First-time Mothers Research Articles

PENGGUNAAN TERAPI KOMPLEMENTER BIRTH BALL TERHADAP PEMBUKAAN SERVIKS PADA IBU BERSALIN PRIMIGRAVIDA

Introduction. One of the complications of childbirth that contributes to maternal mortality is prolonged labor. Various physiological efforts made to prevent prolonged labour, such as pregnancy exercises, deep breathing techniques and the use of birthballs. Birthball means a birth ball that can be used by first-time mothers to their usual position help progress in labour. Birthball can stimulate the opening of the cervix and widen the pelvic outlet. Sit straight on the ball then the force of gravity will help the fetus or the lowest part of the fetus to get down to the pelvis. Objectives. This study aims to determine Effect of complementary therapy with Birth Ball on opening cervix at PMB Yunita Cecilia Malang. Methods. This research uses the method quasi experiment with post test only design with control group design. Subjects in this study were normal primigravida mothers who fulfilled inclusion and exclusion criteria. The size of the research sample is 60 people divided into two intervention and control groups. This research instrument using a questionnaire and partograph. Data analysis using an unpaired difference test. Results. The research results found that After the study, it was found that there was a significant difference in the progress of labor in the two groups (p value = 0.000). Conclusions. So that it can It can be concluded that there is an effect of complementary therapy with a birth ball on the opening of the cervix in women giving birth. It is recommended for mothers who are giving birth practicing complementary therapy exercises while sitting on a maternity ball can recommended as one significant way to improve labor progress.
 
 Keywords: birth ball; opening of the cervix; giving birth

The impact of exclusion due to COVID-19 restrictions on partners' satisfaction with Swedish hospital postnatal ward care: A multi-methods approach.

To prevent the spread of SARS-CoV-2, hospitals around the world adopted protocols that, in varying ways, resulted in the exclusion of partners from hospital postnatal care wards. The objective of this study was to examine the effect this exclusion had on partners' satisfaction with postnatal care. An online survey (the Swedish Pregnancy Panel) including free-text comments was conducted before and during the first wave of the COVID-19 pandemic; partners of pregnant women were recruited at an early ultrasound appointment and followed until 2 months after childbirth. Data were linked to the Swedish Pregnancy Register. The survey was completed by 524 partners of women who gave birth during the pandemic and 203 partners of women who gave birth before. Partners' satisfaction with hospital postnatal care dropped 29.8 percent (-0.94 OLS, 95% CI = -1.17 to -0.72). The drop was largest for partners of first-time mothers (-1.40 OLS, 95% CI = -1.69 to -1.11), but unrelated to clinical outcomes such as mode of birth and most social backgrounds, except higher income. The qualitative analysis showed that partners (1) felt excluded as partners and parents, (2) thought the strain on staff led to deficiencies in the care provided, and (3) perceived the decision about partner restrictions as illogical. The exclusion of partners from the hospital postnatal wards clearly impaired satisfaction with care, and partners of first-time mothers were particularly affected. Planning for future restrictions on partners from hospital wards should factor in these consequences.

Edukasi Persiapan Diri Ibu dalam Menghadapi Persalinan untuk Menurunkan Tingkat Kecemasan dan Persiapan Mental Ibu di Poskeskel Batu Hampa

Childbirth is a process that must be prepared for because it plays a major role in how first-time mothers will develop good self-esteem, positive feelings for the baby and an easier adjustment to the role of mother. Fear and unpreparedness in facing childbirth will have a negative impact both during the birth process which will have an impact on the health of the mother and fetus as well as in the lactation process and optimizing mother and baby bonding. The aim of this community service activity is to provide education on the mother's self-preparation for childbirth including the importance of preparing for childbirth, the mother's self-preparation for childbirth, self-empowerment that pregnant women can do in preparing themselves for the birth process, the importance of positioning during pregnancy to optimize the position of the fetus. and presentation and re-demonstration of pregnancy exercises. Activities were carried out at the Poskeskel Batu Hampa involving local village midwives and health cadres. This activity was very positively welcomed by the village midwives and participants as evidenced by the enthusiasm of the participants in participating in the activity. Hopefully this activity can become a routine agenda so that it becomes a provision for pregnant women when facing childbirth.

Mother–infant bonding in the first nine months postpartum: the role of mother’s attachment style and psychological flexibility

ABSTRACT Introduction Mother’s bond to the infant in the postpartum period plays an important role in the subsequent mother–infant relationship and the infant’s socio-emotional functioning. Several maternal characteristics, such as attachment style and psychological flexibility, may contribute to the quality of mother–infant bonding, though literature examining these variables is still scarce. The present study aimed to examine the impact of mother’s attachment on mother–infant bonding in the first month postpartum and the mediating role of psychological flexibility on that association. Methods Participants were 226 mothers of an infant up to 9 months old, who reported on their own attachment style (in terms of anxiety, comfort with proximity, trust in others), psychological flexibility (in terms of openness to experience, behavioural awareness, valued action) and mother–infant bonding. Results Results showed that mother’s attachment anxiety predicted a bond with the infant directly and indirectly via mother’s psychological flexibility, specifically through behavioural awareness and valued action. Trust in others had an impact on mother–infant bonding through behavioural awareness, whereas comfort with proximity influenced mother–infant bond indirectly, via valued action. Finally, mothers’ civil status, schooling and number of children were relevant to better understand the variance of our mediating and dependent variables. Discussion Our findings highlight the importance of mother’s attachment and psychological flexibility in promoting the quality of mother–infant bonding, which can inform future intervention programmes targeting modifiable factors, such as psychological flexibility, to promote early positive parent–infant relationships, particularly for single, first-time mothers, with higher levels of education.

Polybrominated Diphenyl Ethers in Human Milk of Croatian First-Time Mothers: 2010 Versus 2020.

The presence of selected polybrominated diphenyl ethers (BDE-28, -47, -99, -100, -153, -154, and -183) was investigated in human milk samples collected from first-time mothers living in Zagreb, capital of Croatia. Samples from 2020 and 2010 were analyzed, and the first temporal comparison between the profiles and levels of these compounds in this area was obtained. A statistically significant difference between mass fractions depending on the sampling year was observed only for BDE-99, with values in 2020 higher than in 2010. BDE-153, whose median value (0.25 and 0.26ngg-1 lipid weight (l.w.) in 2010 and 2020, respectively) did not decrease in the 10-year period, was the most frequently detected congener in samples from both years. ΣPBDEs ranged from < LOD to 3.53ngg-1l.w. (median 0.25ngg-1l.w.), and from 0.14 to 6.75ngg-1l.w. (median 0.55ngg-1l.w.) in 2010 and 2020, respectively. Maternal age and reported fish consumption had no effect on observed PBDE mass fractions, while for BDE-153, positive significant correlation (p > 0.05) was observed of its detected mass fraction with mother's body mass index (BMI) before pregnancy and after childbirth. Infants median estimated daily intake (EDI) via milk ingestion for ΣPBDE was higher in 2020 (3.221 ng kg-1 bw day-1) compared to 2010 (1.429ngkg-1bwday-1), but both values were well below threshold value, indicating that human milk consumption in this specific case is unlikely to raise health risks to infants.

Occupational therapy in maternal health: Exploring the Barkin Index of Maternal Functioning as a potential tool.

Transitioning into the role of a mother encompasses many physical and psychosocial changes, affecting the way a woman may function. Maternal health is an emerging area of practice for occupational therapists, and therefore, screening and assessment tools to support work in this area are needed. The Barkin Index of Maternal Functioning (BIMF) is a quantitative outcome measure that is used by health professionals to assess maternal functioning. Currently, its ability to measure occupational performance is unclear. Utilising a mixed methods design, this study analysed the extent to which the BIMF assesses maternal function from an occupational perspective. Thirteen first-time mothers with a baby 12 months of age or younger participated in the study. Results from the BIMF were compared with themes developed from semi-structured qualitative interviews that explored the occupational experiences of first-time mothers. Seven themes were developed from the interviews. The BIMF addressed three themes, including changes to engagement in basic activities of daily living and leisure, transitioning into motherhood, emotions, self-efficacy, and social support. However, four themes were not captured by the BIMF, including changes to partner relationships, identity shift, influence of 'person' factors, and changes to social experiences in early motherhood. Findings suggest that a new tool with a holistic perspective of mothers as occupational beings is needed to be able to identify occupational performance issues and the potential need for occupational therapy support. This study identified key experiences of occupational performance for new mothers.

Changes in Address and the Child Opportunity Index after Delivery in a Cohort of First-time Mothers

Background: The Child Opportunity Index (COI) characterizes social determinants of health across the United States including education, health and environment, and social and economic factors. The objective of the study was to determine if the nulliparous pregnant persons changed addresses between the time of delivery and at the time of follow-up 9-11 years after delivery and to evaluate the trajectory of the COI over time.&#x0D; Methods: We analyzed data from nulliparous pregnant people participating in the nuMoM2b Heart Health follow-up Study (HHS). Residential addresses at delivery and at follow-up (~9 years) were compared to determine if the participant changed addresses and to evaluate the COI trajectory. Descriptive characteristics (age, race, income, pregnancy outcomes) and the COI trajectory were compared for those who did and did not move using chi-square and t-tests.&#x0D; Results: 410 participants were analyzed. 304 (74%) of the participants changed addresses resulting in changes in census tracts. Moving was associated with a lower mean maternal age (24.3 vs. 27.2 yrs, p≤0.001) and a lower average income (62.3% vs 41.1% &lt;200% FPL,p≤0.001) compared to the participants who did not move. 40.5% moved to a neighborhood with a higher COI quintile, 56 (18.4%) participants moved down a COI quintile, and 125 (41.1%) participants did not have a change in COI category. White participants who moved addresses were significantly more likely to increase their COI category (55%) compared to non-White participants who moved addresses (22.2%, p≤0.001). There were no differences in how COI changed between White and non-White participants who did not move.&#x0D; Conclusion: The majority of the participants moved in the years after delivering their first child. Moving was typically associated with an improvement in COI categories, with disparities seen as White participants were more likely to increase their COI if they moved compared to non-White groups.

Risk factors for persistent versus episodic mother-to-infant bonding difficulties in postpartum women in a nationwide Japanese longitudinal study

BackgroundThe quality of mother-to-infant bonding (MIB) is a crucial determinant of nurturing behaviors and infant development, with bonding difficulties (MIBD) posing a substantial threat. While it is essential to identify MIBD risk factors, previous studies have generally examined MIBD at one time point, leaving the contributors to persistent MIBD uncertain. This study aims to discern longitudinal risk factors for persistent versus episodic MIBD. MethodsWe evaluated 1833 postpartum Japanese women who delivered in the past twelve months, utilizing the Mother-to-Infant Bonding Scale (MIBS) and other sociodemographic, health, pregnancy, childbirth, and child-rearing related data (T1). Follow-up data were obtained six months later (T2). MIBD was defined as a MIBS score of five or more, with “persistent” and “episodic” MIBD classified based on its occurrence at both or either one of the time points, respectively. Logistic generalized estimating equations and inverse probability weighting were used to identify risk factors and address selective attribution bias. ResultsOf the subjects, 15.8 % reported episodic and 11.3 % reported persistent MIBD. Shared risk factors for both conditions included postpartum depression and low levels of family support (OR = 1.501–6.343). However, pre-pregnancy underweight status (OR = 1.698) was a unique risk factor for episodic MIBD, while first-time motherhood, no or discontinuation of breastfeeding, and later postpartum months (OR = 1.540–3.179) were distinctive risk factors for persistent MIBD. ConclusionWe identified both shared and unique risk factors for episodic and persistent MIBD. Particular attention should be afforded to persistent MIBD and early and proactive interventions to mitigate identified risk factors are recommended.

Facing a new life-The healthy transition to motherhood: What individual and environmental factors are needed? A phenomenological-hermeneutic study

ObjectiveThe aim of the study was to highlight first-time mothers’ experiences of the transition to motherhood uncovering personal and environmental conditions facilitating or preventing the process of a healthy transition in a Swedish context. DesignA qualitative study with interview data analyzed using a phenomenological hermeneutic method. Setting and participantsTen recent first-time mothers were selected from three primary healthcare centers in western Sweden. FindingsFour themes emerged, and the transition could be divided into several phases, interpreted as facing a new life, while feeling unprepared for identity and existential issues. The experience of becoming a mother was described as oscillation between a loss of former identity from previous life, and on the other hand, the joy and expectations of forming a new family. The mothers had high demands of themselves, often influenced by social media and needed to value the flow of information and `let go of control` to be able to make adequate decisions. The close family of origin was invaluable in this process being able to provide confirmation in the new role, facilitating the development of their own security and self-confidence. Key conclusionsThe vulnerability expressed by new mothers shows that support from the family of origin, partners and professionals are indispensable. The desired result after the transition to motherhood is a prosperous, maturity and confident mother. The main promoting factor in this process seems to be having a safe base that can provide required support. Implications for practiceThe level of wellbeing after the transition is crucial and the possibility of a warm, responsive and secure parenting needs to be strengthened. The challenge to preventive health care will be to identify a lack of support and ensure that these mothers gain sufficient support to meet today´s demands and still feel that they are good enough mothers for their children.

Women's neuroplasticity during gestation, childbirth and postpartum.

Pregnancy is a unique neuroplastic period in adult life. This longitudinal study tracked brain cortical changes during the peripartum period and explored how the type of childbirth affects these changes. We collected neuroanatomic, obstetric and neuropsychological data from 110 first-time mothers during late pregnancy and early postpartum, as well as from 34 nulliparous women evaluated at similar time points. During late pregnancy, mothers showed lower cortical volume than controls across all functional networks. These cortical differences attenuated in the early postpartum session. Default mode and frontoparietal networks showed below-expected volume increases during peripartum, suggesting that their reductions may persist longer. Results also pointed to different cortical trajectories in mothers who delivered by scheduled C-section. The main findings were replicated in an independent sample of 29 mothers and 24 nulliparous women. These data suggest a dynamic trajectory of cortical decreases during pregnancy that attenuates in the postpartum period, at a different rate depending on the brain network and childbirth type.

Predictors of maternal satisfaction with childbirth experience among first-time mothers in Phalombe District, Malawi

Background/Aims Assessing maternal satisfaction with care improves healthcare professionals' understanding of women's needs at maternal healthcare services and can encourage future use of hospital-based intrapartum care. This study's aim was to explore predictors of maternal satisfaction with their childbirth experience at health facilities in Phalombe District, Malawi. Methods A cross-sectional study was conducted with 254 first-time mothers, recruited using systematic random sampling. Data were collected using questionnaires and analysed using bivariate and multivariate analyses to determine predictors of maternal satisfaction. Results Only half (49.2%) of participants were satisfied with their childbirth experience. Welcoming and encouraging doctors/midwives (P&lt;0.001) and being kept informed during labour (P=0.001) were the main predictors of maternal satisfaction. Conclusions Maternal satisfaction is impacted by a woman's relationship with her care providers and the information imparted during care. To improve maternal satisfaction with care at the study site, there is a need for healthcare providers to improve their interpersonal relationships with labouring women and provide adequate information during care.

Comparing the effectiveness of a breastfeeding arm sling with the normal cross-cradle hold position: A quasi-experimental study in Thailand.

In Thailand, the exclusive breastfeeding rate remains low at 14% in 2019, despite the World Health Organization's recommendation of exclusive breastfeeding for the first six months. Many mothers experience challenges such as lack of confidence, fatigue, and discomfort while breastfeeding. To address these issues, the novel arm sling innovation device was developed to provide support during breastfeeding. This study aimed to compare the effectiveness of breastfeeding using the arm sling versus the normal cross-cradle hold among first-time mothers and to evaluate their satisfaction with the breastfeeding arm sling. A quasi-experimental crossover design was employed in the postpartum unit at Ramathibodi Hospital, Thailand, in 2022. Forty-six first-time mothers breastfed using both a breastfeeding arm sling and the normal cross-cradle hold, with a washout period in between. Breastfeeding effectiveness was measured by mothers and nurse-midwives using questionnaires, and mothers' satisfaction with the sling was assessed. Data were evaluated using descriptive statistics and t-tests. The breastfeeding arm sling innovation significantly improved breastfeeding effectiveness compared to the normal cross-cradle hold, reported by both mothers (t=4.32, p<0.001) and nurse-midwives (t=8.93, p<0.001). Most mothers expressed satisfaction with the arm sling, though some design aspects, such as ease of use, require improvement. This study suggests that the breastfeeding arm sling can potentially improve breastfeeding experiences for first-time mothers. Further research is needed on a larger scale and in more diverse settings to confirm these findings and to improve the sling's design for user-friendliness.

The continuum of care for maternal health in Africa: A systematic review and meta-analysis.

The continuum of care for maternal health (COCM) is a critical strategy for addressing preventable causes of maternal and perinatal mortality. Despite notable progress in reducing maternal and infant deaths globally, the problem persists, particularly in low-resource settings. Additionally, significant disparities in the provision of continuous care exist both between continents and within countries on the same continent. This study aimed to assess the pooled prevalence of completion across the maternity care continuum in Africa and investigate the associated factors. Relevant articles were accessed through the EMBASE, CINAHL, Cochrane Library, PubMed, HINARI, and Google Scholar databases. Funnel plots and Egger's test were employed to assess publication bias, while the I-squared test was used to evaluate study heterogeneity. The inclusion criteria were limited to observational studies conducted exclusively in Africa. The quality of these studies was assessed using the JBI checklist. Data extraction from the included studies was performed using Microsoft Excel and then analysed using Stata 16 software. A total of 23 studies involving 74,880 mothers met the inclusion criteria. The overall prevalence of women who successfully completed the COCM was 20.9% [95% CI: 16.9-25.0]. Our analysis revealed several factors associated with this outcome, including urban residency [OR: 2.3; 95% CI: 1.6-3.2], the highest wealth index level [OR: 2.1; 95% CI: 1.4-3.0], primiparous status [OR: 1.3; 95% CI: 2.2-5.1], planned pregnancy [OR: 3.0; 95% CI: 2.3-3.7], and exposure to mass media [OR: 2.7; 95% CI: 1.9-3.8]. The study revealed that only 20.9% of women fully completed the COCM. It also identified several factors associated with completion of the COCM, such as residing in urban areas, possessing a higher wealth index, being a first-time mother, experiencing a planned pregnancy, and having access to mass media. Based on the study's findings, it is recommended that targeted interventions be implemented in rural areas, financial assistance be provided to women with lower wealth index levels, educational campaigns be conducted through mass media, early antenatal care be promoted, and family planning services be strengthened. PROSPERO International Prospective Register of Systematic Reviews (ID: CRD42020205736).

Adverse childhood experiences, emotional distress and dissatisfaction with motherhood among first-time mothers: Mediations and child differences.

Despite the challenges associated with motherhood, studies have not consistently identified factors contributing to first-time mothers' dissatisfaction with motherhood in resource-limited regions. To fill this research gap, this study investigates how adverse childhood experiences (ACEs) result in first-time mothers' dissatisfaction with motherhood through emotional distress in Nigeria. Results from the partial least square structural equation model suggests that ACEs are associated with dissatisfaction with motherhood ( = 0.092; p<0.01) and emotional distress ( = 0.367; p<0.001). There is also a significant association between emotional distress and dissatisfaction with motherhood ( = 0.728; p<0.001). Indirect path from first-time mothers' ACEs to dissatisfaction with motherhood through emotional distress shows significance ( = 0.267; 95% CI (0.213, 0.323); p<0.001). In addition, the indirect path from first-time mothers' ACEs to dissatisfaction with motherhood through child emotional closeness showed significant dampening effects ( = 0.044; 95% CI (0.025, 0.066); p<0.001). No serial impact of emotional distress and child emotional closeness was found in the study. The findings based on child gender indicated that only among first-time mothers of female children are ACEs predictors of dissatisfaction with motherhood. Trauma-informed interventions should be introduced in primary care settings to screen for ACEs and emotional dysfunctions among first-time mothers.

Labour pain intervention: A bibliometrics analysis

Pain and anxiety during childbirth are significant concerns during labour, especially in first-time mothers. This can increase labour time, increase stress hormones and affect the condition of the mother and newborn. This study aimed to determine trends in the number of publications on labour pain interventions, the number of citations and the direction of future research topics. The research method applied in this study was Preferred reporting items for systematic reviews and meta-analyses (PRISMA) which uses 158,201 scientific articles or proceedings sourced from the Dimensions database. Articles were reviewed by using the VOSviewer application. The results of the research revealed that the number of publications on the topic of labour pain intervention had an upward trend, the number of citations on the topic of labour pain intervention had increased. Network visualisation on the topic of labour pain intervention provided information to find newness on topics that were not yet connected, there were 4 clusters reviewing it from co-occurrence, overlay visualisation on the topic of labour pain intervention provided a trend towards future research topics, density visualisation on a topic that was still rare. The conclusion from the results of this research is that it contributes to the development of a research roadmap on labour pain interventions.

Puerperal mastitis caused by limited community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) clones.

To outline the epidemiology of puerperal mastitis caused by methicillin-resistant Staphylococcus aureus (MRSA) and evaluate the effect of an infection control bundle on its incidence. A surge in MRSA puerperal mastitis was noted in a community hospital in September 2009. MRSA samples from mastitis cases and the environment underwent typing using multilocus sequence typing (MLST), staphylococcal cassette chromosome mec (SCCmec), gene encoding surface protein A (spa), accessory gene regulator (agr), and pulsed-field gel electrophoresis (PFGE). The phenotypic characteristics, including superantigen toxin profiles, gene encoding Panton-Valentine leucocidin (pvl), and minimal inhibitory concentration (MIC) against vancomycin, were ascertained. Subsequently, an infection control bundle emphasizing contact precautions was introduced, and mastitis incidence rates pre- and post-intervention were compared. The majority of cases occurred within 6 weeks post-delivery in first-time mothers. Of the 42 S. aureus isolates (27 from mastitis and 15 from colonized staff and environmental sources), 25 (92.6%) clinical and 3 (20%) colonized MRSA were identified as ST59-SCCmecVT-spa t437-agr group I with a vancomycin MIC of 1 mg/L, pvl-positive, and predominantly with a consistent toxin profile (seb-selk-selr). PFGE revealed 13 patterns; pulsotype B exhibited clonal relatedness between two clinical and three colonized MRSA samples. Post-intervention, the incidence of both mastitis and MRSA mastitis notably decreased from 13.01 to 1.78 and from 3.70 to 0.99 episodes per 100 deliveries, respectively. Distinct community-associated MRSA (CA-MRSA) clones were detected among puerperal mastitis patients and colonized staff. The outbreak was effectively controlled following the implementation of a targeted infection control bundle.

Childbirth in adolescents - features and outcomes

Introduction. Adolescent pregnancies significantly impact the welfare of young mothers, their infants, and the general population. These pregnancies represent a public healthcare concern associated with numerous consequences. Aim: To investigate the prevalence of adolescent pregnancies and their outcomes. Material and Methods. This retrospective descriptive study included adolescents who gave birth at the Gynecology and Obstetrics Clinic between January 1, 2020 and December 31, 2020. Data on anthropometric measurements, number and mode of deliveries, newborn birth weights, and complications were collected from medical records and statistically analyzed. Results. A total of 174 adolescents (aged 13-19) were included in the study. Most were first-time mothers living in common-law unions. Four spontaneous twin pregnancies were documented. No significant differences were found in the anthropometric measures between younger (&lt;15 years old) and older (16-19 years old) adolescents. Pelvic measurements did not affect the mode of delivery. Younger adolescents and those with smaller pelvic measurements experienced longer hospitalizations. Vaginal delivery was the prominent mode of birth. Newborns delivered by caesarian section had significantly lower birth weights and lengths. While no significant complications during labor and delivery were observed, there was notable postpartum blood loss and higher rates of anemia in the puerperium. Conclusion. Although the number of adolescent pregnancies and births is declining, it still remains a significant concern. Welldeveloped perinatal care and the promotion of reproductive health within educational and health systems could not only further reduce pregnancy rates but also ensure optimal conditions for normal pregnancies and deliveries in adolescents.

РОЖДАЕМОСТЬ НА ДАЛЬНЕМ ВОСТОКЕ РОССИИ: ТЕНДЕНЦИИ, ПРИЧИНЫ, ПУТИ РЕШЕНИЯ

Significance. Given the current trends in demographic development, the existing disproportion between the population and the vast territory of the Far Eastern Federal District may significantly increase in the future, which will intensify certain concerns about a possible violation of the geopolitical balance out here. Fertility indicators have revealed the main demographic risk zones of the regions of the eastern territories. The purpose of the study is to analyze dynamics in birth rates in the Russian Far East, gender composition and age structure of the population to identify risk zones when taking effective measures to improve the situation. Material and methods. The analysis used World Health Organization data, databases and collections of Rosstat and the Ministry of Health of the Russian Federation by federal district and region of Russia, information on the implementation of the National Demography Project. Results. Determining trends in dynamics in birth rates in the Russian Far East shows that in urban areas of the Far Eastern regions, the type of demographic behavior inherent in the newcomer population and focused on having one child prevails, while in rural areas the traditions of the indigenous population are preserved. Until 2015, relatively high birth rates were recorded in “national” regions with the predominance of populations belonging to the indigenous people of the North and the Far East, in whose culture large families are accepted. The mother’s average age is increasing, there was a shift in the age of first-time mothers (20-24 years) to an older age group (25-29 years and 30-34 years). A decline in fertility in the near future will be due to a significant reduction in the number of women of reproductive age, especially in its active phase (20–39 years). A new model of marital and, as a result, reproductive behavior of young families is being formed. From the point of view of marital behavior, it implies an increase in the age at first marriage, refusal of marriage, popularity of informal marriage, etc. From the point of view of reproductive behavior, it involves postponing births in marriage until material standards are achieved, as well as in the interests of increasing one’s social status. Conclusion. One of the promising areas for improving the demographic situation is the adoption of effective social measures and programs to increase birth rates in young families. Only a rising dynamics in birth rates can give a real and sustainable impetus to stabilizing fertility for the national security of the eastern territories.

Hypnobirthing Training for First-Time Mothers: Pain, Anxiety and Postpartum Wellbeing.

Childbirth represents a significant life event, bringing about both physical and emotional transformations in a woman's life. Among other psychological aspects associated with childbirth, labor pain, death anxiety, and postpartum depression have garnered significant attention in the field of maternal and reproductive health. This study is intended to evaluate how the effectiveness of hypnobirthing training alleviates labor pain, mitigates death anxiety enhances postpartum well-being reduces labor hours, and how anxiety exacerbates the duration of labor. Data were collected from (N = 50) young and middle-aged postpartum women in the outpatient obstetrics and gynecology departments of the Civil Hospital, Waseer Gynecology Hospital and Basic Health Unit Jalal Ballagan in Gujranwala, Pakistan, by using the convenience sampling technique. Out of 50, women were divided into a control (N = 25) and an experimental group (N = 25). They were recruited during their 33 weeks of pregnancy until childbirth for hypnobirthing training. Numerical Pain Rating Scale (NPRS), Templer Death Anxiety Scale (TDAS), and Edinburgh Postnatal Depression Scale (EPDS) were used to collect participants' responses. Findings proved hypnobirthing training as a catalyst in significantly reducing labor pain, death anxiety, and postpartum depression. Furthermore, the analysis indicated that death anxiety exacerbates the labor duration hours and hypnobirthing decreases the labor hours in the experimental group of women. It sheds light on the effectiveness of hypnobirthing training to enhance the birthing process. Findings underscore the significance of collaboration between obstetricians, psychologists, and mental health professionals to develop integrated care plans that address both physical and psychological aspects of childbirth.

An explanatory model of quality of life in high-risk pregnant women in Korea: a structural equation model.

This study aimed to develop and validate a structural model for the quality of life (QoL) among high-risk pregnant women, based on Roy's adaptation model. This cross-sectional study collected data from 333 first-time mothers diagnosed with a high-risk pregnancy in two obstetrics and gynecology clinics in Cheonan, Korea, or participating in an online community, between October 20, 2021 and February 20, 2022. Structured questionnaires measured QoL, contextual stimuli (uncertainty), coping (adaptive or maladaptive), and adaptation mode (fatigue, state anxiety, antenatal depression, maternal identity, and marital adjustment). The mean age of the respondents was 35.29±3.72 years, ranging from 26 to 45 years. The most common high-risk pregnancy diagnosis was gestational diabetes (26.1%). followed by preterm labor (21.6%). QoL was higher than average (18.63±3.80). Above-moderate mean scores were obtained for all domains (psychological/baby, 19.03; socioeconomic, 19.00; relational/spouse-partner, 20.99; relational/family-friends, 19.18; and health and functioning, 16.18). The final model explained 51% of variance in QoL in high-risk pregnant women, with acceptable overall model fit. Adaptation mode (β=-.81, p=.034) and maladaptive coping (β=.46 p=.043) directly affected QoL, and uncertainty (β=-. 21, p=.004), adaptive coping (β=.36 p=.026), and maladaptive coping (β=-.56 p=.023) indirectly affected QoL. It is essential to develop nursing interventions aimed at enhancing appropriate coping strategies to improve QoL in high-risk pregnant women. By reinforcing adaptive coping strategies and mitigating maladaptive coping, these interventions can contribute to better maternal and fetal outcomes and improve the overall well-being of high-risk pregnant women.