Childbirth In Order Research Articles

Understanding the meaning of the puerperium for the embera indigenous of Tierralta, Cordoba, 2018

Introduction: The cultural and ethnic diversity of indigenous peoples in Colombia makes it necessary to adopt a differential approach to the health of different cultures. Objective: To understand the meaning of puerperium assigned by the Embera Katio, from the municipality of Tierralta, Cordoba, 2017-2018. Method: ethnographic study. Theoretical sample with 13 key participants. Participant observation methods and in-depth interviews were used. The analysis was guided by Leininger’s proposal. Ethical aspects were considered. Results: The puerperium, called “Recien Parida”, is a period of change and uncertainty between happiness and danger of getting sick or dying, which consists of four cultural patterns: 1. Just after giving birth my body changes physically and mentally; 2. Right after giving birth I feel happy to be accompanied and alive; 3. Just after giving birth, I am in danger and I am afraid of getting sick and die; 4. A hatch of attention and teachings to take care of me. Conclusions: Embera Katio puerperal women consider puerperium as a process of change and uncertainty which can be dangerous due to natural, physical and emotional factors which generate fear of illness or death. They recognize that their body must recover and close after childbirth in order not to suffer from diseases, and they require a hatch of accompaniment between the care provided especially by the family and self-care.

El alivio del dolor en el parto. Empoderamiento y vulnerabilidad de las mujeres en la toma de decisiones. Estudio cualitativo.

Introduction In Spain the use of epidurals for pain relief during childbirth is widespread. Currently, we can observe a progressive change in attitude towards a less interventionist care and the use of non-pharmacological methods to reduce pain, unless the woman has left instructions otherwise. Aims To explore the decision-making process concerning pain relief methods in childbirth in order to detect the elements of vulnerability that are present in said process and examine the demands directed towards healthcare professionals. Methodology This study has applied a qualitative methodology with a phenomenological theoretical-methodological approach. The technique used to obtain information was the semistructured individual interview. The study was carried out in Catalonia. The participants were 17 adult women with low-risk pregnancies. Results Three categories have been identified after the analysis: (a) Completion of the birth plan: an approach to the decision; (b) The rationale of the decision: resources and barriers; and (c) The approach to pain in childbirth: elements of vulnerability. Conclusions Women do not always make firm decisions when completing the birth plan; The decisions expressed may be statements of intent. At the time of delivery, the perceived pain can be experienced as a threat that makes them feel vulnerable. The role of midwives and other healthcare professionals is to help work out this sense of vulnerability.

Comparison of Kernel Function on Support Vector Machine in Classification of Childbirth

The maternal mortality rate during childbirth can be reduced through the efforts of the medical team in determining the childbirth process that must be undertaken immediately. Machine learning in terms of classifying childbirth can be a solution for the medical team in determining the childbirth process. One of the classification methods that can be used is the Support Vector Machine (SVM) method which is able to determine a hyperplane that will form a good decision boundary so that it is able to classify data appropriately. In SVM, there is a kernel function that is useful for solving non-linear classification cases by transforming data to a higher dimension. In this study, four kernel functions will be used; Linear, Radial Basis Function (RBF), Polynomial, and Sigmoid in the classification process of childbirth in order to determine the kernel function that is capable of producing the highest accuracy value. Based on research that has been done, it is obtained that the accuracy value generated by SVM with linear kernel functions is higher than the other kernel functions.

The Legal Role of Establishing the Origin of the Child in Legal Relations based on Inheritance when Assisted Reproductive Technologies are Applied

The author argues that it is necessary to amend the current legislation of the Republic of Tajikistan, namely, the procedure provided for registration of data regarding parents and child birth registration when the child is born as a result of application of assisted reproductive technologies after the death of the parent in order to make the child the participant of the relations based on inheritance. The author substantiates the conclusion that the child born after the death of the testator, after the distribution of hereditary property had taken place, will not be able to act as the participant of this hereditary relationship. However, being recognized as a legitimate child of the deceased parent, he or she will be entitled to participate in inheritance relations in future.The conclusion is made about ambiguity of the approach chosen by the Tajik law-maker depending on the branch of law to the category «child in the womb» when determining problematic aspects of defining of live birth and vitality of the child for the purpose of referring the child to the participants of hereditary legal relations.The author investigates the problems of including the child into the number of participants of hereditary legal relations in antiquity. A historical review is carried out, and separate categories of marriages created in the territory of historical Tajikistan for the purpose of the child birth in order to transfer inheritance are considered. The author has determined that Zoroastrian law allowed the child born from the deceased person prior to the conception of the child to participate in hereditary legal relations as if the child were native and would be born during the life of a «legal» father. There were no legal obstacles for a child born in this case preventing him or her from receiving inheritance The beginnings of «traditional» surrogacy motherhood in the territory of historical Tajikistan are determined.

Improving quality of care during childbirth in primary health centres: a stepped-wedge cluster-randomised trial in India

BackgroundLow/middle-income countries need a large-scale improvement in the quality of care (QoC) around the time of childbirth in order to reduce high maternal, fetal and neonatal mortality. However, there is...

Women\u2019s experiences of continuous support during childbirth: a meta-synthesis

BackgroundDespite the known benefits of continuous support during childbirth, the practice is still not routinely implemented in all maternity settings and women’s views and experiences might not be considered.The purpose of the study was to integrate individual studies’ findings related to women’s experiences of continuous support during childbirth in order to expand the understanding of the phenomenon. The review question was: What were the views and experiences of women regarding continuous support during childbirth as reported in studies that adopted qualitative or mixed research methods (with a qualitative component) using semi-structured, in-depth or focus group interviews or case studies?MethodsA detailed search was executed on electronic data bases: EBSCOhost: Medline, CINAHL, PsychINFO, SocINDEX, OAlster, Scopus, SciELO, Science Direct, PubMED and Google Scholar, using a predetermined search strategy. Reference lists of included studies were analysed to identify possible studies that were missing from electronic data bases.Pre-determined inclusion and exclusion criteria were applied during the selection of eligible sources. After critical appraisal, a total of 12 studies were included for data-extraction and meta-synthesis.ResultsTwo themes were identified, namely the roles and attributes of the support persons and the type of support provided. Women’s perceptions about continuous support during childbirth were influenced by the characteristics and attributes of the support person as well as the types of supportive care rendered. Women preferred someone with whom they were familiar and comfortable.ConclusionContinuous support during childbirth was valued by most women. Their perceptions were influenced by the type of support person: a health professional or a lay support person. Health care institutions should include continuous support during childbirth in their policies and guidelines.

‘Nonnatus dictus quod caeso defunctae matris utero prodiit’. Postmortem Caesarean Section in the Late Middle Ages and Early Modern Period

Abstract Historians call sectio in mortua the act of opening the abdomen of a woman who has died during pregnancy or in childbirth in order to extract a baby. According to recent studies, the sectio is considered to be a routine practice carried out by male surgeons from the end of the Middle Ages, particularly in Italy, where the evidence of the sectio being performed by a midwife is scanty. But was it really such a popular operation at the time, and can the figure of the midwife be seen as secondary? It is also known that the operation was qualified through aspects which went beyond the surgical sphere, such as religion, myth, and especially law. How did these fields interact? This article highlights the complexity of sectio through the interpretation of different sources spanning from the late Middle Ages to the Early Modern period.

First-time fathers' health status during the perinatal period

BackgroundFor first-time fathers, the perinatal period is a critical period of stress and imbalance. Marital intimacy and social support may affect their stress and health status while they change their roles. AimThis study was to explore the changes of and correlations among marital intimacy, social support, and health status and predictors of first-time fathers' health status during the perinatal period. MethodsWith a repeated measures study design, a total of 217 first-time fathers whose spouses were in the third trimester of pregnancy were recruited for the study. The Chinese Health Questionnaire, Marital Intimacy Scale, and Social Support Scale were employed to collect data at a medical center in the 36th week of pregnancy and the 1st and 4th weeks after childbirth. ResultsThe levels of marital intimacy and social support of first-time fathers during the perinatal period increased significantly with time. Meanwhile, the period of the first week after childbirth was a predictor of first-time father's health status. ConclusionsThis study only tracked the first-time fathers' health status in the 36th week of pregnancy and the 1st and 4th weeks after childbirth. Future studies could track them until one year after childbirth in order to explore the impact of the perinatal period on the couples and their babies. During the perinatal period, health care providers shall assess and provide needed interventions to first-time fathers as soon as possible to facilitate the first-time fathers to get ready for the role transition and to promote their health status.

Effect of Telephone-Based Support on Postpartum Depression: A Randomized Controlled Trial.

Postpartum depression (PPD) is one public health issue that affects both maternal and child health. This research studies the effect of health volunteers' telephone- based support on decreasing PPD. This randomized controlled trial evaluated 203 women who had uncomplicated deliveries. The women completed the Edinburg Postnatal Depres- sion Scale (EPDS), 10 to 15 days after childbirth in order to be assessed for pre-trial depression scores. The cut-off point for depression was considered to be a score of >10. We randomly assigned 54 eligible mothers (n=27 per group) with mild and moderate de- pression to the intervention and control groups. In both groups, mothers received routine postpartum care. The intervention group additionally received telephone support from health volunteers. A questionnaire was used to gather demographic and obstetric infor- mation. By the end of the 6thweek, mothers completed the EPDS to be reassessed for depression after intervention. Data were analyzed using the chi-square, Fisher's exact, t- and paired t tests. The mean depression scores before intervention (10 to 15 days after childbirth) in the intervention and control groups did not significantly differ (P=0.682). Depres- sion scores of the intervention and control groups showed a significant difference after 6 weeks (P=0.035). In addition, there was a significant decrease in depression for the intervention and control groups (P=0.045). Health volunteer telephone-based support effectively decreased PPD and may be beneficial to women with symptoms of mild and moderate PPD (Registration number: IRCT201202159027N1).

Childbirth efficacy: Validating the childbirth self-efficacy inventory in a Greek sample of pregnant women

Objectivechildbirth self-efficacy has been found to be a factor that influences women׳s decision about their choice of delivery. Greece is a country with a high caesarean section rate and the validation of the Childbirth Self-Efficacy Inventory (CBSEI) would help explore Greek pregnant women׳s emotional preparation of childbirth. The aim of the study was to translate the CBSEI to Greek and to examine its psychometric properties. Designa cross-sectional study. Settingprivate hospital in Athens, Greece. Participants145 pregnant women, in late pregnancy, attending routine antenatal visit between April 2014 and June 2014. Measurementsthe CBSEI was ‘forward–backward’ translated from English to Greek language. Descriptive statistics and non-parametric tests were used to describe and compare the scales. Factor structure was investigated using principal axis factoring. Measures of self-esteem and optimism were used to assess the convergent validity of the CBSEI. Cronbach׳s α was used to measure internal consistency reliability. Findingsthe factor analysis suggested the existence of a three-factor structure with meaningful groupings. Greek women were able to distinguish between outcome expectancy and self-efficacy expectancy and between the two labour stages, active phase of the first stage and the second stage of labour. Construct validity was confirmed by computing correlations between the CBSEI subscales and conceptually similar constructions of self-esteem and optimism. Internal consistency reliability was satisfactory. Key conclusion and implications for practicethe Greek version of the CBSEI is a reliable and valid measure. The clinical use of CBSEI may enable midwives and other health care professionals to identify pregnant women with low childbirth self-efficacy. The clinical use of CBSEI may also give the opportunity to provide information and support for preparing and empowering women for childbirth in order to improve their childbirth experience.

Disrespectful and abusive treatment during facility delivery in Tanzania: a facility and community survey.

Although qualitative studies have raised attention to humiliating treatment of women during labour and delivery, there are no reliable estimates of the prevalence of disrespectful and abusive treatment in health facilities. We measured the frequency of reported abusive experiences during facility childbirth in eight health facilities in Tanzania and examined associated factors. The study was conducted in rural northeastern Tanzania. Using a structured questionnaire, we interviewed women who had delivered in health facilities upon discharge and re-interviewed a randomly selected subset 5-10 weeks later in the community. We calculated frequencies of 14 abusive experiences and the prevalence of any disrespect/abuse. We performed logistic regression to analyse associations between abusive treatment and individual and birth experience characteristics. A total of 1779 women participated in the exit survey (70.6% response rate) and 593 were re-interviewed at home (75.8% response rate). The frequency of any abusive or disrespectful treatment during childbirth was 343 (19.48%) in the exit sample and 167 (28.21%) in the follow-up sample; the difference may be due to courtesy bias in exit interviews. The most common events reported on follow-up were being ignored (N = 84, 14.24%), being shouted at (N = 78, 13.18%) and receiving negative or threatening comments (N = 68, 11.54%). Thirty women (5.1%) were slapped or pinched and 31 women (5.31%) delivered alone. In the follow-up sample women with secondary education were more likely to report abusive treatment (odds ratio (OR) 1.48, confidence interval (CI): 1.10-1.98), as were poor women (OR 1.80, CI: 1.31-2.47) and women with self-reported depression in the previous year (OR 1.62, CI: 1.23-2.14). Between 19% and 28% of women in eight facilities in northeastern Tanzania experienced disrespectful and/or abusive treatment from health providers during childbirth. This is a health system crisis that requires urgent solutions both to ensure women's right to dignity in health care and to improve effective utilization of facilities for childbirth in order to reduce maternal mortality.

A comparison of Israeli Jewish and Arab women's birth perceptions

Backgroundbirth is a normal physiological process, but can also be experienced as a traumatic event. Israeli Jewish and Arab women share Israeli residency, citizenship, and universal access to the Israeli medical system. However, language, religion, values, customs, symbols, and lifestyle differ between the groups. Objectivesto examine Israeli Arab and Jewish women's perceptions of their birth experience, and to assess the extent to which childbirth details and perceptions predict satisfaction with the birth experience and the extent of assessing the childbirth as traumatic. Methodsthis study was conducted in two post partum units of two major public hospitals in the northern part of Israel. The sample included 171 respondents, including 115 Jewish Israeli and 56 Arab Israeli women who gave birth to their first (33%) or second (67%) child. Respondents described their childbirth experiences using a self-report questionnaire 24–48 hours after childbirth. Findingsthe Arab women were much less likely to attend childbirth preparation classes than the Jewish women (5% versus 24%). Forty-three per cent of the respondents reported feeling helpless, and 68% reported feeling lack of control during childbirth. Twenty per cent of the women rated their childbirth experience as traumatic, a rate much lower than the rate of medical indicators of traumatic birth (39%). The rate of self-reported traumatic birth was significantly higher among the Arab women than among the Jewish women (32% versus 14%). A higher percentage of the Arab women reported being afraid during labour (χ2=4.97, p<.05), expressed fear for their newborn's safety (χ2=12.44, p<.001), and reported that the level of medical intervention was excessive in their opinion, as compared to the Jewish women (χ2=5.09, p<.05; χ2=7.33, p<.01). However, both the Arab and Jewish women reported similar numbers of medical interventions and levels of satisfaction with their medical treatment. Conclusionsdespite universal access to the Israeli health care system, Arab Israeli women use fewer perinatal medical resources and subjectively report more birth trauma than Jewish Israeli women. Yet, they give birth in the same hospitals with the same practitioners and report similarly high levels of satisfaction with the medical services. Taking into account the fact that perceptions of the birth experience differ between ethno-cultural groups will enable professionals to better tailor intervention and support throughout childbirth in order to increase satisfaction and minimise trauma from the experience.

Work–family attitudes and behaviours among newly immigrant Pakistani expatriates: the role of organizational family-friendly policies

The work–life interface literature is often criticized for its limited sample base, with the majority of research focusing on the experiences of white women living in nuclear family households in Western societies. This paper aims to address some of these criticisms by using a qualitative methodology to explore the impact of organizational family-friendly policies on the work–family attitudes and behaviours of 26 newly expatriate Pakistani employees in the UK. Individual, family and religious/cultural influences on these outcomes were also explored. Findings indicate that study participants undergo a shift of priorities that result from expatriation and the consequent attenuation of extended family and societal pressures to have children immediately after marriage; participants are delaying childbirth in order to gain educational qualifications and establish careers in a foreign country. A strong preference for familial childcare suggests that family-friendly policies such as part-time or flexible hours have the potential to significantly affect employment outcomes for Pakistani expatriate women, who, in the absence of extended family to provide care for children, might not otherwise return to work following childbirth. Other potential organizational interventions are also discussed.

Pharmacotherapy of bipolar II disorder during and after pregnancy

The objective of this study was to evaluate the pharmacotherapy of bipolar II disorder during pregnancy and the postpartum period. The use of psychotropic drugs and recurrence risk during and after pregnancy was studied in a prospective, observational study of 37 women with bipolar II disorder. During pregnancy the majority of participants (54.0%) were not on any psychotropic medication, approximately one third (32%) received monotherapy, and the rest were on combination therapy. In comparison, during the postpartum period only 14% of participants were not on any psychotropic medication, approximately 35% received monotherapy, and over 50% were on combination therapy. While only 13.5% of participants were on 3 or more psychotropic drugs during pregnancy, 21.6% required 3 or more psychotropic drugs after childbirth in order to manage their symptoms. During pregnancy, 51 % of women had a mood episode compared to a recurrence rate of 70% in the postpartum period. Small sample size, lack of a control group, and absence of random treatment assignment. The findings of this prospective, observational study indicate that the recurrence risk is much higher after childbirth than during pregnancy in spite of higher utilization of psychotropic drugs in the postpartum period.

New WHO recommendations on prevention and treatment of postpartum hemorrhage

Improving health care for women during childbirth in order to prevent and treat postpartum hemorrhage (PPH) is an essential step toward achieving Millennium Development Goal 5. In March 2012, WHO held a Technical Consultation on the Prevention and Treatment of Postpartum Haemorrhage to review current evidence and to update previously published PPH guidelines. The present paper provides an overview of the most recent WHO guidelines for both prevention and treatment of PPH, with an emphasis on the key messages and changes.

Manifestations clinicobiologiques aiguës du syndrome de Sheehan

Sheehan’s syndrome (SS) is a potentially serious complication of the postpartum, which remains important despite the progress of gynaecological and obstetrical conditions; it corresponds to an infarction in the adenohypophysis, usually precipitated by a brutal or prolonged haemorrhagic shock during the delivery. The diagnosis is made only several years after the obstetrical event, but it is known that some of the women who die in the month following the postpartum present clinical signs of hypophyseal insufficiency. The aim of this article is to educate clinicians on the various situations that can indicate the SS in the early period following a haemorrhagic childbirth in order to make an early diagnosis and start an urgent and specific management.

Comparing birth plan preferences among Irish and Nigerian women

The demographics of the obstetric population in Ireland are increasingly changing due to immigration patterns. As the obstetric population becomes more ethnically diverse, the challenge for health professionals is to provide more appropriate, culturally-specific care. This observational study compared birth plan preferences among Irish and Nigerian pregnant women. Included in this study were 113 Nigerian women and 519 Irish women attending the Unified Maternity Services in Cork. A questionnaire was used to assess patients' attitudes toward varying aspects of obstetric care. Differences between the two study populations were seen across all aspects of care. Among other differences, Nigerian women booked at a later gestation compared to their Irish counterparts (33.8 weeks vs. 20.8 weeks respectively, P &lt; 0.001), preferred to have a vaginal delivery (90.7% vs. 64.2%) and an analgesia-free birth (39.6% vs. 5.8%). This study demonstrates a need to recognize the cultural variations in preferences for pregnancy and childbirth in order to provide culturally-specific care.

« Le fruit de nos entrailles » : la maternité dans les écrits des nobles toulousaines du siècle des Lumières

« The Fruit of our Wombs » : Maternity in the Writings of the Toulouse Nobility during the Enlightenment. Historians and anthropologists have underlined the evolutions of maternity during the 18th century. Private writings by women have however been little used in these works even though they constitute a major source. They bring a very different vision of pregnancy and of childbirth then undergoing increasing medicalization. Their confrontation with medical, philosophical and religious discourses on maternity allow us to approach this theme from the angle of gender. This article proposes to follow noble Toulouse women from their first suspicions of pregnancy through the illnesses provoked by childbirth in order to show up their own conception of maternity and the role that rests on them in the society of the century of Enlightenment.

Perineal Outcomes and Maternal Comfort Related to the Application of Perineal Warm Packs in the Second Stage of Labor: A Randomized Controlled Study

Perineal warm packs are commonly used during childbirth in order to limit perineal trauma and lessen discomfort late in the second stage of labor. Perineal trauma following delivery may be associated with significant short- and long-term morbidity. In a randomized controlled trial, 360 nulliparous women in the late second stage of labor were assigned to have warm packs applied to the perineum, while 357 others had standard care delivered by midwives. All participants were at least 36 weeks pregnant, and all had singleton pregnancies with cephalic presentation. In all instances a normal birth was expected. None of the women had performed perineal massage or planned to do so. All midwives were trained in warm pack treatment and were regularly updated. Nearly 80% of women in both groups required perineal suturing, and there were no significant differences in the frequency of either minor or major perineal trauma or in the numbers of episiotomies carried out. Women given standard care, however, were twice as likely than those treated with warm packs to have a severe (third- or fourth-degree) perineal tear (odds ratio, 2.16; 95% confidence interval, 1.1–4.3). Women treated with warm packs had lower perineal pain scores at childbirth and on the first and second days after birth. There were no significant group differences in pain during sitting, walking, or intercourse. After 3 months, women given warm packs were significantly less likely to have urinary incontinence than those receiving standard care. The investigators believe that application of perineal warm packs is a simple, inexpensive, and effective practice that should be a routine part of care for women in the second stage of labor.

The Lived Experience of Knowing in Childbirth

Research on knowing in childbirth has largely been a quantitative process. The purpose of this study was to understand the ways first-time mothers learn about birth. A phenomenological approach, using a feminist view, was used to analyze two in-depth interviews and journals to understand nine first-time expectant mothers' experiences of knowing in childbirth. The findings demonstrated a range of knowledge that contributed to issues of control and conflict. The participants also described an increased dependency on their mothers and a lack of their own intuition contiguous to the birth process. These findings contribute understanding to how expectant mothers know birth, suggesting that their knowing does not diminish conflict surrounding the event and may even exacerbate it when not combined with learning skills to manage conflict. Childbirth educators may want to include instruction on negotiating power differential in relationships encountered during childbirth in order to strengthen a first-time mother's ability to receive the care she wants. Educators may also want to assess the expectant mother's view of birth and her expectations for birth. Schools of nursing should consider the inclusion of women-centered care curricula at both the undergraduate and graduate levels. The mothers' responses in this study clearly reveal that the politics surrounding birthing remain in place and must be removed in order to provide a supportive environment for normal birth.