Childbearing Plans Research Articles

Individual empowerment and community norm effects of engaging young husbands in reproductive health in rural India: findings from a pilot study

BackgroundDespite decades of a call to action to engage men in reproductive health, men are often left out of programs and interventions. In India, where half of pregnancies are reported as unintended, patriarchal gender norms and still dominant patterns of arranged marriages make engaging men in family planning and strengthening couples communication critical in increasing reproductive autonomy and helping young couples meet their reproductive goals. This study explores the feasibility and acceptability from the men’s perspective of the pilot of a gender transformative intervention for newly married couples in India.MethodsA pilot study was conducted of TARANG, a 4 month intervention for newly married women, with light touch engagement of husbands (4 sessions). A total of 41 husbands participated in the pilot, and we collected baseline knowledge and endline feasibility and acceptability data from them, along with in depth qualitative interviews with 13 men. The study was conducted in June 2023-January 2024.ResultsMen had low levels of knowledge about biology, family planning, with the majority of men reporting that no one had provided them information about these topics. Most men wanted to delay the first birth by at least 2 years, yet less than a quarter had discussed childbearing plans with their partner or engaged in family planning methods. While all men reported high acceptability (satisfaction and usefulness), feasibility (participation) was low, with only 43% attending 2 or more sessions. Main barriers to participation included commitments due to work and migration. Men reported that the intervention led to improvements in their relationships with their wives, gave them a sense of empowerment, and led them to become resources for other men in their community.ConclusionsMen in these rural communities are not receiving the information that they need to meet their reproductive goals, however, they greatly desire this information and ways to improve relationships with their new wives. Such an intervention appears to have the potential to help change norms and spread information in the community and provide men with positive, life affirming feelings. Providing information through technology could address barriers to in-person engagement.Trial registration clinicaltrials.gov 03/13/24.NCT06320964

Implementation of Genetic Carrier Screening at Gynecologic-Related Visits

ObjectiveTo increase patients’ knowledge and access to genetic carrier screening (GCS) in a gynecologic setting by implementing a protocol to universally offer GCS education and screening to reproductive-age women during the preconception period at gynecologic-related visits. DesignThe model for improvement quality improvement process model was used to guide this initiative. Local Problem/SettingScreening for genetic disease has been a part of preconception and genetic care for the past 50 years. Despite its longstanding presence and better accessibility and affordability of testing, there are no established protocols to universally offer screening to reproductive-age women during preconception care in the United States. The project was implemented at an outpatient gynecology clinic in Phoenix, Arizona. ParticipantsFifty-one women ages 18 to 51 years. Intervention/MeasurementsA protocol was implemented to universally offer expanded GCS and health education to reproductive-age women during the preconception period at gynecologic-related visits. Women’s responses to being offered GCS and the rationale for their response was documented on a spreadsheet. ResultsAll 51 participants were offered GCS during their visit. None of those 51 participants had any previous knowledge of GCS. All 51 participants declined GCS; reasons included the following: would consider it once closer to childbearing (53%), did not have any childbearing plans (31.3%), did not have any further childbearing plans (9.8%), or were not worried about the possibility of genetic disease (5.8%). None cited cost as a reason for declining GCS. After project completion, 3 of the 51 participants returned to the clinic to undergo GCS, and the clinic has adopted the intervention described here as its standard of care for patients who meet criteria for GCS. ConclusionIt is imperative to provide health education about GCS to women during preconception care so that they can make informed choices about family planning.

Climate emotions, parenting plans, and racial difference in the United States

IntroductionIncreasing attention is being paid to the relationship between climate change, emotional and mental distress, and feelings about raising children. These studies often overlook the role of demographics, race in particular, despite evidence that racial minority groups in the U.S. experience more detrimental climate impacts and express more climate concern than do white communities. This survey was conducted to elucidate the relationship between race, climate emotions, and parenting plans in the U.S. MethodsWe surveyed 2489 people in the U.S. between the ages of 22 and 35 in September 2021. Because we were interested in the role of race, we oversampled those who identified as non-white/people of color. The survey assessed participants’ emotions with respect to climate change, and their emotions with respect to birthing and raising children (parenting) in the context of climate change. ResultsNonwhite respondents were more likely than white respondents to report feeling traumatized as a response to climate change, and to plan to have fewer future children than they wanted as a result of their climate-related emotions. They were also more likely to report feeling more optimistic and hopeful in response to climate change and in response to raising existing children in the context of climate change. White women were least likely to report any positive emotions with respect to parenting during climate change. White men were most likely to report non-feeling emotions such as numbness, indifference, or being checked out. Christian respondents were more likely to report feeling positive emotions overall. ConclusionThis study highlights race as a statistically significant factor in the reporting of climate emotions and parenting plans. It demonstrates that climate change has contradictory impacts on the emotions of nonwhite people of color, while having a negative impact on childbearing plans. We call for further research into the role of race in climate-related emotions and parenting plans, particularly with respect to the impacts of traumatized feelings, as well as the roles of religion and positive emotions.

The Influence of Media Leaflet on Increasing Knowledge of Reproductive Health of Brides-to-Be in Padang City

According to WHO (2019), the Maternal Mortality Rate is the number of maternal deaths resulting from pregnancy, childbirth, and postpartum processes, which are used as indicators of women's health status. Maternal Mortality Rate (MMR) is one of the global targets of the Sustainable Development Goals (SDGs) to reduce maternal mortality (MMR) to 70 per 100,000 live births by 2030. Several efforts to reduce MMR have been carried out by the Padang City government, including implementing the Childbirth Planning and Prevention of Complications (P4K) Program, using MCH books, implementing classes for pregnant women, and health counseling activities. This quantitative research uses a pocketbook of the bride and groom using leaflet media. This is a guide for brides-to-be as part of marriage advice and guidance for those who have registered their marriage at the Regional Office of Religious Affairs (KUA). The subject of this study was a bride-to-be in Padang City. Providing reproductive health counseling on women's knowledge in premarital preparation in the working area of KUA Koto Tangah District has an influence.

Individual empowerment and community norm effects of engaging young husbands in reproductive health in rural India: findings from a pilot study.

Despite decades of a call to action to engage men in reproductive health, men are often left out of programs and interventions. In India, where half of pregnancies are reported as unintended, patriarchal gender norms and still dominant patterns of arranged marriages make engaging men in family planning and strengthening couples communication critical in increasing reproductive autonomy and helping young couples meet their reproductive goals. This study explores the feasibility and acceptability from the men's perspective of the pilot of a gender transformative intervention for newly married couples in India. A pilot study was conducted of TARANG, a 4-month intervention for newly married women, with light touch engagement of husbands (4 sessions). A total of 41 husbands participated in the pilot, and we collected baseline knowledge and endline feasibility and acceptability data from them, along with in depth qualitative interviews with 13 men. The study was conducted in June-January, 2023. Men had low levels of knowledge about biology, family planning, with the majority of men reporting that no one had provided them information about these topics. Most men wanted to delay the first birth by at least 2 years, yet less than a quarter had discussed childbearing plans with their partner or engaged in family planning methods. While all men reported high acceptability (satisfaction and usefulness), feasibility (participation) was low, with only 43% attending 2 or more sessions. Main barriers to participation included commitments due to work and migration. Men reported that the intervention led to improvements in their relationships with their wives, gave them a sense of empowerment, and led them to become resources for other men in their community. Men in these rural communities are not receiving the information that they need to meet their reproductive goals, however, they greatly desire this information and ways to improve relationships with their new wives. Such an intervention appears to have the potential to help change norms and spread information in the community and provide men with positive, life affirming feelings. Providing information through technology could address barriers to in-person engagement. clinicaltrials.gov (NCT06320964), 03/13/24.

Comparative Investigation of Color Doppler Ultrasonography Parameters of the Uterine Artery in Patients with Post-molar GTN and Patients Recovered from Molar Pregnancy and its Role in Predicting the Probability of Occurrence

Objectives: Hydatiform mole can progress to gestational trophoblastic neoplasia (GTN), and we are looking for non-invasive methods to predict it. Old age, higher serum BHCG levels, and expression of genes, such as VEGF-EG, HIF-1α, and TGF-ß are known as predictive factors. We performed this study to evaluate the role of bilateral uterine artery doppler ultrasound in predicting postmolar- GTN. Methods: In this prospective cohort study, 42 patients with complete molar pregnancy were examined. Inclusion criteria confirmed molar pregnancy by histopathological examination. Exclusion criteria were patients more than 40 years old, patients with completed family childbearing planning, and diagnosis of GTN during the routine histopathological study. Before molar evacuation and four weeks later, bilateral uterine artery doppler sonography to determine the PI, RI, and PSV was performed. Serum BHCG levels were also measured before molar evacuation and weekly after evacuation until it exhibited spontaneous remission or developed GTN. Results: About 36 patients were cured, and six others developed post-molar GTN. The bilateral uterine artery doppler sonography between the two groups showed a lower UA RI in the post-molar-GTN group before evacuation (P=0.048). Data demonstrated significant increases in Right.UA.RI (P=0/008), Left.UA.PI (P=0/037), and Right.UA.PSV (P=0/024) in the spontaneous remission group during 28 days follow-up period. There were no significant differences in these parameters in the GTN group throughout the time of follow-up. Conclusion: It seems that Doppler ultrasound plays a role in predicting GTN following uterine evacuation. A lower resistance in the uterine artery before evacuation and the remaining uterine artery blood flow constant after evacuation is associated with the development of post-molar- GTN.

Impact of parental leave system on the childbirth plan among working married women: a three-year follow-up study of the Korean longitudinal survey of women and families

BackgroundThe Korean government seeks to balance work and family and alleviate low fertility by implementing a parental leave system. This study aimed to identify the impact of the parental leave system on childbirth among married working women in South Korea.MethodsThis study used three-year follow-up data from the Korean Longitudinal Survey of Women and Families (2016, 2018, and 2020). The number of participants was 324 at baseline. Logistic regressions using a generalized estimating equation model were performed to examine the impact of parental leave on childbirth. Sub-analyses of covariates, childbirth support, and parental leave systems were conducted.ResultsOf workers covered by the parental leave system, 31.7% considered childbirth. Women covered by parental leave were 3.63 times more likely to plan childbirth (95% confidence interval [CI], 1.32–9.99). The tendency to plan childbirth was pronounced among those in their early 30s (adjusted odds ratio [AOR], 7.20) and those who thought that having children was necessary (AOR, 4.30). Child planning was more influenced by leave support (AOR, 6.61) than subsidies.ConclusionsParental leave systems can have a positive impact on working married women’s childbirth plans. Although this system was effective in a group interested in childbirth, it did not create a fundamental child plan. Time support is more important than money concerning childbirth plans. The parental leave system had an impact on childbirth plan. Appropriate parenting policies can effectively increase the fertility rate.

Changes to women’s childbirth plans during the COVID-19 pandemic and posttraumatic stress symptoms: a cross-national study

A considerable number of women giving birth during COVID-19 pandemic reported being concerned about changes to their childbirth plans and experiences due to imposed restrictions. Research prior to the pandemic suggests that women may be more at risk of post-traumatic stress symptoms (PTSS) due to unmet expectations of their childbirth plans. Therefore, this study aimed to examine if the mismatch between women’s planned birth and actual birth experiences during COVID-19 was associated with women’s postpartum PTSS. Women in the postpartum period (up to 6 months after birth) across 11 countries reported on childbirth experiences, mental health, COVID-19-related factors, and PTSS (PTSD checklist DSM-5 version) using self-report questionnaires (ClinicalTrials.gov: NCT04595123). More than half (64%) of the 3532 postpartum women included in the analysis reported changes to their childbirth plans. All changes were significantly associated with PTSS scores. Participants with one and two changes to their childbirth plans had a 12% and 38% increase, respectively, in PTSS scores compared to those with no changes (Exp(β) = 1.12; 95% CI [1.06–1.19]; p < 0.001 and Exp(β) = 1.38; 95% CI [1.29–1.48]; p < 0.001). In addition, the effect of having one change in the childbirth plan on PTSS scores was stronger in primigravida than in multigravida (Exp(β) = 0.86; 95% CI [0.77–0.97]; p = 0.014). Changes to women’s childbirth plans during the COVID-19 pandemic were common and associated with women’s postpartum PTSS score. Developing health policies that protect women from the negative consequences of unexpected or unintended birth experiences is important for perinatal mental health.

Climate change, mental health, and reproductive decision-making: A systematic review

The impact of climate change on reproductive decision-making is becoming a significant issue, with anecdotal evidence indicating a growing number of people factoring their concerns about climate change into their childbearing plans. Although empirical research has explored climate change and its relationship to mental health, as well as the motivations behind reproductive decision-making independently, a gap in the literature remains that bridges these topics at their nexus. This review endeavours to fill this gap by synthesising the available evidence connecting climate change-related concerns with reproductive decision-making and exploring the reasons and motivations behind this relationship. A systematic review using six databases was conducted to identify relevant literature. Included studies reported quantitative, qualitative, and mixed-methods data related to: (1) climate change, (2) mental health and wellbeing concerns, and (3) reproductive decision-making. Findings were synthesised narratively using a parallel-results convergent synthesis design and the quality of studies was appraised using three validated assessment tools. Four hundred and forty-six documents were screened using pre-defined inclusion criteria, resulting in the inclusion of thirteen studies. The studies were conducted between 2012 and 2022 primarily in Global North countries (e.g., USA, Canada, New Zealand, and European countries). Climate change concerns were typically associated with less positive attitudes towards reproduction and a desire and/or intent for fewer children or none at all. Four themes explaining this relationship were identified: uncertainty about the future of an unborn child, environmentalist views centred on overpopulation and overconsumption, meeting family subsistence needs, and environmental and political sentiments. The current evidence reveals a complex relationship between climate change concerns and reproductive decision-making, grounded in ethical, environmental, livelihood, and political considerations. Further research is required to better understand and address this issue with an intercultural approach, particularly among many highly affected Global South populations, to ensure comparability and generalisable results.

Implementation of the Childbirth Planning and Complication Prevention Program in Padang City

&lt;div style="color: #000000; font-family: Verdana, Arial, Helvetica, sans-serif; font-size: 10px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"&gt;&lt;div&gt;&lt;table cellspacing="0" cellpadding="0" align="left"&gt;&lt;tbody&gt;&lt;tr&gt;&lt;td align="left" valign="top"&gt;&lt;p&gt;&lt;em&gt;The&lt;/em&gt;&lt;em&gt; &lt;/em&gt;&lt;em&gt;Planning and Complication Prevention&lt;/em&gt;&lt;em&gt; &lt;/em&gt;&lt;em&gt;program encourages pregnant women to have their pregnancies, deliveries, postpartum examinations and babies born by skilled health workers, including screening for complete tetanus immunization status in every pregnant woman. If the implementer has a positive attitude and support for implementing the P4K program, the P4K program may run according to the initial plan. The purpose of this study was related to the Implementation of the Childbirth Preparation and Complication Prevention (P4K) Program in Padang City. This research is a qualitative study with a phenomenological design. This research was conducted in the working area of Lubuk Kilangan Health Center, Lubuk Buaya Health Center and Pegambiran Health Center in January - May 2023. The informants in this study were 23 informants, namely five key informants, six main informants, and 12 additional informants. Data collection methods use in-depth interview methods, observation and document review—data validity by triangulating sources, methods and data. The research results obtained on the input component in each component have run well according to the requirements. Only the monitoring and evaluation component is not yet available in the process component. Moreover, the output component has been carried out well despite shortcomings because not all activities run optimally. &lt;/em&gt;&lt;em&gt;Research suggestions are expected to increase family participation in implementing P4K, such as counselling and socialization, and increase discipline in following the recommendations of health workers assisted by&lt;/em&gt; &lt;em&gt;Community Health Center&lt;/em&gt;&lt;em&gt; &lt;/em&gt;&lt;em&gt;cadres.&lt;/em&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;&lt;em&gt; &lt;/em&gt;&lt;/strong&gt;&lt;/p&gt;&lt;/td&gt;&lt;/tr&gt;&lt;/tbody&gt;&lt;/table&gt;&lt;/div&gt;&lt;strong&gt;&lt;em&gt;Keywords: Component, Monitoring, Planning, Program&lt;/em&gt;&lt;/strong&gt;&lt;/div&gt;

Understanding the healthcare provider role on post abortion contraception adoption in India using National Family Health Survey-5

BackgroundPost abortion contraceptive use is an important area in provisioning of services associated with child birth planning. This study examines the factors related to the type and timing of initiation of contraception adoption among women who had undergone induced abortion. Study also tries to identify the role of personnel who provided the abortion service on decision of family planning adoption using complementary log–log model in India.MethodologyThe study uses the secondary data from the fifth round of the National Family Health Survey conducted during 2019–21. For, the analysis, we have used five-year women’s reproductive calendar to extract information on contraceptive use, post last induced abortion among women. We used complementary log–log regression models, to estimate relative risk ratios and its 95% Confidence intervals (CI).ResultsAccording to NFHS-5, out of all the last pregnancies (2,55,549), about three percent resulted in abortion. Most of the abortion occurred in private facilities (55%), with the help of health professionals (71%). From the women’s reproductive calendar, it was found that around 40% of the women adopted modern methods of contraception, with maximum adopting spacing method (33%), and only handful adopted permanent method (7%). It was also found that the likelihood of early adoption of permanent method increased to two times when the abortion is done by health professional compared to others [95% CI (1.25–3.30)].ConclusionThis emphasises a need for quality counselling related to timing and types of family planning as an essential part of the family planning program ensuring client centric approach suited to their needs and contexts that helps in alleviating any apprehensions associated with adverse effects of modern contraceptive methods.

Brainstorming Effect in Pregnant Women on Knowledge of Childbirth Planning and Complications Prevention Programs

The birth planning and complication prevention program (P4K) is an effort from the government to reduce maternal mortality (MMR). To support these efforts, learning needs to be provided; brainstorming provides a structured format that can increase the quantity and quality of responses from the participants. The brainstorming method effectively delivers information according to the mother's characteristics. However, the effect of health education on the brainstorming method for pregnant women on the P4K is still not explained. This study aims to explain the impact of brainstorming on pregnant women on knowledge of P4K in Kertosari Village, Lumajang Regency. The design of this research is a Quasy Experiment with a pre-post design. The sample in this study was 30 pregnant women who were taken using total sampling. This research was conducted in Kertosari Village, Pasrujambe District, Lumajang Regency. This research concludes that there is an effect of brainstorming on the knowledge of pregnant women about the Birth Planning and Complications Prevention (P4K) Program in Kertosari Village, Lumajang Regency, with (ρ=0.000&lt;0.05). It is hoped that Brainstorming can be used as an alternative in providing health education to pregnant women in promotive and preventive efforts in the success of the Childbirth Planning and Complications Prevention Program (P4K).

THE EFFECT OF HEALTH EDUCATION ON CHILDBIRTH PROGRAM AND PREVENTION OF COMPLICATIONS USING WA GROUP ON THE ATTITUDE OF THIRD TRIMESTER PREGNANT WOMEN AT SRENGAT HEALTH CENTER IN PREPARATION FOR CHILDBIRTH

MMR in Indonesia is still high, mostly caused by direct causes, namely bleeding, infection, eclampsia, long labor and abortion in addition, maternal mortality is also motivated by low levels of knowledge, attitudes, education, parity, age too young to give birth, giving birth too often, too old to give birth, so it is necessary to prepare for childbirth, but in fact there are still many mothers who are not ready to face childbirth, so there is a need for education, one of which is through the WA group. This type of research uses experimental quasy with a research design, namely Nonequivalent Control Group Design. The population in this study is all III trimester pregnant women who are at the Srengat Health Center for the February 2023 period as many as 82 pregnant women. The sampling technique uses a formula for estimating the sample size of 20 people. Measuring instruments using SAP and questionnaires. Data analysis using the Mann Whitney test. The description of the attitude of pregnant women in the third trimester before education using the WA group had an average value of 37.10, after intervention an average value of 64.60. The description of the attitude of pregnant women in the third trimester before education using leaflets has an average value of 36.00, after intervention the average value is 53.65. There are differences in the attitudes of third trimester pregnant women in preparation for childbirth between those given health education for the Childbirth Planning and Prevention of Complications Program using the WA group and leaflets at the Srengat Health Center in 2023 with a significant value of p value of 0.000. Providing education using WA Group is more effective than leaflets because Whatsapps social media is easy to use to improve mothers' attitudes towards childbirth preparation because through WA Group can provide information and discussion about childbirth preparation rather than leaflets. Eeducation using WA group is more effective in improving the attitude of mothers in preparation for childbirth.

EMPOWERMENT AND FORMATION OF MATERNAL AND CHILD HEALTH CADRES FOR DELIVERY PLANNING AND PREPAREDNESS IN THE FACE OF OBSTETRIC AND NEONATAL COMPLICATIONS IN BOJONEGORO, INDONESIA

&#x0D; In Bojonegoro, the maternal mortality rate has tended to increase over the last 2 years, in 2017 there were 17 people distributed at 100.93 per 100,000 live births in 12 health centres.2017 as many as 17 people spread 100.93 per 100,000 live births in 12 health centres. While in 2018 reached 27 people 157.23 per 100,000 live births. To accelerate the reduction of MMR in Indonesia, the government has issued various policies, such as the planning of childbirth and prevention of complications with stickers (P4K) programme. The programme, which was issued by the Minister of Health in 2007, is a breakthrough effort in accelerating the reduction of maternal and newborn mortality through activities to improve access and quality of services, which at the same time is an activity that builds community potential, especially community awareness for preparation and follow-up in saving mothers and newborns. So that the Bojonegoro Midwifery D III Study Program carries out activities to empower and form maternal and child health cadres in the context of delivery planning and preparedness in the face of Obstetric and Neonatal Complications in Bendo Village, Kapas District, Bojonegoro. The purpose of this community service is to carry out empowerment activities and the formation of maternal and child health cadres in the context of planning childbirth and preparedness in the face of obstetric and neonatal complications in the village of Bendo Kec. Kapas Kab.Bojonegoro.The form of activities is the formation and training of maternal and child health cadres in the context of planning childbirth and preparedness in the face of obstetric and neonatal complications. The source of costs in this activity is charged to funds from DIPA Poltekkes Kemenkes Surabaya. The outputs of this activity are: 1) the formation of maternal and child health cadres who have completed the training; 2) Increased knowledge and skills of Communication, Information, and Education (IEC) of maternal and child health cadres; 2) Maternal and child health cadres disseminate the ability of childbirth planning and preparedness in the face of obstetric and neonatal complications and to carry out counseling on the prevention of complications to pregnant women, fertile women and couples of childbearing age around their place of residence on an ongoing basis; 4) Decreased incidence of maternal mortality.&#x0D;

Fertility Intentions During the Covid-19 Pandemic: An Analysis of Individual- and Municipality-Level Determinants.

Recognizing the prolonged, uneven, and evolving nature of the Covid-19 pandemic, this study provides one of the first dynamic, multilevel perspectives of women's fertility intentions in response to the pandemic and its multifaceted impacts. We examine how evolving individual- and community-level Covid-19 risk mechanisms and socioeconomic and life-course conditions are associated with continuity and change in women's fertility intentions. We combine individual-level panel data from a population-based sample of women aged 18-34 in Pernambuco, Brazil in 2020 and 2021 with corresponding administrative data from 94 municipalities. We use multinomial logit regressions to model continuity and change in fertility intentions across waves. We then estimate fixed effect models to highlight the time-varying determinants of changing fertility intentions while accounting for unobserved, time-invariant individual factors. We find that high and/or increasing individual and community-level Covid-19 exposure is associated with a greater likelihood of abandoning initial childbearing plans and a greater likelihood to maintain intentions to forego versus to intend having additional children. We advance the literature by highlighting how individual-level Covid-19 infection risk perceptions matter for fertility intentions, net of community-level exposure, and the necessity of dynamic perspectives for understanding how fertility intentions have changed (or not) in response to the pandemic.

“Because it eases my Childbirth Plan”: a qualitative study on factors contributing to preferences for caesarean section in Thailand

BackgroundAlthough caesarean section (CS) rates have increased rapidly in Thailand, the upward trend is not supported by significant maternal or perinatal health benefits. The appropriate use of CS through QUALIty DECision-making by women and providers (QUALI-DEC project) aims to design and implement a strategy to optimize the use of CS through non-clinical interventions. This study aimed to explore the factors influencing women’s and health professionals’ preferences for CS delivery in Thailand.MethodsWe conducted a formative qualitative study by using semi-structured in-depth interviews with pregnant and postpartum women, and healthcare staff. Purposive sampling was used to recruit participants from eight hospitals across four regions of Thailand. Content analysis was used to develop the main themes.ResultsThere were 78 participants, including 27 pregnant and 25 postpartum women, 8 administrators, 13 obstetricians, and 5 interns. We identified three main themes and seven sub-themes of women and healthcare providers’ perceptions on CS: (1) avoiding the negative experiences from vaginal birth (the pain of labor and childbirth, uncertainty during the labor period); (2) CS is a safer mode of birth (guarantees the baby’s safety, a protective shield for doctors); and (3) CS facilitates time management (baby’s destiny at an auspicious time, family’s management, manage my work/time).ConclusionsWomen mentioned negative experiences and beliefs about vaginal delivery, labor pain, and uncertain delivery outcomes as important factors influencing CS preferences. On the other hand, CS is safer for babies and facilitates multiple tasks in women’s lives. From health professionals’ perspectives, CS is the easier and safer method for patients and them. Interventions to reduce unnecessary CS, including QUALI-DEC, should be designed and implemented, taking into consideration the perceptions of both women and healthcare providers.

Did the COVID‐19 Pandemic Affect Fertility Desires in Australia? Understanding Why People Changed Their Attitudes towards Having a First or Additional Child

AbstractAn understanding of whether and how childbearing desires have been affected by the COVID‐19 pandemic is key for explaining subsequent fertility patterns and fertility behavior in general, but empirical information is still lacking. Using a quasi‐experimental cohort design and unique panel survey data collected before and after the outbreak of COVID‐19, this study examines whether childbearing desires were affected by COVID‐19 in Australia and investigates which pandemic‐related factors affected childbearing desires the most. Results show that parents who already had one child were the most likely to experience a decline in childbearing desires because of the pandemic, while childbearing desires were most stable among those who were childless. Economic and employment‐related factors did not appear to be of great relevance in predicting changes in childbearing plans. However, changes in the quality of couple relationships and of social support from family and friends were found to be of strong importance.

Autonomy of High-Risk Pregnant Women in an Effort to Prevent Complications during Childbirth

Background: Maternal mortality is a health problem that has not been resolved until now. Based on data from January-September 2020 from the Public Health Center of Panti District, most pregnant women with high risk are those who have a risk of preeclampsia. Pregnant women have an important role and personal autonomy in decision-making during the process of pregnancy. Objective: To analyze the autonomy of high-risk pregnant women to prevent complications during childbirth. Methods: Qualitative research with a case study approach. Determination of the main informants using a purposive technique consisted of five pregnant women at risk of preeclampsia who were under 20 years old and above 35 years old. Data collection using in-depth interview guide and documentation. Data analysis using inductive thematic analysis. Results: intentions, affordability of information, situations in preparing blood donors, and maternity funds can form the negative autonomy of high-risk pregnant women in decision-making. Husband’s social support can form positive autonomy of high-risk pregnant women in decision making. High-risk pregnant women have negative autonomy in choosing a place for maternity care to practice as a midwife even though they have been advised to carry out routine checks at the primary healthcare. High-risk pregnant women have negative autonomy in choosing the place of delivery by not changing their choice and making the primary healthcare or hospital the second and last choice. Conclusion: The autonomy of high-risk pregnant women has formed a negative autonomy in making decisions about childbirth planning and preventing complications.

Did everyone change their childbirth plans due to the COVID-19 pandemic? A web-based cross-sectional survey of Polish pregnant women.

With the worldwide outbreak of coronavirus, a significant impact has been observed on the functioning of healthcare systems and the process of childbirth. Women probably did not even have a choice to adjust their plans accordingly to the current situation. The aim of the study was to examine how the outbreak of the SARS CoV-2 pandemic state affected the decisions of pregnant women about their childbirth plan. This cross-sectional study was performed using a web-based survey published on social media in Poland. The cross-sectional study was performed using web-based questionnaires. The study group included Polish women who changed their childbirth plans, compared to a group of women not sure about delivery plan change and those whose plans had not changed. The data were collected from 4 March 2020 to 2 May 2020, when the first rising count of new infections was observed in Poland and worldwide. Statistical analysis was performed using STATISTICA Software, Inc., 13.3 (2020). Of 969 women who completed the questionnaire and were enrolled into the study, 57.2% had not changed their childbirth plans (group I), 28.4% had changed their plans (group II), and 14.4% of respondents answered "not sure" to this question (group III). The majority of women changed their birth plans during the pandemic because of the potential absence of their partner during labour (56% of women who had changed their plans and 48% of those whose answer was "I am not sure", p < .001). Another reason was the fear of separation from the child after delivery (33% of women who had changed their plans and 30% of those whose answer was "I am not sure", p < .001). Restrictions due to the COVID-19 outbreak have influenced the childbirth plans of pregnant women. The changes were independent of women's vision of birth before the pandemic. The restriction on births with accompanying person and the risk of separation from their infant after childbirth significantly influenced the decision-making process. As a result, some women were more likely to opt for a home birth with or even without medical assistance. The study participants were women who were pregnant at the time of completing the questionnaire, were over 18 years old and spoke Polish.

Anxiety, attitudes, and education about fertility among medical students in the United States

BackgroundAs delayed family building is common among physicians, the goal of this study was to evaluate childbearing plans, anxiety related to future fertility, and interest in fertility education among medical students.MethodsUsing convenience and snowball sampling methods, an electronic REDCap survey was distributed via social media and group messaging applications to medical students enrolled in medical schools across the United States. Answers were collected, and analysis of the descriptive statistics was performed.ResultsThe survey was completed by 175 participants, 72% of which were female (assigned at birth). The mean (± SD) age of participants was 24.9 ± 1.9 years. Of all participants, 78.3% desire to have children and 65.1% of these individuals plan to delay childbearing. On average, the planned age of first pregnancy is 31.0 ± 2.3 years. “Lack of time” was the greatest influence on decision regarding timing of childbearing.Of all respondents, 58.9% reported at least some anxiety related to future fertility. When females and males were compared, significantly more females (73.8%) versus males (20.4%) reported worrying about future fertility (p < 0.001). Participants reported that greater knowledge about infertility and potential treatments would help ease fertility related anxiety, and 66.9% of respondents showed interest in learning about how things such as age and lifestyle can impact fertility, preferably through medical curricula, videos, and podcasts.ConclusionA majority of the medical students in this cohort intend to have children and most plan to delay childbearing. A large percentage of female medical students reported anxiety related to future fertility, but many students showed interest in receiving fertility education. This study highlights an opportunity for medical school educators to incorporate targeted fertility education into their curriculum with the intention of decreasing anxiety and improving future reproductive success.