Maternity Clinics Research Articles

평양의 여성병원

KoangHyoeNyoWon (廣惠女院, Women's Hospital of Extended Grace) was opened in Pyengyang in 1898. I looked into the process of the dispensary's establishment, and some of its medical service activities, its personnel and financial operations, and the history of the changes KoangHyoeNyoWon had undergone.
 KoangHyoeNyoWon was established in Pyengyang by the WFMS (Woman’s Foreign Missionary Society) to provide medical services for women as an independent medical enterprise. The first attempt to open a women’s clinic failed in 1894, but in 1898, KoangHyoeNyoWon began operations. It built a system of medical services in cooperation with Giholbyeowon (the Hall Memorial Hospital), which was another clinic established by the Methodist Church. In addition, it tried to extend the medical services not only to women and children, but also to the poor and the disabled; therefore, it had the characteristics of a social welfare center. These facts led KoangHyoeNyoWon to rely on the support of the WFMS. The WFMS had provided KoangHyoeNyoWon with manpower, personnel expenses, medicine, medical facilities, and fees for maintenance, fuel, insurance, etc. In addition, the WFMS had covered the cost of rebuilding and reequipping the dispensary.
 But Jahye Clinic, a colonial medical center, opened in 1910 and competed with KoangHyoeNyoWon, which explains why the dispensary for women had to make changes. By the 1910s, gender discrimination in Joseon had lessened and women were more likely to use hospitals such as Jahye Clinic and Giholbyeowon; at the same time, demands for KoangHyoeNyoWon to become financially independent increased as the financial situation of the WFMS deteriorated. By 1914, there was talk of closing KoangHyoeNyoWon. However, it began to seek solutions to overcome the crisis and to gain financial independence. Several attempts were made to improve medical facilities, support medical education to supply independent manpower, and diversify medical services. Gradually, KoangHyoeNyoWon became a maternity clinic and offered medical care in conjunction with other clinics.
 In the 1920s, KoangHyoeNyoWon was merged with other hospitals—Giholbyeowon (Methodist Church) and Caroline Memorial Hospital (Presbyterian Church). It resulted from the willingness of the missionary society in Joseon to build a large and strong Christian hospital in order to compete with the colonial and national hospitals that wereexpanding aggressively. As a result, KoangHyoeNyoWon became the women’s ward of the United Christian Hospital. Through the merger, women were able to receive better and more comprehensive medical services, making KoangHyoeNyoWon the best choice for women in need. Now it was time for the question of why and how there should be a women’s clinic.

Pengaruh Relaksasi Pernapasan Terhadap Intensitas Nyeri Pada Persalinan Kala I Di PMB Erlina Herawati Tahun 2023

Maternal who is difficult to adapt to the pain of labor can cause uncoordinated uterine contractions which can lead to prolongation of the first stage of labor and impaired fetal well-being. The purpose of this study was to see whether there was an effect of respiratory relaxation on the intensity of the first stage labor pain in the maternal love clinic Erlina Herawati, sub-district in 2023. This type of quantitative research used the One Group Pre Test- Post Test Design method with a population of all inpartum mothers in April 2023- June 2023 and a sample of 15 respondents. The results that have been obtained during the study including before the treatment showed mild pain by 2 respondents (13.3%), moderate pain by 6 respondents (40.0%), severe pain by 7 respondents (46.7%). Meanwhile, after treatment of mild pain 8 respondents (53.3%), moderate pain 4 respondents (26.7%), severe pain 3 respondents (20.0%). From the results of the study, it was found that the effect of before being treated and after being treated had a significant change in pain in the mother in labor. Therefore, it is hoped that in the future midwives in clinics will be able to facilitate mothers in giving birth by relaxing breathing it can reduce pain during labor, especially during the first stage of labor.

The Effect of the Combination of Marmet-Oketani Massage Technique and Soybean Consumption (Glycin max) on Breast Milk (ASI) in Post Partum Mothers at the Siswani Lubuk Pakam Maternity Clinic

Breast milk (ASI) is a healthy and perfect foods for babies, containing all the nutrients needed for optimal growth and development by babies. Insufficient breast milk is a threat to children's growth and development, which will ultimately affect their health. The Marmet-Oketani massage technique will synergistically increase the flexibility of the breasts and nipples to become softer. The combination with soybeans will stimulate the production of breast milk itself so that the baby's needs for nutrients are fulfilled. Goal of the research is to effect the combination of Marmet-Oketani massage technique as well as soybean consumption (Glycin max) on breast milk (ASI) in Post Partum Mothers at the Siswani Lubuk Pakam Maternity Clinic. The study was conducted on 54 postpartum mothers with purposive sampling techniques with pre-experimental method methods with the design of The One Group Pretest Posttest Design. Breast milk production in the treatment group (given marmet-oketani technique) with many categories amounted to 89.47% (17 respondents), smooth milk production in the control group (given marmet-oketani technique) and soybean consumption with many categories of 18 (94.73%). Based on the results of Chi-Square statistical test analysis, a p-value of 0.025 < ? 0.05 was obtained, this shows that there is an influence of the provision of marmet-oketani techniques and soybean consumption with postpartum maternal milk production at the Siswanti Lubuk Pakam Midwife Clinic. It is recommended that future researchers conduct research on other massage techniques to obtain quality breast milk

The Effect of Prenatal Gentle Yoga on Sleep Quality and Anxiety Levels in Pregnant Women Trimester III

Women who are in pregnancy, especially pregnancy in the third trimester, often experience physical or psychological changes, one of the changes experienced is abnormal sleep quality and anxiety that arises because the time of delivery is approaching, these conditions if not immediately overcome can cause discomfort during pregnancy. Yoga is a complementary therapy that can be applied by pregnant women in overcoming complaints both physically and psychologically. The purpose of the study was to determine how the influence of prenatal gentle yoga on sleep quality and anxiety levels in III trimester pregnant women. The type of research is two group pretest posttest design, namely one group to assess sleep quality and one group to assess the anxiety of pregnant women, which is a sample of III trimester pregnant women with a total of 30 people divided into 2 groups, purposive sampling techniques, research at the Maternity Clinic kasih Ibu Galang, measuring instruments using questionnaires and measuring results are tested with t tests. The results obtained are the influence of prenatal gentle yoga on the sleep quality of third trimester pregnant women with a p value of 0.029 and there is an influence of gentle yoga on the anxiety level of third trimester pregnant women with a p value of 0.000. It is recommended for mothers, especially those who are pregnant in the third trimester, to be able to take part in prenatal gentle yoga to be able to overcome pregnancy complaints such as difficulty sleeping and anxiety facing childbirth.

Guideline documents on caesarean section on maternal request in Sweden: varying usability with a restrictive approach

BackgroundGlobally, studies illustrate different approaches among health care professionals to decision making about caesarean section (CS) and that attitudes regarding the extent to which a CS on maternal request (CSMR) can be granted vary significantly, both between professionals and countries. Absence of proper regulatory frameworks is one potential explanation for high CSMR rates in some countries, but overall, it is unclear how recommendations and guidelines on CSMR relate to CSMR rates. In Sweden, CSMR rates are low by international comparison, but statistics show that the extent to which maternity clinics perform CSMR vary among Sweden’s 21 self-governing regions. These regions are responsible for funding and delivery of healthcare, while national guidelines provide guidance for the professions throughout the country; however, they are not mandatory. To further understand considerations for CSMR requests and existing practice variations, the aim was to analyse guideline documents on CSMR at all local maternity clinics in Sweden.MethodsAll 43 maternity clinics in Sweden were contacted and asked for any guideline documents regarding CSMR. All clinics replied, enabling a total investigation. We used a combined deductive and inductive design, using the framework method for the analysis of qualitative data in multi-disciplinary health research.ResultsOverall, 32 maternity clinics reported guideline documents and 11 denied having any. Among those reporting no guideline documents, one referred to using national guideline document. Based on the Framework method, four theme categories were identified: CSMR is treated as a matter of fear of birth (FOB); How important factors are weighted in the decision-making is unclear; Birth contracts are offered in some regions; and The post-partum care is related to FOB rather than CSMR.ConclusionIn order to offer women who request CS equal and just care, there is a pressing need to either implement current national guideline document at all maternity clinics or rewrite the guideline documents to enable clinics to adopt a structured approach. The emphasis must be placed on exploring the reasons behind the request and providing unbiased information and support. Our results contribute to the ongoing discussion about CSMR and lay a foundation for further research in which professionals, as well as stakeholders and both women planning pregnancy and pregnant women, can give their views on this issue.

What factors influence a Quality Improvement Collaborative in improving contraceptive services for foreign-born women? A qualitative study in Sweden

BackgroundImproved contraceptive services could reduce the unmet need for contraception and unintended pregnancies globally. This is especially true among foreign-born women in high-income countries, as the health outcomes related to unmet need of contraception disproportionally affect this group. A widely used quality improvement approach to improve health care services is Quality Improvement Collaborative (QIC). However, evidence on to what extent, how and why it is effective and what factors influence a QIC in different healthcare contexts is limited. The purpose of this study was to analyse what factors have influenced a successful QIC intervention that is aimed to improve contraceptive service in postpartum care, mainly targeting foreign-born women in Sweden.MethodsA qualitative, deductive design was used, guided by the Consolidated Framework for Implementation Research (CFIR). The study triangulated secondary data from four learning seminars as part of the QIC, with primary interview data with four QIC-facilitators. The QIC involved midwives at three maternal health clinics in Stockholm County, Sweden, 2018–2019.ResultsFactors from all five CFIR domains were identified, however, the majority of factors that influenced the QIC were found inside the QIC-setting, in three domains: intervention characteristics, inner setting and process. Outside factors and those related to individuals were less influential. A favourable learning climate, emphasizing co-creation and mutual learning, facilitated reflections among the participating midwives. The application of the QIC was facilitated by adaptability, trialability, and a motivated and skilled project team. Our study further suggests that the QIC was complex because it required a high level of engagement from the midwives and facilitators. Additionally, it was challenging due to unclear roles and objectives in the initial phases.ConclusionsThe application of the CFIR framework identified crucial factors influencing the success of a QIC in contraceptive services in a high-income setting. These factors highlight the importance of establishing a learning climate characterised by co-creation and mutual learning among the participating midwives as well as the facilitators. Furthermore, to invest in planning and formation of the project group during the QIC initiation; and to ensure adaptability and trialability of the improvement activities.

Detection of postpartum uterine activity with electrohysterography

ObjectiveUterine contractions are essential for childbirth, but also for expulsion of the placenta and for limiting postpartum blood loss. Postpartum hemorrhage is associated with almost 25% of the maternal deaths worldwide and the leading cause of maternal death in most low-income countries. Little is known about the physiology of the uterus postpartum, particularly due to the lack of an accurate measurement tool.The primary objective of this pilot study is to explore the potential of using electrohysterography to detect postpartum uterine contractions.If postpartum uterine activity can be objectified, this could contribute to understanding the physiology of the uterus and improve diagnosis and treatment of postpartum hemorrhage. Study DesignIn this observational study we included women aiming for a vaginal birth in two large maternity clinics in the Netherlands, Amphia Hospital Breda (group A, N2018-0161) and Máxima Medical Center Veldhoven (group B, N17.149). An electrode patch was placed on the maternal abdomen to record real-time electrical uterine activity until one hour postpartum continuously. In group A, the placement of the patch was lower than in group B.For analysis, tracings were divided into five different phases (1: dilatation until start pushing, 2: from start pushing until childbirth, 3: from childbirth until placental expulsion, 4: first hour after placental expulsion and 5: after one hour postpartum). Readability, signal quality and contraction frequency per hour were assessed. Additionally, patient satisfaction was evaluated through a survey. ResultsIn total 91 pregnant women were included of whom 45 in group A and 46 women in group B. Complete registrations were obtained throughout the five labor phases with very little artefacts or signal loss. The readability of the tracings decreased after childbirth. A significantly better readability was found in tracings where the patch placement was lower on the abdomen for phases 4 and 5. Contraction frequency was highest during phase 2 and decreased towards phase 5. Women rated the satisfaction with electrohysterography as high and mostly did not notice the patch. ConclusionIt is possible to detect uterine activity postpartum with electrohysterography. Further investigation is recommended to improve diagnosis and treatment of postpartum hemorrhage.

Parents’ knowledge, attitude, and practice on children’s screen time at home and the implications for nurses in promoting health: A cross-sectional study

Introduction: The present study investigated the parent’s knowledge, attitude, practice, and experience of the screen time spent by their children at home aged below 5 years old, identifying the common screen-based devices used, content type, and level of screen time spent by the children. Method: A cross-sectional survey of parents having children aged 0 to 4 years old attending the Maternal and Child Health Care Clinics in four districts in Brunei Darussalam was conducted. A questionnaire was developed through the Qualtrics platform. Data were analyzed using R Studio Desktop version 1.2.1335. The statistical analyses included descriptive statistics and Fisher’s exact test. Results: Parents’ knowledge, attitude, and practice of screen time spent by their children are generally positive; parents who correctly answered the knowledge section overall average of 30.1% (n=34). Children studied (<2 years old and 3 to 4 years old) were found to spend more time watching television. A statistically significant association was observed between children of both age groups with time spent on tablet device (p=0.037) and (p=<0.001). Also, a significant association between parents’ knowledge, attitude and practice with gender of the parents, household income and total number of children was reported. Conclusions: We conclude that the children in our study exceeded the recommended guidelines on screen time behavior and the parents’ health knowledge with regard to screen time was poor which emphasized the need for improvement and further study. Keywords: screen time, children, parent’s knowledge, parent’s attitude, parent’s practices

IRON COMPLIANCE DURING ANTEPARTUM AND POSTPARTUM PERIOD AMONG WOMEN ATTENDING MATERNAL AND CHILD HEALTH CLINIC OF A TERTIARY HOSPITAL

Background: Daily oral iron supplementation, beginning from second trimester of pregnancy till 45 days postpartum, is recommended by national protocol to reduce risk of low birth weight, maternal anaemia and iron deficiency. The aim of the study was to assess iron compliance during antepartum and postpartum period among women attending maternal and child health clinic. Methods: A descriptive cross-sectional study was carried out among women visiting maternal and child health clinic of Tribhuvan University Teaching Hospital for first dose of infant’s pentavalent vaccine. Non-probability consecutive sampling technique was used to select 426 sample for the study. Data were collected through interview schedule using structured and semi-structured questionnaire. Data were analyzed using descriptive statistics (mean, standard deviation, etc.), and inferential statistics (simple binary logistic and multiple logistic regression). Results: Overall compliance during both pregnancy and postpartum was 61.0%. The common reason for compliance included doctors’ prescription (53.8%) followed by self-awareness (41.1%). For non-compliance, negligence or forgetfulness (16.2%) was commonest reason followed by improper information provided during pregnancy and postpartum (15.3%). Significant association was found between number of ANC visits [p=0.017,OR=0.269(0.091-0.792)], self-awareness on iron supplementation [p=<0.001, OR=0.319(0.198-0.515)] and buying tablets from pharmacy rather than free supply [p=0.001, OR=0.437(0.274-0.698)]. Conclusions: Iron compliance during antenatal and postnatal period is low among women. Enhancing self-awareness on iron supplementation through education and counseling among women during antenatal and postnatal visits and regular prescription could improve iron compliance during pregnancy and postpartum period.

Family MUAC supported by a two-way SMS platform for identifying children with wasting: the Mama Aweza randomised controlled trial

Effective methods of preventing and identifying childhood wasting are required to achieve global child health goals. Family mid-upper arm circumference (MUAC) programs train caregivers to screen their child for wasting with MUAC tapes. We assessed the effectiveness of a two-way short message service (SMS) platform (referred to as the Maternally Administered Malnutrition Monitoring System [MAMMS]) in western Kenya. In this individual-level randomised controlled trial in two rural countries in western Kenya, children (aged 5-12 months) were randomly allocated (1:1) to receive either standard care (SOC) or MAMMS. Randomisation method was permuted-block randomisation with a block size of 10. Eligible participants were children attending maternal child health clinics in the two counties whom had a MUAC between 12.5 and 14.0cm. The MAMMS group received two MUAC tapes and weekly SMS reminders to screen their child's MUAC. The SOC group received routine community health volunteer services and additional quarterly visits from the study team. The primary analysis used a cox proportional hazards model to compare SOC and MAMMS time-to-diagnosis of wasting (MUAC <12.5cm) confirmed by a health professional during 6-months follow-up. Secondary outcomes were days from enrolment to treatment initiation among children with wasting, proportion of all children with wasting who were identified by the two approaches (treatment coverage), mean MUAC at treatment initiation, and duration of wasting treatment. This trial was registered on ClinicalTrials.gov, NCT03967015. Between August 1, 2019 and January 31, 2022, 1200 children were enrolled, among whom the incidence of confirmed wasting was 37% lower in the MAMMS group (hazard ratio: 0.63, 95% CI: 0.42-0.94, p=0.022). Among children with wasting, the median number of days-to-diagnosis was similar between study groups (MAMMS: 63 days [interquartile range (IQR): 23-92], SOC: 58 days [IQR: 22-94]). Treatment coverage in the MAMMS group was 83.3% (95% CI: 39.9-100.0) while coverage in the SOC group was 55.6% (95% CI: 22.3-88.9%, p=0.300). Treatment duration and mean MUAC at treatment initiation were similar between groups. Family MUAC supported by SMS was associated with a 37% reduction in wasting among young children. Empowering caregivers to monitor their child's nutritional status at home may prevent a substantial proportion of moderate wasting. Thrasher Research Foundation and Pamela and Evan Fowler.

Sleep, light exposure at night, and psychological wellbeing during pregnancy

BackgroundPsychological wellbeing during pregnancy is imperative for optimal maternal outcomes. The present study aimed to determine the association between sleep quality, light exposure at night, and psychological wellbeing in the 2nd and 3rd trimesters of pregnancy.MethodsThis prospective study was conducted in 9 randomly selected government maternity clinics in Kuala Lumpur, Malaysia. Healthy women aged 20–48 years old with single pregnancy were recruited using convenience sampling (n = 169). Sleep quality, light exposure at night, and psychological wellbeing were self-reported using the Pittsburgh Sleep Quality Index (PSQI), Harvard Light Exposure Assessment (H-LEA), and Depression, Anxiety, and Stress Scale (DASS-21) in the 2nd trimester and followed-up at the 3rd trimester.ResultsDuring the 2nd and 3rd trimesters of pregnancy, mild to severe symptoms of stress (10.7 and 11.3%), anxiety (42 and 44.3%), and depression (9.6 and 16.6%) were observed among the participants. Adjusted multiple linear regression revealed that poor sleep quality and higher light exposure at night were attributed to greater stress and depression symptoms in the 3rd trimester. Higher lux level exposed from 10 pm to < 1 am was associated with increased stress (β = 0.212, p = 0.037) and depression (β = 0.228, p = 0.024). Only poor sleep quality was observed to adversely affect anxiety (β = 0.243, p = 0.002) and depression levels (β = 0.259, p = 0.001) in the 2nd trimester.ConclusionsPresent study provided preliminary findings on the association between sleep quality, light at night, and psychological wellbeing of pregnant women. As a recommendation, future research could investigate whether public health interventions aimed at decreasing artificial light at night can benefit sleep quality and the psychological health of pregnant women.

Constraints to maternal healthcare access among pastoral communities in the Darussalam area of Mudug region, Somalia "a qualitative study".

While countries embrace efforts to achieve Sustainable Development Goals (SDG) goal 3.1 (to reduce the global maternal mortality ratio to less than 70 per 100,000 live births by 2030 and end preventable deaths of new-borns and children), an estimated 2.5 million pastoralists in Somalia are struggling to access maternal and child healthcare services. Institutional delivery and access to antenatal care remained to be a challenge in Somalia, where pastoralism is a common means of livelihood. The aim of this study is to explore the maternal health services available for settled pastoralists (transhumant) and their families who still practice nomadic pastoralism in the Mudug region of Somalia. A qualitative study, including 14 interviews and one FGD, was conducted in Darussalam village (a transhumant village along the border between Somalia and Ethiopia), Puntland State, from December 2022 to January 2023. The study participants were community members who support the maternal and child health clinic (MCH), village administration, and health providers. We found that the efficiency of the health facilities that serve for pastoralist women and children are hampered by staff-related, supply-related, patients-related and referral-related constraints. This study highlights that the absence of essential supplies, the unmet need for training among the staff as well as the absence of important facilities in the MCH such as ambulance and blood bags. Numerous strides could be made in the provision of affordable maternal healthcare to pastoralist communities in Darussalam areas of the Mudug region when organizations that support health care in Somalia and the Ministry of Health include pastoralists' healthcare in their priorities.

Factors Associated with Exclusive Breastfeeding among Working Mothers Attending Maternal and Child Health Clinic

Introduction: Breast milk is a natural and perfect food that protects against illness and death by acting as the baby’s first immunization. The employment of the mother is considered to be one of the most important barriers to exclusive breastfeeding (EBF).&#x0D; Methods: A hospital-based descriptive cross-sectional study was done to find out the associated factors with EBF among working mothers. A total of 150 working mothers having children six to 24 months were selected. Self-developed semi-structured interview schedule was used. Pre-testing was done on 15 (10%) of the total sample and necessary modifications were done. Data were analyzed by using descriptive (Frequency, percentage) and inferential statistics (Chi-square and odds ratio).&#x0D; Results: A total of 52 (34.66%) working mothers reported to have practice of EBF for six months. Majority (80%) of the working mothers fed colostrum. Majority (92.85%) of the working mothers gave powdered milk due to inadequate milk secretion. Regarding Expressed Breast Milk (EBM) storage, more than 50% had no idea about EBM and 47 (31.33%) of the mothers had a breastfeeding room at their workplace. 80 (53.33%) mothers had allowed children in their workplace while 47 (88.0%) had family support. EBF was associated with mode of delivery (OR = 0.440, 95% CI: 0.214 - 0.903), child hospitalization in the past (OR = 0.139, 95% CI: 0.031 - 0.618), facility of express breastmilk (OR = 4.087, 95% CI: 0.978 - 17.079) and flexible working environment (OR = 4.2, 95% CI: 1.789 - 9.863).&#x0D; Conclusions: About only one-third of working mothers had given EBF to their child. Vaginal delivery, child hospitalization in the past, a facility of EBM at home, and a flexible working environment were associated factors with EBF among working mothers.

Feeding Mothers, Making Citizens: Japanese Maternity Clinic Meals as Treatment, Care, and Identity

Abstract: Postpartum Japanese mothers and neonates typically spend 5-6 days in a hospital or clinic. Therefore, institution-prepared meals are an important part of the immediate postpartum experience. Drawing from ethnographic research conducted at a 17-bed maternity clinic in central Japan, I discuss how 1) nutrients are calculated to ensure adherence to national nutrition guidelines, and meals are individualized to fit specific patients, 2) staff incorporate local ingredients and specialties that support local identity, and 3) non-Japanese foods are used both as entertainment and vehicles through which Japanese mothers consume regional, national, and non-Japanese cultures. With attention to the emic terms tanoshimi , shigoto , and ikigai , I demonstrate that meals here go beyond prescription and care: they are sites of the production and consumption of regional, national, and global citizenship ideals and constitute what Takeda calls “biopolitical governing” (2008).

Complementary Feeding and Child Appetitive Traits in a Sample of Hispanic Mother-Child Dyads.

Complementary feeding practices may contribute to toddler eating practices that affect weight outcomes. Studies are needed to understand the relationship between complementary feeding practices and toddler dietary self-regulation. This study tests the hypothesis that earlier complementary food introduction predicts toddler food responsiveness and emotional overeating (ie, tendency to overeat in response to food cues and emotions, respectively), and considers whether introduction of certain foods better predict toddler dietary self-regulation. This study is a secondary analysis of data from a parent longitudinal birth cohort study on early growth/development among Hispanic mother-infant dyads. The analytic sample included 174 mother-child dyads recruited from maternity clinics affiliated with the University of Southern California in Los Angeles County. Recruitment and data collection were ongoing from July 2016 to April 2020. At 1-, 6-, 12-, and 24-months postpartum, mothers reported exclusive breastfeeding duration and age of complementary food introduction via questionnaire. Child food responsiveness and emotional overeating scores calculated from the Child Eating Behavior Questionnaire at 12 and 24 months of age. Separate linear mixed models with repeated measures were used to examine associations between age of complementary food introduction as a predictor of child food responsiveness or emotional overeating, controlling for infant sex, birth body mass index z score, duration of exclusive breastfeeding, and mother's body mass index. In separate models, delaying complementary food introduction by 1 month was associated with a 6% reduction in food responsiveness (P= 0.007) and a 5% reduction in emotional overeating scores (P= 0.013). Fifty-eight unique combinations of complementary foods introduced first were found, precluding analyses to examine whether specific combinations were related to eating behavior outcomes due to sample size limitations. Earlier complementary feeding was associated with higher food responsiveness and emotional overeating scores among Hispanic children. Future studies in larger samples are needed to characterize patterns of complementary food introduction and their influence on child self-regulation.

Improving Delivery Outcomes with the Application of Murottal Therapy Al-Qur'an on Length of Second Stage of Labor and Apgar Score.

Introduction: The second stage of labor is called the expulsion period, starting when the opening of the cervix is complete (10 cm) and ending with the birth of the baby with his force and straining the fetus is pushed out until birth. Childbirth is a stress response that the body responds to. Anxiety in pregnant women is caused by psychosocial factors such as the need for security and comfort. Al-Qur'an stimulants can generate delta waves of 63.11% with reduced anxiety in the mother making the muscles more relaxed and the mother can go through labor easily so there are no cases of prolonged labor and can improve the welfare of the fetus. Method: This type of research is a quasi-experimental study that aims to determine the increase in labor outcomes by applying the Murottal Al-Quran to the Length of the Second Stage of Labor and the APGAR Score. While the research design used was a pre- experimental design with a posttest only with a control group design to measure the effect of murottal QS. Ar-Rahman in the experimental group by comparing it with the control group. The population in this study were all mothers giving birth during the first active phase at the Ar-Rahmah Indaralaya Maternity Clinic in Palembang. Results: There were 66 respondents (55.5%) who applied Murottal Al-Quran with a duration of 2 under 1 hour, while 53 respondents (44.5%) did not apply Murottal Al-Quran with a duration of 2 under 1 hour. Respondents who applied Murottal Al-Quran in the absence of asphyxia were 64 people (66%) while respondents who did not apply Murottal Al-Quran in the absence of perineal rupture were 33 people (34%). Discussion: There was a difference in the length of stage II between the intervention group and the control group after the application of Murottal Al- Qur'an and there were differences in APGAR scores between the intervention group and the control group after the application of Murottal Al-Qur'an.

Postpartum health of working mothers: A prospective study.

Most working women experience poor physical and mental health during their postpartum period. This prospective study aimed to describe the physical and mental health issues faced by working mothers during their postpartum period. Respondents were recruited using the proportional sampling method among mothers who attended the Maternal and Child Health Clinic in the Kuching division in Sarawak, Malaysia. Face-to-face interview was conducted using a questionnaire that consisted of items on socio-demographic data as well as perinatal, prenatal and postpartum factors, and the Edinburgh Postnatal Depression Scale and a checklist of 28 specific postpartum symptoms were used during the first 6 weeks and after 12 weeks of childbirth. A total of 281 respondents participated in this study. Fatigue (42.7%), back or neck pain (36.3%), breast discomfort (16.4%), dizziness (13.5%) and nipple irritation (11.0%) were among the most common symptoms experienced by the mothers during the first 6 weeks after childbirth. There was a significant decrease in the physical symptom scores of the respondents from the first 6 weeks to after 12 weeks of childbirth (1.73±1.96 vs 0.16±0.42; P<0.0005). A significant decrease was also found in the depression scores (6.26±4.26 vs 1.35±1.85, P<0.0005). The prevalence of postnatal depression was higher during the first 6 weeks of postpartum than after 12 weeks of postpartum. Screening and treatment of poor postpartum mental health among working women are essential owing to the impacts on occupational outcomes.

Depression Level and Its Associated Factors among Postpartum Working Women in Kuching, Sarawak-A Cross-Sectional Study.

Postpartum depression (PD) among women, if left untreated, may result in long-term health and social consequences for them and their families. This cross-sectional study aimed to determine the factors contributing to PD among working mothers in Kuching, Sarawak, Malaysia. Systematic sampling was used to recruit working mothers who attended Kuching's maternal and child health clinics. They were interviewed with a validated translated questionnaire to obtain data on sociodemographics, health profiles, and Edinburgh Postnatal Depression Scale (EPDS) and postpartum symptoms. Data were analysed using IBM SPSS version 21.0. Out of the total 281 respondents, 15.3% of respondents had depression symptoms. Fatigue (42.7%), back or neck pain (36.3%), breast discomfort (16.4%), dizziness (13.5%) and nipple irritation (11.0%) were the most common physical symptoms experienced by the mothers. Regression analysis showed that working mothers who exhibited higher scores of physical symptoms were 1.26 times more likely to develop PD (adjusted odd ratio 1.26, P < 0.01; 95% CI: 1.071, 1.487). Physical symptoms were the predictors of PD among working mothers.

Proportion of Reproductive Age Women Utilizing Mobile Maternal Health Services in Makueni County

Purpose: The aim of the study was to determine the proportion of reproductive age women utilizing mobile maternal health services in Makueni County.&#x0D; Methodology: An analytical cross-sectional study was carried out in Makueni County. Kibwezi East and Kaiti Sub-Counties were purposively selected. Ukia ward from Kaiti sub-county and Nzambani ward from Kibwezi East sub-county were randomly selected using folded pieces of paper. Both qualitative and quantitative data were collected. Questionnaires were the tools used for quantitative data while guides for key informant were used to collect data qualitatively. The study systematically sampled 367 women of reproductive age as primary respondents from households at a sampling interval of 5. Twelve Key Informant Interviewees were purposively selected to provide additional qualitative data which were community health extension workers and healthcare providers. The research instruments were pretested at Kilome Sub County before actual data collection. Analytical correctional statistical analysis was done using the Statistical Package for Social Sciences software version 20.0. Pie-charts, frequency tables and graphs were used to present data. Triangulation of data collected qualitatively with quantitative data was done and presented as direct quotes.&#x0D; Findings: The study found out that 40.6% of respondents utilized mobile maternal health services in Makueni County. The most common service sought was antenatal care. Distance from health facilities was the main reason for using mobile maternal health services. However, the main reason for non-use was preference for hospitals among respondents.&#x0D; Unique Contribution to Theory, Practice and Policy: These results would inform policy makers to craft interventions seeking to advance mobile maternal health services utilization. Community Health Volunteers should conduct house to house campaigns on availability of mobile maternal health clinics and the designated days on their respective regions to increase awareness among women of reproductive age.

Governing pregnancy in the Global South: the case of post-apartheid South Africa

Critical feminist research on risk, pregnancy, and birth, mostly conducted in the Global North, has generally focussed on how risk responsibilises pregnant women. In this article, we provide a critical history of the development of maternal healthcare policy and practices in democratic South Africa as an illustration of the government of pregnancy in a Global South context. Using Michel Foucault’s governmentality framework, we show that the risk techniques deployed in the South African maternity clinic primarily aim to govern the conduct of healthcare workers rather than that of pregnant women. This includes a shift from traditional clinical judgement towards clinical risk management, working within a referral system and simplifying diagnostics through risk assessment. Adopting development as a rationality of government was a condition of possibility for this shift, resulting not in responsibilisation but rather the management of risk on behalf of the pregnant subject.