Journal of Midwifery & Reproductive health
Volume:11 Issue: 3, Jul 2023

Fetal occiput posterior (OP) position during labor may be associated with negative maternal and neonatal outcomes. It is therefore necessary for the mothers to have active participation in changing their position during the labor in order to facilitate OP rotation. The present study aimed to investigate whether maternal lateral decubitus position during labor can correct fetal OP position and childbirth outcomes.

In this systematic review, searches were made in the databases of Medline, Web of Science, Embase, Scopus, and Cochrane Central Controlled Trials Register as well as Persian databases including SID, Magiran and IranMedex from inception to September 2021. Eligible randomized controlled trials evaluating the effect of maternal position on fetal OP position during labor were selected. Cochrane risk of bias tool for randomized trials was used to assess the quality of included articles.

Four randomized controlled trials (RCTs) met the eligibility criteria. They included 871 participants, who were divided into two groups. overall, no difference was reported between the intervention and control groups in terms of the rate of occiput anterior position at birth. The mother's position in the same or opposite direction of the fetal occiput had no role in the spontaneous vaginal delivery rate and other outcomes and neonatal Apgar score.                           

The lateral decubitus position of mother during labor played no role in fetal head rotation toward the OP position or delivery outcomes.

Midwives can participate in empowering women by improving women's health and supporting them through different life stages. Despite the emphasis on the role of midwives in empowering women, the strategies through which midwives can fulfill this role are not fully investigated. The aim of this study was to review the role of midwifes in women's empowerment.

In this narrative review, which was conducted based on the Scale for Assessing Narrative Review Articles (SANRA), databases including ISI, Scopus, PubMed, Cochrane library, PsycInfo, SID, Magiran and IranMedex were searched by two researchers without time limit up to September 2022, using keywords of "female empowerment", "empowerment", "midwife", "midwifery" and their Persian equivalents. All the original articles focused on midwives’ role in women's empowerment were included. Articles without access to full-text, conference papers, short communications and editorials were excluded. Qualitative synthesis was conducted on 27 articles included in the study.

Two main categories including "reproductive and sexual health" and "gender-based discrimination and violence" were identified. The first category included midwives' role in pregnancy, childbirth, postpartum, breastfeeding and family planning services. The second category involved midwives role to empower women in confronting domestic violence and harmful cultural practices.

Despite midwives success in empowering women, they face many obstacles, both within and outside the health system, especially in combatting against discrimination and gender-based violence, which need to be addressed. To empower women, it is crucial that governments, communities and international organizations pay more attention to the role of midwives in women’s empowerment.

The spread of COVID-19 has increased the stress level in pregnant women. The present study was performed to determine the effect of a mobile-based health educational intervention on the stress induced by the COVID-19 pandemic among pregnant women.

This randomized controlled trial study was carried out on 80 pregnant women (40 sampleintervention and 40 control) referred to Gonabad Comprehensive Urban Health Service Centers from October to December 2021 who were selected using stratified random sampling. Data collection tools included demographic questionnaire (12 questions) and the valid and reliable questionnaire of the Corona Stress Scale (CSS-18). The questionnaires were filled out through self-administered method svia the Porsline platform in three stages: before, immediately after, and one month after the intervention. The intervention group received five 30-minute education sessions as twice a week based on the latest Ministry of Health maternity and neonatal health guidelines. The control group received educational content in PDF format. Data were analyzed by Wilcoxon, Benferroni, Mann-Whitney, and independent t-tests using SPSS (version 16).

 The mean COVID-19 stress score before the intervention was not statistically significant in the two groups (P= 0.92). After the intervention, the mean stress score of COVID-19 in the intervention group was estimated 48.12 ±12.24, which was significantly lower than the control group (57.02 ± 15.99) (P˂0.001).

Mobile-based education intervention reduces COVID-19 stress in pregnant women. It is suggested that this approach be implemented for the provision of healthcare to pregnant women during the COVID-19 pandemic.

Despite the concerns about using cell phones and internet on women's reproductive health, few studies have considered this issue, with most focusing on animal models. The present study was conducted to examine the effect of using cell phones and internet on miscarriage.

In this case-control study, a sample of 211 cases and 394 controls were selected through stratified random sampling from women referred to urban health centers in Zanjan in 2019. Data on telephone and internet use was collected using a self-administered questionnaire, while health records were collected using a checklist. Women with miscarriage history were chosen randomly as the case and women with a successful pregnancy history as the control.

  Considering the average internet use per hour, and with the effect of other variables remaining constant, the odds of miscarriage increased, and this association was borderline significant (OR=1.07, 95% CI: 0.99, 1.15, P=0.050). Meanwhile, for every hour of cell phone conversations during pregnancy, although the odds of miscarriage increased, but this association was not statistically significant (OR=1.12, 95% CI: 0.86, 1.45, P=0.380). Similarly, turning off cell phones at night decreased the odds of miscarriage, but this association was also not statistically significant (OR=0.97, 95% CI: 0.58, 1.61, P=0.380).

Although the effect of internet use on miscarriage was small and had borderline statistical significance, it appears reasonable to take preventive measures to reduce exposure to low-frequency electromagnetic waves by pregnant women.

Given recent demographic changes, Iran has revised its reproductive health (RH) programs. To respond to the need for monitoring the new programs and policies, this study aimed to identify appropriate indicators for RH and population programs monitoring in the Iranian context.

A mixed-methods approach was applied which was conducted in four phases: identification of goals of RH policies and programs, a scoping review of the RH indicators, developing and ranking the identified indicators, and indicators' finalization. The final indicators were selected through consensus, with a cut-off point of 75%. Data was collected from June 21, 2020, until February 18, 2021. Data analysis was conducted simultaneously during each stage of the study. MAXQDA.11 and MS Excel 2017 software were used in the first and third phases for data analysis.  

A total of 37 RH indicators were finalized after three rounds of screening. The first five indicators with the highest score were: total fertility rate, population under 15 years, total population, population aged 65 years and older, and age-specific fertility rate. The lowest score was related to the recuperation index (degree of recuperation relative to fertility decline at younger ages).

The nature and number of indicators might vary at different organizational levels; so, the need to develop specific indicators is pivotal.

Physiological skin changes in pregnant women can negatively affect both women's self-image and their quality of life. This study aimed to examine the relationship between socio-demographic characteristics, body image, and quality of life with physiological skin changes in pregnant women.

This cross-sectional study was performed on pregnant women who attended the obstetricoutpatient clinic of a training and research hospital in Turkey between April and May 2019. The sample consisted of 350 pregnant women aged 18-45, who were in their second or third trimester, had singleton pregnancy and gave birth to a healthy fetus, and were literate in Turkish. A questionnaire featuring socio-demographic and obstetric characteristics, alongside the Body-Cathexis Scale and SKINDEX-16 for measuring body image and quality of life were used to collect the data.  The data were analyzed with Mann‐Whitney U Test, Chi-square test and spearman correlation.

A significant difference was found between women with and without Stria gravidarum, hirsutism, androgenetic alopecia, and varicose veins according to the subjects’ socio-demographic and obstetric characteristics. There was a significant difference in the body-image of pregnant women according to presence of varicose vein and hirsutism status (P<0,05). The same also applied to their quality of life, according to presence of melasma, linea nigra, stria gravidarum, gingival change, pruritus, and hirsutism (p<0.05). 

The physiological skin changes can affect the body image and quality of life of the pregnant women. Counseling services should be offered to pregnant women think that their life is affected by skin changes during pregnancy.

Obesity is one of the most important health problems for mothers and has been increasing in recent years. It has been showed that cognitive-behavioral counseling is an effective method to increase women’s physical activity. The present study was conducted to determine the effect of cognitive-behavioral counseling on physical activity before pregnancy in women with high BMI.

This randomized control trial was carried out on 60 married women who referred to pre-conception clinic in Gonabad, Iran in 2020. Sampling was done by two-stage cluster random method and subjects were randomly assigned to two groups. The intervention group underwent six two-hour sessions of cognitive-behavioral counseling as three face-to-face and three virtual sessions. The control group only received the routine care. International Physical Activity Questionnaire (IPAQ), Depression Anxiety Stress Scale 21(DASS-21) and Silhouette Figure Rating Scale (SFRS) was used to collect data, which were completed before, immediately, after, and one month following intervention. The data was analyzed using Chi square, Fisher Exact test and T-test.

There was no statisticallysignificant difference in terms of average physical activity score between the intervention and control group before intervention. However, a significant difference was seen between intervention and control group in terms of physical activity immediately after the intervention and one month later (P < 0.001).

Considering that cognitive-behavioral counseling increases physical activity before pregnancy in women with high BMI, it is recommended to provide such  counseling programs for these women in preconception clinics to improve their health before pregnancy.

The usage of the Partograph assists to identify deviations from normal labour progression and supports prompt and effective intervention, which is crucial to help saving the lives of women. This study assessed Partograph utilization and its determinants among health care workers in Dessie town, North East Ethiopia.

A cross-sectional study with an institutional focus was conducted in Dessie Town from December 2016 to March 2017. 267 healthcare workers were selected by systematic random sampling method. Data analysis was performed by SPSS software (version 25.0) using bivariate and multivariate logistic regression.

Despite the fact that 64% of respondents reported that they routinely used a partograph to monitor the progress of labour, actual partograph usage in the study area was quite low (29%) and fell below the WHO standard by one third.  In this study, level of specialization (MSc/specialist) (AOR = 3.52, 95% CI=1.03, 11.98), training on partograph (AOR = 3.63, 95% CI=1.45, 9.09), number of staffs assigned per shift (>2) (AOR=2.12, 95% CI=1.58, 4.11), having good knowledge (AOR = 1.68, 95%CI = 1.21, 3.02) and favourable attitude towards partograph utilization (AOR = 2.00, 95%CI = 1.25, 5.31) were significantly associated with utilization of parthograph at p<0.05.

Compared to WHO recommendation, the actual use of partograph in the research area was extremely low. Health care organizations and other responsible parties should strictly enforce partograph usage for every woman, set up training for all obstetric health care professionals, and assign enough obstetric health care professionals per shift.

childbirth and labor pain is physiological condition due to contraction of the smooth muscle of the uterus. Labor contractions vary from person to person in terms of being painful, and its management is of particular importance. This study was conducted to determine the effect of spiritual counseling on childbirth self-efficacy to cope with labor in primiparous women.

This experimental study was performed in 2019 on 100 healthy pregnant women at 28-30 weeks of pregnancy in Urmia, Iran. Sample were selected by convenient sampling from two selected hospitals. Demographic questionnaire, Spiritual Well-Being Scale and Childbirth Self-Efficacy inventory were used to collect data. For the intervention group, six spiritual counseling sessions were held weekly and each session lasted 45-60 minutes. Pregnant women in the control group received only usual pregnancy care. The questionnaire was completed after the last counseling session and 12-24 hours after delivery. The data was analyzed using SPSS18 through Chi-square, Independent t-test, Anova repeated measures and Bon Ferroni tests. 

The results showed a statistically significant difference between the mean scores of self-efficacy to cope with labor, after the intervention and 12-24 hours later in the intervention group compared to the control group (P <0.001). 

Based on the results of this study, spiritual counseling can increase childbirth self-efficacy to cope with labor. Thus, using this method as a non-pharmacological and safe method is recommended during childbirth.

Some studies have called into question medical students' competency in neonatal resuscitation. Therefore applying standard training methods has been recommended. This study compared the effect of Structured Clinical Instruction Module (SCIM) and video-assisted Instructor -led training (ILT) in accelerating and retention of students’ knowledge and skill in neonatal resuscitation.

In this experimental study 48 nursing and midwifery students of Mashhad University of Medical Sciences, Mashhad Iran, who did not attended in any related education, were allocated in SCIM, VT and control group through stratified randomization. In SCIM group, after lecture, six groups of students rotated through six stations, trained and practiced under supervision of six instructors.  In VT group after lecture an instructional video presented then students repeated the video and discussed its content with each other and instructor. Before, after and one month following workshops all students participated in an OSCE to assess their cognitive, technical and behavioral skills. Paired t-test and One-way ANOVA were used for data analysis.

In post-test, both groups of SCIM and VT had better performance than control group (p<.001, p<.001, respectively). But SCIM group demonstrated a marked improvement compared with VT group (202.97±16.6 vs 173.6±15.3 (P<0.001). There was a significant difference between students’ comfort and confidence in both SCIM and VT groups (P<0/001). In retention test total score between three groups showed significant difference (P<0.001); whilst the SCIM group had significantly better performance (P<0.001).

SCIM is an effective method in acquisition and retention of neonatal resuscitation skill. So its application is recommended in the neonatal resuscitation training.

Breast cancer is the most common cancer among women. Self-efficacy and fear are effective factors in using mammography in women. Considering the high rate of breast cancer and the low number of women referring to mammography, the present study was performed to determine the relationship between self-efficacy in using mammography and fear of breast cancer. This cross-sectional study was conducted on 86 women over the age of 40 years referring to three comprehensive health centers in Khalkhal, Northwest of Iran between December 2020 and May 2021. Data collection tools were a demographic questionnaire, Sherer’s General Self-Efficacy Scale and Champion’s Fear of Breast Cancer Scale. Data were analyzed by SPSS (version 20) and Pearson correlation coefficient. The mean age of the participants was 47.47±6.77 years. The mean score of self-efficacy was 59.71±6.03 (46-71) and the mean score of fear of breast cancer was 24.34±7.11 (8-40). There was a significant relationship between self-efficacy and fear score (p<0.001). Self-efficacy is recognized as an influential factor in the regular implementation of breast cancer screening behaviors.

A vaginal septum is a condition in which the wall of the tissue dividing vagina does not resolve completely. This complication can be transverse and longitudinal. Although the occurrence of a transverse vaginal septum is 2 per 100,000 births, the exact etiology of this anomaly remains still unidentified. In this study, a case of high transverse vaginal septum with vaginal and cervical agenesis is reported.

Case report: 

A 13-year-old single and virgin girl presented with cyclic abdominal pain. On examination and magnetic resonance imaging, vaginal and cervical agenesis was diagnosed. Surgical therapy included an incision in the lower part of the uterus at the site of the bulging and the use of a hysterometer passing down the uterus. The cervix was not touched, cervical agenesis was diagnosed, and the patient underwent abdominal hysterectomy and bilateral tubal salpingectomy. The pathological results confirmed the cervical agenesis.

It is recommended that in patients with high transverse vaginal septum, hysterectomy be performed for the treatment of cervical and vaginal agenesis. However, it may not be a suitable treatment choice for some cases, and it is better to decide based on the patient's condition.