Birth Plan Research Articles

Does having a birth plan influence Cesarean section rates?

Nellis Family Medicine Residency Las Vegas, NV The authors declare no conflicts of interest. The opinions and assertions contained herein are those of the authors and are not to be construed as official or as reflecting the views of the US Air Force Medical Department, the Air Force at large, or the Department of Defense.

The impact of the Covid-19 lockdown on the experiences and feeding practices of new mothers in the UK: Preliminary data from the COVID-19 New Mum Study

BackgroundThe COVID-19 New Mum Study is recording maternal experiences and infant feeding during the UK lockdown. This report from week 1 of the survey describes and compares the delivery and post-natal experiences of women who delivered before (BL) versus during (DL) the lockdown. MethodsWomen living in the UK aged ≥18 years with an infant ≤12 months of age completed an anonymous online survey (https://is.gd/covid19newmumstudy). Information/links are shared via websites, social media and existing contacts. ResultsFrom 27.5.20–3.6.20, 1365 women provided data (94% white, 95% married/with partner, 66% degree/higher qualification, 86% living in house; 1049 (77%) delivered BL and 316 (23%) DL. Delivery mode, skin-to-skin contact and breastfeeding initiation did not differ between groups. DL women had shorter hospital stays (p < 0.001). 39% reported changes to their birth plan. Reflecting younger infant age, 59% of DL infants were exclusively breast-fed/mixed fed versus 39% of BL (p < 0.05). 13% reported a change in feeding; often related to lack of breastfeeding support, especially with practical problems. Important sources of feeding support were the partner (60%), health professional (50%) and online groups (47%). 45% of DL women reported insufficient feeding support. Among BL women, 57% and 69% reported decreased feeding support and childcare, respectively. 40% BL/45% DL women reported insufficient support with their own health, 8%/9% contacted a mental health professional; 11% reported their mental health was affected. 9% highlighted lack of contact/support from family and distress that they had missed seeing the baby. ConclusionLockdown has impacted maternal experiences, resulting in distress for many women. Our findings suggest the need for better infant feeding support, especially ‘face-to-face’ support for practical issues; and recognising and supporting mothers who are struggling with mental health challenges or other aspects of their health. The effectiveness of online versus face-to-face contact is currently uncertain, and requires further evaluation.

Pregnant Women's Reports of the Impact of COVID-19 on Pregnancy, Prenatal Care, and Infant Feeding Plans.

The aim of this study is to describe how the COVID-19 (coronavirus) pandemic has affected pregnancy, prenatal maternity care practices, and infant feeding plans among pregnant persons in the United States. Cross-sectional descriptive study using an app-based survey. A link to the survey was sent via email to users of the Ovia Pregnancy app on May 20, 2020 and was open for 1 week. Participants were asked to complete the survey as it applied to their pregnancy, breastfeeding, and maternity care received during the COVID-19 pandemic, beginning approximately February 2020 through the time of the survey. There were 258 respondents who completed the survey. The majority (96.4%; n = 251) of pregnant women felt they received safe prenatal care during this time period. Slightly less 86.3% (n = 215) felt they received adequate prenatal care during this time period. 14.2% (n = 33) reported changing or considering changing the location where they planned to give birth due to COVID-19. Of those who reported they had begun purchasing items for their baby, 52.7% reported that the COVID-19 pandemic has affected their ability to get items they need for their baby. Although it is imperative to implement policies that reduce risk of transmission of COVID-19 to pregnant women and health care providers, it is necessary for health care providers and policy makers to listen to the collective voices of women during pregnancy about how COVID-19 has affected their birth and infant feeding plans and their perception of changes in prenatal care.

Pandemic Has Compromised Mental Health of New Moms

Pandemic Has Compromised Mental Health of New Moms

Perinatal Palliative Care Birth Planning as Advance Care Planning

Purpose of Review: A significant number of pregnancies are complicated by a fetus with a life-limiting diagnosis. As diagnoses are made earlier in the pregnancy, families experience anticipatory grief and are faced with navigating goals of care for a baby that has yet to be born. With the support of the care team, families can begin to grieve, plan, and make meaningful memories during the duration of the pregnancy, the birth of their baby, and life of the child. Creating a palliative care birth plan, which expands beyond the traditional concept for delivery planning to include prenatal, perinatal, and neonatal care has become an important method for parents to process the diagnosis, for parents to document their wishes, and for members of the care team to communicate with the goal of supporting and enhancing the experience of the family. This articles reviews recent and relevant literature on the importance of birth planning and the role of perinatal palliative care when a life-limiting fetal diagnosis is made.Recent Findings: The process of birth planning is an important component of perinatal palliative care. Through this process, families can express their fears, values, hopes, and wishes. It also offers an opportunity for providers to communicate these wishes for the remainder of the pregnancy, the delivery, birth, and time afterwards. This has been demonstrated to decrease maternal stress and promote family centered care.Summary: Perinatal birth planning is an important component of perinatal palliative care when a fetus has a life-limiting diagnosis. The process of birth planning can be supportive and therapeutic as well as an important communication tool. With multiple practices and designs of perinatal palliative care programs, there are no standard tools even though important components have been identified. Ultimately, the strategies outlined here can be used as advance care planning tools.

Evaluation of the birth plan implementation: a parallel convergent mixed study

BackgroundPregnancy, birth, and motherhood are among the most important events of every woman’s life. Training and participation of mothers in the decision-making process of delivery play an essential role in physical as well as psychosocial preparation of the mother. The healthcare system can improve and enhance the level of care by involving the patient in their self-care process. The aim of the present study is to assess the implementation of the birth plan for the first time in Iran in Tabriz city.Methods/designThe present study uses a mixed-method with a parallel convergence approach, including both quantitative and qualitative phases. The quantitative phase is a randomized controlled clinical trial performed on 106 pregnant women, 32–36 weeks of pregnancy, referring to Taleghani educational hospital in Tabriz city. The participants will be assigned into intervention and control groups using a randomized block method. A training session will be held about the items of the birth plan checklist at weeks 32–36 of gestation for the participants in the intervention group, whereby a mother-requested birth plan will be developed. It will then be implemented by the researcher after admitting them to the delivery ward. Also, those in the control group will receive routine care. During and after the delivery, the questionnaire of delivery information, neonatal information, and Delivery Fear Scale (DFS) will be completed. Also, a partogram will be completed for all participants by the researcher. The participants in both groups will be followed up until six weeks post-delivery, whereby the instruments of Childbirth Experience Questionnaire (CEQ2.0), Edinburgh’s Postpartum Depression Scale and PTSD Symptom Scale 1 (PSS-I) will be completed six weeks 4–6 weeks postpartum by the researcher through an interview with participants in Taleghani educational hospital. The general linear model and multivariate logistic regression model will be used while controlling the possible confounding variables.The qualitative phase will be performed to explore the women’s perception of the effect of the birth plan on childbirth experience within 4–6 weeks postpartum. The sampling will be of a purposeful type on the women who would receive the birth plan and will continue until data saturation. In-depth, semi-structured individual interviews would be used for data collection. The data analysis will be done through content analysis with a conventional approach. The results of the quantitative and qualitative phases will be analyzed separately, and then combined in the interpretation stage.DiscussionBy investigating the effect of implementing the birth plan on the childbirth experience of women as well as other maternal and neonatal outcomes, an evidence-based insight can be offered using a culturally sensitive approach. The presentation of the results obtained from this study using the mixed method may be effective in improving the quality of care provided for women during labor.Trial registrationIranian Registry of Clinical Trials (IRCT): IRCT20120718010324N58. Date of registration: July 7, 2020. URL: https://en.irct.ir/user/trial/47007/view

Telemedicine system for improving maternal and neonatal health: an interventional trial in Tanzania

Abstract Background In Tanzania, maternal and neonatal mortality is still high, mainly due to poor quality of Antenatal Care (ANC) and Post Natal Care (PNC) services. PANDA (Pregnancy And Newborn Diagnostic Assessment) is a telemedicine system that uses mobile technology to perform adequate ANC/PNC visits according to WHO recommendations. Two pilot studies showed that PANDA is efficient in providing high-quality ANC and facilitating the continuity of care for underserved communities. This project aims at testing the impact of PANDA in Tanzania for improving the adherence to both ANC and PNC WHO protocols. Methods This case-control study is conducted in two different areas of the Mufindi district, Tanzania. The PANDA system includes: - solar backpack containing instrumentation for communicable and non-communicable diseases screening; smartphone with an icon-based application, including 5 modules: socio-demographic information, medical history, clinical screening, health education and birth plan, postnatal care;hospital database with the data collected during the visits. Results At present, 405 women (1,066 ANC visits) were recruited in the implementation site and 200 in the control site. The preliminary results show that 60% of women attended ≥ 2 ANC visits in the implementation site. In this area, 52 women were found positive for HIV and 4 for syphilis. Data collection in both the sites is ongoing. Conclusions PANDA system allows the creation of electronic patient records and the identification of the high-risk pregnancies. The collection of population data is useful for health planning policies. The easy-to-use and easy-to-understand graphic interface overcomes language and literacy barriers and facilitates comprehension of women and compliance to visits. This can improve the quality of ANC/PNC services with an expected reduction in maternal and neonatal mortality. Key messages PANDA system increases access to high-quality ANC for pregnant women in low-income countries, improving the adherence to WHO recommendations. The telemedicine system PANDA is a useful tool for public health policy-makers, as it allows the collection of previously unavailable population data.

Status of Home Delivery and Its Associated Factors among Women Who Gave Birth within the Last 12 Months in East Badawacho District, Hadiya Zone, Southern Ethiopia.

Background Home delivery is responsible to maternal mortality due to obstetric complication like hemorrhage, hypertensive disorders, and sepsis. The prevalence of home delivery is remained very high both nationally (73%) and regionally (SNNPR) with 74.5%. Efforts were made to increase institutional delivery through skilled birth attendance. But women still prefer home as a place of delivery. This study was done to determine whether home preference has association with home delivery or not and the reason why they prefer home delivery Method A community-based cross-sectional study was conducted in East Badawacho District from January 26 to February 25/2018. A total of 552 participants were selected by systematic sampling. Data were collected using both quantitative and qualitative methods. Bivariate and multivariable analyses were carried out to identify factors associated with home delivery. Qualitative data was analyzed thematically, and results were triangulated with the data. Associations were determined by using OR at 95% CI and p value at 0.05. Result Home delivery is found to be 73.6% (95% CI, 69.9%-77.2%). Lack of written birth plan for birth preparedness and readiness (AOR = 14.965, 95% CI: 4.488-49.899), incomplete number of ANC visits (1-3)(AOR = 4.455, 95% CI: 1.942-10.221), and home preference as a place of delivery (AOR = 4.039, 95% CI: 1.545-10.558) were independent predictors of home delivery. Conclusion Home delivery was high in the district. The independent factors significantly associated with home were lack of written birth plan for preparedness and readiness, incomplete number of ANC visits (1-3), and home preference as place of delivery. Actions targeting maternal education, encouraging number of ANC visits, and avoiding barriers for ID utilization were the crucial areas to tackle the problem.

Association Between Region of Birth and Advance Care Planning Documentation Among Older Australian Migrant Communities: A Multicenter Audit Study.

ObjectivesThis study explored associations between birth region, sociodemographic predictors, and advance care planning (ACP) uptake.MethodsA prospective, multicenter, cross-sectional audit study of 100 sites across 8 Australian jurisdictions. ACP documentation was audited in the health records of people aged 65 years or older accessing general practice (GP), hospital, and long-term care facility (LTCF) settings. Advance care directives (ACDs) completed by the person (“person completed ACDs”) and ACP documents completed by a health professional or other person (“health professional or someone else ACP”) were counted. Hierarchical multilevel logistic regression assessed associations with birth region.ResultsFrom 4,187 audited records, 30.0% (1,152/3,839) were born outside Australia. “Person completed ACDs” were less common among those born outside Australia (21.9% vs 28.9%, X2 (1, N = 3,840) = 20.3, p < .001), while “health professional or someone else ACP” was more common among those born outside Australia (46.4% vs 34.8%, X2 (1, N = 3,840) = 45.5, p < .001). Strongest associations were found for those born in Southern Europe: “person completed ACD” (odds ratio [OR] = 0.56, 95% confidence interval [CI] = 0.36–0.88), and “health professional or someone else ACP” (OR = 1.41, 95% CI = 1.01–1.98). English-language proficiency and increased age significantly predicted both ACP outcomes.DiscussionRegion of birth is associated with the rate and type of ACP uptake for some older Australians. Approaches to ACP should facilitate access to interpreters and be sensitive to diverse preferences for individual and family involvement in ACP.

Subsequent childbirth after previous traumatic birth experience: women's choices and evaluations

Background After a traumatic childbirth experience, women are often afraid of future pregnancies, and may be at risk for also experiencing their subsequent childbirth as traumatic. Aims Two questions were investigated regarding women's experience of their subsequent childbirth after a previous traumatic birth: (1) which factors in the previous traumatic birth are associated with the subsequent childbirth experience, and (2) fear of childbirth and coping behaviour during the subsequent pregnancy associated with the subsequent birth experience. Methods A total 474 Dutch women (mean age during traumatic childbirth=28.9 years; SD=3.9) answered an online survey about their previous traumatic and subsequent birth experience. Findings Making a birth plan, choosing a home birth in a high-risk pregnancy, and having a planned caesarean section emerged as statistically significant correlates of positive subsequent birth experience. Conclusion Experiencing control over the subsequent birth might underlie practices associated with more positive subsequent childbirth experience among women with a traumatic childbirth history.

Kommunikative Beteiligung von Partnern in der Schwangerenberatung

Abstract The interaction between midwifes or other medical professionals and pregnant women in the last trimester of pregnancy plays an important role during antenatal care and birth. The partners of the pregnant women are often present for these conversations and can affect the interaction with their contributions, e. g. their input to the birth plan and their experiences during pregnancy. In this interactional work, triadic interactions during antenatal care consultations were analysed. Using examples from a corpus of 37 primary consultations between midwifes, pregnant women and doctors in an obstetric ward, it is shown that partners can affect the information exchange during these interactions. With their utterances, partners can provide various information, such as facts about previous deliveries, information about the pregnant woman, own pregnancy experiences, information about past abortions and miscarriages as well as information about congenital diseases. In doing so, they enriched the conversation and provided emotional support for the pregnant woman. Only very few partners acted in the role of ‘critic’ or ‘opponent’ and controlled the informational exchange between midwife and pregnant woman or focused solely on themselves during these interactions.

Contraceptive practice among married women of reproductive age group in rural Telangana: a cross sectional study

Background: Contraceptive practice in India is known to be very heavily skewed towards terminal methods which mean that contraception in India is practiced primarily for birth limitation rather than birth planning. The objective of the study was to study contraceptive practice among married women of reproductive age in rural area.Methods: The study was a cross sectional study among married women with reproductive age group in rural areas of Sangareddy district carried out in Department of Community Medicine, MNR Medical College, Sangareddy, during November 2015 to February 2016. A total sample size of 113 women who are married in age group of 15-45 years and presumed to be sexually active were included in study. The data were collected using structured questionnaire and in-depth interview guide in local language. The collected data were analyzed with proper statistical methods using MS excel 2010.Results: Out of 113 women majority of women were in age group 20-29 years (52.21%). The utilization of contraceptive method was present in 52.21% women with oral contraceptive pills (23.89%) as a choice of method in majority of women.Conclusions: Hence, we conclude that still there is need to create awareness regarding importance of contraception among rural women.

The complex effects of maternal expectations on postpartum depressive symptoms: when does a protective factor become a risk factor?

Purpose The present study assessed the effects of several prenatal maternal expectations on postpartum depression (PPD), while considering two relevant factors – incongruence between planned and actual birth and the rigidity of the birth plan – that can affect whether maternal expectations act as protective factors or risk factors for PPD. Methods Primiparous women (N = 527) were recruited to a longitudinal study about women’s birth choices and experiences. At time 1, during pregnancy, women completed a questionnaire assessing prenatal depression, preferred birth plan, birth plan flexibility–rigidity and maternal expectations (i.e. Natural-Fulfillment, Infant-Reflects-Mothering, Sacrifice). At time 2, two-months post-partum, they reported their actual birth mode and answered a questionnaire assessing their PPD symptoms. Results Natural-fulfillment maternal expectations were negatively related to PPD symptoms. Yet, the interaction of high natural-fulfillment expectations with an unfulfilled birth plan and the rigidity of the birth plan, served as a risk factor for PPD symptomatology. Conclusions Understanding the conditions under which specific prenatal maternal expectations serve as a risk factor for PPD, can help healthcare providers identify women who are at high risk for developing PPD symptoms and plan preemptive interventions.

Menses, pregnancy, delivery, and menopause in hidradenitis suppurativa: A patient survey.

BackgroundHidradenitis suppurativa (HS) is a chronic inflammatory disorder that primarily affects women of childbearing age. There is a paucity of data on HS disease activity during menstruation, pregnancy, and menopause and the potential impact of HS on the method of delivery.ObjectiveWe aimed to characterize the natural history of HS symptoms during menses, pregnancy, and menopause. We also sought to evaluate the potential impact of HS on delivery method and whether there were delivery-related healing complications unique to women with HS.MethodsAn anonymous survey was distributed via social media to international HS support groups and patients at three HS specialty clinics in North America. Responses were collected from March to July 2019.ResultsA total of 279 respondents answered questions on disease changes during pregnancy. Menstruation caused worsening of HS symptoms in 76.7%, no change in 22.2%, and improvement in 1.1%. During pregnancy, the distribution between symptoms worsening (34.8%), having no change (28.7%), and improving (36.6%) was relatively even. After menopause, participants typically reported either worsening (39.5%) or no change (44.2%) in HS symptoms. Among respondents with anogenital HS involvement who delivered vaginally, 3.1% believed that HS interfered with vaginal delivery (VD), and 23.5% believed that VD caused an HS flare. Cesarean section (C-section) delivery was reported by 44.2% of participants. Ten participants reported that they were advised by their doctor to have a C-section instead of a VD because of severe anogenital HS. Of those who underwent a C-section, 33.9% reported that HS interfered with incision healing, and 51.2% reported developing new HS lesions in their C-section scar.ConclusionTo our knowledge, this is the first study describing the potential influence of HS on a patient’s method of delivery. Multidisciplinary collaboration plays a pivotal role in developing individualized treatment and birth plans for pregnant women with HS.

A Qualitative Exploration of Access and Utilization of Focused Antenatal Care among Pastoral Community in North Eastern Kenya

Background: Ministry of Health Kenya has adopted new guidelines for FANC services emphasizing on four antenatal care visits, birth planning and emergency preparedness. In North eastern Kenya predominately occupied by Somali pastoralist Communities only 37% of women of reproductive age receive ANC service at least 4 times during pregnancy, which is considerably lower than the national rate of 58%. There is limited utilization of healthcare services among nomadic pastoralist compared to general population, this is due to several constraints stemming from their migratory way of life, poor social services and spatial disparities. Limited studies have adopted qualitative approaches to explore access and utilization FANC among pastoralist communities. The study explored access and utilization of FANC service among pastoralist community of North Eastern Kenya.&#x0D; Methodology: The study is an exploratory qualitative study, using a purposive sampling method forty eight women who give birth two years prior to the study were selected, sixteen male partners and three ANC providers. Data was collected using FGDs and KIIs and analyzed thematically.&#x0D; Results: There is low utilization of FANC among pastoralist communities, the proportion of respondents who had utilized was 83.3% but only few 39.6% had utilized the required four visits (FANC). There is delayed initiation of uptake of FANC services where majority respondents 55.0% had attended ANC in their second trimester while only 17.5% had utilized in their first trimester as recommended. Barrier that hampered FANC uptake are: long distance to health centre, transport cost, low level of FANC knowledge, TBAs practice, low income and harmful cultural practices. Major facilitators identified are free FANC charges, good attitude of a care giver and fear of pregnancy complication. Access challenges range from inadequate infrastructure, lack of skilled health attendants and logistical constraints to harmful cultural practices.&#x0D; Conclusion: There is need to reduce travelling time to the health facility by conducting regular outreach services targeting nomads with no near facility, improve culturally sensitive FANC to increase accessibility, involving all health stakeholders and community representatives to increase cultural acceptability and also help priorities policies that increases FANC service uptake.

The Use of Birth Plan to Support Waterbirth: A Qualitative Approach

Background: The professional resistance to childbirth in water and the limitation of robust scientific evidence to support its safety constitute a context prone to the restriction of women’s freedom of choice. The elaboration of the birth plan by pregnant women who wish to experience a birth immersed in water can be an important instrument for the exercise of their choice and autonomy. This qualitative and descriptive case study aim to realize how women experienced their birth plan in two hospitals in Portugal.

The Patient's Perspective and Patient Satisfaction in Labor and Delivery [35N

INTRODUCTION: Clinical and subjective factors affect the patient's perception of labor and delivery, but little is known about how much each factor contributes to patient satisfaction. This study evaluates the correlation between clinical and subjective patient parameters during the intrapartum course and patient satisfaction. METHODS: This is a cross-sectional observational study. Participants completed surveys in the immediate postpartum period. Surveys assessed the patient's perception of intrapartum events and patient satisfaction. Survey responses were compared to patient charts. Logistic regressions determined predictors of patient satisfaction. RESULTS: 332 women completed surveys. Positive subjective factors which predicted patient satisfaction included feeling the provider explained the intrapartum course well (OR 3.47, 95% CI 1.17–10.31, P=.025), patient input into managing labor (OR 2.96, 95% CI 1.46–5.98, P=.002), and increased support during labor (OR 2.45, 95% CI 0.99–6.04, P=.05). Having a birth plan led to less satisfaction (OR 0.49, 95% CI 0.24–0.96, P=.04). Birth classes and feeling pressured by providers in labor were not significant predictors of patient satisfaction. Positive clinical predictors of patient satisfaction included a vaginal delivery (OR 1.97, 95% CI 1.07–3.27, P=.02), but multiparity, advanced maternal age, regional anesthesia, episiotomy, or a postpartum hemorrhage were not significant predictors of satisfaction. Understanding the labor and delivery events predicted high satisfaction (P=.02). CONCLUSION: Patient satisfaction is dependent on patient input into labor, adequate explanations of the labor course, increased support in labor, high patient understanding, and achieving a vaginal delivery.

Perceptions of paternal involvement and labour pain management in Chinese couples during childbirth: A qualitative study

BackgroundLabour pain is an individual experience embedded in a socio-cultural context. In childbirth, the father’s involvement provides important support to the mother during labour. However, few published studies have evaluated couples’ experiences of paternal involvement and labour pain management in the Chinese context. AimThis study aimed to understand the experience of labour pain management and the father’s involvement in childbirth from the perspectives of women and their partners in Hong Kong. MethodsAn exploratory qualitative design was adopted. A purposive sample of 45 Chinese parents was recruited at the postnatal unit of a regional hospital. Data were collected through semi-structured face-to-face interviews within 1 month after birth. The data were subjected to content analysis. FindingsThe findings revealed six major themes: the mothers’ experience of labour pain, effectiveness of pain relief measures, mothers’ perceptions of support from their partners, mothers’ perceptions of support from healthcare professionals, fathers’ experience of involvement in childbirth and suggested improvements to maternity services. DiscussionChinese mothers experienced intense labour pain and used various pain relief measures. Both parents considered the involvement of fathers and support from healthcare professionals to be highly significant during childbirth. ConclusionsThis study highlights the need for a family-centred model of care during childbirth that involves both parents in the decision-making process. Chinese maternity services should implement individualised birth plans that acknowledge both parents’ expectations and preferences, thus promoting a positive childbirth experience for the parents.

What do women want? An analysis of preferences of women, involvement of men, and decision-making in maternal and newborn health care in rural Bangladesh

BackgroundTo improve the utilization of maternal and newborn health (MNH) care and to improve the quality of care, the World Health Organization (WHO) has strongly recommended men’s involvement in pregnancy, childbirth, and after birth. In this article, we examine women’s preferences for men’s involvement in MNH care in rural Bangladesh and how this compares to husbands’ reported involvement by women.MethodsA cross-sectional household survey of 1367 women was administered in 2018 in the district of Brahmanbaria. Outcomes of interest included supporting self-care during pregnancy, participation in birth planning, presence during antenatal care, childbirth, and postnatal care, and participation in newborn care. Binary and multiple logistic regressions were done to understand the associations between the outcomes of interest and background characteristics.ResultsAlthough women preferred a high level of involvement of their husbands in MNH care, husbands’ reported involvement varied across different categories of involvement. However, women’s preferences were closely associated with husbands’ reported involvement. Around three-quarters of the women reported having been the primary decision makers or reported that they made the decisions jointly with their husbands. The likelihood of women reporting their husbands were actively involved in MNH care was 2.89 times higher when the women preferred their husbands to be involved in 3–4 aspects of MNH care. The likelihood increased to 3.65 times when the women preferred their husbands to be involved in 5–6 aspects. Similarly, the likelihood of husbands’ reported active involvement was 1.43 times higher when they jointly participated in 1–2 categories of decision-making. The likelihood increased to 2.02 times when they jointly participated in all three categories.ConclusionThe findings of our study suggest that women in rural Bangladesh do indeed desire to have their husbands involved in their care during pregnancy, birth and following birth. Moreover, their preferences were closely associated with husbands’ reported involvement in MNH care; that is to say, when women wanted their husbands to be involved, they were more likely to do so. Programmes and initiatives should acknowledge this, recognizing the many ways in which men are already involved and further allow women’s preferences to be realized by creating an enabling environment at home and in health facilities for husbands to participate in MNH care.

Information System For Monitoring Of Pregnant Mother In Riau Province Health Office

The data collection of pregnant women is the realization of the Birth Planning and Prevention of Complications (P4K) Program in the Riau Provincial Health Office of the Family and Nutrition Health Section. The data collection of pregnant women aims to find out information about pregnant women scattered in 12 regencies and cities in Riau Province including: the number of pregnant women, Tabulin, transportation, blood donors, assisting pregnant women and birth assistance plans. Currently reports and data recording of pregnant women are still done manually using Excel. To make it easier for officers to monitor the health of pregnant women in Riau Province, a Web based health monitoring system for pregnant women was built. This system integrates data on pregnant women in Riau Province starting from the Puskesmas level. This system can help officials in the Health Department monitor and record pregnant women, so that they can assist in planning a safe delivery and preparing for complications for pregnant women.