Journal of Midwifery & Reproductive health
Volume:11 Issue: 4, Oct 2023

Infertile couples face different marital issues in their relationships. Emotion-focused counseling has been proposed as one of the approaches in the counseling process of infertile couples in several studies in Iran. Since effective counseling approaches with the greatest impact could help therapists to adopt the best counseling method. This systematic review was conducted to determine the effect of emotion-focused counseling on the marital issues of infertile couples.

This systematic review was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). English and Persian databases including Pubmed, Scopus, Web of Science, Cochrane Library, Embase, Proquest, Magiran, SID, and Irandoc were searched by two independent researchers using the keywords of "infertility," "barrenness," "childlessness," "sterility," "emotion-oriented couple therapy" and "emotion-focused counselling" and their combinations using Boolean operators without time limit until Feb. 2023. Inclusion criteria were experimental studies that investigated the effect of emotion-focused counseling on the marital issues of Iranian infertile couples. The Cochrane risk of bias tool were used for assessing quality of articles.

Out of 88 articles, six articles with a sample size of 586 people were included in the systematic review. The findings revealed a significant increase in marital compatibility and commitment and a significant decrease in marital boredom and conflicts in the group receiving emotionally focused counseling. No significant effect was observed in marital satisfaction.                   

Emotionally focused couple therapy is one of the effective counseling methods that can be used to improve the marital issues of infertile couples.

Many illegal and underground centers lacking minimal medical standards are operating in addition to the women who personally decide to terminate their pregnancy with unsafe means, which can lead to maternal mortality and morbidity. The socio-economic effects of abortion can bring enormous costs to the healthcare system. Therefore, this study was conducted to review the effects of unsafe abortion on the health system from a socio-economic perspective.

In this narrative review, English databases including Pubmed, Scopus, SID, Web of Sciences, and Google Scholar, as well as Persian databases of Magiran and SID, were examined. To obtain all the desired Persian and English articles, the English keywords, Including pregnancy, unintended pregnancy, abortion, illegal abortion, intentional abortion, economic consequences, social consequences, costs, social and economic consequences, reproductive health indicators, and their Persian equivalents, were used in the period between 1990  and 2022. Thirteen related articles were reviewed

The findings extracted from the reviewed studies were in three areas unsafe abortion and population; unsafe abortion and health; and unsafe abortion and reproductive health from a socio-economic point of view.

From a socio-economic perspective, unsafe abortion can affect fertility indicators in the health system and cause a decrease in women’s quality of life and labor force productivity.

Cervical ectropion refers to a condition in which the cylindrical epithelium of the endocervix extends towards the ectocervix. The present study was conducted to compare clinical improvement, disease recurrence, and patient satisfaction following treatment with vaginal effervescent tablets of tranexamic acid and cryotherapy in patients with symptomatic cervical ectropions.

This randomized clinical trial was conducted on 92 women with symptomatic cervical ectropions from March 2021 until September 2022 at Ayatollah Mousavi Hospital in Zanjan. Sampling was done at first step by convenience sampling, and then randomly assigning the sample to two groups: an intervention group receiving 400 mg of vaginal effervescent tranexamic acid tablets for 10 days and a comparison group with cryotherapy. At the end of the third month of the intervention, the rate of clinical improvement, disease recurrence, and patient satisfaction were evaluated in both groups. Data analysis was performed by SPSS software (version 22) using Chi-square and Fisher's exact tests.

 At the end of the intervention, 97.72% and 93.18% of the participants reported improvement in clinical symptoms following tranexamic acid and cryotherapy, respectively. There was no statistically significant difference between the two groups in terms of clinical improvement (P = 0.31), disease recurrence (P = 0.64), and patient satisfaction (P = 0.57).

Considering the similar effectiveness of tranexamic acid and cryotherapy in improving the clinical symptoms of patients, this method can be a suitable alternative to cryotherapy.

Ethiopia plans to immunize 20% of its population by the end of 2021. However, there is little data available on the vaccine's current uptake in our nation.  This study aimed to assess the uptake of COVID-19 vaccination and its contributors among reproductive-aged women in Dessie Town, Northeast Ethiopia, in 2022.

A community-based cross-sectional study was conducted in Dessie town, northeast Ethiopia, on February 2022. A multiple-stage stratified sampling method was employed to select 636 reproductive-aged women. A pretested researcher-made, semi structured questionnaire was administered by an interviewer to collect the data.  Data were entered into the Epi-data version 4.4.2.1 program and exported to the software SPSS version 25 for additional analysis. Bivariable logistic regression was performed to ascertain the association between each independent variable. 

From 636 surveyed reproductive-aged women, 114 (18.1% (95% CI, 15.3%, 21.3%)) uptake the COVID-19 vaccination. Factors such as urban residency (AOR=3.24, 95% CI 1.74, 6.03), primary educational level (AOR=3.66, 95% CI 1.64, 1.71), having children (AOR=2.16, 95% CI 1.32, 3.55), confirmed medical problems (AOR=4.94, 95% CI 2.45, 9.97), favourable attitude (AOR=4.01, 95% CI 2.38, 6.77), and practice of prevention strategies (AOR=3.36, 95% CI 1.91, 5.91) were contributed to the use of the COVID-19 vaccine.

The magnitude of uptake of COVID-19 vaccination is still low. Therefore, addressing the information regarding the vaccine to all women will be important.

Pregnant women experience some levels of stress during pregnancy. COVID-19 was able also increase their stress. This study performed to evaluate the efficacy of supportive counseling on stress caused by COVID-19 in pregnant women.

This clinical trial performed on 97 pregnant women 49 in the intervention and 48 in the control group) referred to comprehensive healthcare centers of Gorgan, Iran in 2021. Data collection tools included an electronic questionnaire containing demographic, fertility-related data, and questions related to the COVID-19 pandemic as well as the coronavirus stress scale. The intervention group received three supportive counseling sessions by 60-90 minutes weekly. The control group received only routine pregnancy care. Data were analyzed by independent t-test, Chi-square test, and Fisher's exact tests using SPSS (version 24).

The results showed that before the intervention, there was no significant difference in the mean score of stress in the intervention group (48.28 ± 5.976) and the control group (47.08 ± 5.158) (P=0.258). However, four weeks after the intervention, the mean score of stress in the intervention group (41.77±5.296) had a significant decrease compared to the control group (46.29±5.220) (P˂0.001).

The level of stress during the COVID-19 pandemic is high and providing supportive counseling can reduce pregnancy-specific stress and increase healthy behaviors. Supportive counseling can be used as an effective way to reduce the adverse consequences of stress during pregnancy.

  Infertility has serious implications on psychological and social well-being as well as the sexual life. Considering that sexual health is an essential element of human health, the present study was performed to explore the experiences of Iranian infertile women regarding their sexual health.

 This qualitative study was conducted using conventional content analysis (Lundman and Graneheim's approach) in Tehran, Iran from November to March 2018. Twenty infertile women (aged 25-42 years old with various reasons for infertility), who were selected purposefully, participated in this study. The data were collected through in-depth semi-structured interviews All interviews were tape-recorded and transcribed verbatim. Guba and Lincoln's criteria including credibility, transferability, confirmability, and dependability were applied to achieve trustworthiness.

 Three themes emerged from the data analysis including 1) Impact of the process of diagnosis and treatment on women’s sexuality 2) Psychological, behavioral, interpersonal and economic factors influencing sexual health, and 3) cultural and religious norms affecting sexual life.

 Infertile women's sexual health is influenced by the process of diagnosis and treatment; psychological reactions to infertility, economic, personal, and cultural-belief system.

Amniocentesis is the most common invasive method used for diagnosis of genetic disorders. Studies showed that women with insufficient information about amniocentesis have high level of anxiety. The present study was performed to evaluate the impact of education on perceived stress of women referring for amniocentesis.

This quasi-experimental study was conducted on 62 pregnant women referring to Alzahra hospital, Tabriz, Iran for amniocentesis from March 2019 to January 2020. Using block randomization, the subjects were assigned to two groups of 31 women for each group. The intervention group received an oral and face-to-face individual training session. Perceived Stress Scale and Spielberger State-Trait Anxiety Inventory were completed before and 2 to 3 weeks after amniocentesis (before receiving results). ANCOVA and repeated measures ANOVA were used for data analysis.

The mean score of perceived stress before, after the intervention and 2 to 3 weeks after amniocentesis was 25.25±7.49, 23.87±7.40 and 24.45±7.09, respectively. The mean score of state anxiety were 43.84±10.03, 42.35±11.13 and 41.67±11.24, and trait anxiety were 42.53±10.56, 39.19±9.35 and 41.29±10.40, respectively. After the intervention, with adjusting the baseline scores, significant difference was found between two groups regarding stress (P=0.020), state anxiety (P=0.029) and trait anxiety (P=0.002), but 2 to 3 weeks after amniocentesis, no difference was observed in terms of perceived stress (P =0.198), state anxiety (P =0.394) and trait anxiety (P =0.516).

Positive short-term effect of education was seen on perceived stress and anxiety of women referring for amniocentesis. It is recommended to perform more trials to assess its long-term effects.

WHO proposed using the Robson Ten Group Classification System (TGCS) for assessing, monitoring, and comparing cesarean section (CS) rates. This study aimed to identify which group of women have more complications after CS based on TGCS in Shiraz maternity teaching hospitals.

This cross-sectional study included a sample of 1787 pregnant women who underwent cesarean section. From September to November 2018, convenience sampling was carried out at selected maternity teaching hospitals affiliated with Shiraz University of Medical Sciences, Shiraz, Iran. Demographic, obstetric, and fertility-related data were collected through personal interviews and a review of CS records. This study employed the TGCS to classify the women based on their obstetric data. Descriptive statistical analysis was done using SPSS software (version 23).

 Out of the 1787 patients, 455 (25.5%) had planned and 1332 (74.5%) had emergency CS. Complications of CSs included three causes: surgical, maternal, and neonatal. Surgical complications were the most prevalent in groups 5, 10, and 8; maternal complications were the most prevalent in groups 5, 2, and 10; and neonatal complications were the most prevalent in groups 5, 2, and 10. The most common CS complications were breastfeeding disorders (56.1%) and bladder adhesions to the uterus (27.5%). In total, 563 (25%) patients had surgical complications, 1077 (49.6%) had maternal complications, and 531 (24.4%) had neonatal complications.

Most complications occurred in cases where the women had a previous history of CS (group 5). It seems essential to develop more efficient strategies to prevent unnecessary CSs.

 Quality of work life and job satisfaction are two important components in creating a developed and capable workforce in all health care systems. The midwifery profession needs special attention due to its feminine nature and having many job stresses. The aim of this study was to compare the quality of work life and job satisfaction of midwives working in related and non-related workplaces to midwifery in Iran.

 The current study was a cross-sectional study using census sampling method, which was performed on 106 midwives (53 working in related and 53 working in unrelated workplaces) in all hospitals of Yazd, Iran in 2021. Data collection tools included demographic Questionnaire (including personal and midwifery characteristics), Walton Work Life Quality and Job Satisfaction Questionnaire. Independent t-test, Mann-Whitney test, correlation coefficient, regression analysis and Chi-square were used to analyze the data.

 According to the results, the mean total score of quality of work life in midwives working in related workplaces (80.03±12.62) was higher than the mean of overall scores of quality of working life in midwives working in unrelated workplaces (76.94±9.11). However, this difference was not statistically significant except in two dimensions of integration and social cohesion (P=0.027) as well as development of human capabilities (P=0.002). There was no significant difference in job satisfaction of two groups (P=0.242).

 The results showed that quality of work life in midwives working in related departments are higher than midwives working in unrelated workplaces. Therefore, it is recommended to use midwives as much as possible in positions and workplaces related to their field of study.

Lumbopelvic pain (LPP) in pregnancy is prevalent. Although poor body mechanics (BM) and lack of posture awareness contribute to LPP, prenatal care services do not address these issues. The purpose of this study was to evaluate the association of BM awareness and practice with LPP among pregnant women.

In this cross-sectional researchو 110 pregnant women with LPP were enrolled between October 2020 and October 2021 using a convenient sampling technique. The study setting was antenatal care units within Public Primary Health Center in Sulaymaniyah, Iraq. For data collection a structured questionnaire comprised of three parts of sociodemographic data, pain Numeric Rating Scale, and 44 images created by the researchers were used to assess both knowledge and practice related to BM via face-to-face interview. The collected data were analyzed in SPSS (version 27).

Over half of the participants (53.6%) demonstrated an awareness of the BM to carry out their everyday tasks, appropriately. However, 55.5% reported that they were engaging in routine tasks improperly. The degree of BM knowledge (P=0.024), and the level of practice (P=0.038) were substantially correlated with lumbopelvic pain. Participants with significant discomfort and improper BM practices showed a higher odds ratio (OR=5.105). The odds ratio (OR=4.581) was greater in patients with extremely acute pain and inadequate BM knowledge.

It is less common for pregnant women to have low back discomfort when there is greater awareness of proper BM and posture during prenatal care sessions.

Like becoming a mother, becoming a father is a new and important role that entails several responsibilities and expectations for men. This study aimed to investigate the relationship between psychological status and perceived social support in men during their wives’ pregnancy.

This cross-sectional study investigated 372 Iranian men in the third trimester of their wives' pregnancy using multistage cluster sampling from May 2014 to February 2015 in Tabriz, Iran. The self-administered questionnaires used included demographic questionnaire, Personal Resource Questionnaire (PRQ-85-part2), and short form of depression, anxiety, and stress (DASS-21). The statistical tests including Spearman correlation, Mann-Whitney, Kruskal Wallis and linear regression model were used for data through SPSS v. 21.

 Perceived social support was negatively correlated with anxiety (r=-0.390, P<0.001), depression (r= -0.277, P<0.001), and stress in men (r= -0.290, P<0.001). Based on the results of multiple linear regression, the father's education, mother's occupation, income, and fetus gender by ultrasound were significantly related to the anxiety of fathers. Moreover, mother's age was significantly correlated with men's depression.

Based on the results, social support affects the psychological status of men in the third trimester of pregnancy of their wives and the levels of anxiety, depression and stress decrease in men with increasing of social support.  Healthcare providers should pay more attention to the increasing public awareness, stress management and communication skills training, and support of men during their wife’s pregnancy.