Journal of Midwifery & Reproductive health
Volume:11 Issue: 2, Apr 2023

Job satisfaction of midwives plays an important role in the efficiency and performance of health centers and the quality of midwifery services. This study reviewed job satisfaction and its related factors among midwives working in health systems in Iran.

In this systematic review, the databases of Web of Science, Scopus, PubMed, PsycINFO, Embase, Google Scholar and Magiran, were searched between 2000 and 2021 using keywords of midwife, job satisfaction, occupational stress, and Iran. The research steps were based on PRISMA. For quality assessment, the articles were evaluated according to the inclusion criteria by two researchers with the Newcastle-Ottawa scale. 

A total of 23 articles including 3,352 midwives working in the health and medical centers were reviewed. The level of job satisfaction was moderate, and the job satisfaction of midwives working in hospitals was lower than that of those working in health centers. The highest level of satisfaction was related to the job positions and relationships with colleagues, and the lowest level was in relation to the salary and job benefits. Marital status, age, income, salary, organizational position, education, employment status, interest in the field of education, and workplace had a relationship with increasing job satisfaction. Tensions in the workplace environment was associated with decreasing job satisfaction.

It is necessary to provide conditions to improve job satisfaction of midwives in order to identify and removing barriers and improving professional belonging to promote occupational health and optimize the quality of providing midwifery services.

Little is known about the effects of COVID-19 on pregnancy outcomes. The present study was performed to investigate maternal and perinatal outcomes in pregnant women affected by COVID-19.

This case-control study was conducted on 264 pregnant women, including 132 infected (case group) and 132 uninfected pregnant women with COVID-19 (control group), using a retrospective record review design and matched sampling in three hospitals in Hamadan Province, Iran.Pregnant women with a positive COVID-19 test were identified through the registration system for COVID-19 in the health centers. The two groups were matched in terms of gestational age and maternal age. Data were collected from February 2020 to October 2021 using a questionnaire consisting of demographic and obstetric data, maternal and perinatal outcomes, and information about COVID-19 detection and treatment. Data were analyzed by SPSS software (version 22).

A high percentage of the case group lived in urban areas (p=0.026). In the case group, newborn hospitalization and death were significantly higher (p=0.032). No differences were observed between the two groups in other maternal or perinatal outcomes. Although there was one maternal death, two HELLP syndromes, and two cases of pregnancy cholestasis in the case group, however, they were not statistically significant.

Although most maternal and perinatal outcomes were not statistically significant in COVID-19 pregnancies, some important outcomes, especially maternal death, occurred only in the case group. More evidence is needed to confirm whether COVID-19 can negatively affect pregnancy outcomes.

Pregnancy due to hormonal changes can cause psychological changes such as increased depression, stress, anxiety and decreased resilience, which could be more complicated during coronavirus pandemic. Massage may be beneficial for a number of mental health conditions. The aim of this study was to determine the effect of telemedicine-based massage training to spouses on the resilience of pregnant women during the coronavirus pandemic.

This randomized clinical trial was performed on 120 pregnant women attending health care centers in Mashhad, Iran by available sampling method in 2021. Spouses of pregnant women in the intervention group received massage training by telemedicine. The intervention group performed the trained items for their pregnant wives three times a week for four weeks. The control group received only routine pregnancy care. Data collection tools included Conor and Davidson resilience questionnaires and DASS-21 questionnaires which were completed in person before, immediately after and 4 days following the intervention. Data were analyzed by SPSS statistical software (version 24) and descriptive and analytical statistical methods.

At the beginning of the study, resilience score did not differ significantly between the two groups (P=0.235). But immediately after and 4 days after the intervention, there were significant changes in resilience scores (P <0.001).

The results of this study showed that teaching telemedicine-based massage to spouses during the coronavirus pandemic can increase the resilience of pregnant women. Since resilience is one of the components of mental health, increasing the resilience of pregnant women improves their mental health.

The Fertility rate is decreasing in most countries and the total fertility rate (TFR) has reached its lower replacement level, and negative population growth is observed in some countries, including Iran. This study aimed to explore the childbearing barriers among women living in northern Iran.

This qualitative study was performed with a conventional content analysis approach in Gorgan, Iran, from November 2018 to October 2019. A total of 23 women participated in this study. Of these, ten women had delayed childbearing at least four years after marriage, nine experienced induced abortion (without medical reasons), and four were voluntarily childless. Three childbearing politicians were also interviewed. Data were collected via face-to-face interviews and analyzed following recommendations by Hsieh & Shannon. The four criteria of credibility, dependability, conformability, and transferability were used to achieve trustworthiness.

Seven themes emerged as childbearing barriers: undesirable society, economic hardship, work-family conflict, changed value of motherhood and childbearing, self- interest and convenience, feeling of inadequacy about parental role, being worried about child suffering and loneliness.

It seems that societal and personal concerns are the most important childbearing barriers among Iranian women. Perhaps some barriers such as economic and social problems could be resolved by advancing women's status in society, equality policies and paid parental leave. However, personal concerns might be reconciled by implementing appropriate educational interventions ensuring that assist couples in making informed decisions about childbearing.

Sexual health education to female adolescents in schools is one of the most challenging topics in most parts of the world. This study investigated the barriers to sexual health education for female adolescents in schools from health care providers’ perspective.

This descriptive cross-sectional study was performed on 200 health care providers in the comprehensive health center of Isfahan from October 2019 to October 2020, who were selected using multistage sampling. A valid and reliable researcher-made questionnaire including five sections and 28 questions was used to assess the barriers to sexual health education in areas including individual domain related to the health care providers and female adolescents as well as organizational and socio-cultural domains. Data were analyzed using descriptive statistics.

The most important barriers to sexual health education for female adolescents included insufficient knowledge of health care providers (59%), lack of appropriate communication skills with female adolescents (59.5%) and conflict of sexual education to female adolescents with cultural beliefs of society (56.5%). Among the four domains studied, organizational (31.4±4.93) and socio-cultural domain (27.1±5.12) barriers had higher mean scores.

Insufficient knowledge and skills of health care providers and conflict of sexual education to female adolescents with cultural beliefs of society are the most important barriers to sexual health education for this population. Training of the health team as well as education and culture building in the community for families and the general public can be effective to remove barriers to sexual education for female adolescents.

The global burden of iron deficiency anemia remains substantial, accounting for 41.8% of the population. This study assessed the rural‒urban differential in iron supplementation compliance during pregnancy among reproductive-aged women.

A comparative cross-sectional study was conducted among women aged 15-49 in all parts of Ethiopia. The study was conducted from January 18 to June 27, 2016. After data related to the compliance with iron supplementation were obtained from the demographic survey, a mixed-effects logistic regression model was performed on a weighted sample of 3096 (563 urban and 2533 rural). Significant relationships were determined using multivariable logistic regression analysis. 

The general proportion of iron supplementation compliance was 15.07% (95% CI= 13.8%-16.4%). However, the proportion of adherence to iron among urban and rural women was 17.7% (95% CI=14.8%-21.1%) and 11.2% (95% CI=10.1% -12.5%), respectively. Urban areas were associated with exposure to media (AOR=2.04, 95% CI, 1.07, 3.89) and frequent ANC≥4 (AOR=2.31, 95% CI, 1.10, 4.86). However, those with a high school education level were 65% less likely to adhere to iron supplementation. Additionally, for Rural, the odds of iron supplementation adherence were higher for primary (AOR=1.39, 95% CI, 1.03, 1.89) and secondary education (AOR=1.77, 95% CI, 1.02, 3.08), unemployed women (AOR=1.35, 95% CI, 1.04, 1.76), first ANC registration at 1st 13 months (AOR=3.03, 95% CI, 1.41, 6.54), and 2nd trimester (AOR=2.82, 95% CI, 1.34, 5.95).

The proportion of iron use adherence through gestation is low in both urban and rural Ethiopia compared to the national recommendation.

Restless leg syndrome (RLS) is a frequent sensory dyskinesia disorder of the nervous system and a cause of disability in several aspects. This study aimed to determine the relationship between RLS and mood complications, menstrual patterns, and its associated symptoms among young women.

This cross-sectional study was undertaken on 118 female university students in Birjand, Iran, from December 2019 to January 2020 using a multistage cluster sampling method. The degree of RLS was assessed using the International RLS Severity Scale. The severity of PMS was characterized via the Premenstrual Syndrome Screening Tool (PSST). Neuropsychological performance of participants was evaluated. Data analysis was performed by SPSS software (version 16.0).

Of 118 participants, 29.7%, 32.2%, 27.9%, and 10.2% of them were not affected by RLS or suffered from mild, moderate, or severe types of RLS, respectively. The subjects with RLS had a significantly lower duration of their menstruation cycle and higher PSST scores compared to those without it. Subjects with different severities of RLS scored higher for the severity of depression, anxiety, stress, insomnia, and sleepiness than normal women (P<0.01). The RLS score was a significant factor related to the scores for cognitive abilities (β=-0.33; P=0.022), depression (β=0.32; P=0.001), anxiety (β=0.24; P=0.003), stress (β=0.44; P<0.001), quality of life (β=-0.23; P<0.001), insomnia (β=0.21; P=0.001), sleepiness (β=0.15; P=0.014) and PSST (β=0.28; P=0.019).

In the absence of health management, RLS is potentially associated with depression, anxiety, sleep disruption, cognitive impairment, decreased quality of life, and menstrual problems.

Primary dysmenorrhea is one of the most common complaints in women. This study compared the effect of ginger-lavender, ginger and mefenamic acid capsules on the severity of primary dysmenorrhea among female university students.

This randomized, triple-blind clinical trial was performed in 2020 on 90 female students with primary dysmenorrhea, who lived in dormitories of Shahid Beheshti University of Medical Sciences, Tehran, Iran and randomly assigned to three groups. During the first three days of menstruation, the students received ginger-lavender (250 mg ginger and 50 mg lavender extract), ginger (250 mg), and mefenamic acid (250 mg) in two consecutive cycles, which were prescribed four times daily for three days from the onset of menstruation. A menstrual status questionnaire, verbal multidimensional scoring system, and visual analog scale were used to measure pain duration and intensity before and two cycles after intervention. Data were analyzed using two-way (intragroup) and one-way (intergroup) repeated measures ANOVA.

 Ginger- lavender, ginger and mefenamic acid significantly reduced the severity and duration of primary dysmenorrhea (P 0.05). This decrease was greater in the ginger-lavender group than in the other two groups. Also, the mean score of pain in the ginger-lavender group was 1.04 and 1.53 units lower than the ginger and mefenamic acid groups, respectively. The mean pain score in the ginger group was 0.49 units lower than that the mefenamic acid group.

Ginger-lavender significantly reduced the duration and severity of menstrual pain and was more effective than only ginger and mefenamic acid.

Women spend more than a third of their lives in menopause, and paying attention to their health is one of the most important health issues. The present study was performed to determine the physical activity and food frequency in postmenopausal women.

This cross-sectional study was conducted on 600 postmenopausal women who referred to health centers of Urmia, Iran in 2019. Sampling was performed as multi-stage randomization. To collect data, international physical activity and food frequency questionnaire were used.

The mean age of postmenopausal women was 56.64 ± 3.19 years and 93% of them had a body mass index higher than normal. Also, 75% of postmenopausal women had moderate daily physical activity and the average daily physical activity in this group of women was 202.57 ± 135.13 MET. Among the types of physical activities, sports activities had the lowest and working at home had the highest energy consumption. The mean total daily energy intake in postmenopausal women was 3739.80 ± 1251.40 calories, and the consumption of fats, sweets, bread and cereals was more than the standard recommended intake. They had the consumption of dairy products and vegetables less than the need of the body.

Postmenopausal women do less daily exercise and use more high-calorie food groups, and their daily energy intake is more than the standard recommended intake.

Infertility, as an important stressful factor in women’s lives, leads to an increase in psychological distress. Self-efficacy is one of the determinants, which is considered one of the basic structures of mental health. This study was conducted to measure the relationship between self-efficacy and psychological distress in infertile women.

This descriptive correlational study was done on 205 infertile women attended Milad Infertility Research Center in Mashhad, Iran, who were selected via convenience sampling. Data were collected using a demographic questionnaire, the Tara Infertility Self-Efficacy Questionnaire, and the Akios Infertility Distress Questionnaire. Infertile women who met the inclusion criteria completed the questionnaires in a self-report basis. The data was analyzed with SPSS 20 using descriptive statistics as well as Pearson and Spearman correlation coefficient tests.

The mean score of self-efficacy was moderate (51.70±12.29) and the mean score of infertility-related distress was relatively high (81.38 13± 13.14). There was a direct and significant relationship between self-efficacy and infertility-related distress (P = 0.001), i.e., higher self-efficacy was associated with less infertility-related distress. There was no significant relationship between either self-efficacy or infertility-related distress with women’s age, education, length of marriage, duration of infertility, and duration of infertility treatment.

It is recommended to incorporate self-efficacy promotion programs into the treatment process of infertile couples in order to control the adverse psychological effects of infertility such as infertility distress.

Despite the high prevalence of early pregnancy loss, little is known about the subsequent psychological consequences. The purpose of this pilot study was to find an appropriate sample size for conducting a large study to compare psychological consequences of early pregnancy loss compared with ongoing pregnancy. The study was carried out at a public hospital and the health centers of Torbat Heydariyeh, Iran in 2020. It included 90 women with miscarriage (N=30), ectopic pregnancy (N=30), and ongoing normal pregnancy (N=30). Cohen Perceived Stress Scale, Center for Epidemiologic Studies Depression Scale, Spielberger State-Trait Anxiety Inventory, and Posttraumatic Stress Diagnostic Scale were used. Based on the results, there was no statistical difference between the groups for the perceived stress levels, the status of depression, and post-traumatic disorder in the groups (P>0.05). Diagnosis of state anxiety was present in 53.3% of the ectopic pregnancy and 33.3% of miscarriage groups, but only in 20.0% of the ongoing pregnancy group (P=0.025). For trait anxiety, these proportions were 33.3%, 13.3%, and 6.7% in the ectopic pregnancy, miscarriage, and ongoing pregnancy groups respectively (P=0.019). In conclusion, women who experienced miscarriage or ectopic pregnancy reported more anxiety compared to women with ongoing pregnancy. Large-scale studies are needed to substantiate these findings.