding of information.We will use descriptive statistics, multiple correspondence analysis, and simple and multiple logistic regressions.Ethics and disseminationEthical approval has been obtained from the hospital Ethics Committees and from the Université libre de Bruxelles (No: P2017/055/B406201730877). Written informed consent will be sought from all participants.In addition to disseminating findings and recommendations to the scientific community through open-source journal articles and conferences, we will also address local organisations and healthcare professionals via a written report and seminars.
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Farrell, Tom, Shuja Reagu, Suruchi Mohan, Riham Elmidany, Feras Qaddoura, Ebtehag Elfadil Ahmed, Gillian Corbett, Stephen Lindow, Salwa Mohammed Abuyaqoub e Majid Ali Alabdulla. "The impact of the COVID-19 pandemic on the perinatal mental health of women". Journal of Perinatal Medicine 48, n.º 9 (26 de novembro de 2020): 971–76. http://dx.doi.org/10.1515/jpm-2020-0415.
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AbstractObjectivesThe physical health impact of the coronavirus disease infection (COVID-19) has received attention worldwide; however, data around the psychological impact of the pandemic is still emerging and little has been reported on psychological effects among vulnerable groups. This study was undertaken with the aim of studying the impact of the COVID-19 pandemic and related restrictions on perinatal mental health among women in Qatar.MethodsA cross- sectional survey of women accessing maternity services in Qatar was carried out during the months of June and July 2020 at the local peak of the pandemic. Background data including relevant demographic details, pregnancy and mental health history, concerns, as well as helpful stress-reducing factors reported by women was collected. Depression and anxiety symptomatology was studied using the Patient Health Questionnaire Anxiety-Depression Scale (PHQ-ADS).ResultsThe survey results revealed a high prevalence of anxiety and Depressive symptomatology (34.4 and 39.2% respectively), based on PHQ-ADS scoring. These rates appeared much higher than the reported pre-pandemic prevalence and were not affected by occupation, previous mental health problems or pregnancy complications. Women’s most commonly reported concerns as well as coping factors are discussed.ConclusionsResults indicate a marked increase in anxiety and depressive symptoms during the COVID-19 pandemic, among pregnant and puerperal individuals, who constitute a vulnerable group with respect to mental health morbidity. These findings can be used to inform public health interventions, among which, consideration should be given to routine mental health screening of vulnerable groups during major health crises.
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Romanenko, Tamara H., Olha M. Sulimenko e Svitlana O. Ovcharenko. "A STATISTICAL ANALYSIS OF OBSTETRIC AND PERINATAL COMPLICATIONS IN SINGLETON AND MULTIPLE PREGNANCIES ONCE ASSISTED REPRODUCTIVE TECHNOLOGIES ARE USED". Wiadomości Lekarskie 74, n.º 4 (2021): 915–22. http://dx.doi.org/10.36740/wlek202104120.
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The aim: To carry out a comparative statistical analysis of obstetric and perinatal complications in singleton and multiple pregnancies once assisted reproductive technologies (ART) are applied according to the records taken from archival materials (maternity and delivery records) and identify the clinical features of multiple pregnancy. Materials and methods: Over the period of 2017-2019, 522 women gave birth in LELEKA Maternity Hospital LLC after using assisted reproductive technologies and 331 women among them were followed-up in the women’s health center of LELEKA maternity hospital. Among these women (522) with singleton pregnancy 445 women gave birth, while in multiple pregnancy – 77. The statistical analysis of 150 maternity and delivery records was carried out. All pregnant women were divided into two groups: group 1 – 75 women having singleton pregnancy after ART; group 2 – 75 women having multiple pregnancy after ART. Women getting pregnant after ART, or in vitro fertilization (IVF) and five-day frozen embryo transfer to be exact, turned out to be the selection criterion for a comparative statistical analysis. Mathematical methods for research were used as O.P. Mintser (2013) suggested. The reliability of the digit cancellation test was calculated using the Fisher’s exact test and Student’s T-test. Graphs were designed using Microsoft Excel. Results: The complications of early multiple pregnancy were the following: anemia (47.8% as opposed to 22.9%, p<0.01), placental insufficiency (43.3% in contrast to 22.9%, p<0.01), threatened abortion (41.8% in contrast to 28.6%, p<0.01). The complications in late pregnancy are as follows: preeclampsia (52.7% as opposed to 20.6%, p <0.01), intrauterine growth restriction (20.0% as opposed to 7.4%, p <0.01), anemia in pregnancy (76.4% in contrast to 32.4%, p<0.01), placental insufficiency (47.3% in contrast to 22.1%, p<0.05). Conclusions: Multiple pregnancy is a high risk for anemia in pregnancy, preeclampsia, placental insufficiency, early intrauterine growth restriction and fetal distress in pregnancy and labor. It predetermines the high level of a caesarean section. Therefore, further research aimed at prediction and prevention of obstetric and perinatal complications in multiple pregnancy after ART is currently topical.
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Misra, Dawn P., Holly Grason e Carol Weisman. "An intersection of women’s and perinatal health: the role of chronic conditions". Women's Health Issues 10, n.º 5 (setembro de 2000): 256–67. http://dx.doi.org/10.1016/s1049-3867(00)00054-2.
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Srinivasan, K. "Perspectives of Pregnant Women’s Infant Oral Health Knowledge and Beliefs: A Prenatal Survey". Indian Journal of Dental Education 17, n.º 1 (31 de março de 2024): 21–31. http://dx.doi.org/10.21088/ijde.0974.6099.17124.2.
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Background: Early childhood caries is a virulent form of dental caries that can destroy the primary dentition of infants and preschool children. ECC is a preventable disease and prevention should begin in pre and perinatal. Mothers with poor oral health may be at greater risk of infecting their children. Biologically, the mother is the primary source of Streptococci and young children are dependent on their mother for oral hygiene. Aim: So, it’s essential to explore pregnant women and nursing mothers' knowledge, attitude, and practices as they affect the dental care children receive. Methodology: A survey was presented which was designed to assess the knowledge, attitude, and practices of pregnant women regarding infant’s oral health. A survey was conducted in and around Vellore at a government and private maternity hospital among pregnant women and new mothers. A self-administered questionnaire consisting of a total of 41 questions concerning basic information on proper infant oral hygiene procedures was given. A statistical analysis was performed. Results: A greater percentage of women were unaware of the importance of their oral hygiene, infant feeding practices and oral hygiene procedures. Conclusion: Based on these results there is a need for education for mothers and would-be mothers.
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Malachynska, Mariya. "Management of perinatal care during the COVID-19 pandemic in Ukraine: organizational and legal mechanism". Democratic governance 31, n.º 1 (20 de junho de 2023): 185–97. http://dx.doi.org/10.23939/dg2023.01.185.
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Introduction. The topic of maternity and childhood care is one of the most important in the health care system of Ukraine, given the importance of the issue of the birth of healthy children – the future potential of an independent state. At the beginning of the era of implementation of the Sustainable Development Goals, the morbidity and mortality of women during pregnancy and childbirth remained unacceptably high. Most of them could have been prevented. The 2019 coronavirus disease (COVID-19) pandemic significantly changed the way of life of most people and disrupted the work of specialized health care systems. Therefore, anticipating the possibility of repeated pandemics, it is necessary to analyse the experience of the functioning of the medical field at this stage and justify new approaches to the organization of high-quality medical perinatal care in the conditions of possible repeated outbreaks of infection. Isolation of previously unresolved parts of the general problem. Although there is much published scientific literature on various aspects of the organization of perinatal care, there is almost no literature on how management approaches to women's routine prenatal care have changed and how the system has been reorganized during the pandemic in Ukraine. Results. The effectiveness of Ukrainian health care system, which has historically been built on face-to-face interactions between patients and health care providers, has suffered severely. And it is not only in Ukraine. Healthcare systems of all countries, especially those with limited financial resources, are facing a challenge. Pregnant women are particularly vulnerable to respiratory pathogens due to physiological changes in the immune and cardiorespiratory systems and may be at increased risk of severe disease. In this regard, it is extremely important to reorganize the system of prenatal visits not only to reduce the possibility of contact of a healthy pregnant woman with infected people, but also to minimize the contact of medical workers with patients who may be infected. International experience shows that during this COVID-19 pandemic, some countries have decided to reduce the number of in-person antenatal visits to only three (for example, Australia) or four (as recommended by the WHO) for low-risk women throughout pregnancy. For Ukraine, a model of prenatal care has also been proposed as a quick response to combating the spread of infection. According to this model, when monitoring a pregnant woman in an outpatient setting, all consultations that do not require testing and ultrasound should be conducted remotely (video consultations or telephone consultations). Pregnant women must be referred to a specialized maternity hospital, designated by the Department of health care of Regional State Administration, to provide assistance to pregnant women with suspected or confirmed COVID-19 infection in clearly defined cases. We emphasize: the main conditions for the introduction of such a model in Ukraine are a well-established system of medical services using telemedicine, as well as a well- thought-out information campaign. And the foundations for its implementation are already laid in the branch state policy and legislation. In the event of an epidemic or an outbreak of an infectious disease, the media, regardless of the form of ownership, assist the executive authorities and local self- government bodies in carrying out the necessary explanatory work among the population, regarding the dangers of self-medication. According to the results of our study, conducted based on the Lviv Regional Clinical Perinatal Centre, in which 535 women in labour were interviewed, it was established that 22 percent of the surveyed women took medication for the prevention of COVID-19. Conclusion. Health care facilities should develop plans to minimize exposure to healthy pregnant women while continuing to provide both routine and emergency obstetric care. Telemedicine can play an important role in updating healthcare systems during the outbreak of COVID-19 cases. Even though such digital technologies have existed for decades and are already at the advanced stage of implementation in some areas, they are still minimally studied for obstetric care. Therefore, the following key components are needed to rapidly deploy an antenatal care model in response to the COVID-19 pandemic: 1) a locally approved antenatal care program; 2) a developed algorithm for monitoring pregnant women with suspected or confirmed diagnosis of COVID-19; 3) provision of equipment and Internet supply to healthcare institutions; 4) staff training; 5) informing the population.
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Lalo, Rezarta, Fatjona Kamberi e Vjollca Ndreu. "A Cross-Sectional Study of COVID-19 Pandemic Impact on Postpartum Women's Level of Anxiety, Depression and Breastfeeding Duration". OBM Neurobiology 07, n.º 02 (15 de maio de 2023): 1–15. http://dx.doi.org/10.21926/obm.neurobiol.2302169.
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Pregnancy and postpartum periods are known as sensitive periods in women’s life and COVID-19 pandemic seems to be worsening their mental health with major impacts on exclusive breastfeeding duration. Therefore, the present study aims to fill the gap in the literature by assessing the links between postpartum anxiety and depression symptoms and breastfeeding duration as well as the associated factors during the COVID-19 pandemic. A longitudinal prospective observational study was conducted between November and December 2020 at the Maternity ward of Vlore Regional Hospital, Albania. A total of 321 postpartum women were invited to participate in the study, resulting in 215 participants with a response rate of 66.9%. Along with modified questions from the Infant Feeding Practices Study II (IFPS II) Neonatal Questionnaire on breastfeeding follow-up from birth to third and sixth months, the Generalized Anxiety Disorder 7-item scale (GAD-7) and the Edinburgh Postnatal Depression Scale (EPDS) were used to measure anxiety and depression levels. The binomial logistic regression model was applied to reflect the relationship between variables with the corresponding p-value ≤ 0.05. The mean age of participants was 27.4 ± 5.32 years old. 41% of them experienced postpartum anxiety and 51% showed symptoms of depression. Unemployment (69%; OR = 3.66), COVID-19 threat to their own life (89%; OR = 2.89), and feelings of isolation (62%), were all significant predictors of postpartum anxiety and depression disorders. Both anxiety and depression were significant barriers to unsuccessful breastfeeding duration, especially among primiparous women (p = 0.001). The findings revealed high anxiety and depression among postpartum women, which was linked to COVID-19 stressors and breastfeeding outcomes. The careful follow-up of perinatal mothers during a pandemic should be the priority of healthcare professionals to reduce maternal morbidity rates and improve the health of infants.
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Šegregur, Jadranko, e Domagoj Šegregur. "Antenatal characteristics of Roma female population in Virovitica-Podravina County, Croatia". Slovenian Journal of Public Health 56, n.º 1 (1 de março de 2017): 47–54. http://dx.doi.org/10.1515/sjph-2017-0007.
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Abstract Introduction This study reports about antenatal characteristics of Roma minority population. The study was designed to investigate data about health behaviours known to be associated with reproductive outcomes of Roma women that have very good living conditions and relatively high resource availability. Methods A retrospective study included 204 Roma and 408 non-Roma hospitalised singleton births that occurred in the Maternity Ward of the General Hospital Virovitica in the period from 1991 to 2010. Data about women’s age, marital status, smoking, reproductive health (abortions, delivery), antenatal care, perinatal complications and gestational age were taken from hospital records and analysed. Results Roma women were averagely more than three years younger than non-Roma women, only 10.8% were married. Smoking was more frequent. The average number of births of Roma and non-Roma women was similar, averagely two children per woman. The rate of induced abortions in the Roma women was higher, while the frequency of spontaneous abortions was equal. Inadequate antenatal care of Roma women was associated with two times higher incidence of perinatal complications. A higher frequency of deliveries at home without professional assistance in Roma pregnancy resulted in lower perinatal outcomes. It was confirmed that Roma mothers give birth earlier (38+6 vs. 39+4 weeks) and have a higher incidence of premature births (9.3% vs. 2.2%). Conclusions In the comparison of antenatal parameters between the two researched groups, poorer prenatal outcomes in the Roma population were found, despite full integration and considerable improvement in living standards of this ethnic Roma population.
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Higginbottom, Gina MA, Catrin Evans, Myfanwy Morgan, Kuldip K. Bharj, Jeanette Eldridge, Basharat Hussain e Karen Salt. "Access to and interventions to improve maternity care services for immigrant women: a narrative synthesis systematic review". Health Services and Delivery Research 8, n.º 14 (março de 2020): 1–122. http://dx.doi.org/10.3310/hsdr08140.
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Background In 2016, over one-quarter of births in the UK (28.2%) were to foreign-born women. Maternal and perinatal mortality are disproportionately higher among some immigrants depending on country of origin, indicating the presence of deficits in their care pathways and birth outcomes. Objectives Our objective was to undertake a systematic review and narrative synthesis of empirical research that focused on access and interventions to improve maternity care for immigrant women, including qualitative, quantitative and mixed-methods studies. Review methods An information scientist designed the literature database search strategies (limited to retrieve literature published from 1990 to 2018). All retrieved citations (45,954) were independently screened by two or more team members using a screening tool. We searched grey literature reported in related databases and websites. We contacted stakeholders with subject expertise. In this review we define an immigrant as a person who relocates to the destination country for a minimum of 1 year, with the goal of permanent residence. Results We identified 40 studies for inclusion. Immigrant women tended to book and access antenatal care later than the recommended first 10 weeks of pregnancy. Primary factors included limited English-language skills, lack of awareness of availability of the services, lack of understanding of the purpose of antenatal appointments, immigration status and income barriers. Immigrant women had mixed perceptions regarding how health-care professionals (HCPs) had delivered maternity care services. Those with positive perceptions felt that HCPs were caring, confidential and openly communicative. Those with negative views perceived HCPs as rude, discriminatory or insensitive to their cultural and social needs; these women therefore avoided accessing maternity care. We found very few interventions that had focused on improving maternity care for these women and the effectiveness of these interventions has not been rigorously evaluated. Limitations Our review findings are limited by the available research evidence related to our review questions. There may be many aspects of immigrant women’s experiences that we have not addressed. For example, few studies exist for perinatal mental health in immigrant women from Eastern European countries (in the review period). Many studies included both immigrant and non-immigrant women. Conclusions Available evidence suggests that the experiences of immigrant women in accessing and using maternity care services in the UK are mixed; however, women largely had poor experiences. Contributing factors included a lack of language support, cultural insensitivity, discrimination and poor relationships between immigrant women and HCPs. Furthermore, a lack of knowledge of legal entitlements and guidelines on the provision of welfare support and maternity care to immigrants compounds this. Future work Studies are required on the development of interventions and rigorous scientific evaluation of these interventions. Development and evaluation of online antenatal education resources in multiple languages. Development and appraisal of education packages for HCPs focused on the provision of culturally safe practice for the UK’s diverse population. The NHS in the UK has a hugely diverse workforce with a vast untapped linguistic resource; strategies could be developed to harness this resource. Study registration This study is registered as PROSPERO CRD42015023605. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 14. See the NIHR Journals Library website for further project information.
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Rasskazova, V. N., Pavel F. Kiku, T. Yu Kurleeva, G. N. Bondar, O. A. Izmaylova e A. V. Sukhova. "THE ANALYSIS OF THE EFFECTIVENESS OF THE PERINATAL CENTER IN PROVIDING QUALITY MEDICAL CARE". Health Care of the Russian Federation 62, n.º 6 (24 de maio de 2019): 304–9. http://dx.doi.org/10.18821/0044-197x-2018-62-6-304-309.
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Introduction. Among the problems of health care during the reform period, the problem of quality management of medical care and effective management of the medical organization is particularly highlighted. The purpose of the study is to determine the main priorities of effective management of the medical organization of obstetric and gynecological profile to ensure the proper quality of medical care to the population. Materials and methods. We carried out quantitative and qualitative evaluation of the perinatal center in the period 2015-2017. Studied the efficiency of the administration of the human resources capacity of health organizations quality indicators of the hospital bed Fund and the financial-economic activity of enterprises. Results. The effective activity of the institution in the conditions of the established perinatal center is Shown due to the chosen strategy and tactics of the phased development of new obstetric, neonatal, inpatient-replacement technologies, the provision of highly specialized care with the use of modern equipment and medicines, which allowed to expand the range and volume of Advisory and diagnostic and treatment services, to reduce the level of perinatal and maternal losses. Discussion. The strengths of the organizational activities of the perinatal center management include: the inclusion of women’s consultation in the structure of the perinatal center, ensuring the continuity of care for gynecological and pregnant patients; state social support for motherhood and childhood, changing the conditions and procedure for the provision of free medical care to the population; functioning on the basis of the perinatal center of the Department of pathology of newborns, Department of resuscitation and intensive care of newborns, consultative and diagnostic and gynecological departments. The weak side of the organization can be attributed to the shortage of highly qualified personnel (doctors, nurses and Junior medical staff). Conclusion. In order to effectively use the resources of the institution, it is important to change the approach to the provision of material resources and their rational use in the process of the institution’s activities. The chosen strategy and tactics of management decision-making makes it possible to improve the quality and availability of medical care for pregnant women, mothers, maternity and newborn children.
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Atukunda, Esther Cathyln, Lynn T. Matthews, Angella Musiimenta, Godfrey Rwambuka Mugyenyi, Samuel Mugisha, Norma C. Ware, Celestino Obua e Mark J. Siedner. "mHealth-Based Health Promotion Intervention to Improve Use of Maternity Care Services Among Women in Rural Southwestern Uganda: Iterative Development Study". JMIR Formative Research 5, n.º 11 (25 de novembro de 2021): e29214. http://dx.doi.org/10.2196/29214.
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Background Antenatal care (ANC) prevents perinatal morbidity and mortality, but use of these services in Uganda remains low and maternal mortality rates are among the highest in the world. There is growing evidence that mobile health (mHealth) approaches improve timely communication of health-related information and produce positive health behavior change as well as health outcomes. However, there are limited data to guide development of such interventions in settings where ANC attendance and uptake of skilled maternity care are low. Objective The aim of this study is to develop a novel patient-centered mHealth intervention to encourage and support women to use maternity care services in Mbarara district, southwestern Uganda. Methods Using an iterative development approach, we conducted formative stakeholder interviews with 30 women and 5 health care providers (HCPs) to identify preferred key ANC topics and characterize the preferred messaging intervention; developed content for SMS text messaging and audio messaging with the help of 4 medical experts based on the identified topics; designed an app prototype through partnership with an mHealth development company; and pilot-tested the prototype and sought user experiences and feedback to refine the intervention through 3 sets of iterative interviews, a focus group discussion, and 5 cognitive interviews. Qualitative data were coded and analyzed using NVivo (version 12.0; QSR International). Results Of the 75 women who completed interviews during the development of the prototype, 39 (52%) had at least a primary education and 75 (100%) had access to a mobile phone. The formative interviews identified 20 preferred perinatal health topics, ranging from native medicine use to comorbid disorders and danger signs during pregnancy. In all, 6 additional topics were identified by the interviewed HCPs, including birth preparedness, skilled delivery, male partner’s involvement, HCP interaction, immunization, and caring for the baby. Positive audio messaging and SMS text messaging content without authoritative tones was developed as characterized by the interviewed women. The postpilot iterative interviews and focus group discussion revealed a preference for customized messaging, reflecting an individual need to be included and connected. The women preferred short, concise, clear actionable messages that guided, supported, and motivated them to keep alert and seek professional help. Complementary weekly reminders to the women’s significant others were also preferred to encourage continuity or prompt the needed social support for care seeking. Conclusions We used an iterative approach with diffuse stakeholders to develop a patient-centered audio messaging and SMS text messaging app designed to communicate important targeted health-related information and support rural pregnant women in southwestern Uganda. Involving both HCPs and end users in developing and formulating the mHealth intervention allowed us to tailor the intervention characteristics to the women’s preferences. Future work will address the feasibility, acceptability, and effectiveness of this design approach.
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Ghufran Fadhil Abo-Khuwait e Najmah Mahmood Meran. "Assessment the Complications of Caesarean Section among Women’s attending AL -Diwaniyah Maternity and Pediatric Hospital/Iraq". Indian Journal of Forensic Medicine & Toxicology 15, n.º 4 (5 de setembro de 2021): 3218–23. http://dx.doi.org/10.37506/ijfmt.v15i4.17262.
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Aims: This study aimed to assess complications of caesarean section among pregnant women attending ALDiwaniyah Maternity and Pediatric Hospital; and find out relationship between complications of caesareansection and socio-demographic data of women.Methods: A descriptive cross-sectional study design is conducted for the period of December 26th 2020 toJune 1st 2021. The validity of the questionnaire is determine through a panel of experts and reliability wasachieved through a pilot study. By a purposive sample is selected among pregnant women who undergocaesarean section, data was collected through the use of questionnaire and interview techniques; andanalyzed through the descriptive and inferential statistic.Results: Findings indicate participants age, the mean age was 29±7.723, the age 20-29 years old (n=217;43.4%), a not read and write (n=149; 29.8%), more than half of studied participants were housewife(n=339; 67.8%), most of study participants were overweight (n=248; 49.6%). Findings showed that thefactors associated with caesarean section were post-partum hemorrhage, prolonged operation woundinfection and postpartum infection among studied sample. Regarding fetal complication ,Low Apgarscore(n=348;69.6%),respiratory distress syndrome (n=352;70.4%), and perinatal asphyxia(n=468;93.6%),among studied sample. The education and BMI have been significant relationship with their associatedfactors of caesarean section at p-value <0.05.
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Kentschke, Dominik, Ilena Bauer, Julia Moser, Franziska Schleger, Marlene Hahn, Jan Pauluschke-Fröhlich, Peter Jakubowski, Harald Abele, Hubert Preissl e Julia Hartkopf. "COVID-19 and Perinatal Stress Experience – a Study Conducted as Part of the COVGEN Initiative". Geburtshilfe und Frauenheilkunde 82, n.º 11 (novembro de 2022): 1265–73. http://dx.doi.org/10.1055/a-1909-0451.
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Abstract Introduction During the COVID-19 pandemic, stress and anxiety in the population increased due to concerns about people’s own health and that of their relatives, as well as changes in everyday life due to measures taken to reduce the infection rate. Pregnant women are particularly stressed. The present study examines how the COVID-19 pandemic affects the stress experience and mental health of pregnant women and mothers of newborns and how care could be optimized. Methods As part of the international COVGEN initiative (https://www.covgen.org) to investigate the effects of the COVID-19 pandemic on the peripartum period, pregnant and postpartum women were asked about their experience with stress using the COPE-IS (Coronavirus Perinatal Experiences – Impact Survey) questionnaire developed for this purpose and translated from the English. In addition, demographic data, pre-existing diseases, pregnancy complications and the care situation were recorded. The questionnaire was either administered as hardcopy to inpatients at the Department of Women’s Health, University Hospital Tübingen, Germany, or online. All pregnant women and mothers who were pregnant or had given birth after the official start of the COVID-19 pandemic (11 March 2020) were eligible to participate. Results Complete data sets of n = 156 pregnant women and n = 221 postpartum women were available for evaluation. The general stress level assessed with the COPE-IS was significantly increased by the COVID-19 pandemic in both, pregnant and postpartum women, with pre-existing conditions such as respiratory diseases and pregnancy-related diseases like gestational diabetes adding to the stress. The subjectively perceived quality of care/support during pregnancy also influenced the stress level. Conclusions Fears of a COVID-19 infection and changes in preventive and aftercare services were a burden for the women surveyed. Intensified care during pregnancy and puerperium could help to stabilize the mental situation and reduce stress.
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Fellmeth, Gracia, Siân Harrison, Maria A. Quigley e Fiona Alderdice. "A Comparison of Three Measures to Identify Postnatal Anxiety: Analysis of the 2020 National Maternity Survey in England". International Journal of Environmental Research and Public Health 19, n.º 11 (28 de maio de 2022): 6578. http://dx.doi.org/10.3390/ijerph19116578.
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Perinatal anxiety affects an estimated 15% of women globally and is associated with poor maternal and infant outcomes. Identifying women with anxiety is essential to prevent these adverse associations, but there are a number of challenges around measurement. We used data from England’s 2020 National Maternity Survey to compare the prevalence of anxiety symptoms at six months postpartum using three different measures: the two-item Generalised Anxiety Disorders Scale (GAD-2), the anxiety subscales of the Edinburgh Postnatal Depression Scale (EPDS-3A) and a direct question. The concordance between each pair of measures was calculated using two-by-two tables. Survey weights were applied to increase the representativeness of the sample and reduce the risk of non-response bias. The prevalence of postnatal anxiety among a total of 4611 women was 15.0% on the GAD-2, 28.8% on the EPDS-3A and 17.1% on the direct question. Concordance between measures ranged between 78.6% (95% CI 77.4–79.8; Kappa 0.40) and 85.2% (95% CI 84.1–86.2; Kappa 0.44). Antenatal anxiety was the strongest predictor of postnatal anxiety across all three measures. Women of Black, Asian or other minority ethnicity were less likely to report self-identified anxiety compared with women of White ethnicity (adjusted odds ratio 0.44; 95% CI 0.30–0.64). Despite some overlap, different anxiety measures identify different groups of women. Certain population characteristics such as women’s ethnicity may determine which type of measure is most likely to identify women experiencing anxiety.
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Alhussain, Khulud, Fatimah Alhussain, Jasmine Mirasol e Najla Alotaibi. "Influence of Covid-19 Pandemic on Prenatal Care Utilization and Birth outcome - Qualitative Systematic Review Protocol". American Journal of Medical Science and Innovation 2, n.º 2 (5 de dezembro de 2023): 206–15. http://dx.doi.org/10.54536/ajmsi.v2i2.2226.
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The COVID pandemic disrupted routine prenatal care, yet little is known about expectant mothers’ experiences during this time. This qualitative systematic review aims to synthesize evidence on the experiences, views and impact of COVID on prenatal care utilization and birth outcomes. A systematic search is conducted in 5 databases and Google Scholar. Studies providing qualitative data on pregnant women’s experiences accessing prenatal care during COVID are included. Methodological quality is assessed using CASP and thematic synthesis is used to analyse the data. Even among these patients from affluent backgrounds, those who responded to the survey stated that the pandemic had significantly disrupted many parts of their daily lives and medical care, especially regarding social activities and postpartum support. Our findings make it clear that, in addition to increased support from healthcare systems, counseling on coping mechanisms and stressor adaptation techniques should be a part of perinatal care during public health emergencies for everyone. Results have provided an in-depth understanding of pregnant women’s experiences with barriers and facilitators to prenatal care during COVID, and the impact on maternal and neonatal outcomes. This review has identified recommendations to improve prenatal care access and quality during future health crises, contributing to more resilient and equitable maternity care systems.
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González-Cazorla, Ernesto, Ana Pilar Brenes-Romero, María José Sánchez-Gómez, Elena Estévez-Ruiz, Antonio Díaz-Enjuto, Ana Cantón-Cisneros, Daniel Lubián-López, Juan Mozas-Moreno e Ernesto S. González-Mesa. "Physical Activity in Work and Leisure Time during Pregnancy, and Its Influence on Maternal Health and Perinatal Outcomes". Journal of Clinical Medicine 13, n.º 3 (26 de janeiro de 2024): 723. http://dx.doi.org/10.3390/jcm13030723.
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Background: Physical inactivity during pregnancy has been shown to be linked to an increased risk of complications. However, during pregnancy, doubts arise about what type, intensity and frequency of physical activity are most recommended. Objective: Our main objective was to know the level of physical activity (PA) and sedentary lifestyle in a representative sample of pregnant women in Málaga, one of the most populated cities in Spain. Also, we aimed to find out the effects of PA on obstetric and perinatal outcomes and on the mental health of pregnant women, differentiated according to PA intensity and domain. Methods: Five hundred and forty full-term pregnant women who had their obstetric checks in the maternity ward of the Regional University Hospital of Málaga were recruited through consecutive sampling. Participants answered a questionnaire that included the WHO Global Physical Activity Questionnaire (GPAQ), the Edinburgh Depression Scale (EDS), the Generalized Anxiety Disorder Scale (GAD-7) and some other sociodemographic and health-related questions. Subsequently, information about perinatal outcomes was obtained after birth. Results: Only 50.8% of women followed the WHO recommendations on activity. We found a high proportion of obese pregnant women and a direct effect of a sedentary lifestyle on the rate of cesarean sections and vulvovaginal tears in spontaneous births, as well as on the mental health of future mothers. Women’s age, the number of children, BMI at the beginning of pregnancy and leisure time physical activity (LTPA) explained anxiety scores, and age, LTPA, BMI at the end of pregnancy and intense work-related physical activity (WTPA) predicted depression scores. Conclusions: LTPA improves obstetric outcomes, helping to reduce the rate of cesarean sections and vulvovaginal tears, as well as reducing prenatal anxiety and depression.
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Gaga, Asaminew Geremu, Teshome Abuka Abebo e Yilkal Simachew. "Predictors of homebirth amidst COVID-19 pandemic among women attending health facilities in Wondo Genet, Sidama Region, Ethiopia: A case control study". PLOS ONE 18, n.º 5 (2 de maio de 2023): e0283547. http://dx.doi.org/10.1371/journal.pone.0283547.
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Background In developing countries, home delivery increases the risk of maternal and perinatal mortality. Despite this, home deliveries account for a considerable share of deliveries in developing nations such as Ethiopia. Evidence on factors that affect homebirth is required for the measures needed to overcome these conditions. Objective To identify predictors of homebirth among women attending health facilities in Wondo Genet, Sidama Region. Methods Unmatched case-control study was conducted from May to June 2021 among 308 mothers (102 cases and 206 controls) who recently delivered and visited either postnatal care or sought immunization service at public health facilities of Wondo Genet. A structured interviewer-administered questionnaire was used to collect data. Epi-Data version 3.1 was used for data entry, and the Statistical Package for the Social Sciences (SPSS) version 20 was used for data analysis. Bivariate and multivariate logistic regression analyses were used to identify the determinants of homebirth. The association between the outcome variable and independent variables was declared statistically significant at a P-value < 0.05 with a 95% Confidence Interval (CI) in a multivariable model. Results Rural residence [AOR: 3.41; 95%CI: 1.58–7.39], lifetime physical IPV [AOR: 2.35; 95%CI: 1.06–5.17], grand-multiparity [AOR: 5.36; 95%CI: 1.68–17.08], non-use of contraception before recent pregnancy [AOR: 5.82; 95%CI: 2.49–13.60], >30 min to reach health facility [AOR: 2.14; 95%CI: 1.02–4.51], and lack of facemask [AOR: 2.69; 95%CI: 1.25–5.77] were statistically significant predictors of homebirth. Conclusion and recommendation The access gap to maternity services should be narrowed between rural and urban women. Healthcare programs concerning women’s empowerment could help reduce persistent intimate partner violence. Family planning needs to be promoted, and multiparous women should be counseled on the adverse obstetric consequences of homebirth. The devastating effect of the coronavirus disease 2019 pandemic on maternity services should be prevented.
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Shrestha, M., P. Chaudhary, M. Tumbhahangphe e J. Poudel. "Prevention of Mother to Child Transmission (PMTCT) Program at Paropakar Maternity and Women’s Hospital: A Review". Nepal Journal of Obstetrics and Gynaecology 7, n.º 2 (21 de setembro de 2014): 25–28. http://dx.doi.org/10.3126/njog.v7i2.11138.
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Aims: Vertical transmission from mother to fetus is the main route of HIVinfection among children. This study is an effort to review utilization of prevention of mother to child transmission (PMTCT) services by pregnant women seeking care in Paropakar Maternity and Women’s Hospital (PMWH). Methods: Case records of 165 pregnant women with HIV positive status who delivered at Paropakar Maternity and Women’s Hospital, Kathmandu from April 2005 to Dec 2011 were reviewed. Demographic profile of these women and interventions to prevent mother to child transmission (MTCT) including antiretroviral prophylaxis (ARV), mode of delivery, infant feeding practice as well as HIV status of their children were recorded. Results: Hospital records showed 109262 antenatal attendees and 120823 deliveries including 165 HIV infected women who delivered in this facility. Prevalence of HIV infection among antenatal attendees was 0.11 % and 0.13% in hospital deliveries. Migrant worker spouse (44.2%) was the main source of infection in their wives. Eighty eight (55.7%) out of 150 eligible women received ARV drugs and 97% babies received antiretroviral prophylaxis . Spontaneous vaginal delivery occurred in 60% women and caesarean section performed in the rest. While 60.8% women opted for exclusive breast feeding, remaining 39.2% chose formula feeding. For prophylaxis of opportunistic infection, Cotrimoxazole was given to 70.3% children. The incidence of HIV infection in babies born to HIV infected mother was 5.1%. Conclusions: Integrating PMTCT services into existing maternal and child health system can significantly reduce perinatal transmission of HIV infection to children. DOI: http://www.dx.doi.org/10.3126/njog.v7i2.11138 Nepal Journal of Obstetrics and Gynaecology / Vol 7 / No. 2 / Issue 14 / July-Dec, 2012 / 25-28
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Littlewood, Elizabeth, Shehzad Ali, Lisa Dyson, Ada Keding, Pat Ansell, Della Bailey, Debrah Bates et al. "Identifying perinatal depression with case-finding instruments: a mixed-methods study (BaBY PaNDA – Born and Bred in Yorkshire PeriNatal Depression Diagnostic Accuracy)". Health Services and Delivery Research 6, n.º 6 (fevereiro de 2018): 1–210. http://dx.doi.org/10.3310/hsdr06060.
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Background Perinatal depression is well recognised as a mental health condition but < 50% of cases are identified in routine practice. A case-finding strategy using the Whooley questions is currently recommended by the National Institute for Health and Care Excellence. Objectives To determine the diagnostic accuracy, acceptability and cost-effectiveness of the Whooley questions and the Edinburgh Postnatal Depression Scale (EPDS) to identify perinatal depression. Design A prospective diagnostic accuracy cohort study, with concurrent qualitative and economic evaluations. Setting Maternity services in England. Participants A total of 391 pregnant women. Main outcome measures Women completed the Whooley questions, EPDS and a diagnostic reference standard (Clinical Interview Schedule – Revised) during pregnancy (20 weeks) and postnatally (3–4 months). Qualitative interviews were conducted with health professionals (HPs) and a subsample of women. Results Diagnostic accuracy results: depression prevalence rates were 10.3% during pregnancy and 10.5% postnatally. The Whooley questions and EPDS (cut-off point of ≥ 10) performed reasonably well, with comparable sensitivity [pregnancy: Whooley questions 85.0%, 95% confidence interval (CI) 70.2% to 94.3%; EPDS 82.5%, 95% CI 67.2% to 92.7%; postnatally: Whooley questions 85.7%, 95% CI 69.7% to 95.2%; EPDS 82.9%, 95% CI 66.4% to 93.4%] and specificity (pregnancy: Whooley questions 83.7%, 95% CI 79.4% to 87.4%; EPDS 86.6%, 95% CI 82.5% to 90.0%; postnatally: Whooley questions 80.6%, 95% CI 75.7% to 84.9%; EPDS 87.6%, 95% CI 83.3% to 91.1%). Diagnostic accuracy of the EPDS (cut-off point of ≥ 13) was poor at both time points (pregnancy: sensitivity 45%, 95% CI 29.3% to 61.5%, and specificity 95.7%, 95% CI 93.0% to 97.6%; postnatally: sensitivity 62.9%, 95% CI 44.9% to 78.5%, and specificity 95.7%, 95% CI 92.7% to 97.7%). Qualitative evaluation: women and HPs were supportive of screening/case-finding for perinatal depression. The EPDS was preferred to the Whooley questions by women and HPs, mainly because of its ‘softer’ wording. Whooley question 1 was thought to be less acceptable, largely because of the terms ‘depressed’ and ‘hopeless’, leading to women not revealing their depressive symptoms. HPs identified a ‘patient-centred’ environment that focused on the mother and baby to promote discussion about mental health. Cost-effectiveness results: screening/case-finding using the Whooley questions or the EPDS alone was not the most cost-effective strategy. A two-stage strategy, ‘Whooley questions followed by the Patient Health Questionnaire’ (a measure assessing depression symptomatology), was the most cost-effective strategy in the range between £20,000 and £30,000 per quality-adjusted life-year in both the prenatal and postnatal decision models. Limitations Perinatal depression diagnosis was not cross-referenced with women’s medical records so the proportion of new cases identified is unknown. The clinical effectiveness and cost-effectiveness of screening/case-finding strategies was not assessed as part of a randomised controlled trial. Conclusions The Whooley questions and EPDS had acceptable sensitivity and specificity, but their use in practice might be limited by low predictive value and variation in their acceptability. A two-stage strategy was more cost-effective than single-stage strategies. Neither case-finding instrument met National Screening Committee criteria. Future work The yield of screening/case-finding should be established with reference to health-care records. The clinical effectiveness and cost-effectiveness of screening/case-finding for perinatal depression needs to be tested in a randomised controlled trial. Funding The National Institute for Health Research Health Services and Delivery Research programme.
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De Mucio, Bremen, Lorena Binfa, Jovita Ortiz e Anayda Portela. "Status of national policy on companion of choice at birth in Latin America and the Caribbean: Gaps and challenges". Revista Panamericana de Salud Pública 44 (1 de março de 2020): 1. http://dx.doi.org/10.26633/rpsp.2020.19.
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The World Health Organization (WHO) recommends a companion of choice during labor and birth, to improve maternal and perinatal outcomes and women’s satisfaction with health services. To better understand the status of companion of choice in Latin America and the Caribbean (LAC), an online survey was conducted with members of a midwifery virtual community of practice and with key informants, aiming to identify: 1) existing regulatory instruments related to companion of choice in the countries where the members are practicing; and, 2) key characteristics of implementation of companion of choice, where regulation exists. Responses (n = 112) were received from representatives of 20 of the 43 countries of LAC. Respondents reported existence of a national policy or legislation in seven countries, ministerial norms or institutional protocols in five countries, and no existing policy/protocol in eight countries. Respondents from the same country often provided contradictory responses. Responses differed from information provided by ministries of health in a WHO-led global policy survey in 11 instances. These variations may reflect that midwives were not always aware of the national policy/guideline in their country. We propose that a more robust effort should be undertaken to understand the status of companion of choice for labor and birth in LAC countries, at national, regional, and local level, in public and private facilities. It is important to know if policies exist, at what level of the system, and if key stakeholders, maternity-care health providers, and women are aware of their existence. Efforts should also be made to understand barriers to implementing companion of choice.
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Tunc, Turan, Erkan Demirkaya, Mustafa Kul, Halil Yaman, Sinan Karadeniz, Tayfun Gungor, Faruk Alpay e Ismail Kurt. "The relation between delivery type and cord blood levels of chitotriosidase and Troponin T". Open Medicine 5, n.º 6 (1 de dezembro de 2010): 693–97. http://dx.doi.org/10.2478/s11536-010-0016-7.
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AbstractThe operative deliveries can expose the fetus to acute and systemic hypoxia along with an increase in perinatal morbidity. The aim of this study was to reveal any relationship between delivery type and Chitotriosidase and Troponin T levels in cord blood. Ninety babies born in Ankara Etlik Maternity and Women’s Health Teaching Hospital were involved in the study. The babies were divided into three groups; Group 1: Normal vaginal; Group 2: Caesarean section; Group 3: Forceps application. Cord blood samples were drawn from umbilical arteries of the babies soon after the birth. Chitotriosidase enzyme activities in group 3 (141 nmol/ml/h (0–246)) were found higher than groups 1 (100 nmol/ml/h (0–208)) and 2 (91 nmol/ml/h (0–202)) (p<0.01 and p<0.03 respectively). Although cardiac Troponin T levels were higher in group 3, the difference among groups was not statistically significant (p=0.79). Acute or systemic hypoxic exposure of the organism gives rise to a microvascular response characterized by interactions between leukocytes and endothelium. We are hypothesizing that the high levels of chitotriosidase found in the forceps group were due to hypoxia, and that chitotriosidase level can be used as a marker of acute and systemic hypoxia.
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Cull, Joanne, Gill Thomson, Soo Downe, Michelle Fine e Anastasia Topalidou. "Views from women and maternity care professionals on routine discussion of previous trauma in the perinatal period: A qualitative evidence synthesis". PLOS ONE 18, n.º 5 (17 de maio de 2023): e0284119. http://dx.doi.org/10.1371/journal.pone.0284119.
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Background Over a third of pregnant women (around 250,000) each year in the United Kingdom have experienced trauma such as domestic abuse, childhood trauma or sexual assault. These experiences can have a long-term impact on women’s mental and physical health. This global qualitative evidence synthesis explores the views of women and maternity care professionals on routine discussion of previous trauma in the perinatal period. Methods Systematic database searches (MEDLINE, EMBASE, CINAHL Plus, APA PsycINFO and Global Index Medicus) were conducted in July 2021 and updated in April 2022. The quality of each study was assessed using the Critical Appraisal Skills Programme. We thematically synthesised the data and assessed confidence in findings using GRADE-CERQual. Results We included 25 papers, from five countries, published between 2001 and 2022. All the studies were conducted in high-income countries; therefore findings cannot be applied to low- or middle-income countries. Confidence in most of the review findings was moderate or high. The findings are presented in six themes. These themes described how women and clinicians felt trauma discussions were valuable and worthwhile, provided there was adequate time and appropriate referral pathways. However, women often found being asked about previous trauma to be unexpected and intrusive, and women with limited English faced additional challenges. Many pregnant women were unaware of the extent of the trauma they have suffered, or its impact on their lives. Before disclosing trauma, women needed to have a trusting relationship with a clinician; even so, some women chose not to share their histories. Hearing trauma disclosures could be distressing for clinicians. Conclusion Discussions of previous trauma should be undertaken when women want to have the discussion, when there is time to understand and respond to the needs and concerns of each individual, and when there are effective resources available for follow up if needed. Continuity of carer should be considered a key feature of routine trauma discussion, as many women will not disclose their histories to a stranger. All women should be provided with information about the impact of trauma and how to independently access support in the event of non-disclosures. Care providers need support to carry out these discussions.
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Takyi, C., A. Samba, K. Mumuni, J. D. Seffah e W. Kudzi. "Perinatal Risk Factors Associated With Intrapartum Perineal Injuries At The Korle Bu Teaching Hospital". Postgraduate Medical Journal of Ghana 9, n.º 1 (12 de julho de 2022): 20–24. http://dx.doi.org/10.60014/pmjg.v9i1.215.
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Background: Obstetric perineal injury is a major contributor to women’s reproductive health problems. More than 60% of women suffer varying degrees of obstetric perineal injuries during vaginal delivery requiring repair. This study determined the risk factorsassociated with perineal injury. Method: Prospective observational study of 356 women who had singleton term vaginal delivery between 1stApril and 31stMay, 2018 at the KBTH. Sociodemographic and clinical data of participants were collected and analysed to determine association betweenvariables. A p-value of <0.05 was considered statistically significant.Results: Two hundred and thirty-six women (66.29%) had vaginal deliveries with no perineal injuries comprising 81 primiparous and 155 multiparous women. Perineal injury among the study participants were 120/356 (33.71%) while perineal injury for first degree, second degree, third degree and fourth degree were 75/356 (21.07%), 41/356 (11.52%), 2/356 (0.56%), 2/356 (0.56%) respectively. A total of 948 vaginal deliveries was conducted during the study period. The odds of developing a perineal injury was 8 times higher among participants with previous surgery on genital tract (OR, 8.29 [95% CI 2.69- 25.6]; p<0.001) and 18 times higher among participants with previous postpartum complication (OR, 18.00 [95% CI 4.06-79.71], p<0.001). Babies with birth weights ≥2.5kg had 4.11 increased odds of developing perineal injury when compared to those with birth weights <2.5kg (OR, 4.11 [95% CI, 1.70-9.98] p=0.001). Vacuum delivery was strongly associated with a 4.81 odds perineal injury (OR, 4.81 [95% CI, 1.22-18.9] p<0.014).Conclusion: The incidence of perineal injury among women who had vaginal delivery at the KBTH maternity during the study period of (12.66%) was high compared to other studies from the West African Subregion. Risk factors such as previous postpartum complication, episiotomy, and gestational age at delivery, head circumference of the baby, asthma, hypertension and past genital tract surgery weresignificantly associated with perineal injury. Early identification of women at risk of perineal injury could help with interventions to reduce the incidence of this complication during childbirth.
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Tamma, Evelyn, Kwame Adu-Bonsaffoh, Adanna Nwameme, Phyllis Dako-Gyeke, Emmanuel Srofenyoh e Joyce Browne. "Maternal hypertensive mother’s knowledge, attitudes and misconceptions on hypertension in pregnancy: A multi-center qualitative study in Ghana". PLOS Global Public Health 3, n.º 1 (6 de janeiro de 2023): e0001456. http://dx.doi.org/10.1371/journal.pgph.0001456.
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Hypertension in pregnancy is one of the commonest complications of pregnancy and a leading cause of maternal and perinatal morbidity and mortality globally, with the highest burden in low and middle income countries. Pregnant women’s knowledge about hypertension in pregnancy facilitates early health seeking behavior, which can result in early diagnosis and treatment. This study therefore explored the knowledge, misconceptions and attitudes of Ghanaian women who were affected by hypertension in pregnancy. A qualitative study was carried out across five referral hospitals in the Greater Accra Region of Ghana. In-depth interviews (IDIs) and focus group discussions (FGDs) were used to explore the women’s knowledge on hypertensive disorders of pregnancy (HDP), and particularly preeclampsia. Women of at least 16 years, admitted with a HDP to the maternity ward with gestational ages from 26–34 weeks were eligible for participation. The inductive approach was used to develop a code book and the dataset was coded using Nvivo version 12 software. A total of 72 women participated in the study. Fifty IDIs and 3 FGDs involving 22 women were conducted. Although most of the women had regular antenatal visits, several had never heard of “pre-eclampsia”. More common terminology used by women (i.e. “Bp”) referred to any of the hypertensive disorders (e.g. pre-eclampsia, gestational hypertension and chronic hypertension). Women also perceived that pre-eclampsia may be inherited or caused by “thinking too much”. The study revealed that the knowledge about hypertension in pregnancy is limited among the affected women despite regular antenatal attendance with some form of health education. There should be more education programs on hypertensive disorders of pregnancy including pre-eclampsia with revised strategies.
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Soltani, H., H. Watson, F. Fair, M. van den Muijsenbergh, M. Papadakaki, M. Jokinen, E. Sioti, L. Raben, C. Burke e V. Vivilaki. "Perinatal mental health services for mothers from ethnic minority and migrant backgrounds". European Journal of Public Health 31, Supplement_3 (1 de outubro de 2021). http://dx.doi.org/10.1093/eurpub/ckab164.467.
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Abstract Perinatal mental health disorders are among the most common morbidities of the perinatal period with considerable adverse effects on mothers and their offspring. Members of ethnic minority groups, particularly those from migrant backgrounds, are at higher risk of developing mental illness with evidence of ongoing inequality in access to support. We will present an exploratory mixed-methods study scoping ethnic minority and migrant women's experiences accessing perinatal mental health services in the UK. Results showed how women perceived access to services as very challenging and how they experienced ‘suffering in silence', a ‘need for a safe space to talk and to be listened to', and a ‘need of finding other women like them'. We will complement these findings with the lessons learned from a related project, a three-site European study (ORAMMA) evaluating the feasibility of implementing an integrated perinatal care model for migrant mothers comprising maternity peer supporters (MPSs)-women from migrant backgrounds who had lived in the country for a longer time and were trained to support other migrant women during the childbearing continuum-. Results showed that MPSs supported migrant women accessing maternity care, overcoming language barriers, and advocating for them in their encounters with healthcare professionals. Besides, they provided emotional support and increased women's confidence, helping them overcome loneliness, encouraging them to build relationships with others and promoting bonding with the new baby. Bringing these two projects together, we will discuss how MPSs have the potential to help overcome barriers that immigrant women experience in seeking perinatal mental health and how the benefits of maternity peer supporters have the potential to reduce perinatal mental health risks amongst migrant mothers. Findings will point to the need for future research to evaluate the direct impacts of MPSs on immigrant's mother perinatal mental health.
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Frederiksen, M. S., V. Schmied e C. Overgaard. "Supportive maternity care services: A Danish study exploring parents’ experiences with perinatal mental health issues". European Journal of Public Health 30, Supplement_5 (1 de setembro de 2020). http://dx.doi.org/10.1093/eurpub/ckaa165.127.
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Abstract Background Mental illness can have negative impact on pregnant women, their infants and their families, including adverse birth outcomes, as well as place children at risk of developing mental illness later in life. It is recommended to offer additional support in the ante - and postnatal period, but to be able to offer appropriate, timely and effective care, more knowledge is needed on women's own experiences. The aim of this paper is to explore women's experiences with mental illness in the context of pregnancy and early motherhood, and how they experience and engage with supportive services. Methods This paper presents selected findings from an ethnographic field study carried out in a Danish municipality. The findings are based on data from 22 women, who were recruited when they were pregnant or had a newborn baby. The women were currently facing or had previously suffered from one or multiple mental health conditions. Results Analysis found that women with current or prior mental illness experienced a high level of fear, worries and uncertainty during pregnancy and early motherhood, which shaped how they engaged with supportive maternity services. Some were deeply worried about their mental health and reached out for support to cope with this. Concerns about being a bad mother and about the potential influence of their mental illness on their infants were common. Furthermore, some women were scared of being judged as unfit mothers and losing custody of their children. Many experienced stigma surrounding mental illness, making some more hesitant about reaching out for support. Conclusions By providing new insight into women's own perspectives, this study contributes with in-depth knowledge on women's experiences with mental illness during pregnancy and early motherhood, and illustrates how engaging with supportive services may be an ambivalent experience.
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Khan, Saida, Pamela Scorza, Kathryn L. Lovero, Palmira dos Santos, Wilza Fumo, Barbara Camara, Maria A. Oquendo, Milton L. Wainberg, Marcelo Fejo e Cristiane S. Duarte. "Women's mental health in Mozambique: is maternity a protective factor?" Global Mental Health, 11 de fevereiro de 2022, 1–7. http://dx.doi.org/10.1017/gmh.2022.1.
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Abstract Backgroud Globally, women have been shown to have high rates of common mental disorders (CMDs). In low and middle-income countries (LMICs), women face significant challenges related to maternity. However, no study has compared mental health problems among pregnant/post-partum women, childless women of childbearing age, and women with children in a low-income country. We sought to compare the frequency of CMD and suicide risk in a sample of women presenting or accompanying patients in primary care in two Mozambican semi-urban settings. Methods We administered the MINI International Neuropsychiatric Interview to 853 women, of whom 220 (25.8%) were pregnant/post-partum, 177 (20.8%) were non-pregnant and childless, and 456 (53.5%) were non-pregnant and with children more than 1-year-old. Logistic regression models compared the likelihood of a psychiatric disorder across groups, adjusting for sociodemographic and chronic-illness covariates. Results We found a high frequency of CMD and suicide risk among all women in this low-income context sample. In adjusted models, no differences in rates of depression, anxiety, or panic disorder were observed among groups. However, suicide risk was higher in women without children than pregnant/post-partum women. Conclusion The frequency of CMD among women of childbearing age in our study was higher than documented rates in high-income countries and other LMIC. Additionally, we found that motherhood was not protective and that pregnancy and the postpartum period were not stages of increased risk for most disorders. This highlights the need to expand mental health services not only for perinatal women but all women of childbearing age in this and possibly similar settings.
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Hrdličková, Kristýna, Renata Banášová, Eliška Nosková, Renata Vodičková, Nancy Byatt e Antonín Šebela. "Self-Reported Causes of Psychological Distress Among Czech Perinatal Women". Journal of the American Psychiatric Nurses Association, 20 de outubro de 2022, 107839032211310. http://dx.doi.org/10.1177/10783903221131049.
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Background: Various risk factors to perinatal mental health disorders have been described; however, there is a dearth of data on the perspectives of women themselves regarding what increases the risk of psychological distress. This qualitative study explores women’s perceptions of factors that increase the risk of perinatal psychological distress. Aim: The aim of this study was to elucidate women’s perceptions of factors that increase the risk of perinatal psychological distress. Methods: A qualitative design with an exploratory and descriptive approach is used. Women ( N = 188) aged 18 to 45 years who self-report experiencing perinatal psychological distress complete an online survey. Results: Perceived causes of perinatal psychological distress include: adverse experiences with childbirth and/or breastfeeding, negative attitudes of people close to the participant, financial and social challenges, health challenges, staff behavior in a maternity hospital, a challenging baby, family circumstances, and the new role as mother. Conclusion: Women’s perceived causes of perinatal psychological distress may allow for women-centered innovations in perinatal mental health care. The results highlight the need to train maternity staff regarding perinatal mental health and communication. These findings can serve as important guidelines on women-centered planning of innovations of perinatal mental health care. Interventions need to focus on the role of partners and others close to women so as to support the women during the perinatal period.