Journal of Midwifery & Reproductive health
Volume:9 Issue: 3, Jul 2021

Reproductive health is one of the most essential steps in achieving sustainable development, which generally changes in crises. Restrictions such as home quarantine and social restrictions due to Covid-19 pandemic have reduced women's access to the services that is effective on their reproductive health. In this study, the effect of Covid-19 pandemic on women's reproductive health issues was reviewed.

In this narrative review, searches were performed in databases such as PubMed, Google Scholar, Science Direct, Cochran library, and Farsi database of Magiran in 2019-2020 using the keywords including Covid-19, reproductive health, sexual satisfaction, mental health, domestic violence, childbearing, pregnancy, fertility, partner violence, maternal health, and family planning.

Covid-19 pandemic has different effects on reproductive health issues. Studies have shown an increase in the frequency of sexual intercourse due to increased presence of the spouse at home, but also there was a decrease in the quality of sexual intercourse due to the stress caused by the Covid-19 pandemic. Also regarding women's mental health, an increase was observed in domestic violence as well as stress, anxiety and depression in women of reproductive age.

In the pandemic high-risk situation, it is necessary that health care teams to focus more on women's reproductive issues and screen them in terms of mental health, domestic violence, sexual relationships, use of contraceptive methods and intending for childbearing. Providing virtual group educations and use of national media, could enhance the awareness of women of reproductive age.

 Maternal near-miss (MNM) is a condition of maternal mortality in which women survive accidentally or by best hospital care. This is useful to examine the excellence of obstetric care. The study aimed to assess MNM and its associated factors in governmental health centers in Northern Oromia, Ethiopia, from September 11 in 2014 to March 30, 2018.

 This retrospective record review was conducted in governmental health centers in Sandafa town, from April 10 to May 5, 2018 by reviewing the medical records of 1,667 treated mothers. The study participants were selected through simple random sampling. The data were collected using standard tools by trained data collectors. The data entered into EpiData version 3.1 and analyzed by SPSS version 20. Multiple logistic regressions were used to identify the associations between independent and outcome variables. The variables with P < 0.25 during bivariate analysis were included in the multivariable logistic regression model. Finally, the variables with P ≤ 0.05 were considered the determinants of MNM.

 In this study, there were 344 (20.6%) MNM cases. The place of residence (AOR=1.4; 95% CI: 1.03-1.81; P=0.031), duration of labor (AOR=6.5; 95% CI: 4.5-9.5; P=0.001), and antenatal care (ANC) visits (AOR=6.53 [4.5, 9.5]; P=0.001) were the factors significantly associated with MNM.

 The study revealed that the frequency of MNM was high in the study area. The place of residence, duration of labor, and ANC visits were significantly associated with MNM.

The prevalence rate of exclusive breastfeeding (EBF) is continued to be reported low in spite of all the benefits and numerous advantages of EBF. Hence, the aim of the study was to compare the prevalence of EBF and its associated factors among primiparaous and multiparaous women in an urban slum, Agartala, West Tripura, Northeast India.

A community based cross sectional study was conducted in an urban slum among 200 subjects (100 primipara and 100 multipara mothers), who were selected by simple random sampling technique. Data was collected by interviewing the subjects using a predesigned, pretested, structured interview schedule. Statistical analysis was done using Chi-Square test, Fisher’s exact test and Independent t-test.

The prevalence rate of EBF among primiparous and multiparous mothers were 53% and 68%, respectively [OR= 1.88 (1.060, 3.349)]. Those primiparaous mothers who went for antenatal check-up (ANC) minimum four times or more during pregnancy had 2.71 odds (1.009, 7.297) and who delivered at the health care facility had 2.43 odds (0.828, 7.168) of practice more EBF compared to those who had ANC less than 4 times and delivered at home. However, among multiparaous mothers, Muslims mothers had 2.33 odds (0.962, 5.659) of practice more EBF than Hindus.

The findings suggests that to improve the EBF rate among those who are not practicing EBF till six months of age, a special attention is needed to focus. Hence, community based awareness programme should be conducted frequently in the study area to promote EBF.

Due to the importance of psychological health of infertile women, this study aimed to determine the effectiveness of the psychological empowerment (PE) and dialectical behavior therapy (DBT) on infertile women's anxiety and sexual satisfaction during pretreatment phase of in vitro fertilization (IVF).

This clinical trial was conducted in February and March 2020 on 45 infertile women seeking IVF treatment, who referried to Isfahan infertility center. The participants were randomly assigned to three groups (two experimental groups and a control group, each with 15 participants). The experimental groups received psychological empowerment package (11 sessions) and dialectical behavior therapy (8 sessions) and the control group did not receive any intervention. The Depression, Anxiety, and Stress Scale and Sexual Satisfaction Scale-Women, whose reliability and validity were confirmed on Iranian sample were completed in pretest, posttest, and follow-up phases in the three groups. The data were analyzed using the repeated measures ANOVA in SPSS-24 software.

The results showed that PE had a significant effect on reducing anxiety and increasing sexual satisfaction (P <0.001). Also, a significant effect of DBT was seen on reducing anxiety (P <0.05).  However, it had no effect on increasing sexual satisfaction (p> 0.05). The difference between the mean scores showed that PE was more effective than DBT in reducing anxiety and increasing sexual satisfaction.

Using PE improves infertile women's mental health by reducing anxiety and increasing sexual satisfaction so that it is expected to could positively affect the outcome of IVF.

Every day, at least 830 women die around the world as a result of complications related to pregnancy and childbirth, with the majority of the deaths occurring in the developing countries. Traditional practices throughout pregnancy and childbirth are one of the causative reasons for this maternal death. This study aimed to assess traditional practices that affect maternal health and its associated factors among women of childbearing age.

A facility-based cross-sectional study design was conducted on 308 participants using systematic sampling method. The study was done from 17 May to 17 June 2018, at Aysaita primary hospital, Afar region, Northeast Ethiopia. The data was collected by a structured interviewer-administered questionnaire. Data were entered into SPSS version 20 for analysis. X2 test with a p-value of less than 0.05 was used to declare the significance of the association with the independent and outcome variable.

The study findings showed that 101 women (32.8%) practiced nutritional taboo during pregnancy. Also, 53(17.2%) and 56(18.2%) women practiced abdominal massage during pregnancy and delivery, respectively. Among included study participants, 54(17.5%) washed their babies immediately after birth. There was an association between educational status (p=0.041) and parity (p=0.003) with nutritional taboo. Additionally, an association was seen between parity (p=<0.001) and education (p=<0.001) with abdominal massage and home delivery.

Traditional practices in the study area were relatively high. Therefore, health education of the mother and promoting formal female education are crucial to the reduction or avoidance of these cultural malpractices.

The global prevalence of Gestational Diabetes Mellitus (GDM) is increasing with an alarming rate. It commonly manifests during the third trimester of pregnancy and may lead to multiple maternal complications. Neonates of women with GDM are more likely to suffer from metabolic problems later. Considering the importance of GDM, this study was performed with aim to determine the prevalence and risk factors of GDM in Yazd province.

This cross-sectional study was carried out on 3202 pregnant women in Yazd province from March 2008 to March 2011. The Glucose Challenge Test and Oral Glucose Tolerance Test were used to diagnose GDM. The interpretation was based on Coustan-Carpenter criteria. Sampling was done in a full-census manner. Statistical analysis was performed using SPSS software (version 19). Logistic Regression was used to calculate the Odds Ratio at 95% Confidence Interval to estimate the independent association of different risk factors with GDM.

The overall prevalence of GDM in this study was 3.3%. The mean age of participants was 27.7±5.7 years. Identified risk factors were age (OR: 1.1, p <0·001), BMI (OR: 1.1, p <0·001), history of abnormality in neonates (OR: 2.84, P=0·036), macrosomia (OR: 3.19, P=0·004), and diabetes in the family (OR: 2.9, p <0·001).

Among the risk factors identified for GDM, BMI is the only modifiable factor, which can implicate the development of gestational diabetes mellitus. Public management of weight, and avoiding a sedentary lifestyle can reduce the risk of GDM. It is also suggested that it is better to plan for pregnancy at younger ages.

Pregnancy is considered a critical period in marital life and any changes can lead to marital burnout in pregnant women. Therefore, this study was conducted to investigate the predictors of marital burnout in pregnant women in Gonabad, based on social cognitive theory components.

This descriptive-analytical study was performed on 261 pregnant women in Gonabad, Razavi Khorasan Province, Iran. The required data were collected using questionnaires, namely a demographic information form, the Couple Burnout Measure, and a lf-structured questionnaire based on social cognitive theory. The data were analyzed in SPSS software (version 25) using Spearman's coefficient, Kruskal-Wallis, Mann-Whitney U test, and linear regression.

The mean age of pregnant mothers was obtained at 28.69±5.47 and they were at 23.67±9.91 weeks of pregnancy. It was revealed that all components of social cognitive theory, except outcome expectation, were significantly associated with marital burnout. This model was able to predict 15% of marital burnout in pregnant women. It was also found that the components of skills (P=0.006), understanding of the situation (P=0.041), self-efficacy of overcoming obstacles (P=0.128), and self-efficacy (P=0.153) were the strongest predictors of marital burnout in descending order.

In this study, the components of skills and understanding of the situation were found to be the most important predictors of marital burnout in pregnant mothers. It is suggested to use this theory, and especially focus more on these variables, in designing educational programs to reduce problems caused by marital burnout in pregnant women.

Domestic violence is a major public health concern that could cause long-term physical and mental health problems for women. Evidence indicates that addiction is among important issues resulting in violence against women. This study was performed to investigate the relationship between domestic violence andspousal addiction with experiences of menopausal women.

This cross-sectional study was performed on 250 menopausal women aged 45-65 years who referred to Mashhad health centers, Mashhad, Iran in 2017. The subjects were selected using multistage sampling. Data collection tools included the Menopausal Experiences Questionnaire and the Spouse Unhealthy Behavior Questionnaire (Violence, Addiction). Data were analyzed using Pearson’s correlation coefficient by SPSS Version 16.

The mean age of participants was 55.05± 5.72 years. The mean score of violence and addictive behaviors was 73.3% and 26.7%, respectively. Total score of menopausal experiences was 33.5 ± 18.11%. There was a significant direct relationship between the dimensions of violence and mental, physical, emotional as well as total score of menopausal experiences (p= 0.04, r= 0.139; p= 0.009, r = 0.177; p= 0.002, r= 0.211; p= 0.03, r= 0.147, respectively). Also, a significant direct relationship was seen between the sexual dimensions of violence and experiences of menopausal women (p = 0.002, r = 0.22).[l1] 

Considering the relationships between husband's violence and physical, mental and emotional experiences of menopausal women, it is recommended to provide appropriate counseling and training programs for spouses to decrease violence and negative experiences of menopausal women.

 Spouses’ participation in childbirth preparation classes seems to be effective in the promotion of pregnant women's mental health. Considering the barriers to spouses' participation in these classes, this study aimed to determine the effect of teaching an educational package to spouses using two methods of in-person and distance education in childbirth preparation classes on pregnant women's mental health.

 This quasi-experimental study was conducted on 102 pregnant women and their husbands in health centers of Mashhad, Iran, in 2019. The subjects were randomly assigned to three groups of in-person education (n=35), distance education (n=33), and control (n=34).In the in-person education group, spouses attended in the third and eighth sessions. In the distance education group, an educational package was delivered to spouses, followed by follow-up calls within three weeks to resolve possible ambiguities. In the control group, the spouses did not receive any training. Pregnant women's mental health was assessed by the General Health Questionnaire-28 before, immediately after, and three weeks after the intervention.

 The mean scores of mental health in the three groups did not differ before the intervention (P<0.05).In the distance education group, the mean scores of mental health decreased by 16.1 and 20.1 after the intervention and in the follow-up stage, compared to the control group (P<0.001). In the in-person education group, there were no significant changes in the scores in any stages of pre-intervention, post-intervention, and follow-up, compared to the control group (P<0.05).

 Distance education of spouses in childbirth preparation classes was more effective in the promotion of pregnant women's mental health, compared to in-person education.

 Considering importance of developing maternal care, the present study was designed to compare the implications of a midwifery-led care (MLC) and standard model on maternal and neonatal outcomes during pregnancy, childbirth and postpartum.

 This clinical trial performed through quasi- experimental method on 200 pregnant women referred to health centers of Kashan, Iran, between 2014 and 2017. Participants were randomly assigned to MLC and standard model of care group (each 100). Data on maternal and neonatal outcomes were collected using self-structured questionnaires and checklists. The validity and reliability of tools were evaluated through content validity and also test-retest and observer reliability. The collected data were analyzed using SPSS version 21 by T test, chi-square and Mann-Whitney.

 The implementation of MLC resulted in improved outcomes including decrease in cesarean section, increase in spontaneous delivery, increase in physiological delivery, increased participation in preparatory classes for labor, decrease in induction, decrease in hospital stay, decrease in the number of prenatal visits, decrease in ultrasound, and increase in mean gestational age at admission (p <0.05). The results also pointed to increased lactation and decreased hospitalization due to jaundice (p < 0.05). There was no statistically significant difference in terms of anesthesia, narcotic use, postpartum hemorrhage, curettage, episiotomy, postpartum infection and postpartum depression. No maternal mortality was observed in two groups.

 Midwifery-led care can lead to improved maternal and neonatal outcomes at least in low-risk pregnant women. More chance of physiological delivery, spontaneous labor and less cesarean section, induction and augmentation were significant.

Maternal-fetal attachment is one of the several psychological processes during pregnancy that builds the relationship between a mother and her unborn child. It seems that Prenatal Gentle Yoga (PGY) promotes wellbeing during pregnancy. However, no study has evaluated the effect of PGY on maternal-fetal attachment in Indonesia. This study aimed to measure the effect of PGY on maternal-fetal attachment among first-time expectant mothers.

This interventional study, was conducted from July-August 2018 in Central Java Province, Indonesia, compared maternal-fetal attachment among 130 primigravidae women who did (n=65) and did not (n=65) practice PGY. Participants were 20 to 35 years old, between 32 and 42 weeks of gestation, with normal singleton pregnancies and no obstetric complications as well as no history of psychological disorders which recruited with convenience sampling. The intervention group participated in eight or more hours of PGY classes (a minimum of six, 90-minute, once-weekly sessions). The control group did not do yoga. Women completed a demographic questionnaire and the Prenatal Attachment Inventory, analyzed with SPSS 20.0. Independent samples t-test and hierarchical multiple linear regression were used to analyze the data.

Prenatal Gentle Yoga increased maternal-fetal attachment scores among participants who attended eight or more hours of classes compared to those who did not (P=0.001). Educational level and participation in yoga classes were the strongest predictors of maternal-fetal attachment (R2=.142).

Practicing PGY can increase maternal-fetal attachment. Midwives could recommend PGY to pregnant women in the routine antenatal care in Indonesia and around the world.

Cervical cancer is one of the leading causes of cancer death among females. Human papillomavirus (HPV) is the most important risk factor for cervical cancer. The aim of the present study was to explore the prevalence of high-risk human papillomavirus types 16 and 18 in women who undergo HPV test.

In this descriptive epidemiological study, which was conducted in Mehr Medical Institute, Rasht, Iran from 2019 to 2020, two cervical samples were obtained from each of 301 patients for cytological and real-time PCR evaluation. Genotyping the samples was carried out using the Real-Time PCR technique. Different genotypes were divided into the following groups: 16 and 18 genotypes, other high risk genotypes, possibly low risk and high risk genotypes.

The prevalence of HPV types in the study participants with a mean age of 33.4± 6.5 (18-61) years were 36.5% (n=110). HPV16 and 18 were detected in 28 (25.7%) and 7 patients (6.4%), respectively. Histopathological findings among HPV positive and negative participants were similar. HPV distribution according to women´s age was: group 1 (20-24.9 years, 47%), group 2 (25-29.9 years, 42.6%), group 3 (30-34.9 years, 40.4%), group 4 (35-39.9 years, 27.6%) and group 5 (40≤ years, 28.3%).

The general percentage of HPV positive patients in the local area can be compared to the previous literature. The study includes updates on the prevalence and type of HPV distribution between women of Guilan province in Iran.

An investigation of the attitudes towards menopause is considered to help to understand the menopausal period better in order to plan more comprehensive health promotion approaches.  This study aimed to investigate the relationship between the attitudes towards menopause and sexual functions among women in the climacteric period.

This cross-sectional study was conducted between the 1st May 2019 and the 1st January 2020 in Turkey. The study was completed with 153 women in climadteric period, who were selected using the simple random sampling method. Data were collected through the socio-demographic questionnaire, the Attitude towards Menopause Questionnaire (ATMQ), and the Female Sexual Function Index (FSFI). Data analysis was done using descriptive statistics, independent t-test, and Pearson correlation test.

Themean scores of ATMQ and FSFI were found 34.39±12.30 and 20.05±9.18, respectively. The ATMQ indicated positive, and significant relationship with all FSFI sub-scales and total scores (p <0.05).A significant difference was found between the FSFI scores and age, age at first marriage, presence of a chronic disease, duration of the marriage, number of births, number of pregnancies, and the features of the menopausal period (p <0.05); however, these variables did not indicate significant relationships with the ATMQ scores (p>0.05).

The results showed that two-thirds of the participating women had negative attitudes towards menopause, and increased negative attitudes of women affected their sexual functions, negatively. It is recommended to design health promotion programs and counseling services to promote positive attitude towards menopause in women in the climacteric period.

Pregnancy is a critical period in the women's life which causes great changes in their feelings, sexual desire, satisfaction and sexual compatibility and the number of sexual intercourses. This study was carried out to determine the effect of counseling based on the PLISSIT model on marital satisfaction of women during pregnancy.

This was an interventional study and conducted on 128 pregnant women with gestational age of 13 to 33 weeks, who were randomly assigned to the experimental and control groups. The experimental group received sexual counselling based on the PLISSIT model and control group received routine care. The marital satisfaction score was measured 2 and 4 weeks after the intervention. The results were analyzed using descriptive statistics, independent t-test and paired t-test.

Comparing the mean score of marital satisfaction among pregnant women in the two groups showed no statistically significant difference between groups before intervention (P=0.524). However, the mean score of marital satisfaction in the second and fourth weeks after intervention was higher in the intervention than control group (p <0.001). Also, the results of paired t-test showed that the mean score of marital satisfactionin the intervention group was significantly increased after intervention (p <0.05), whereas in the control group, no significant difference in the marital satisfaction score was seen over time.

Sexual counseling based on PLISSIT model can improve marital satisfaction in pregnant women. It is, therefore, recommended to incorporate sexual counseling in the prenatal care of pregnant wome, particularly those with sexual dissatisfaction.

 As the level of understanding about the factors affecting the choice of profession increases, individuals will receive better advice about choosing a profession, and the number of individuals satisfied with their profession will increase. This research was carried out to explore the factors that affect the choice of midwifery as a profession during the COVID-19 pandemic.

 This study, which featured a qualitative content analysis, was conducted using a conventional approach. The research was carried out between 10 March 2021 and 21 April 2021 through socially-distanced face-to face interviews with 17 first-year students in the Department of Midwifery of a Health School in a district in the Mediterranean Region of Turkey. A student information form and semi-structured interview schedule were used as the data collection tools. Students were interviewed until the data saturation was achieved. The qualitative data of study was analyzed using conventional content analysis.

 Five themes emerged from the analysis of the interviews: “interest in midwifery as a profession”, “the future of midwifery”, “the public image of midwifery”, “choosing midwifery as a profession” and “anxiety for selecting midwifery as a profession”.

 The midwifery students were interested in the profession despite the COVID-19 pandemic, and the outlook for midwifery was good. The students articulated both the positive and negative public images of midwifery, and it was found that the anxiety they experienced during the pandemic played an important role in their choice of the profession.

Beckwith Wiedemann Syndrome (BWS) is an infrequent inborn malformation that presents with exomphalos, macroglossia and gigantism. In addition, some children with BWS have other features including nevus flammeus, prominent occiput, midface hypoplasia, hemihypertrophy, genitourinary anomalies, heart anomalies, musculoskeletal aberrations, and auditory loss. In this case report a newborn with BWS presenting with macroglossia is reported.

Case report:

 A 26 years old gravida 3 para 2 married women admitted at hospital when she was in labour at 38 weeks’ gestational age (GA). During admission all vital signs were normal as well as fetal status were noted to be normal. She attended three ANC visits, no any abnormality that was detected during prenatal. No history of genetic abnormality in her family, she was treated malaria during pregnancy at 19 weeks GA. In previous obstetrics history she got PPH during her previous pregnancy in the last two years.The women had normal labour. She had spontaneous vaginal delivery of a female baby with 3.3 kg with Apgar score of 7 in 1 minute and 9 in 5 minutes. On postnatal examination the baby was detected to have an abnormal big tongue a case which is known as BWS. The case management was too complicated following its rarity and later the baby died due to complications of hypoglycemia.

Revelation of the etiological mechanisms and use of a laboratory procedure to detect alterations in these disorders may be useful for management of these rare malformations and genetic counseling of the families.