Childbirth Practices Research Articles

Ethnographic Study: The Choice of Place and Birth Attendants from the Socio-Cultural Perspective in the Tunjung Benuaq Dayak Tribe

WHO recommends Skill Birth Attendants (SBA) for all births. Around 50 million mothers in developing countries give birth at home without the help of medical personnel. The trust in traditional birth attendants (TBA), meaning that social and cultural influences still strongest. Objective: to analyze the choice of place and birth attendants in the Tunjung Benuaq Dayak Tribe through a socio-cultural perspective in the working area of the Barong Tongkok Community Health Center. Methodology: Qualitative Design with Ethnographic study using the Rapid Ethnographic Assessment Procedure (REAP) method. Snowball sampling is a variation of Purposive Sampling. In-depth interviews were conducted with 12 informants. Data analysis uses Thematic analysis. Results: The Tunjung Benuaq Dayak tribe upholds the values of balance and harmonization regarding human relationships with God, human and the environment. They developed local cultures based on complementary belief systems. There is a positive acceptance of science. The local wisdom of Santaap, eating a small portion of the food served, illustrates that they can accept little of knowledge. Customs are still maintained in the birthing process which is carried out by village shamans who are highly trusted by the community. They make the rituals, belief in myths (tempuunt), the existence of spirits who guard and interfere with the birthing process. Conclusion: Socio-cultural values such as trust, knowledge, and customs are very strong guidelines for the Tunjung Benuaq Dayak tribe in choosing a place and birth attendant. Suggestion: preservation of culture and customs that are still considered good in childbirth practices is highly desirable.

Exploring Indigenous Ways of Childbirth Management and its Perinatal Outcomes During Cyclonic Periods in Hilly Tribal Homebirth Settings: A Qualitative Observational Study

Objective This study explores the cultural-based management of childbirth vulnerabilities in the hilly regions during cyclone periods, where the land mass has been frequently exposed to floods during and aftermath of cyclones due to low-high cyclonic depressions in the Bay of Bengal coast. Methods The present study was a community-based qualitative observational study conducted for three weeks immediately after the two cyclonic periods occurred between October and December 2022. With the purposive sampling method, 21 postpartum mothers were selected on the inclusion criteria, of having had childbirth around the cyclonic period of ‘Sitrang’ (late October 2022) and ‘Mandous’ (early December 2022). Semi-structured in-depth interview schedules were employed to document socio-demographic profiles and probed for their cultural ways of managing childbirth complications and neonatal exposures to infections during the cyclonic period. Results Views of 21 mothers were coded into three themes with two sub-themes each according to repeated frequencies of information. The themes were (a) Striving for Safe Childbirths; (b) Surviving with Traditional Capacities; (c) Strength and Sustenance. The results indicated that home deliveries were considered safest over institutional deliveries except in the cases of complicated childbirths confirmed difficult by the traditional birth attendants (TBA). Rough climatic conditions compounded by geographical distance, lack of appropriate financial help and timely transportation facilities were the major prevailing factors influencing their childbirth practices during the cyclonic periods. Conclusion Disasters do not alone influence childbirth outcomes, but the evidence is still mixed. The expediency of birth technology has effectively managed childbirth vulnerabilities. Ensured sleep, rest and enough food had also been disturbed during and aftermath cyclones. The results showed an urgent need for focused planning on tribal areas for gestation, birthing and postpartum people during natural disasters.

The Involvement of Religious Leaders in Supporting Institutional Childbirth in Rural Jimma Zone, Oromia, Southwest Ethiopia: An exploratory Qualitative Study.

This exploratory qualitative study examined the involvement of religious leaders in maternal health practices with a focus on promoting institutional childbirth in the rural Jimma Zone, Oromia, Ethiopia. In-depth interviews with 24 male religious leaders revealed five key themes: awareness of childbirth practices, religious beliefs, experiences of childbirth preparedness, experiences at health institutions, and challenges with using institutional childbirth services. The findings indicate that, while religious leaders significantly influence community attitudes toward institutional childbirth, their impact is often limited by a lack of awareness and insufficient engagement with health services. This study underscores the need for culturally sensitive interventions incorporating religious beliefs into maternal health promotion. Enhanced collaboration between health care providers and religious leaders, along with targeted training, is essential for improving maternal health outcomes and increasing the use of institutional childbirth services in rural Ethiopia and other similar contexts.

Iranian midwives’ experiences of using the World Health Organization’s Safe Childbirth Checklist: A qualitative research

BACKGROUND: The goal of natural childbirth care is to have a healthy mother and baby with minimal interventions that are contrary to health. Worldwide, there is concern that non-evidence-based interventions and care in labor and childbirth will remain standard practice. Therefore, access to care related to pregnancy and childbirth is considered a priority. To address safety concerns during organized births, the Safe Childbirth Checklist (SCC) was created by the World Health Organization (WHO). This checklist is a tool that combines evidence-based practices that should be provided before, during, and after childbirth. As midwives have a vital role in using this up-to-date evidence, this study was conducted to explore Iranian midwives’ perception of using SCC. MATERIALS AND METHOD: This qualitative study was conducted from January 2022 to April 2023 in two public (teaching and nonteaching) hospitals in Ahvaz, Iran. Seventeen semi-structured interviews were conducted with midwives who had more than one year of work experience in maternity wards. Participants were selected purposefully. A content analysis approach was used to analyze the data and extract themes. RESULTS: All midwives had a positive attitude toward using SCC. The midwives’ reasons for being in favor of using the checklist during the clinical procedures of childbirth are summarized in four main themes, namely “standardized maternity care practices,” “SCC as a guide for performing essential childbirth practices,” “self-efficacy of midwifery care,” and “improved maternal and neonatal outcomes.” CONCLUSION: Midwives have endorsed this checklist as a guide to standard childbirth management. It seems that the use of this checklist will help to improve the health outcomes of mothers and babies by strengthening the self-efficacy of midwives.

Antibiotic use in cesarean procedures in developing countries: current practices and improvements

Cesarean delivery, a common surgical procedure worldwide, is associated with a significantly increased risk of postoperative infections compared to vaginal births. This risk is notably higher in developing countries due to varying practices in antibiotic prophylaxis and differences in healthcare settings. This study aims to evaluate the current practices and potential improvements in antibiotic use in cesarean sections within these regions. Our analysis revealed that cesarean sections are performed at an increased rate in developing countries, with infection rates ranging from 10% to 40%, primarily due to inconsistent and often inadequate antibiotic prophylaxis. The most common postoperative infections include endometritis, wound infections, and urinary tract infections, largely influenced by factors such as the timing of antibiotic administration, the choice of antibiotic, and the presence of risk factors like prolonged labor and membrane rupture. The standard practice in many developing countries involves the administration of antibiotics post-cord clamping, which has been challenged by recent studies suggesting that preoperative administration can significantly reduce infection rates without adverse effects on neonatal outcomes. A shift towards a single dose of broad-spectrum antibiotics such as cephalosporins administered 30-60 minutes before incision is recommended based on our findings. This approach aligns with the successful reduction of infectious morbidity observed in developed countries and supports the need for standardized guidelines. Furthermore, our study underscores the importance of healthcare provider education and the establishment of clear protocols for antibiotic prophylaxis in cesarean sections. By adopting these improvements, developing countries can achieve a significant reduction in maternal morbidity and contribute to safer childbirth practices.

The cultural significance of Syrian refugees' traditional childbirth and postpartum practices

ProblemChildbirth and the postpartum period are critical times for both mothers and babies. Traditional cultural practices often play a significant role in providing support during this time. However, in exceptional circumstances, such as those faced by refugees giving birth in disrupted social environments, these practices may be inaccessible, leading to emotional distress and delayed physical recovery. AimTo explore the cultural significance of traditional motherhood practices in Syria that are still observed by some Syrian refugees in Lebanon. MethodsThe study used a phenomenological approach and included in-depth interviews with eight Syrian mothers residing in informal settlements in Lebanon. FindingsFindings were organized around three themes: (1) Familial Support during the Postpartum Period, (2) Specific Cultural Practices during the Postpartum Period, and (3) Emotional Experiences during the Postpartum Period DiscussionUnderstanding these cultural practices is essential for developing culturally sensitive interventions that can improve wellbeing of refugee mothers.

Knowledge and Attitudes of Pregnant Women towards Bankjo Lamp Technology: Case Study of Choosing a Birth Place

Background: A high-risk pregnancy jeopardizes both maternal and fetal lives. Despite recommendations for hospital births, six out of ten high-risk expectant mothers in Kawedanan opt for PMB or Community Health Center Maternity. To identify high-risk pregnancies, Kawedanan Community Health Center employs the innovative Bankjo lamp. This study investigates how pregnant women's attitudes and knowledge about Bankjo lamps influence their maternity location choice. Methods: This type of research uses quantitative descriptive research. This observational analytical research involved 57 expectant mothers due to maternity in January, February, or March. Using a cross-sectional design, the study treated knowledge and attitudes about Bankjo lamps as independent variables, with maternity location preference as the dependent variable. Data collection methods included knowledge and attitude questionnaires and monthly midwife reports. The data was analyzed using the Chi-Square test and descriptive statistics in the form of frequency distribution with presentation. Results: Findings indicate that pregnant women generally possess adequate knowledge about suitable maternity locations, with some showing insufficient understanding. A significant correlation (p = 0.013) exists between knowledge levels and preferred birthplace. Despite the preference for hospital births among nearly all expectant mothers, a majority hold negative attitudes, strongly correlated (p = 0.000) with their birthplace choices. Interestingly, while most pregnant women understand the Bankjo lamp innovation well, they harbor negative attitudes toward it. Nevertheless, almost all opt for hospital births, prioritizing medical safety despite reservations about new technologies. Conclusions: The study underscores the need for government support in advancing maternal health initiatives, including innovative technologies like Bankjo lamps. Enhancing awareness and promoting positive attitudes among expectant mothers can foster safer childbirth practices. By disseminating knowledge and addressing misconceptions, healthcare providers can better support high-risk pregnancies, ensuring better outcomes for both mothers and babies.

The First Baby Study: What women would like to have known about first childbirth. A mixed-methods study.

Although prenatal care providers aim to prepare women for first childbirth, little research has explored retrospectively what birthing people would like to have known before first childbirth. To describe women's reports of what they would like to have known before first childbirth but feel they were not told. This is a secondary analysis of the First Baby Study, a large prospective cohort study conducted in Pennsylvania, USA. Telephone interviews were conducted with 3006 women 1 month after their first childbirth. Women were first asked: "Was there anything that you would have liked to have known before your delivery that you were not told?". If "yes" they were asked a second question: "Please tell me what you would have liked to have known before your delivery". A convergent mixed-methods analysis including descriptive analytics to compare characteristics of women by answers to the first question, and qualitative content analysis of women's open-ended answers to the second question. A total of 441 women (14.7%) reported there was something they would like to have known before their first childbirth. Women described that communication with care providers was their main concern. They would have liked a better understanding of their options before birth, more agency in decision-making, and more information about the topics of their body, their birth, their baby, and what to expect beyond birth. Results highlight important topics for childbirth education, and the impact of gaps in shared decision-making, patient-provider communication, and supportive care practices for first childbirth, especially where women have identified vulnerabilities.

COVID-19 related barriers to institutional childbirth during the early phase of the pandemic in rural Arsi zone, Ethiopia, 2022: A qualitative study

IntroductionGlobal, national, and local studies revealed that the COVID-19 pandemic has significantly reduced institutional childbirth. However, it is not well understood how the COVID-19 epidemic affected institutional childbirth service utilization. Therefore, this study aimed to evaluate COVID-19 related impediments to institutional childbirth service uptake during the early phase of the COVID-19 pandemic (March 20/2020–June 20/2020) in the rural Arsi zone of Ethiopia. MethodsA community-based Phenomenological study was conducted from January 10–25/2022, among mothers who gave birth in the Arsi zone during the early phase of the COVID-19 epidemic (March 20/2020–June 20/2020) in Ethiopia. Data was collected by the primary author and a university graduated Midwives with experience in qualitative data collection. Eight focus group discussions and six in-depth interviews were conducted among mothers who gave birth in selected rural areas of the Arsi zone during the early phase of the COVID-19 pandemic. Nine key informant interviews were also conducted among Midwives, Maternity Ward Heads, and Community Health Extension Workers. Data was transcribed, translated, and analyzed thematically using Atlas Ti.7 version. ResultsFour major themes and eleven sub-themes emerged regarding the barriers to institutional childbirth during the early phase of COVID-19 pandemic. The COVID-19 related fear was a reason for avoiding institutional childbirth for almost all participants. COVID-19 restrictions such as transportation bans, market bans and public transport price doubling were also critical concerns to seeking institutional childbirth. Perceived Poor quality of institutional childbirth care during the curfew was also an impeding factor. Poor communication, incomplete care components and absenteeism were mentioned under this theme. Unbalanced mass media tragedies and rumors of unknown sources were COVID -19 related infodemics found affecting the practice of institutional childbirth. ConclusionsCOVID-19 related fears, COVID-19 restrictions, Perceived Poor quality of care during the COVID-19 pandemic and the COVID-19 Infodemic were the main reasons for reduced institutional childbirth service utilization during the early phase of the COVID-19 pandemic in Ethiopia. Therefore, strategies must be designed proactively to maintain essential maternal health services, particularly institutional childbirth, during pandemics like COVID-19 and similar future epidemics.

Impact of disrespectful maternity care on childbirth complications: a multicentre cross-sectional study in Ethiopia

BackgroundGlobally, disrespectful, and abusive childbirth practices negatively impact women’s health, create barriers to accessing health facilities, and contribute to poor birth experiences and adverse outcomes for both mothers and newborns. However, the degree to which disrespectful maternity care is associated with complications during childbirth is poorly understood, particularly in Ethiopia.AimTo determine the extent to which disrespectful maternity care is associated with maternal and neonatal-related complications in central Ethiopia.MethodsA multicentre cross-sectional study was conducted in the West Shewa Zone of Oromia, Ethiopia. The sample size was determined using the single population proportion formula. Participants (n = 440) were selected with a simple random sampling technique using computer-generated random numbers. Data were collected through face-to-face interviews with a pretested questionnaire and were entered into Epidata and subsequently exported to STATA version 17 for the final analysis. Analyses included descriptive statistics and binary logistic regression, with a 95% confidence interval (CI) and an odds ratio (OR) of 0.05. Co-founders were controlled by adjusting for maternal sociodemographic characteristics. The primary exposure was disrespectful maternity care; the main outcomes were maternal and neonatal-related complications.ResultsDisrespectful maternity care was reported by 344 women (78.2%) [95% CI: 74–82]. Complications were recorded in one-third of mothers (33.4%) and neonates (30%). Disrespectful maternity care was significantly associated with maternal (AOR = 2.22, 95% CI: 1.29, 3.8) and neonatal-related complications (AOR = 2.78, 95% CI: 1.54, 5.04).ConclusionThe World Health Organization advocates respectful maternal care during facility-based childbirth to improve the quality of care and outcomes. However, the findings of this study indicated high mistreatment and abuse during childbirth in central Ethiopia and a significant association between such mistreatment and the occurrence of both maternal and neonatal complications during childbirth. Therefore, healthcare professionals ought to prioritise respectful maternity care to achieve improved birth outcomes and alleviate mistreatment and abuse within the healthcare sector.

Humanized Childbirth: An Experience Report of the Assistance Offered by the Unified Health System in a City in the SouthEast of Brazil

Background: Childbirth is a crucial event in a woman’s life and her baby’s, with significant implications for the health and well-being of both. In Brazil, the predominant approach has been medicalized childbirth, with frequent medical interventions during the birthing process. However, growing evidence highlights the benefits of humanized childbirth for the physical and emotional health of the mother and baby. In this context, this study analyzes the transition towards more humanized childbirth practices in Brazil, its impacts, and associated challenges. Objectives: This study aims to analyze the implementation of humanized childbirth practices in Brazil, focusing on the stages of pregnant women reception, preparing the environment for the child’s arrival, and the symbolism of childbirth through Placenta Printing. Specific objectives include evaluating pregnant women’s satisfaction with the childbirth experience, analyzing the reduction of unnecessary medical interventions, and assessing neonatal outcomes associated with these practices. Methods: The study is an experience report that occurred in a municipal hospital in Minas Gerais, Brazil, during the year 2024. Humanized childbirths were followed through the Brazilian public healthcare system, which offers free and universal assistance to pregnant women during childbirth. The stages of pregnant women reception, preparing the environment for the child’s arrival, and the symbolism of childbirth through Placenta Printing were detailed and implemented according to established protocols. Pregnant women’s satisfaction was assessed through postpartum interviews, while data related to the rate of medical interventions and neonatal outcomes were collected and analyzed. Results: The results demonstrated high satisfaction among pregnant women with the humanized childbirth experience, highlighting empathetic reception, clear and respectful communication, and consideration of their preferences in preparing the environment and practicing Placenta Printing. Additionally, there was a significant reduction in unnecessary medical interventions, reflected in a decrease in the cesarean section rate, episiotomies, and other medical procedures during childbirth. Neonatal outcomes were also positive, with favorable neonatal adaptation indicators. Conclusion: The experience of humanized childbirth in Brazil represents a significant advancement in promoting maternal and neonatal health. Despite the challenges faced, the benefits associated with this comprehensive approach to childbirth are undeniable. It is crucial for health authorities, healthcare professionals, and society to continue supporting and promoting humanized childbirth practices as part of a broader effort to improve maternal and neonatal health outcomes in Brazil

Evaluation of educational activity in a district reference unit: perception of pregnant women

Introduction: Health education during prenatal care is crucial for the knowledge and empowerment of families, but studies show gaps in this service. Courses and groups for pregnant women have been useful in disseminating information about childbirth practices. Objective: To identify the perception of pregnant women about the Pregnancy and Companion Courses offered by Obstetric Nursing residents in a District Reference Unit (URD) ​​in the Federal District. Methodology: Exploratory descriptive study with a qualitative approach. Results: Of the eleven interviewees, the majority are between 30 and 40 years old and married. Most of them are not linked to the study's URD and receive assistance from private health services. They are all first-time mothers and this is the first Pregnancy Course they have attended. The most highlighted information in the course were the phases of labor and the changes in the parturient woman's body during this process. Final considerations: Obstetric Nursing residents train pregnant women and companions, promoting the humanization of childbirth and transforming the families' experience. This helps to demystify outdated beliefs and prepare them for eventualities.

Awareness and Use of World Health Organisation Safe Childbirth Checklist among Midwives Practicing in Health Institutions in Imo State

Maternal and child health are pivotal to the growth and development of any nation and a critical aspect of the healthcare practice that ensures that adequate and safe childbirth practices are in place for safe delivery especially in resource-constrained settings. This study determined the awareness, use, benefits and challenges with the WHO Safe Childbirth Checklist among the Midwives in Imo State, Nigeria. The study utilized a descriptive survey design and surveyed 145 midwives as a sample. Data was collected from both primary and secondary sources. For the quantitative data, a well-structured questionnaire was issued to midwives employed by certain health facilities in Imo state. The midwives were selected using a random sampling method. Both descriptive and inferential statistics were conducted, and results were presented in the form of tables, charts, and percentages. More of the respondents were 36 years or older (74.5%), spent greater than 10 years in practice (57.9%), are graduates (75.9%), work in the public health facilities (64.1%). only 27.6% of the midwives working in these facilities are aware of the WHO Childbirth Checklist and only 4.8% of them consistently incorporate the checklist in their routine care of women in labour. Staff with more than 10 years of experience (p = 0.021), involved in teaching/administration (p = 0.007), as well as those without professional memberships (p<0.001) were significantly associated with consistent use of the WHO Checklist. The study's findings add to the existing body of knowledge and provide valuable insights into the awareness and utilization of the WHO SCC among midwives in the Imo State. This, in turn, sheds light on potential areas for improvement in maternal delivery.

Spatial patterns and determinants of low utilization of delivery care service and postnatal check-up within 2 months following birth in Ethiopia: Bivariate analysis.

Home delivery is a nonclinical childbirth practice that takes place in one's home with or without traditional birth attendants and postnatal care is the care given to the mother and her newborn baby; according to world health organization (WHO), the postnatal phase, begins one hour after birth and lasts six weeks (42 days). This paper aimed to study the spatial pattern and determinant factors of low utilization of delivery care (DC) services and postnatal check-up (PNC) after live births in Ethiopia. This study used the 2016 Ethiopian Demographic and Health Survey data as a source. A total weighted samples of 11023 women-children pairs were included. The bivariate binary logistic regression analyses with spatial effect were modeled using SAS version 9.4 and ArcGIS version 10.8 was used for mapping. The spatial distribution of low utilization of delivery care service and postnatal check-up were significantly clustered in Ethiopia (Moran's I statistic 0.378, P-value < 0.001 and 0.177, P-value < 0.001 respectively). Among 11023 children-women pair, the prevalence of home delivery and no postnatal check-up within two months following birth were 72.6% and 91.4% respectively. The Liben, Borena, Guji, Bale, Dolo and Zone 2 were predicted to have high prevalence of home delivery and part of Afder, Shabelle, Korahe, Dolo and Zone 2 were high risk areas of no postnatal checkup. Lack of occupation, region, large family size, higher birth order, low utilization of antenatal care visit, unable to access mass media, big problem of health facility distance and the spatial variable were found to be jointly significant predictors of low utilization of DC and PNC in Ethiopia. Whereas older age, being reside in rural area and low wealth status affects delivery care service utilization. We suggest health providers, policy makers and stakeholders consider those variables with priority given to Liben, Borena, Guji, Bale, Dolo, Zone 2, Afder, Shabelle and Korahe, where home delivery and no PNC were predicted relatively high. We also recommend researchers to conduct further studies using latest survey data set.

Implementing a Respectful Maternity Care Guideline During Childbirth Experiences

ObjectiveTo measure the impact of an evidence-based guideline on respectful maternity care on nurses’ attitudes and beliefs about childbirth practices. DesignA quality improvement pilot project with a pretest/posttest design examining the attitudes and beliefs of intrapartum nurses about childbirth practices of respectful care. SettingHigh-risk intrapartum unit at a tertiary care center in the southeastern United States. ParticipantsA convenience sample of 130 registered nurses were invited to participate, and nine completed the pre- and posttests. Intervention/MeasurementsThe intervention included a recorded webinar, access to printed and electronic copies of the guideline, discussions in daily huddles, and a virtual journal club. Data were collected using the 42-item Nurse Attitudes and Beliefs Questionnaire–Revised. Lower scores are reflective of attitudes and beliefs that support a medical model of care, whereas higher scores are reflective of a physiologic model of care. Descriptive statistics and the Wilcoxon signed rank test were used to analyze changes in attitudes and beliefs based on the aggregate scores of the nurse participants. ResultsAlthough there was no change in nurse attitude and beliefs about childbirth practices after 3 months (p = .058), the aggregate scores on a scale of 42 to 168 increased by 5.6 points. Two subscales of the Nurse Attitudes and Beliefs Questionnaire–Revised—Medical Model of Conflict and Women’s Autonomy—had the greatest increase in aggregate scores. ConclusionUnderstanding nurses’ attitudes and beliefs can assist in identifying barriers to the provision of respectful care, particularly during labor and birth, when patients are most vulnerable. Measurement of nurse attitudes and beliefs regarding respectful maternity care may require a longer immersion in a respectful maternity care program to allow for changes over time.

Respectful maternity care in Israel during the Covid-19 pandemic: a cross-sectional study of associations between childbirth care practices and women’s perceptions of care

BackgroundRespectful maternity care is a crucial part of quality care and is associated with better health outcomes. Early in the Covid-19 pandemic, reports from across the world indicated that infection containment measures were often implemented in ways that resulted in disrespectful care of women during facility-based childbirths in violation of evidence-based practices. This study aimed to explore the associations between childbirth care practices and perceptions of care as satisfactory and respectful among women who delivered in Israeli hospitals during the first six months of the Covid-19 pandemic.MethodsA cross-sectional self-administered online survey was conducted to explore women’s perceptions of maternity care using an adapted version of the WHO Community Survey Tool for measuring how women are treated during facility-based childbirth. Multivariate logistic regression models evaluated the associations between sociodemographic characteristics, obstetric information, and measurements of childbirth experiences and women’s perceptions of receiving respectful and satisfactory care.ResultsThe responses of 981 women were included in the analysis. While the majority of women perceived the care they received as both respectful (86.54%) and satisfactory (80.22%), almost 3 in 4 women (72.68%) reported experiencing at least one type of disrespectful care. Positive communication with the medical staff and respect for autonomy were associated with a more positive birth experience for women. Women were more likely to perceive their care as respectful if they did not feel ignored (AOR = 40.11;22.87–70.34). Perception of satisfactory care was more likely among women who had the opportunity to discuss preferences with the medical staff (AOR = 10.15; 6.93–14.86). Having Covid-19 procedures explained increased the likelihood of reporting respectful and satisfactory care (AOR = 2.89;1.91–4.36; AOR = 2.83;2.01–4).ConclusionUnderstanding which care practices are associated with women’s perceptions of care at facility-based births is critical to ensuring quality care. The findings of this study can inform future work and research aimed at enhancing respectful maternity care during times of crisis and beyond.

Traditions, Rituals and Policy on Gender Discrimination in Nepal

This research investigates the impact of cultural traditions on gender discrimination in Nepal, particularly through the lens of sex-selective abortion. Despite some progress, deeply rooted cultural practices continue to influence policy-making and implementation, especially regarding gender issues. These traditional customs persistently shape childbirth practices, educational opportunities, and basic rights, perpetuating gender discrimination. This study examines how entrenched cultural norms both support and hinder the advancement of gender equality in Nepal. Focusing on the interaction between cultural traditions and gender-related policies, the research explores how these customs affect birthing practices and healthcare policies. It also analyzes the cultural norms that dictate educational expectations for women and girls and evaluates the broader implications for gender rights. The study highlights how ritualistic childbirth practices and gender-specific educational expectations create disparities and challenge the effectiveness of gender equality initiatives. Recent reforms and cultural shifts in Nepal reflect efforts to address these gender imbalances. This study emphasizes the need for policy frameworks that respect cultural traditions while promoting gender equality. By integrating primary qualitative data with secondary sources and using descriptive and analytical methods, the research provides a comprehensive view of the challenges and opportunities in aligning tradition with modern gender equality goals. Ultimately, the study advocates for ongoing reform and cultural adaptation to effectively combat gender discrimination and ensure equal rights for all individuals in Nepal. It underscores the importance of developing policies that acknowledge and integrate cultural contexts while striving for genuine gender equality.

Optimizing caesarean section use and feasibility of implementing the Robson classification system: Perspectives of healthcare providers and policymakers.

In recent decades, caesarean section rates have increased dramatically worldwide and the reasons for this trend are not fully understood. This continuing trend has raised public health concerns regarding higher maternal and perinatal risks, high costs, healthcare efficiency, and inequality of services. The current study aimed to explore the perspectives and insights of healthcare providers and policymakers in the Israeli health system regarding the factors that drive caesarean section rates and the readiness and feasibility of implementing the Robson Ten Group Classification System for the first time. Semi-structured interviews were conducted (n = 12) with purposefully selected healthcare providers and policymakers in Israel. Data was analysed inductively using a thematic analysis approach. The findings reflected the "changing landscape" in childbirth practices and attitudes that contributes to the rising caesarean section rate, including childbirth at older ages, birth planning, and a transition toward a more collaborative decision-making approach to childbirth. The participants emphasized the lack of a standardized classification or consistent data monitoring of caesarean section in the Israeli health system. Additionally, enablers to implement the Robson Ten Group Classification System in Israel (ease of use, data collection and recording, and the allocation of resources and personnel), as well as barriers (concerns over workload, limited resources, budget implications, and technological complexity), were found. This study revealed the multifaceted factors shaping caesarean section rates within Israel and underscored the perceived need for evidence-based monitoring and informed decision-making in healthcare practices. Our findings support the conclusion that empirical evidence and clear data are crucial for effective caesarean section use and are currently lacking in Israeli hospitals. Thus, it is recommended to adopt a globally standardized, accepted, and effective tool-the Robson Ten Group Classification System-to accommodate the "changing landscape" in alignment with evolving medical and societal dynamics, which consequently will assist in optimizing caesarean section use.

Statistical exploration and projection of SDG-3 in Bangladesh through DHS: a study on data-driven perspectives using logistic regression

Sustainable Development Goal-3, as defined by the United Nations, aims to ensure healthy lives, and promote well-being for all at all ages. In the context of Bangladesh, achieving the targets of SDG-3 is a critical priority for public health and development. This study presents a data-driven exploration of SDG-3 in Bangladesh, focusing on maternal and child health indicators. We utilized data from multiple Bangladesh Demographic and Health Surveys conducted in 2011, 2014, and 2018 to provide a comprehensive analysis of health-related trends and determinants. We employed rigorous statistical techniques, including backward stepwise logistic regression and Pearson correlation coefficients, to uncover insights into the status of maternal and child health in Bangladesh. The prevalence of safe childbirth practices exhibited a gradual improvement from 2011 (32.5%) to 2018 (50.2%). Notably, women with higher levels of education demonstrated a significantly higher likelihood of safe childbirth practices (odd ratio = 1.73, 95% Confidence Interval: 1.19 – 1.97). Additionally, residing in urban regions (odd ratio = 1.07, 95% Confidence Interval: 0.96 – 1.39), having access to mass media (odd ratio = 1.34, 95% Confidence Interval: 0.98 – 1.41), receiving antenatal care (odd ratio = 1.62, 95% Confidence Interval: 1.16 – 1.92), being in the rich wealth index category (odd ratio = 1.13, 95% Confidence Interval: 0.92 – 1.39), and choosing to deliver outside the home (odd ratio = 1.48, 95% Confidence Interval: 1.11 – 1.86) were all associated with a higher likelihood of safe childbirth practices. The findings from this study show the power of data-driven decision-making in shaping health policies and interventions. They reveal critical factors affecting health outcomes, offering a roadmap for policymakers and stakeholders to design evidence-based strategies for improving maternal and child health in Bangladesh. This proposed work not only contributes to the academic understanding of public health in Bangladesh but also serves as a practical guide for those working to achieve SDG-3. As Bangladesh continues its journey toward health and well-being for all, this study sets a benchmark for evidence-based policymaking, emphasizing the importance of data-driven perspectives in the pursuit of SDG.

Issues and Agendas of Infertility Studies in Bangladesh

Abstract: In Bangladesh, people and its culture immensely focus on the importance of fertility and reproduction. Motherhood thus became a purified identity in both cultural and mystical ways. As a result, any factor hindering fertility is considered deviant and ignored in all aspects. Hence, our studies mainly triggered the notion, significances and hinders to maternal and child health, birth practices, fertility and reproduction etc. Therefore, the socio-economic and psychological strains of infertile people remain insignificant in our studies. In addition, infertility has been considered a neglected and stigmatized issue due to our overpopulation and socio-cultural perceptions of it. Though the number of infertile people is increasing in Bangladesh still there is a dearth of research on the social aspects and consequences of infertility in the country. Infertility has been considered as a stigmatized, gendered, psycho-social turmoil and sensitive agenda to explore, where the stakeholders consciously ignore the biological and psycho-social solutions to it and exploit the infertile. This piece of paper focuses on the nature of studies conducted on infertility issues in Bangladesh, which emphasize the significance of infertility studies in anthropology and other branches of social sciences. This study also categorizes the issues, perspectives and agenda of infertility studies here in Bangladesh. In doing so, the paper also outlines the future scopes and corridors for infertility studies in Bangladesh.