Maternal Practices Research Articles

Maternal socialization and infant helping in Uganda and the United Kingdom.

Prosocial behavior, including instrumental helping, emerges early in development, but the role parental attitudes and practices take in shaping the emergence of early helping across different cultural contexts is not well understood. We took a longitudinal approach to investigate maternal socialization of early helping across two different cultural groups. Participants were mother-infant dyads from urban/suburban York, United Kingdom (43 infants: 21 females, 22 males) and the rural Masindi District, Uganda (39 infants: 22 females, 17 males). We examined cultural variations in mother's helping-related parenting practices toward 14- and 18-month-olds and infants' actual helping in experimental tasks at 18 months. We then asked whether maternal parenting practices and socialization goals predicted individual variation in infant helping. We found that U.K. mothers scaffolded infant helping using a larger range of strategies than Ugandan mothers, but expecting an infant to help was more common in Uganda than in the United Kingdom. Moreover, we found that the Ugandan infants were more likely and often quicker to help an adult in need than the U.K. infants. Finally, we found that maternal scaffolding behaviors positively predicted individual variation in infant helping at 18 months in the United Kingdom, but not in Uganda. By contrast, maternal alignment with relational socialization goals at 11 months positively predicted infant helping at 18 months in the Ugandan, but not in the U.K., sample. These results indicate that early instrumental helping behavior varies across societies and that maternal socialization goals and scaffolding behaviors can shape infant helping in culturally specific ways. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

From home to community: The role of parenting and religious identity in Muslim American emerging adults' civic engagement.

This study expanded on the existing literature by examining the unique associations between maternal religious socialization, as a form of cultural socialization, along with civic socialization practices, and Muslim American emerging adults' civic engagement. In addition, the mediating role of Muslim American emerging adults' religious identity in the association between maternal socialization practices and their civic attitudes and behaviors were assessed. Participants included 329 self-identified Muslim American emerging adults (Mage = 21.4, SDage = 1.9, 63% female). Path analysis results revealed indirect associations between maternal religious socialization and civic behaviors through religious identity private regard and a direct link between maternal civic socialization and civic attitudes. Thus, Muslim American emerging adults whose mothers engaged in transmitting their heritage values, beliefs, and virtues reported a greater sense of pride about their religious group and subsequent higher engagement in informal helping and lower engagement in political actions. Additionally, discussions about social and political issues with their mothers directly fostered Muslim American emerging adults' civic responsibility. Our findings revealed specificity in how civic engagement can be promoted and provided insights into efforts to build civic capacity for minoritized emerging adults.

Caste, wealth and geographic equity in program reach and expected outcomes: an exploratory analyses of Suaahara in Nepal.

Monitoring and evaluation of maternal and child nutrition programs typically concentrates on overall population-level results. There is limited understanding, however, of how intervention reach and expected outcomes differ among sub-populations, necessary insight for addressing inequalities. These analyses aim to determine if maternal exposure to social and behavior change (SBC) interventions is associated with scales of maternal practices (antenatal care, iron and folic acid in pregnancy, diet in pregnancy, postnatal care, iron and folic acid postpartum, and maternal dietary diversity) and child practices (institutional birth, health mothers' group participation, growth monitoring and promotion, early initiation of breastfeeding and infant and young child feeding) in Nepal, overall and by wealth, caste, and geography. Cross-sectional data from 2022 from the USAID-funded Suaahara program in Nepal were used for analysis. The study focused on households with children aged 0-2 years (N = 1815). Descriptive analysis was followed by regression models, adjusted for potentially confounding child, mother, and household factors, as well as community-level clustering. Greater intensity of maternal engagement with the SBC interventions was positively associated with both scales for maternal and child nutrition-related practices. The magnitude of the positive associations, however, was less for the socially excluded caste versus others for maternal nutrition; there was almost no caste-based variation in associations for child nutrition. Positive associations were found only among the lower 40% socio-economically when mothers engaged with at least two platforms for maternal nutrition and at least three platforms for child nutrition. In contrast, engagement with one platform for the relatively wealthier was positively associated with both maternal and child outcomes. Similarly, the positive associations were stronger among those residing in the terai (lowland plains) than those in the hills and mountains for both maternal and child outcomes. The scope for improving maternal and child nutrition practices is significant, in part via well-designed, targeted, SBC programs. These analyses highlight the importance of considering different domains of equity both in implementation and related research. Further mixed methods research is needed to more deeply explore why certain types of interventions reach and/or have a greater effect on sub-populations.

Newborn care knowledge and practices among mothers in Baguio City, Philippines: A descriptive correlational study

Background: Maternal knowledge and practices on newborn care are crucial in ensuring the well-being of infants, particularly in areas such as cord care, pain and fever management, and stimulation of senses. The Department of Health (DOH) and other health programs aim to promote better newborn care practices, but maternal knowledge gaps may persist. Objective: The study aimed to assess the level of knowledge and practice of mothers regarding newborn care, specifically focusing on cord care, pain and fever management, and stimulation of senses. Methods: A quantitative descriptive correlational design was used. The study involved 308 mothers from three barangays in Baguio City, selected using stratified random sampling. Data were collected from 6 February 2023 to 20 March 2023 through a self-administered questionnaire. Descriptive and inferential statistics were used to analyze the data. Results: Mothers had high knowledge of cord care and stimulation of senses, and average knowledge of pain and fever management. For practice, mothers scored highly in cord care, pain and fever management, and stimulation of senses. Significant differences were found in knowledge of pain and fever management by age (p = 0.044) and civil status (p = 0.015). A weak, significant positive correlation (r = 0.229, p <0.001) was observed between knowledge and practice. Conclusion: The study found a positive relationship between knowledge and practice, indicating that informed mothers are more likely to implement appropriate newborn care practices. There is a need to enhance maternal education, especially on pain and fever management, to promote better neonatal outcomes. Health programs should continue to focus on improving maternal knowledge through accessible information and support.

Do socio-cultural practices by elderly women influence obstetric complications? A study in Limpopo province.

Worldwide, women continue to die from obstetric-related complications, despite the global progress made to reduce maternal mortality. Elderly women play a key role in using their own socio-cultural practices during pregnancy and childbirth. The study aimed to explore the practices based on the beliefs of elderly women in Limpopo province. A qualitative approach using descriptive, explorative and contextual design was employed. Audio recording of unstructured focus group discussions was conducted of the elderly women who were purposively sampled. Data were analysed and coded using thematic analysis approach following Tesch's method and co-coded to ensure trustworthiness. Ethical considerations were also adhered to. The findings discuss practices based on beliefs of elderly women and the need for them to be trained to participate in maternal health practices. The study concluded that practices based on beliefs of elderly women lead to delays in seeking medical intervention. Therefore, elderly women need to be trained to reduce maternal mortality.Contribution:This study adds knowledge to the need for training and the importance of elderly women to be trained in order to reduce maternal mortality.

Perception and Practice of Maternal Nutrition among Pregnant Women in Primary Health Centres Ogbomoso-North Local Government, Oyo State, Nigeria

Introduction: Maternal nutrition and practices among pregnant women are crucial factors that significantly impact the health and well-being of both the mother and the developing fetus. Adequate nutrition during pregnancy is essential to support fetal growth and development, and to also maintain the health of the pregnant women. This study will therefore assess the perception and practice of Maternal nutrition among pregnant women attending selected Primary Health Centres. Methods: The study adopted a quantitative descriptive cross-sectional design. A simple random sampling technique was used to recruit 125 pregnant women from Katangua and Ibrahim Primary Health Centres at Ogbomoso North Local government. Ethical approval was taken to both centres. Questionnaire was used as the instrument of data collection during clinic visit. The data collected was analyzed with SPSS using descriptive statistics. Results: The result of the study revealed an overall good perception (97.6%) of maternal nutrition. Contrariwise, there is a disturbing rate of poor nutritional practice as majority (45.6%) rarely eat fruits and vegetables during pregnancy. There is no significant relationship between the level of education (p=0.129), perception (p=0.894) and the practice of nutrition among pregnant women. Family income and family size were the leading factors associated with nutritional practices among respondents. Discussion: Reorienting the health system using primary health care (PHC) approach is important in improving the nutritional practices and the general well-being of pregnant women, as it gives access to them at grassroot level. Also, it is imperative for health professionals, especially nurses, to raise awareness regarding the importance of maternal nutrition during pregnancy. This will help to improve maternal nutritional perception and practice.

Pre-Separation Mother-Child Relationship and Adjustment Behaviors of Young Children Left Behind in Rural China: Pathways Through Distant Mothering and Current Mother-Child Relationship Quality.

In China, some rural parents do not live together with their children because they migrate to urban regions for work, and therefore they sometimes use a mobile phone in parenting their left-behind children (LBC), who are living with grandparents. This study used a serial mediation model to test the mediating roles of distant mothering and post-separation mother-child relationship quality in the link between recalled pre-separation mother-child relationship quality and social-emotional adjustment of 3-to-6-year-old LBC living in a rural context in China. Cross-sectional questionnaire data were collected from 185 triads, consisting of grandparents (rating child adjustment), migrant mothers (rating mother-child relationship qualities and distant mothering), and preschool teachers (rating child adjustment). The results showed that pre- and post-separation relationship qualities were positively related to each other and to positive distant mothering. There were no serial mediating effects, but a full individual mediating role of post-separation relationship quality and positive distant mothering was identified for the link between child prosocial behavior and externalizing problems, respectively. Despite the general decline in mother-child relationship quality after separation, mothers who perceived a higher quality of the pre-separation mother-child relationship showed a more cohesive relationship with their LBC, which might increase the prosocial behavior of the children. Additionally, a higher quality of the pre-separation relationship was associated with more distant mothering of positive characteristics, which went together with fewer children externalizing problems. These findings highlight the importance of a continuous high-quality mother-child bond and favorable maternal parenting practices in digital interactions for separated families.

Influence of social media on maternal decision-making and breastfeeding practices.

Breastfeeding practices are influenced by multifactorial determinants including individual characteristics, external support systems, and media influences. This commentary emphasizes such complex factors influencing breastfeeding practices. Potential methodological limitations and the need for diverse sampling in studying breastfeeding practices are highlighted. Further research must explore the interplay between social influences, cultural norms, government policies, and individual factors in shaping maternal breastfeeding decisions.

Study of knowledge, attitudes and practices of complementary feeding among caregivers of children from 6 to 23 months of age from a rural community of Ecuador: A cross-sectional study.

Introduction. Nutritional deficiency due to an unbalanced diet is one of the most important factors contributing to stunting or the development of comorbidities in infants. Poverty, lack of knowledge about complementary feeding (CF) schedules, or lack of information accessibility are among the major causes that affect nutritional status. Our objective was to investigate the association of caregivers' knowledges, attitudes, and CF practices with the nutritional status of children aged 6 to 23 months attending the Camilo Ponce Enriquez Health Center from October to December 2022. Methods: An observational study was conducted. Information from caregivers of 137 children aged from 6 to 23 months (mean age 12.66 ± 5.00, 51.82% female) was analyzed. The data collection process was carried out through the application of the KAP survey of the Food and Agriculture Organization of the United Nations (FAO), which first includes a socio-demographic survey consisting of 10 questions, 7 of which obtain information from the caregiver and 3 oriented to obtain data from the child. Informed consensus was obtained previous to the survey application. Information on the nutritional status was obtained from the medical history data provided by the nursing department. Pearson's Chi-squared test was applied to establish whether or not there was an association between the nutritional variables. Results: 55.96% of caregivers had appropriate CF practices. Meanwhile, 77.89% and 77.55% had adequate knowledge and attitudes about CF. A statistically significant association (p < 0.05) was found between nutritional diagnosis and maternal CF knowledge, attitudes, and practices. Conclusions: The knowledge, attitudes, and practices of the target population reached a moderate level, laying the foundation for the study of risk factors, as well as educational strategies to prevent malnutrition.

Factors associated with the admission of moderate to late preterm and term neonates within 72 hours of birth at Dedza and Mangochi District Hospitals, Malawi: a matched case-control study

ObjectiveTo investigate the demographic characteristics, maternal, and perinatal factors associated with the hospitalization of moderate to late preterm and term neonates within 72 h of birth in the Dedza and Mangochi districts of Malawi.MethodsThis case-control study was conducted with one-to-one matching for age, location, and sex. Cases were sick neonates who were admitted in the Sick Intensive Neonatal Care Unit (SINCU) within 72 h of life, while controls were non-sick neonates delivered within two weeks of the birth dates of cases. Prenatal data were extracted from case files, while other maternal practices and demographic characteristics were obtained by interviewing primary care takers or legal guardians after obtaining consent. Descriptive analyses and logistic regression were used to identify factors associated with hospitalization of moderate to late preterm and term neonates within 72 h of birth.ResultsApplication of tetracycline eye ointment (AOR: 0.41, 95% CI: 0.20–0.82, p = 0.012) applying chlorhexidine to the umbilical cord stump (AOR: 0.30, 95% CI: 0.10–0.88, p = 0.027), and stimulation resuscitation (AOR: 0.20, 95% CI: 0.05–0.78, p = 0.020) were associated with a reduced odd of hospitalization. An increased odds of hospitalization was significantly associated with low birth weight (AOR: 10.48, 95% CI: 4.25–25.89, p = 0.001), Apgar score < 5 (AOR: 5.0, 95% CI: 2.14–11.63, p = 0.001), suctioning resuscitation (AOR: 2.82, 95% CI: 1.17–6.83, p = 0.021), and resuscitation using O2 (AOR: 4.23, 95% CI: 1.32–13.56, p = 0.015). Maternal factors associated with reduced odds of hospitalization included the mother testing positive and successfully treated for syphilis antenatally (AOR: 0.06, 95% CI: 0.02–0.18, p = 0.001) and the mother being married (AOR: 0.39, 95% CI: 0.16–0.93, p = 0.34). Maternal factors associated with an increased odds of hospitalization include premature rupture of membranes (AOR: 2.49, 95% CI: 1.12–5.52, p = 0.025) and presence of meconium stain during delivery (AOR: 3.14, 95% CI: 1.63–6.06, p = 0.001).ConclusionThe research findings indicate that several interventions significantly reduce infections in neonates within their initial 72 h of life. These include the application of ophthalmic ointment to all neonates, utilization of chlorhexidine on the umbilical cord stump, and provision of antenatal treatment for syphilis and HIV in infected mothers. Conversely, certain factors increase the likelihood of neonatal morbidity and potential hospitalization during this critical period. These risk factors include low birth weight, a low Apgar score, and conditions necessitating suctioning or oxygen resuscitation at birth. Furthermore, infants born to mothers who experienced premature rupture of membranes or meconium-stained amniotic fluid during parturition are more susceptible to infectious conditions, which may necessitate hospitalization within the first 72 h postpartum. We recommend that stimulation be used as the core procedure for resuscitation, whereas suctioning should be used with caution and only when it is essential. Infection prevention measures should always be adhered to during all procedures on neonates. We recommend intensifying HIV and syphilis testing and treating during the antenatal period to reduce neonatal infection.

Critical evaluation of factors influencing maternal knowledge, attitude, and practice regarding the immunization of their children

Critical evaluation of factors influencing maternal knowledge, attitude, and practice regarding the immunization of their children

Influence of Infant and Young Child Feeding Practices (IYCF) on Nutritional Status of Children Aged 6-59 Months in Moheshkhali, Cox’sbazar, Bangladesh: A Cross-Sectional Study

Background: This study addresses the critical issue of malnutrition among under-five children in Moheshkhali, Cox's Bazar, Bangladesh. Despite the alarming rates of stunting, wasting, and underweight in this region, there is a significant lack of localized data on socioeconomic factors, IYCF practices, and overall health status. Understanding these variables is essential for developing effective interventions. Methods: The research involved a cross-sectional study design, where anthropometric measurements were conducted to assess the nutritional status of children aged 6 to 59 months. Maternal education, age, and Body Mass Index (BMI) were also evaluated to explore their impacts on child nutrition. Data were analyzed using standard statistical methods to draw correlations and identify trends. Results: The findings revealed a high prevalence of malnutrition among under-five children, with notable gender disparities in stunting and underweight. The analysis indicated a strong relationship between maternal health indicators—particularly BMI—and child nutritional outcomes. Moreover, inadequate adherence to IYCF practices was observed, with many mothers failing to implement optimal breastfeeding and complementary feeding strategies. Conclusion: The study underscores the urgent need for targeted interventions aimed at improving maternal education and IYCF practices in Moheshkhali. A multi-sectoral approach involving government and non-government organizations is essential to address the malnutrition crisis effectively. Investing in preventive measures and promoting healthy feeding practices are crucial for ensuring the well-being of both mothers and their children.

Postnatal cord care practices and associated factors in Arba Minch town, southern Ethiopia.

Cord care is one component of essential newborn care that reduces newborn morbidity and mortality. Poor cord care practice leads to a large amount of neonatal death due to infection. In Ethiopia, many women give birth at home, where neonates are exposed to unclean cord care practices or application of different traditional substances. Despite the severity of the problem, studies related to postnatal cord care practice are scarce. Hence, this study is aimed to assess umbilical cord care practices and associated factors in the postnatal period in Arba Minch town. To assess postnatal cord care practices and associated factors among mothers who gave birth in the last six months in Arba Minch Town, southern Ethiopia, 2019. Cross-sectional study design was conducted and using simple random sampling method 423 mothers who gave birth with in the last six months in Arba Minch town from November 11 to December 02, 2019, were selected. Data was collected using structured questionnaire administered by the interviewer. EpiData version 4.4 was used for data entry and SPSS version 25 was used for data analysis. Variables with p ≤ 0.25 in bivarible logistic regressions were considered as potential candidates for multivariable logistic regression analysis to control confounders. Adjusted Odds Ratio with 95% confidence interval was applied in multivariable logistic regression models, to identify variable, which has significant association. The overall proportion of women who had good postnatal cord care was 67.1%. The maternal age group of 25 to 29 years (AOR = 2.51; 95% CI: 1.35-4.68), maternal educational status of secondary school and above (AOR = 4.19; 95% CI: 2.05-8.54), mothers with good knowledge of cord care (AOR = 1.77; 95% CI: 1.03-3.05), and health facility delivery (AOR = 2.60; 95%CI: 1.05-6.41) were independent factors associated with good cord care. The proportion of good cord-care practice reported in this study was relatively worthy. Maternal age group of 25-29 years, maternal educational status of secondary school and above, having good knowledge of cord care, and delivering at health facility were factors that increased good postnatal cord care practice. Therefore, investing in improving these factors would positively affect maternal postnatal cord care practice. In order to reduce neonatal morbidity and mortality, routine counseling of cord care practice to mothers would attain good knowledge about postnatal cord care practices. Community health education would also increase awareness and practice of postnatal cord care.

Association between coordinated counseling from both ASHA and Anganwadi Workers and maternal health outcomes: A cross-sectional study from Madhya Pradesh and Bihar, India.

Community Health Workers (CHWs) play crucial roles in health promotion and services in rural India. Previous research investigating the effectiveness of coordinated health promotion by different community health workers (CHWs) cadres on health practices is scarce. This study examines the effectiveness of coordinated health promotion by different CHW cadres, specifically Accredited Social Health Activists (ASHA) and Anganwadi Workers (AWW), on maternal health outcomes. Using endline data from a 2019 impact evaluation of 6635 mothers with children <12 months in Madhya Pradesh and Bihar, we compared the association between standalone and coordinated counseling by ASHA and AWW on various maternal health practices. Outcomes included four or more antenatal care visits, birth preparedness, institutional delivery, postnatal care visits, and contraceptive uptake. Fixed effects logistic regression with robust standard errors, corrected for multiple hypothesis tests, was used for analysis. Results showed that 39.6% of women received four or more ANC visits, 31.2% adopted birth preparedness practices, 79.6% had institutional deliveries, 23.3% received postnatal care, and 19.5% adopted a postpartum contraceptive method. Coordinated counseling from both ASHA and AWW was associated with a greater prevalence of four outcomes (birth preparedness, institutional delivery, PNC visit, and contraception) compared to standalone counseling from either ASHA or AWWs. These findings suggest that health promotion by AWW complements that of ASHA, collectively associated with improved health outcomes. This study underscores the effectiveness of coordinated health promotion and highlights the need for multisectoral and coordinated efforts among different CHW cadres at the community level. The results emphasize the importance of integrating various CHW roles to enhance maternal health practices and outcomes in rural India. Trial registration number: https://doi.org/10.1186/ISRCTN83902145. Date of registration: 08/12/2016.

Mothers’ health-seeking practices and associated factors towards neonatal danger signs in Ethiopia: a systematic review and meta-analysis

BackgroundA decrease in obtaining quality healthcare is a major cause of maternal and newborn deaths in low-income and middle-income countries. Ethiopia has one of the highest neonatal mortality rates. Increasing...

Electrocardiographic Changes in Second and Third Trimester in Bangladesh: A Comparative Study

Background: During pregnancy, there are notable changes in cardiovascular function to meet the increasing needs of the developing baby. The objective of this study was to compare ECG in pregnant women during their second and third trimesters with a control group of non-pregnant women in Bangladesh. This study aims to offer valuable insights into the cardiovascular changes that happen during pregnancy. This study's findings are important for maternal health research and clinical practice in Bangladesh and beyond. Objective: The purpose of this study is to analyze and compare the ECG variations in women during the second and third trimesters of pregnancy. Methods: The study took place in the gynecology Department at CMH Saidpur, Bangladesh. This study was conducted from March 2023 to August 2023. During this period, 75 pregnant patients in their 2nd trimester and 75 patients in their 3rd trimester were chosen as cases from antenatal outdoor, while 75 non-pregnant women of the same age were selected as the control group. We use the purposive sampling method. Results: During pregnancy, there were notable changes in BMI, heart rate, and PR interval. BMI decreased in the second trimester and increased in the third trimester.22.67% were nulliparous and 77.33% were multiparous in 2nd trimester. In the third trimester, 26.67% were nulliparous and 73.33% multiparous. So, no significant difference in parity. Heart rate increased in both trimesters, while the PR interval shortened in both trimesters. No significant changes were observed in the durations of the QRS complex or QT interval. In our study, the QTc interval displayed a significant rise. ST depression, which may suggest decreased blood flow, was exclusively seen in pregnant women, particularly in the third trimester. Conclusion: We found no significant changes in age, but BMI, heart rate, and PR interval were significantly different from the control group throughout pregnancy. No significant QRS complex or QT interval duration changes were identified. The QTc interval rose. ST depression, more prominent in the third trimester, only affected pregnant women. As shown by ST depression, pregnancy may change cardiac function, electrical activity, and ischemia.

Assessment of knowledge, attitude, practice and barriers of exclusive breastfeeding among nursing mothers in Makurdi Local Government Area of Benue State

Introduction: Over the years, breastfeeding has been a universal means of feeding infants and a common feature of all cultures since the survival of mankind. It is a phenomenon that is deeply rooted in the tradition of human culture. Although, breastfeeding practices have fluctuated over the years, it is widely regarded as an unequalled way of providing ideal nutrition for the healthy growth and development of infants. This study aims to assess the knowledge, attitude, practice and some barriers of exclusive breastfeeding among nursing mothers in Makurdi Local Government Area of Benue State. Method: This is a descriptive cross-sectional study to assess the knowledge, attitude, practice and barriers of nursing mothers towards Exclusive Breast Feeding (EBF). An interviewer-self-administered pretested questionnaire was used to collect data on maternal knowledge, Attitude, Practice and barriers of EBF. The modified Blooms criteria was adapted to grade knowledge, attitude and practice as either Good or poor. Statistical significance was considered at 95% confidence interval. Results: The results from this study showed that nursing Mother’s knowledge of EBF was good, 84.0% of the respondents displayed good knowledge of EBF, good attitude towards EBF was at 54.7% and the practice of EBF was 67.3%. Notable barriers to EBF includes, poor knowledge of EBF among nursing mothers (75.0%), followed by concurrent breast disease 6 months post-natal (66.7%), next was women who have never attended Antenatal Care Clinic (ANC) 62.5%. Conclusion: These findings suggest good knowledge and practice of EBF, however there is need to institute intervening measures aimed at reducing barriers associated with EBF in the study community.

Associations between maternal origin, breastfeeding and health service use: a mediation analysis

Abstract Background The influence of maternal health utilization on breastfeeding practices is well established. However, research shows that immigrant women tend to face challenges in accessing maternal health services. Our aim was to examine any variation in maternal and child health service utilization between immigrant and native-born mothers as well as to examine potential mediation roles of service utilization on the association between maternal origin and breastfeeding practices. Methods We used a nationwide FinChildren (2020) survey on parents with infants focusing on Somali (n = 29), Arabic (n = 81) and Russian speaking (n = 181) parents and their infants. We compared them with native Finnish speakers (n = 7508). We used Process Macro to conduct mediation analysis. Results Almost 25%/ of Somali-/Arabic-speaking mothers reported not taking their infants to routine child health clinic visits. The proportion was 0.4% for native-born mothers and 1.6% for Russian-speaking mothers (p &amp;lt; 0.001). Around 18% of Somali-/Arabic-speaking mothers and only 0.6% of the native-born mothers reported not utilizing child health clinic services in the past year (p &amp;lt; 0.001). Somali-/Arabic speaking mothers were more likely to receive breastfeeding support from maternity clinics and native-born mothers from maternity hospital or peer support groups. Russian-speaking mothers were most satisfied with the received child healthcare services while Somali/Arabic-speaking mothers were least satisfied with these services (p &amp;lt; 0.001). Only participating in breastfeeding peer support groups had mediation effects on association between maternal origin and breastfeeding practices. Conclusions This study shows that immigrants mothers, particularly Somali/Arabic speaking mothers use less the maternal health services particularly routine health visits. It is essential to encourage them to use the services to be able to monitor the health of both mother and the child. Key messages • Somali-/Arabic-speaking mothers are in a vulnerable position when it comes to utilizing healthcare services. • This study call for more research exploring factors contributing to this.

Racial disparities in maternal blood transfusion in the United States by mode of delivery.

Despite well-documented racial disparities in maternal health in the United States, gaps remain in characterizing the distribution of these disparities in maternal blood transfusion. To assess racial disparities in maternal blood transfusion using detailed, self-identified racial groupings in the United States overall and stratified by mode of delivery. We performed a population-based, retrospective cohort study of full term, live births (2016-2021) using the National Vital Statistics System's Natality Files. Regression models were constructed to estimate adjusted odds ratios (aORs) and 95% confidence intervals (CIs) of maternal blood transfusion by self-identified maternal race in the total population, and among subgroups stratified by mode of delivery. Models were adjusted for maternal and obstetric practice factors. The study included 17,905,699 deliveries; maternal blood transfusion occurred in 3.4 per 1,000 deliveries. Compared with individuals who identified as White (3.3 per 1,000 transfusion rate), higher odds of transfusion were found among those who identified as American Indian and Alaska Native (AIAN; aOR 2.36, 95% CI 2.23-2.49), Black (aOR 1.15, 95% CI 1.12-1.17), Filipino (aOR 1.33, 95% CI 1.22-1.44), Korean (aOR 1.25, 95% CI 1.10-1.42), and Pacific Islander (aOR 1.63, 95% CI 1.45-1.83). The frequency of transfusion and racial disparities in transfusion varied substantially by mode of delivery. Lower rates of transfusion in Black vs White patients were observed in the spontaneous vaginal delivery (2.2 vs 2.3 per 1000; aOR 0.95, 95% CI 0.92-0.99), forceps (6.8 vs 8.9 per 1000; aOR 0.77, 95% CI 0.60-0.99), vacuum (4.2 vs 5.0 per 1000; aOR 0.85, 95% CI 0.74-0.97, and cesarean delivery with trial of labour (8.8 vs 8.9 per 1000; aOR 0.95, 95% CI 0.91-1.00) groups, while a higher rate was shown among cesarean deliveries without trial of labour (6.8 vs 4.3 per 1000; aOR 1.45, 95% CI 1.40-1.51). Racial disparities in maternal blood transfusion persist after adjustment for several confounders, particularly for AIAN and Pacific Islander individuals, and vary by mode of delivery.

Ensuring ethical maternal care: Addressing episiotomy trends in Pakistan.

Madam, The use of routine episiotomies, particularly those performed without consent, is a concerning and escalating trend during childbirth in Pakistan. An Episiotomy is a surgical incision in the pelvic floor to enlarge the vaginal opening during labour. The incision is performed under local anaesthetic with scissors. It is deemed necessary only under certain conditions: abnormal progression of labour, suspected foetal distress, vacuum or forceps childbirth, and shoulder dystocia.1,2 Despite the WHO’s recommendation of an episiotomy rate of less than 10% to be considered safe, the rates are disproportionately high in Pakistan. This prompts the need for improved maternal care that is responsible, accountable, and consensual.3 The need for respectful maternal care is crucial in Pakistan. A study conducted in Rawalpindi analysed data from 124798 deliveries and found an 80% incidence of routine episiotomies during normal vaginal deliveries in primigravida cases.3 Another cross-sectional study conducted in Karimabad on 235 patients, also revealed an alarming prevalence of episiotomies, with a rate of 78%.4 These rates differ significantly from those of other countries, such as 17% in New Zealand and 36.5% in Norway, underscoring the potential overuse of episiotomies beyond medical need in Pakistan. Cultural beliefs and a lack of adequately trained staff likely exacerbate this disparity.2,3 Furthermore, increasing episiotomy rates can adversely impact emotional well-being, cause perineal trauma, difficulty in breastfeeding, infection, and delayed healing.2 The intensity of these impacts and the high incidence of episiotomy highlight the need for comprehensive reforms in maternal care practices to ensure the safety and well-being of women. To address this issue, it is imperative to adopt a multifaceted approach that prioritizes informed consent and aims to curb the increasing trend of episiotomies. A commonly presumed benefit of an episiotomy is the prevention of advanced tears; yet, a randomized control trial on 676 patients found no association between decreased use of episiotomy and significant prevalence of severe tears.5 This stresses the need to shift to a policy of selective episiotomies like that implemented in Vietnam. The approach encompasses allocating a budget for routine training of staff, regularly recording rates of episiotomy/tears and including updated guidance about the use of episiotomies within the curriculum.2 Furthermore, when performing an episiotomy patients must be fully informed and individually consented, written or verbal. Opt-out consent may apply in emergencies.1 Such interventions can help ensure higher maternal care standards within Pakistan.