فهرست مطالب

Midwifery & Reproductive health - Volume:10 Issue: 1, Jan 2022
  • Volume:10 Issue: 1, Jan 2022
  • تاریخ انتشار: 1400/10/19
  • تعداد عناوین: 14
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  • Faezeh Ghorbani, Robab Latifnejad Roudsari * Pages 3055-3065
    Background & aim

    Embryo donation is one of the infertility treatment strategies that have various consequences. This review was carried out to investigate the legal, jurisprudential and ethical aspects of embryo donation with counseling approach in Iran.

    Methods

    In this narrative review, the published evidence on various legal, jurisprudential and ethical aspects of embryo donation by Iranian authors was searched in English databases of PubMed, Scopus and CINAHL as well as the Persian databases of Iran Medex and SID. To collect data, keywords including "third party reproduction”, “embryo donation", "infertility", "law", "jurisprudence", "ethics" and “Iran" were searched alone or in combination in English and their equivalent Persian words without time limitation. Out of 177 articles, 39 were included in the study.

    Results

    The results showed that in the process of embryo donation, the legal dimensions of embryo donation such as lineage, inheritance, marriage, alimony, custody and citizenship should be considered in infertility counseling. Also the ethical dimensions of embryo donation i.e., informed consent, as well as screening donors and recipients, and its jurisprudential aspects including the juridical permission of the principle of embryo donation from the jurists' point of views are salient issues to be taken into account in recipient and donor counseling.

    Conclusion

    It seems necessary to provide infertility counseling services based on the mentioned dimensions in embryo donation to recipient and donor couples.

    Keywords: Donated Fetus, Law, Ethics, Jurisprudence, Counseling, Infertility
  • Motahhare Hashemzahi, Samira Khayat *, Somayeh Khazayan Pages 3066-3074
    Background & aim

    The coronavirus pandemic has increased stress and anxiety among pregnant women and established barriers to in-person care around the world. Accordingly, the purpose of this study was to determine the effect of COVID-19 self-care training via telemedicine on perceived stress and corona disease anxiety in pregnant women.

    Methods

    The present quasi-experimental study was conducted on 100 pregnant women who referred to comprehensive health centers in Zahedan, Iran between June and September 2021. The sample was randomly assigned into two groups of 50 subjects. The intervention group received the educational content via WhatsApp Messenger in six sessions. Data collection tools were Perceived Stress Scale (PSS) and Corona Disease Anxiety Scale (CDAS). The self-administered questionnaires were completed before the intervention and one month after the training program.

    Results

    After the intervention, mean PSS score in the intervention group (25.34±6.63) was significantly reduced compared to the control group (28.42±5.75) (p=0.015). Also, mean CDAS score in the intervention group (13.14±7.29) had a significant decrease compared to the control group (20.54±6.67) (P<0.001).

    Conclusion

    The results of our study confirmed the effectiveness of COVID-19 self-care training via telemedicine in reducing the perceived stress and anxiety of pregnant women during the coronavirus pandemic. Therefore, the use of this method in the care of pregnant women is recommended to mitigate stress and anxiety.

    Keywords: self-care, COVID-19, Telemedicine, Perceived stress, Anxiety, pregnancy
  • Masoumeh Simbar, Farzaneh Rashidi Fakari, Abbas Ebadi, Saeed Safari, Hamid Alavi Majd Pages 3075-3083
    Background & aim

     Service providers should frequently assess the clients’ satisfaction and use tools with high level of reliability and validity to meet clients' needs. This study was performed to evaluate psychometric properties of a tool to assess the clients’ satisfaction with obstetrics triage. 

    Methods

     This validation study was conducted by the exploratory sequential mixed method in two qualitative and quantitative phases using the four stage approach proposed by Waltz and colleagues. In the first qualitative phase, a conventional content analysis approach was used to develop the concept of satisfaction as well as extract the initial items for the questionnaire. The semi-structured interviews were conducted with 23 participants in Tehran. In the second stage, a descriptive study was performed to assess the face, content and then construct validity using exploratory factor analysis on 200 subjects as well as reliability through measuring internal consistency and stability.

    Results

     Ten items were extracted from the content analysis. In quantitative face validity, the maximum impact score obtained was five and the minimum impact score was 3.5. The numerical CVR of all items was above 0.49 and the I-CVI Modified Content Validity Index of all items ranged from 0.86-1, and the S-CVI score was 0.97. Following exploratory factor analysis, SATOT having nine items and two factors was finalized. Cronbach’s alpha value and intra-class correlation coefficient was 0.793 and 0.884, respectively.

    Conclusion

     SATOT can help healthcare providers and managers to identify problems in the structure and process of obstetrics triage that lead to clients’ dissatisfaction.

    Keywords: Patient's Satisfaction, Obstetrics, Triage, Psychometrics, Midwifery
  • Maryam Moradi, Azin Niazi *, Farzaneh Salajegheh, Ehsan Mazloumi Pages 3084-3092
    Background & aim

    Diet and nutritional deficiencies in women during pregnancy are considered among the significant factors inducing preeclampsia. The present study aimed to compare the major dietary patterns during pregnancy in women with preeclampsia and healthy women.

    Methods

    This unmatched case-control study was carried out on 240 women (90 case and 150 control) referred to the university hospitals in Mashhad, Iran, between 2018 and 2019. The convenience sampling technique was used to select the sample in the case group from hospitalized individuals with a certain diagnosis of preeclampsia, and those in the control group among pregnant women without preeclampsia referred to the midwifery clinics and the maternity wards of the same hospitals to receive prenatal care. The data collection tools included the demographic questionnaire with gynecological/obstetric records, the Clinical Evaluation Form (CEF) to determine preeclampsia symptoms and severity, and the modified Food Frequency Questionnaire (CEF).

    Results

    There was a significant difference between the two groups in terms of fast-food consumption (p=0.038), consumption of vegetables, carbonated soft drinks, table salt (p<0.05) as well as total diet scores (p=0.019). There was no significant difference between the two groups in terms of educational level (p=0.213), occupation (p=0.118), place of residence (p=0.623), level of income (p=0.583), and parity (p=0.249).

    Conclusion

    Lower consumption of vegetables and increased frequency of fast foods, carbonated soft drinks, and table salt were also associated with the incidence of preeclampsia. Therefore, encouraging and promoting healthy eating habits and dietary patterns during pregnancy can effectively prevent the incidence of preeclampsia.

    Keywords: pregnancy, Preeclampsia, Dietary, Patterns, Healthy
  • Meltem UĞURLU * Pages 3093-3099
    Background & aim

    Midwives are the main healthcare professionals who play a critical role in supporting mothers for initiating and maintaining breastfeeding. Due to the importance of midwifery students having sufficient breastfeeding knowledge and non‐judgmental attitudes prior to graduation, this study aimed to examine the attitudes towards infant feeding of midwifery students.

    Methods

    This survey was conducted at Health Sciences University in Ankara, Turkey in June 2021. The study was carried out on 212 midwifery students in total who agreed to take part in the study. Data was collected using the Student Information Form and IOWA Infant Feeding Attitude Scale, which were completed electronically through WhatsApp messenger and analyzed using SPSS Version 22.00.

    Results

    The mean age of the students was 20.40±1.25. The mean score of IOWA Infant Feeding Attitude Scale was 66.18±5.52 out of 87. There was a statistically significant difference found between the mean scores of the students in the infant feeding attitude scale and their grade in school (p<0.001), receiving information in related classes (p<0.005), attending courses in the related subject (p=0.044), taking additional classes (p<0.001), and feeling themselves sufficient in terms of knowledge (p=0.009). There was no statistically significant difference with the status to give counseling.

    Conclusion

    Midwifery students had positive attitudes towards infant feeding. It is, therefore, suggested to present an educational curriculum that supports and encourages breastfeeding in midwifery programs and to evaluate students' attitudes towards infant feeding in order to train professional midwives who will encourage families to breastfeed in the future.

    Keywords: Midwifery, Infant Feeding, Breastfeeding, Attitude, Student
  • Rafiat Anokwuru *, Fhumulani Mulaudzi Pages 3100-3108
    Background & aim

    The process of country lockdown, social distancing and limited access to services as a result of COVID-19 pandemic brought a change to established patterns in the antenatal care services in the primary health care systems. The current article presents the lived experience of utilization of antenatal services among pregnant women during covid-19 pandemic.

    Methods

    A descriptive phenomenological design was used to elicit data from 12 pregnant women. Pregnant women who booked in healthcare services were recruited from Gauteng and Limpopo province in South Africa using a purposive and snowballing sampling method.  The data were collected and recorded from July to August 2020, either through the telephone or e-platforms (Zoom and google meet).  The recorded data was transcribed and analyzed using the steps outlined by Sundler et all.

    Results

    Four themes emerged from the analysed data. Three themes focused on the experiences of the pregnant women showing the negative impact of the COVID-19 pandemic on antenatal services including: fear of contracting COVID-19 during antenatal; limited available antenatal services and coping with the new normal. The fourth theme is need for digital health education which focused on the antenatal services development.

    Conclusion

    The study showed that the covid-19 pandemic negatively impacted utilization  of antenatal services among pregnant women. It is therefore important for the health departments to adopt innovative ways to improve utilization  of antenatal services among pregnant women during a pandemic situation such as the COVID-19 pandemic.

    Keywords: Midwives, Pregnant Women, COVID-19, antenatal services, Pandemic, experience
  • Zohreh Abasi, Zohreh Keshavarz, MohammadJalal Abbasi Shavazi, Abbas Ebadi, Habibollah Esmaily, Salar Poorbarat * Pages 3109-3118
    Background & aim

    Cohesion and sense of ethnicity belonging can be effective in shaping reproductive behaviors. The aim of this study was to compare the reproductive behaviors in two ethnicities of Fars and Turkmen in North Khorasan, Iran.

    Methods

    This cross-sectional study was performed on 406 Fars and Turkmen women using a self-structured reproductive behavior questionnaire between April and September 2017. Content validity and reliability of the tool was confirmed with Cronbach's alpha of 0.75. Data was collected on a self-report basis and analyzed using SPSS software (version 21) and descriptive and analytical indices.

    Results

    Reproductive behaviors were significantly different between the two groups in terms of number of children (P=0.001), the timing of the first childbirth (P=0.043), interval between the first and second pregnancy (P=0.002), desire to re-childbearing (P=0.002), number of desired children (P=0.025), current method of contraception and decision to continue or terminate unwanted pregnancies (P=0.074). General linear test showed that with the introduction of demographic variables to measure the effect of the number of children in the analysis, the effect of ethnicity on the number of children was removed, but the variables of maternal age (P=0.001), husband's age (P=0.001), education of woman and husband (P=0.001) and the woman's job (P=0.001) remained as effective variables on the number of children.

    Conclusion

    Today, the value of childbearing has changed more than other family values. In order to achieve the targets of population policies, population policy-making must be based on economic, social, cultural and demographic realities of the societies.

    Keywords: Ethnicity, Reproductive behavior, Childbearing
  • Afolabi Adebukunola Olajumoke, Afolabi Kolade Afolayan, Adetoye Clara T, Adetoye Adedapo O, Avwioro Temidayo O, Idowu Olanrewaju A, Abioye Abigail A, Ayegbusi W, Adelami Oluwagbenga Pages 3119-3127
    Background & aim

    Reducing the rate of COVID-19 transmission and infection has remained as a major public health priority in pregnancy, while the Safe Motherhood Initiative aims at attaining optimal maternal and new-born health, reduction in maternal mortality and morbidity. This study was conducted to assess knowledge and level of adherence towards COVID-19 preventive measures as well as identifying the factors influencing the level of adherence among pregnant women in Nigeria.

    Methods

    This study adopted a descriptive cross-sectional design involving 442 pregnant women who attended antenatal clinic between August 15th and September 30th, 2020 in a tertiary health facility in South West Nigeria. Respondents were selected through a two-stage sampling technique and answered to an interviewer-administered questionnaire. Data obtained from 431 pregnant (97.5% response rate) were analyzed using SPSS software version 25 with descriptive and inferential statistics.

    Results

    Findings showed that 31.6% of the pregnant women had good knowledge about COVID-19 prevention, 48.0% had fair knowledge and 20.4% had poor knowledge. Also, 78.0% had high level of adherence to COVID-19 preventive measures and 14.2% moderately adhere while 7.9% had low level of adherence to COVID-19 preventive measures. Regression analysis revealed that high level adherence to COVID-19 preventive measures was significantly associated with Hausa (p=0.03, RRR=0.03, CI=0.001-0.76) and Igbo ethnicity (p=0.01, RRR=0.05, 0.005-0.51), while moderate adherence was significantly associated with secondary education (p=0.04, RRR=5.25, CI= 1.06-26.18).

    Conclusion

    Improving adherence to preventive measures against COVID-19 among pregnant women requires advocacy that prioritize women’s education and address various forms of ethnic and cultural misconceptions about COVID-19 infection.

    Keywords: COVID-19, Adherence to COVID-19 Preventive Measures, Pregnant Women, Nigeria
  • Nahid Jahani Shoorab, Morvarid Irani, Khadijeh Mirzaei, Tahereh Sadeghi, Seyed Reza Mazloum, Jamshid Jamali Pages 3128-3134
    Background & aim

    Prenatal and postnatal social support could affect pregnancy consequences, especially the number of wanted pregnancies. This study was performed to compare the social support of women with wanted and unwanted pregnancies referred to the health centers of Mashhad, Iran.

    Methods

    This descriptive cross-sectional study was conducted on 177 pregnant women selected by multistage sampling method in the health centers of Mashhad, from 20th Nov. 2016 to 20th Jan 2017. The pregnant women were classified into two groups, with wanted and unwanted pregnancies at the beginning of pregnancy. They were asked to complete the modified questionnaire of social support during pregnancy. Also, in the second or third visit after birth, they were again asked to complete the modified version of the Postpartum Social Support Questionnaire (PSSQ). Data were analyzed by SPSS software version 27 using T-test, Chi-Square, and MANCOVA.

    Results

    Both the mean score of social support during pregnancy (15.36±.96 VS 14.49±1.33, P<0.000) as well as postnatal social support were higher in wanted compared to unwanted pregnancy groups (161.58 ± 16.90 VS 156.79 ±13.07, P=0.044).

    Conclusion

    The results of this research indicated that mothers with wanted pregnancies had higher social support than unwanted pregnancies; hence, more attention should be paid by specialists and service providers to promote social support in women with unwanted pregnancies.

    Keywords: Social Support, pregnancy, Postnatal, Birth, Iran
  • Mekete Firde, Hassen Mosa *, Ritbano Ahmed, Minychil Demelash, Fitusm Endale Pages 3135-3143
    Background & aim

    Hepatitis B virus (HBV) is a serious liver infection that affects millions of people around the world. The risk of vertical transmission from an infected woman to her fetus is extremely significant when HBV is identified during pregnancy. As a result, the goal of this study was to determine the seroprevalence of HBV infections and its associated risk factors among pregnant women attending antenatal clinic (ANC).

    Methods

    A hospital-based cross-sectional study was conducted on 245 pregnant women attending an antenatal clinic at Shone hospital, Southern Ethiopia from October to December 2020 using a systematic sampling procedure. The data was collected using a structured and pre-tested questionnaire. An enzyme linked immunosorbent assay (ELISA) was used to detect the Hepatitis B surface antigen (HBsAg).The data was analyzed using SPSS (version 24.0). With a 95 percent confidence interval (CI), multivariable logistic regression analysis was conducted to assess the relationship between the independent and the dependent variable.

    Results

    The rate of HBV infection was found to be 4.9%. Abortion (AOR=6.5; 95% CI: 2.20-24.27), blood transfusion (AOR=4; 95% CI: 1.34-13.87), body tattooing (AOR=6.3; 95% CI: 2.30-22.36), and having multiple sexual partners (AOR=11.4; 95% CI: 4.51-17.23) were the contributing factors of HBV.

    Conclusion

    Considering that HBV is an intermediate trouble in the study region, enhancing antenatal health education programs on HBV transmission and prevention, adhering to infection prevention principles throughout procedures, and testing every pregnant woman for HBV during an ANC visit are all critical steps in limiting the spread of the illness.

    Keywords: Hepatitis B virus, Prevalence, associated factor, pregnancy
  • Fahimeh Rashidi Maybodi, Farzane Vaziri, Neda Zarebidoki, Mahsa Fakhari * Pages 3144-3154
    Background & aim

    Pregnant and lactating women need special considerations for dental treatments. This study was performed to evaluate the knowledge and practice of general dentists and dental students about treatment considerations during pregnancy and lactation.

    Methods

    In this cross-sectional study, 96 general dentists and 66 last-year dental students were selected by random number table and census, respectively. The knowledge and practice of the participants was assessed using a self-structured questionnaire on a self-report basis. Data were analyzed by SPSS software (version 17).

    Results

    The mean knowledge score of dentists and dental students was 8.56±2.33 and 8.11±2.23 (out of 13), with no significant difference between the two groups. There was a significant association between knowledge and age (p= 0.001) as well as work experience of dentists (p= 0.001). A significant relationship was found between students' knowledge and their gender and average grade point (p=0.040 and p=0.001). 0.6% of dentists and 28.7% of dental students did not choose the correct position on the unit during pregnancy. 32.3% of dentists and 27.3% of dental students wrongly considered adrenaline-containing anesthetics as contraindicated during pregnancy. 22.9% of dentists and 12.1% of dental students incorrectly considered Metronidazole and 20.8% of dentists and 30.3% of dental students Barbiturates as safe medications during lactation.

    Conclusion

    Considering the level of knowledge and practice of general dentists and dental students about treatment considerations during pregnancy and lactation, it is suggested to consider this subject in dentistry education programs and also to hold training workshops to improve the level of knowledge into ideal.

    Keywords: pregnancy, Dental Student, Lactation, Dentists
  • Somayeh Zarei, Sakineh Mohammad Alizadeh Charandabi, Azam Mohammadi, Fatemeh Effati Daryani, Mojgan Mirghafourvand * Pages 3155-3164
    Background & aim

    Exclusive breastfeeding for the first 6 months of life is recommended for all infants. Therefore, this study was performed to determine the predictors of exclusive breastfeeding in mothers.

    Methods

    This cross-sectional study was conducted on 183 lactating mothers with infant aged 4 months referring to Tabriz health centers and health bases in July to October 2017. Sampling was done by a two-stage cluster random sampling method. Data were collected using the infant feeding checklist, the Iowa Infant Feeding Attitude Scale (IIFAS), and the Self-efficacy Scale. Independent t-test was used to determine the relationship between feeding attitude and breastfeeding self -efficacy. Logistic regression was used to determine the predictors of exclusive breastfeeding.

    Results

    Mean of attitude toward breastfeeding was 55.13±5.5 (ranging 17 to 85).  Mean of breastfeeding self-efficacy was 131.8±15.5 (ranging 33 to 165). From 183 mothers who participated in the study, 72.0% reported exclusive breastfeeding. The results showed a statistically significant correlation between exclusive breastfeeding with feeding attitude (P = 0.005) and breastfeeding self-efficacy (P = 0.004). According to the logistic regression model, there was a statistically significant relationship between neutral breastfeeding attitude with positive attitude toward formula feeding (OR=16.6; P<0.001), vaginal delivery (OR=9.3; P<0.001), breastfeeding immediately after delivery (OR=6.8; P=0.006), personal experience of breastfeeding (OR=11; P=0.008) and refusal to breastfeed (OR=8.7; P=0.003). These variables led to increased frequency of exclusive breastfeeding.

    Conclusion

    It is recommended to promote practical management to resolve breastfeeding problems as well as encouraging women for vaginal delivery and early breastfeeding.

    Keywords: Breastfeeding, Attitude, Self-efficacy, Exclusive breastfeeding
  • Agerie Mengistie Zeleke, Gashaw melkie Bayeh Pages 3165-3174
    Background & aim

     Respectful and non-abused maternal healthcare services can reduce maternal and child mortality rate. However, there is a scarcity of evidence on status of maternal health services. Therefore, this study aimed to assess maternal disrespect and abuse during maternal health service.

    Methods

     An institution-based cross-sectional study was employed among 415 post-partum mothers from March 1st to May 30th, 2020.  A stratified random sampling technique was used to select participants. Data were collected using a structured pretested questionnaire, entered into Epi-Data version 3.1, and then exported to SPSS version 20 software for analysis with descriptive and inferential statistics.

    Results

     The study revealed that 49.6% (95% (CI: 44.7–55.0)) of mothers experienced disrespect and abuse during receiving care. Non-confidential care (49.9%), unconsented care (35.8%), and delayed care (28.7%) were the most frequently mentioned disrespects and abuses. Being uneducated (AOR = 0.32, 95% CI: 0.13 0.75), having ANC visits (AOR = 0.19, 0.07 0.52), hospital delivery (AOR = 1.88, 95% CI: 1.18.97), staying more than12 hours in health facility (AOR = 1.84, 95% CI: 1.13.01), having birth complications (AOR = 2.56, 95% CI: 1.52.28), and instrumental delivery (AOR = 2.75, 95% CI: 1.62, 4.65) were predictors of disrespect and abus care.

    Conclusion

     Maternal disrespect and abuse was common during maternal healthcare services. To decrease maternal and child mortality, providing respectful and non-abused maternal healthcare and safeguarding women’s fundamental rights during facility delivery is necessary.

    Keywords: Abuse, Disrespect, Childbirth, Public health facilities, Ethiopia
  • Öznur Akcayüzlü, Evsen Nazik Pages 3175-3183
    Background & aim

     Nausea and vomiting are important pregnancy problems that are common in the first months of pregnancy and  affect daily activities and decrease women’s quality of life. Assessment of maternal adaptation and health behaviors in pregnancy with hyperemesis gravidarum (HG) is extremely important in terms of raising the quality of care. This study was carried out to measure the adaptation to pregnancy and health practices of women with hyperemesis gravidarum.

    Methods

     This descriptive study was carried out on 70 women with HG who were selected using simple random sampling between August 2016 and April 2017 in two state hospitals in Adana, Turkey. A demographic questionnaire, the Prenatal Self Evaluation Questionnaire (PSEQ) and the Health Practices Questionnaire in Pregnancy (HPPQ) were used to collect data. The data were evaluated using SPSS 22.0.

    Results

     The mean total score of PSEQ and HPPQ in women with HG was 149.7±26.8 and 116.0±14.0, respectively. There was a positive correlation between the PCEQ and the HPPQ (P=0.000/ r=-0.386), i.e. with increased women's adaptation to pregnancy, their health practices was improved.

    Conclusion

     The results suggest that women who are hospitalized with the diagnosis of HG should be assisted with adapting to pregnancy and having routine evaluations of their health practices during pregnancy.

    Keywords: Hyperemesis Gravidarum, Adaptation, Health Care, Pregnancy