مجله زنان مامائی و نازائی ایران
سال پانزدهم شماره 4 (هفته دوم خرداد 1391)

First sexual experience plays significant role in sexual health and increases marital satisfaction and mental health. This study aims to understand women's first sexual experience in the city of Sabzevar. The descriptive phenomenological study with purposive sampling method was performed in 2010 on 30 women in the Sabzevar with less than 1 year after their first marriage. Researcher with a deep, semi-structured interview helped the participants to explain their first sexual experience. Data recording and implementation was performed with Colaizzi method of content analysis (data analysis in 7 steps). Psychological changes (fear, spouse mental fitness and a sense of relaxation after sex), change in approach to consulting (need of right consulting, knowledge gained through modern means of mass communication, gain knowledge from people with good experience and partner with good morals), gender differences (pain, flushed body, ruptured hymen, lack of orgasm, how to prepare in a relationship and not using contraception) and signs of cultural change at first sex (not shown blood tissue after rupture of the hymen, sex before marriage ceremony), are extracted in this study. Beliefs and attitudes of couples, and educational reform can be effective in improving sexual health and can improve the experience. Understanding this experience can help policymakers promote educational courses before marriage.

Abdominal hysterectomy is the most common abdominal surgery in women after cesarean. After separating the uterus from the vagina, vaginal cuff can be closed or left open. Despite application of this technique over the years, one still cannot comment on which technique is preferred over another. Present study is the comparison of febrile complications of abdominal hysterectomy (Determined and compared with postoperative fever, wound infection and antibiotics need) in both closed and open vaginal cuff technique. This double-blind clinical trial was performed in 2005 on 93 patients at the Obstetrics and Gynecology Department in Shodada Hospital on volunteers for abdominal hysterectomy. 45 patients were placed in the control group (closed cuff) and 48 patients in the case control (open cuff). Inclusion criteria included no fever; no immunosuppressive drugs, active cervicitis and vaginitis symptoms. Surgery techniques were similar in the two groups studied except for vaginal cuff repair. After surgery in both groups, variables such as: fever, wound infection, wound dehiscence, need for antibiotics, urinary tract infection, hemoglobin after surgery, need to accommodate injection and bowel obstruction were measured and compared using t-test, Leuven, Chi-square and Fisher's exact test. Two groups were not significantly different for age, diabetes history, preoperative hemoglobin, prophylactic antibiotics administration, type of anesthesia, incision type, duration and extent of surgery (p>0.05). Most of surgery-related causes were abnormal uterine bleeding (37.8%) and myoma (33.3%), respectively. There was no significant difference in febrile morbidity in two groups. Postoperative pain and need for parenteral analgesics in the control group was significantly lower than the case group (p<0.006). Febrile morbidity was similar in both groups showed no significant difference (p =0.525). Vaginal cuff not healing has no affect on febrile complications, the need for antibiotics and wound complications. Closing the vaginal cuff has shorter duration of surgery and less pain after surgery.

Breastfeeding initiation time has a significant effect on lactation performance. Breastfeeding initiation within a half-hour of birth and exclusive breastfeeding are important strategies to reduce neonatal morbidity and mortality. Different factors such as psychosocial support and received education affect breastfeeding initiation time. Therefore, hospital-based and community-based strategies are recommended for early breastfeeding initiation. So far, no study has been conducted to compare these two methods. Therefore, this study has been performed to compare the effect of peer support (community-based) and the education received by health care providers (Hospital-based) on the time of breastfeeding initiation among primiparous women. This clinical trial was performed on 3-group with 105 primigravida women participants. 16 health care centers were selected via cluster selection method and then were allocated randomly into 3 different groups: peer support receivers, education receiver by health care provider and control group. 16 eligible volunteers were selected as peer support receivers and trained for 15 hours. 7 women were selected as education receivers by health care providers and were trained for 2 hours. For peer support receivers, a single peer support was received by peer support providers, and educational group participants received one individual training session in 36-38 weeks of pregnancy by health care provider. The control group received only routine care. Data were collected by a questionnaire and were analyzed by SPSS software version 11.5. Kruskal-Wallis and Fisher’s Exact tests were used to analyze data. Only 20% of peer support receivers, 14.7% of education receivers (by health care providers) and 19.4% of control group members initiate breastfeeding within the half-hour of delivery. 51.4% of peer support receivers, 61.8% of education receivers and 55.6% of control group member began their first breastfeeding within the period of 1- 24 hours after delivery. There were no significant difference at the time of breastfeeding initiation among three groups (p=0.852). The present study did not provide any evidence in terms of impact of peer support and education received by health care providers on the time of breastfeeding initiation; Whereas, some studies have shown positive effect of peer support during labor on breastfeeding initiation time. So, it seems that further study regarding effect of peer support during labor and effect of medication during labor may be needed.

Professional labor support is a continuous support to obviate emotional, physical and informational needs of women during labor appropriately which is an essential aspect of reproductive health. The aim of this study is to determine the application and importance of professional labor support and some factors affecting it by midwives and midwifery students. This is a cross sectional study, and 81 midwifery students and midwives of hospitals related to Tehran University of Medical Sciences were investigated in 2010. The standard Labor Support Questionnaire (LSQ) was used to determine the amount, importance and some barriers regarding support with the score range of 0-135, and it was classified into three levels: Poor, average and good. The average LSQ application score was 85.56±21.7 (moderate level); 82.44±22.46 (moderate) for students and 94.52±16.98 (good) for midwives. Also, the application of physical, emotional and advocacy support was at a moderate level and in terms of informational supports was at a good level. Midwives and students perceived all aspects of support as important. No significant correlation was observed between the importance of support and individual characteristics of students and midwives (p>0/05). From the midwives’ point of view, poor paperwork and no valuable support by the mothers, and from students’ viewpoint, lack of skill and experience were the most important barriers in the application of supportive behaviors. Considering the barriers in application of labor supports, there is a need to eliminate these barriers and to valorize the given support.