Journal of Midwifery & Reproductive health
Volume:11 Issue: 1, Jan 2023

Childbearing is an important component of reproductive and sexual health. The total fertility rate in Iran has reached below the replacement level of 2.1, which has the lowest rate in the Middle East. Based on World Health Organization, Iran will soon face the phenomenon of "aging tsunami”. This study aimed to review the challenges and strategies of childbearing from the perspective of sexual and reproductive health in Iran.

A narrative review was conducted based on the Scale for the Assessment of Narrative Review Articles (SANRA), without time limitation until September 2022. Literature search was performed through the English databases of PubMed, Web of Science, Scopus, as well as Persian databases of Magiran and SID. A qualitative synthesis was carried out on the 69 eligible articles out of 166 retrieved documents. 

The most important challenges of childbearing included socio-economic issues, individual preferences, medicalization of fertility, and effects of the COVID-19 pandemic. Strategies to overcome these challenges comprised identifying appropriate target groups for childbearing, modifying fertility control methods and providing them to high-risk groups, establishing laws that support women and family, allocation of infertility treatment facilities, empowerment and skills training of youth and family, and appropriate cultural interventions in lifestyle.

Iran has the best time for childbearing due to being in an open demographic window. This opportunity could be used to identify the target groups eligible for childbearing and to do appropriate interventions. However, it appears that certain childbearing policies need to be reevaluated.

Choosing an evidence-based approach to ovarian stimulation in order to maintain the donor's health is of high importance. Selecting studies with optimal quality is crucial to obtain best evidence. This study was conducted to critically review the published randomized clinical trials on the impact of ovarian stimulation approaches on donation outcomes of egg donors.

In this critical review, databases including ISI, Scopus, PubMed, EMBASE, Magiran, and SID were searched using keywords of ovulation induction, ovarian stimulation, oocyte donation, and ovum donation and their Persian equivalents, with no time limit. All randomized human clinical trials on ovarian stimulation in egg donors published in Persian or English were included. Exclusion criteria were lack of access to the full-text or non-compliance with the principles of RCTs. Articles were evaluated using Consort Checklist 2010. The scoring range was 0-32. Articles were classified based on their quality to poor, moderate, good and excellent quality.

The mean score of 19 evaluated articles was 21.31±4.76 and 66.59, which indicates 66.55 percent compliance to the Consort Checklist. The lowest and highest scores were 14 and 32. In relation to the main parts of the published articles, the order of compliance to Consort checklist sections was as follows: findings (61.9%), method (66.1%), discussion (78.9%), title and abstract (84.2 %), and introduction (100%).

The quality of reviewed articles was moderate. To improve the quality of reporting clinical trials, researchers must consider necessary components and standards of reporting research method and findings with accuracy.

Midwives must have sufficient self-efficacy in addition to knowledge and skills to effectively provide reproductive health services. Self-efficacy is an important factor for successful performance. Strengthening self-efficacy of employees requires identifying its determinants or predictive factors. One of these factors is ethical climate. The aim of this study was to determine the relationship between ethical climate and self-efficacy of midwives working in maternity hospitals in Ahvaz, Iran.

The present study was a descriptive study that was conducted on 192 midwives working in maternity hospitals in Ahvaz city in 2019 using convenience sampling. In order to collect data, Scherer's self-efficacy and Victor's and Cullen's ethical climate questionnaires were used. SPSS version 22 and Pearson and regression tests were used to analyze the data.

The results of the Pearson correlation coefficient test showed that there is a significant correlation between the total score of self-efficacy and all dimensions of ethical climate (p<0.05). However, no significant relationship was seen between the total self-efficacy score and total ethical climate score (p=0.119, r=0.113).

The results showed that there is a significant relationship between the dimensions of self-efficacy and ethical climate. As a result, it is necessary to pay attention to the ethical climate of organizations. Also, the necessary measures and planning in order to improve the ethical climate of the hospital and finally increase the self-efficacy of personnel and service providers should be taken into account by policy makers and senior managers.

Low sexual compatibility is one of the reasons for emotional divorce. This study aimed to investigate the effect of counseling based on Sexual Health Model on sexual compatibility of women at risk of emotional divorce.  

In this two-group quasi-experimental study, 72 women at risk of emotional divorce were assigned to intervention and control groups. For women in the intervention group, one individual interview session along with her spouse and four weekly sessions of 90-minutes group counseling based on the Sexual Health Model, focusing on sexual compatibility, were held. An educational package was prepared for the spouses of the intervention group. The research tools included the demographic and fertility characteristics questionnaire, the standard Guttman Emotional Divorce Questionnaire, Sexual Compatibility with Spouse (SCS) questionnaire and Depression-Anxiety-Stress Scale (DASS-21). The questionnaires were completed before, immediately, and one month after the intervention.

The two groups were homogeneous in terms of demographic data and fertility characteristics (P> 0.05). There was no significant difference between the mean total sexual compatibility scores of women at risk of emotional divorce in the two groups of intervention and control before counseling. But the mean of total score of sexual compatibility in the intervention group was significantly higher than the control group immediately and one month after the counseling intervention compared to pre intervention (P <0.001).

Counseling based on the Sexual Health Model is effective in increasing the sexual compatibility of women at risk of emotional divorce.

Dysmenorrhea is one of the most common problems among women, and researchers are looking into treatment modalities using herbal methods. This study aimed to determine the effect of aromatherapy massage with lavender oil on the severity of primary dysmenorrhea among university students.

This randomized clinical trial was performed on 71 students with primary dysmenorrhea who were recruited from dormitories of Mashhad University of Medical Sciences, Mashhad, Iran and were randomly assigned to three groups. Questionnaires for demographic and menstrual-related data and a visual analogue scale (VAS) were used to collect data. The intervention was a 15-minute massage at the top of the symphysis pubis on the first day of menstruation and for the next three cycles. The first group used 2% lavender oil (2 ml), the second group used 1% odorless paraffin oil (2 ml), and the third group just did massage. The subjects measured and recorded their pain intensity before and 30 minutes after the intervention using VAS. Analysis was done with SPSS version 16 software.

The average pain score changes in three groups in repeated observations over time were different, so the time effect (p=0.009), the group effect (p≤0.001), and the time-group interaction effect (p≤0.001) were statistically significant. Pain score changes between groups and at different times had different patterns, and the most changes were observed in the massage group with lavender oil.

Massage with lavender oil is effective in reducing dysmenorrhea and suggested to be used in the management of dysmenorrhea.

Teenage pregnancy remains a significant epidemiological and social health problem in Haiti. Its prevention and the improvement of the lived experience of pregnant teenagers appear to be imperative in light of its consequences. This article aimed to identify the traditional, community, and clinical practice recommendations that emerge from the participants' discourse to promote the implementation of strategies that can contribute to the prevention and improvement of the lived experience of teenage pregnancy in the Haitian context.

A qualitative research design developed from Dewey's social inquiry was used. Data were collected from October 2020 to January 2021 in the North and North-East departments of Haiti from 69 participants, including 33 pregnant teenagers, 15 health professionals, 17 relatives of teenagers (partners, guardians, and sisters), and four agency leaders.  Thematic analyses were conducted as part of this qualitative study. 

This study revealed recommendations to prevent teenage pregnancy in the Haitian context, to improve the transition from teenage pregnancy to motherhood, and to improve the living conditions of teenage mothers and their children. These intervention strategies are categorized into health system, community, family, adolescent, and state policy.

The results of this study show that the fight against teenage pregnancy should be a collective responsibility and concern. The engagement of every member of the community is imperative in the quest for a sustainable solution to the problem and for healthy lives.

Any problem faced by maladjusted couples has roots in their little knowledge of their own moods, emotions, and personality traits. The present study investigated the effectiveness of solution-focused brief therapy (SFBT) on marital commitment and marital burnout among couples with marital conflicts.

This quasi-experimental research was performed based on a pretest-posttest control group design. The statistical population consisted of all couples who visited the couple therapy clinics of Mahshahr, Iran, in 2019. Using convenience sampling, 60 participants were selected and randomly divided into experimental and control groups. The research tools included the Marital Burnout Questionnaire and Marital Commitment Questionnaire. The experimental group participated in eight sessions of SFBT, whereas the control group only received routine counseling. At the end of the intervention, participants were administered a post-test and a follow-up questionnaire. Data were analyzed by SPSS software-23.

The mean of post-test scores for marital commitment and marital burnout were 196.10±18.72 and 48.81±5.32 in the experimental group and 100.27±5.43 and 75.79±4.28 in the control groups, respectively. The results showed that the mean score of marital commitment was higher and the men score of marital burnout was lower in the experimental group than in the control group, and the difference between the two groups was significant (p<0.001).

SFBT was effective in reducing couples’ marital burnout and improving their marital commitment. Therefore, this intervention is recommended to be used in counseling centers to reduce marital conflicts in couples

Postpartum hemorrhage continues to be a major cause of maternal mortality and serious morbidity and the majority of cases occur in low and middle-income countries. Data related to postpartum hemorrhage are needed for strategic policy and program development to ensure the implementation of effective interventions for lowering the burden of PPH. Therefore, this study aimed to assess the magnitude and maternal outcome of primary postpartum hemorrhage.

Institutional-based cross-sectional study using retrospective chartreview design was conducted at Alemata General Hospital northern Ethiopia from 1st -5th January 2020. Data were collected using a pre-tested structured and standardized checklist from one-year records of the mothers and their neonate's charts, delivery registration logbooks, and operation registration logbooks.  A total of 185 delivery records were selected by systematic sampling method and reviewed. Texts, figures, and tables were used to summarize and present the overall result.

This study revealed that the magnitude of postpartum hemorrhage was 16 (8.6%), and the most common cause identified was uterine atony. Moreover, maternal vital sign derangement and anemia were the common complications secondary to postpartum hemorrhage.

The magnitude of primary postpartum hemorrhage in the study area was relatively high and it results in serious postpartum morbidities. Uterine atony was found to be the most common cause. To prevent postpartum hemorrhage and accompanying consequences, special attention should be paid to the universal use of active management of the third stage in all labors and early detection and management if a complication arises.

Menopause is associated with early and late complications that affect menopausal women's quality of life. Based on evidence, acupressure could increase the quality of life. This study investigated the effect of auricular acupressure on quality of life in postmenopausal women.

This single-blind three-arm randomized clinical trial was conducted on 107 postmenopausal women referred to an Acupuncture Center in Mashhad, Iran in 2020. The patients were randomly allocated to three groups. In the intervention group, participants received ear seeds attached to an adhesive material on specific points on both ears. In one control group, participants received ear adhesive without seed and acupressure, on the same points as the intervention group. For the other control group, routine care was given. After four weeks, the quality of life questionnaire for menopause (MENQOL) was completed. Data were analyzed with SPSS software version 16 using Kruskal-Wallis, Mann-Whitney, and Wilcoxon tests.

The average quality of life in the three groups did not show any significant difference at the beginning of the study (p=0.798). After four weeks, the quality of life in the acupressure group was significantly improved (P=0.002) compared to the two control groups. The average quality of life changed from 92.48 ± 21.88 to 73.77 ± 16.74 (p<0.001). However, there were no changes in the ear adhesive without seed group (p=0.67) and group with routine care (P=0.059). 

The auricular-acupressure technique can be applied as a simple, effective, and non-invasive alternative method for enhancing quality of life during postmenopausal period.

In recent years, population growth has faced to serious challenges. In addition to population decline, some demographic changes could exacerbate the population crisis. One of them is the sex ratio of birth. This study was conducted to investigate the sex ratio in Ardabil from 2011 to 2022. In this cross-sectional study, data of the last ten years in all rural and urban areas of Ardabil were collected. The results showed that in addition to the decreasing trend of live births in Ardabil, the sex ratio is higher than normal and has an increasing trend. The highest sex ratio was observed in 2022, when there were 127 live boys’ births versus 100 girls, is higher than all reports so far in the world. This trend is threatened the regeneration. Some of the solutions in this field is to create a culture and eliminate preventing social factors to have girls.

Robertsonian translocation is a chromosomal structural anomaly resulting in infertility and miscarriage. Robertsonian translocation includes balanced and imbalanced types. The balanced type presents a normal phenotype and the patient may have reproductive issues such as recurrent abortion and birth of neonates with chromosomal abnormalities. In unbalanced type, partial monosomy or trisomy will appear, which can cause miscarriage, and congenital and developmental disabilities may occur in surviving fetuses.

Case report: 

The present study reported a female infant with suspicious minor labial adhesion, and imbalanced adrenal hormones, who was found to be a 45xx (13; 14) (q10; q10) balanced Robertsonian translocation compatible to the normal female phenotype.

Therefore, it is recommended to the family for prenatal amniocentesis in each future pregnancy. As this translocation can be a reason for infertility, genetic counseling and karyotype analysis may be helpful in the assessment of infertile adults without other presentations except recurrent abortion in women and oligospermia in men.