Journal of Midwifery & Reproductive health
Volume:7 Issue: 2, Apr 2019

Paternal-fetal attachment develops an emotional relationship between father and his infant which can affect their future interactions. Therefore, the present study aimed to determine the effect of attachment training on paternal-fetal attachment. This clinical trial was conducted in Karmandan and 22 Bahman health centers in Mashhad in 2015. The participants of the study consisted of 60 randomly-selected fathers whose wives `gestational age was 28 to 32 weeks. The intervention group received three 120-min sessions of attachment training once a week in the forms of group discussion, lectures, question and answer, film screenings, and educational booklet. Data collection was performed by means of two questionnaires, named personal and fertility characteristics questionnaire and Weaver Cranley paternal-fetalattachment questionnaire. Two groups were assessed before, immediately after, and 3 weeks after intervention (follow-up) by paternal-fetal attachment questionnaire. Data analysis was performed in SPSS (version 22) using the Chi-square, independent t-test, Fisher, Mann-Whitney U test, and repeated measure tests. P The results of repeated measures showed that mean scores of paternal-fetal attachment was not significantly different between the control and intervention groups before training (P=0.527) However, paternal-fetal attachment significantly increased at post-test (P=0.069) and follow-up (P=0.006) in the experimental group. Attachment training increases paternal-fetal attachment; therefore, pregnancy care programs should include training sessions for fathers.

Women experience childbirth in a variety of contexts with different aspirations. However, the experience has far-reaching implications for women’s health and that of their neonates. To explore the childbirth experiences of women giving birth in Zambia in order to better understand how they give meaning to the experience this study was conducted. This study was carried out using an interpretive phenomenological approach. Purposive sampling was utilized to recruit 50 participants from all the 10 provinces of Zambia. The ages of the subjects ranged from 16 to 38 years. The deliveries, both home and institutional, occurred between 2005 and 2011. The data were collected through tape-recorded in-depth unstructured interviews. Data analysis was performed using van Manen’s six steps of analysis. The major theme of “being there” constituted two subthemes, namely “feeling safe” and “sense of achievement” emerged from the obtained data. The major theme elucidated the physical presence of the provider, as well as feelings of safety, comfort, trust, being recognized, and respected. The subtheme of “feeling safe” explicated women’s feelings of being at ease and at peace with their care providers, while the subtheme of “sense of achievement” clarified the participants’ expressions of pride that came through experiencing childbirth perceived by the woman giving birth to be satisfactory.  By being physically and psychologically present for the woman who is giving birth, birth attendants, particularly midwives assisted in raising their confidence levels. Caring behaviours, such as showing kindness and respect, giving privacy, as well as making the cases feel comfortable made a qualitative difference of the childbirth experience.

Pregnant women with systemic lupus erythematosus (SLE) are considered to be at high risk regarding fetal complications and adverse outcomes. The aim of this study was to evaluate the fetal outcomes in pregnant women with the SLE. This retrospective study was conducted on a total of 125 patients with the SLE referred to the Clinic and Department of Rheumatology of Imam Reza Hospital in Mashhad, Iran from January 1 in 1997 to December 31 in 2017. The patients were classified according to the criteria of the Systemic Lupus International Collaborating Clinics classification for the SLE. The data were obtained, including age, personal background, and pregnancy outcomesfrom medical records and discharge reports of the cases. There were 217 pregnancies in 125 patients with the SLE. The mean age of the subjects was 27.25±5.08 years at pregnancy time. Among all, 86 (36.9%) pregnancies were reported as full-term deliveries. The incidence of fetal wastage in the patients was observed as 49.3%. Abortion, prematurity, and stillbirth were announced in 114 (52.5%), 12 (5.5%), and 5 (2.3%) pregnancies, respectively. Neonatal death was noticed in 8 (3.6%) pregnancies and neonatal lupus was reported in 3 neonates (1.3% of the pregnancies). The risk of fetal complications and adverse outcomes were very high in the patients with SLE. In geographical region under study, the subjects with the SLE continued to have high-risk pregnancies and consultation with their doctors should be considered.

Hypertensive disorders of pregnancy are among the severe medical disorders peculiar to pregnancy. It is one of the risk factors during pregnancy either for the mother or fetus or both. Therefore, this study aimed to assess fetal and neonatal outcomes of mothers with hypertensive disorders of Pregnancy. This hospital-based cross-sectional study was conducted on neonates born from June 20 to November 20, 2014 at hospitals in Wolaita zone, Southern Ethiopia. The check lists of the study conducted on Prevalence of Hypertension and Complications of Hypertensive Disorders in Pregnancy in patients visiting in the Delivery Ward of Valiasr Hospital were used as base and then modified before being used in our study. Data were analysed using Epi Info (version 7) and SPSS (version 20). Bivariate and multivariate analyses were used to identify factors associated with perinatal outcomes. Analysis were used to identify factors associated with perinatal outcome. Preeclampsia and eclampsia can adversely affect the wellbeing of the fetuses and neonates. Nulliparous women were about five times more likely to develop unfavorable outcome in comparison with multiparous women (AOR 4.85; 95% CI: 0.064-12.442). Hypertensive disorder of pregnancy is associated with the increased risk of adverse fetal and neonatal outcome. Therefore, it is of utmost importance to have timely diagnosis and appropriate care.

Among Muslim nations, Iran holds the highest level of contraceptive practice. It was reported that the rate of traditional methods is relatively high particularly withdrawal. The present study aimed to define the determinants of withdrawal method and its effect on sexual satisfaction among the couples in Shiraz County, Iran. This descriptive correlational study was conducted on all married women in reproductive age (age range: 15-49 years) living in Shiraz County (city and rural areas) in 2014-2015. Data were collected using a semi-enclosed questionnaire from 626 women selected by multi-cluster sampling and purposive sampling. Data analysis was performed in SPSS software (version 20) using Chi-square test and multiple logistic regression The results of this study indicated that withdrawal was used by about 24.0% of the couples. There was a set of socioeconomic, cultural, and accessibility factors affected using this method. According to the respondents’ answers, the main advantage of withdrawal was its safety. However, 73% of the users stated that they were concerned about the method failure and unintended pregnancy risks. Moreover, 65% of them expressed that their stress about method failure decreased their sexual satisfaction. The findings of multiple logistic regression analysis indicated the residential place (OR=24.91, 95% CI=10.48-59.21, P<0.05) and participant’s authority were the main predictors of withdrawal practice (OR= 0.805, 95% CI=0.675-0.960, P<0.05).  Furthermore, the third predictor of withdrawal use was the negative perception of modern contraceptives (OR=1.42, 95% CI=1.25-1.61, P<0.05). Despite the fact that Iran is one the successful countries in family planning; however, some shortcomings in family planning programs are reflected by a high rate of withdrawal practice as a traditional contraceptive method, as well as some rumors and concerns regarding the modern contraceptives.

Premenstrual Syndrome (PMS) includes different symptoms that appear periodically throughout the luteal phase of the menstrual period. The PMS has not been properly investigated as an influencing factor of marital satisfaction. Thus the purpose of this study was to assess the relationship between PMS and its symptoms with women's marital satisfaction. This cross-sectional study was conducted on 246 women referred to health centers in Yazd, Iran. The data were collected through the Index of Marital Satisfaction and Premenstrual Syndrome Screening Tool and analyzed in SPSS software (version 18) using the Chi-Square test. According to the results, "somatic symptom disorders, such as breast pain, headache, muscle pain, arthritis, bloating, and weight gain" (%22.8) and "anger and irritability" (%21.5) obtained the highest frequency in terms of syndrome severity. With regard to the effect of symptoms on daily life, the strongest impact was on "the relationship with the family" (%10.6). The results showed that the levels of marital dissatisfaction among women with PMS (P=0.013) were higher, compared to the non-affected population. The severe symptoms of this syndrome disrupt family relationship leading to marital dissatisfaction. Therefore, the women and their families are required to receive the required training for better communication in this period.

Postpartum blues is the most common postpartum mood disorder, which can turn into a chronic depression.. Therefore, the prevention of this disorder is effective for the improvement of family mental health. The present study was conducted to investigate the effect of Melissa officinalis(Lemon balm) on the incidence of postpartum blues. The present triple-blinded placebo-controlled clinical trial was performed on 60 women with cesarean section(C- section)at teaching hospitals affiliated to Mashhad University of Medical Sciences, Mashhad, Iran, in 2016-2017. The participants were randomly divided into case and placebo groups. The case group was administered lemon balm capsules (500 mg) from the first day after cesarean section three times a day for 10 days. Edinburgh postnatal depression scale was completed by all subjects at three stages, namely on the 3rd-5th,10th, and 14th days after C-section. The data were analyzed by SPSS software (version 16) using independent t-test, as well as Mann-Whitney U, Chi-square, Fisher's exact tests and Friedman test. P-value less than 0.05 was considered statistically significant. The Fisher's exact test showed that the incidence rates of postpartum blues on the 3rd-5th , 10th, and 14th days after C-section were 3.3% and 43.3% (P<0.00), 3.3% and 50% (P<0.00), and 0% and 33.3%  (P<0.00) in the case and placebo groups, respectively. The results of the two-way ANOVA test revealed that the depression score increased with maternal age due to the intervention (P=0.046). The present study showed that the use of lemon balm could reduce the incidence rate of postpartum blues, which is one of the most common postpartum psychiatric disorders, without the development of possible side effects. Therefore, it is recommended to use it especially in susceptible women after their delivery.

Most of the maternal mortalities are preventable when safe maternal healthcare practices adhere to antenatal care. Lack of birth and emergency preparedness is one of several factors contributing to maternal mortalities. Adequate birth preparedness (BP), as well as emergency, and complication readiness (CR) planning can determine the survival rate of a pregnant woman and her unborn neonate. The present study aimed to describe the experiences of pregnant women at Jachie Health Center regarding BP and CR. In this qualitative study, a phenomenological approach was used for data collection. In-depth interviewing was conducted with a total of 15 pregnant women from Jachie Health Center. The interviews were digitally recorded, transcribed verbatim, reviewed several times, and thematic analysis was performed. NVivo software (version 11) was utilized to manage the data and help with thematic analysis. The pregnant women practiced preparations towards the place of delivery, support person, layette, and warning signs of pregnancy. The majority of the cases were not aware of obligatory preparations in terms of transportation and the need for emergency compatible blood donor prior to delivery. Most of the respondents were not sufficiently prepared for delivery due to poverty and low educational status. The role of community members could include the instruction of pregnant women to attend antenatal clinic to receive education regarding birth preparedness and complications readiness. The district health directorate and public health nurses should train community leaders for the benefits of birth preparedness and complications readiness.

Cesarean section (C-section) has often been one of the most common surgical procedures for women. It can be associated with several psychological and mental factors. Recently, spirituality related to adaptation with stressful situations has also been emphasized. Therefore, the purpose of this study was to investigate the relationship between spiritual health and pain intensity following a C-section. This cross-sectional study was conducted in Sayyad Shirazi Hospital, Gorgan city, Iran in 2013-2014. To this aim, 200 pregnant women, who wanted to undergo C-section were selected through convenience sampling method. The data were collected via demographic characteristics form, well-being Questionnaire at the beginning of the study, and Visual Analogue Scale at three stages of immediately, one hour, and 6-8 hours post-delivery. All the data were analyzed by statistical tests, including Pearson’s correlation and independent t-test using SPSS Version 16. This cross-sectional study was conducted in Sayyad Shirazi Hospital, Gorgan city, Iran in 2013-2014. To this aim, 200 pregnant women, who underwent C-section were selected through convenience sampling method. The data were collected via demographic questionnaire, Paloutzian and Ellison well-being Questionnaires (SWBQ,1982) at the beginning of the study, and Visual Analogue Scale at three stages of immediately, one hour, and 6-8 hours post-delivery. Data were analyzed by statistical tests, including Pearson’s correlation and independent t-test using SPSS Version 16. According to the results of this study, no relationship was found between the pain intensity after C-section and spiritual health at several stages of post-delivery phase.

Breast cancer is one of the leading cancer types among women. In Ethiopia, the knowledge, attitude and practice among health extension workers (HEWs) towards breast cancer self-examination are not well understood. Therefore, this study assessed knowledge, attitude, and practice (KAP) of breast cancer self-examination (BCSE) and associated factors among HEWs. This cross-sectional study was conducted from October to November 2017 among female HEWs in Addis Ababa, using self-administered questionnaire. Multivariate logistic regression was used to assess factors associated with KAP of the BCSE. Adjusted odds ratio (AOR) with 95% confidence interval (95% CI) was used to assess statistical significance. A total of 453(89.2%) HEWs participated in this study. Close to two-third (64.0%) of the respondents had adequate knowledge on breast cancer signs, symptoms, and practice of BCSE. However, only 146(40.0%) of the respondents practiced BCSE on a monthly basis. The majority (81.0%) of the respondents had a positive attitude towards BCSE. Work experience ranging from one to four years (AOR: 2.8; 95%CI: 1.2, 6.4)and ≥five years(AOR: 2.4; 95%CI: 1.1, 5.7), familiarity with people who had history of breast cancer (AOR: 1.7; 95%CI: 1.1, 2.6),perceived susceptibility (AOR: 1.8; 95 %CI: 1.2, 3.0), and knowledge of BCSE(AOR: 2.3; 95 %CI: 1.4, 3.7) were significant predictors of BCSE. More than half of HEWs had adequate knowledge and attitude towards BCSE; however, only a few put them into practice. With regard to in-service training focusing on severity, consequences and detection methods of breast cancer may enhance the BCSE practices of the HEWs.

Sexual self-efficacy refers to the belief of each individual about his/her ability to be sexually active, his/her desirability for sexual partner, and assessment of the ability and self-efficacy in sexual behavior. Sexual relationship is one of the key pillars of a successful family; accordingly, functionality in this domain largely affects marital satisfaction. The aim of this study was to determine the relationship between sexual self-efficacy and sexual function among married women. This descriptive-correlational study was conducted on 201 married women referring to the clinic of Lenjan Hospital, Isfahan in 2017. The study population was selected through convenience sampling. The women scoring below 40 in the Beck Depression Inventory were entered into the study and filled out the questionnaires of sexual self-efficacy and sexual function. The data were analyzed in SPSS software (version 22) using descriptive statistics and Spearman’s rank correlation coefficient. The mean age of participants was 32±6.70 years, and their mean menarche age was 12±36.1 years. The mean scores of sexual function and sexual self-efficacy were obtained as 26.17±1.44, 21.54±2.70, respectively. The results revealed a positive correlation between sexual self-efficacy and sexual function (r=0.205, P=0.001). Also, sexual self-efficacy showed a significant relationship with some subscales of sexual function, including libido, orgasm, lubrication, and sexual arousal (P≤0.05). Sexual self-efficacy had a positive relationship with some of the subscales of sexual function. Therefore, sexual function in women can be strengthened by the enhancement of their sexual self-efficacy.

Flaxseed is the richest source of lignan which is one of the main categories of phytoestrogens. In addition to the estrogenic and anti-estrogenic properties of lignan, it has non-hormonal properties as well. The treatment of menopausal hot flashes and cyclic mastalgia, the reduction in vasomotor symptoms and tumor cell growth and recurrence, the prevention of breast and ovarian cancer,  and the improvement of the symptoms of premenstrual syndrome are some of the indications of this plant. Therefore, the current study aimed to review the effect of flaxseed on the control of menopausal symptoms, premenstrual syndrome as well as breast and ovarian cancers. In this study, English keywords of mastalgia, mastodynia, ovarian neoplasm, ovarian cancer, breast neoplasm, breast cancer, hot flashes, premenstrual syndrome, flax, flaxseed, lignan, phytoestrogen, and linum usitatissimum along with their Persian equivalents were searched through databases incluing PubMed, Proquest, Scopus, Science Direct, Google Scholar, SID, and Magiran. All the selected articles were the clinical trials and case-control studies performed from 1991 to 2017. Finally, 30 English and 8 Persian studies were reviewed in this study. The results obtained from most studies on this plant showed its positive effects on menopausal symptoms, breast cancer, mastalgia, and premenstrual syndrome. According to the results, it can be concluded that due to the high properties of this plant (i.e., the negligible side effects and safe use of it in recommended amounts), it can be used within the field of obstetrics and gynecology.

Prenatal ultrasound plays an important role in the early and accurate evaluation of the congenital skeletal and non-skeletal abnormalities of the fetus and is effective in predicting pregnancy outcomes. Congenital femoral deficiency (CFD) is a rare complicated and non-hereditary anomaly that includes the hypoplasia of a portion of the femoral bone with shortening the lower limb.
Case report: The aim of this study was to report a rare case of neonatal CFD, which was not detected in prenatal ultrasound. In this study, we presented the case of a 28-year-old multiparous woman with the gestational age of 39 weeks hospitalized for labor pain. She had a history of 2 to 3 irregular prenatal visits and her only pregnancy ultrasound was related to late pregnancy, which reported a healthy live fetus with a cephalic presentation, which was in 35-36 weeks of gestation according to biparietal diameter (BPD) and femur length (FL). Finally, normal vaginal delivery occurred and a neonate was born with a severe bilateral CFD with deformity and immobilization of the lower limbs. It seems that in order to identify the early diagnosis and case management it is necessary to differentiate both femoral and tibia bones in routine ultrasound more precisely, measure the length, and strongly emphasize the need for the ultrasound examination of fetal anomalies for all pregnant women.